PMC3920374_01
Computer tomography image shows a mass measuring 1.9 cm and located in the lateral segment of the right middle lobe.
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A routine chest CT during her follow up showed a mass in the right middle lobe lateral segment, and the patient was referred to our department. (Fig. 1) She was asymptomatic, and all laboratory studies were normal.
PET CT shows a mass in the lateral segment of the right middle lobe, showing a malignant character with SUV max: 3.9.
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Since the patient was a smoker, this lesion was primarily considered as a second primary or the lung metastasis of another malignancy. (Fig. 2) The mass was also considered to be inappropriate for transthoracic fine needle aspiration (TTFA) for technical reasons.
(a): Storiform and fascicular pattern tumor separated from the lung tissue by smooth borders (H&Ex100). (b): Tumor cells with eosinophilic cytoplasm, oval and spindle shaped nuclei, thin chromatin distribution, and accompanied by lymphocytes, plasma cells and histiocytes in between (H&Ex200). (c): Tumor elements without cytologic atypia or mitotic figures, and inflammatory cells. (H&Ex400).
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The Ki-67 proliferation index (1%) was low (Figs. 3-9).
cd34 staining revealed that the internal control (vascular structures) was positive, whereas the tumor did not show staining. (IHK-cd34x200).
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The Ki-67 proliferation index (1%) was low (Figs. 3-9).
Positive staining of tumor elements with sma. (IHK-smaX200).
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The Ki-67 proliferation index (1%) was low (Figs. 3-9).
s100 staining revealed that the internal control (cross section of a peripheral nerve is marked in the lower right) was positive whereas the tumor did not show staining. (IHK-s100x100).
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The Ki-67 proliferation index (1%) was low (Figs. 3-9).
Pan-ck staining showed that the internal control (bronchial epithelium) was positive, whereas the tumor did not show staining. (IHK pan-ckx100).
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The Ki-67 proliferation index (1%) was low (Figs. 3-9).
The external control is positive with cd99, and the tumor is negative. (IHK-cd99x200).
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The Ki-67 proliferation index (1%) was low (Figs. 3-9).
Scarce nuclear positivity in tumor elements with ki-67. (IHK-ki-67 x400).
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The Ki-67 proliferation index (1%) was low (Figs. 3-9).