PMC5140864_01
Computed tomographic images of the chest with the mediastinal (A, B) and lung window settings (C) obtained at onset.
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Computed tomography (CT) of the chest and abdomen demonstrated a bulky mass measuring 10 cm in diameter in the left anterior mediastinum, multiple pulmonary nodules (measuring up to 3 cm in diameter), axillary lymph node swelling (Fig. 1), and a pancreatic tumor.
Fiberoptic bronchoscopy findings of the lingular segment of the left lung.
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Fiberoptic bronchoscopy revealed a white-tinged irregularly shaped endobronchial tumor accompanied by capillary vessel dilatation in the left upper lobar bronchus, which was found to be almost completely obstructed (Fig. 2).
Pathological features observed during Hematoxylin and Eosin staining.
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The cells exhibited a proliferative and invasive activity, but they had not yet formed a well-defined structure (Fig. 3), and an immunohistochemical examination showed the tumor cells to be negative for CD3 (Fig. 4A), CD56, synaptophysin, and AE1/AE3 (data not shown), while they were positive for CD20 (Fig. 4B) and leukocyte common antigen.
Pathological features observed during an immunohistochemical examination of the CD3 (A) and CD20 (B) expression.
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The cells exhibited a proliferative and invasive activity, but they had not yet formed a well-defined structure (Fig. 3), and an immunohistochemical examination showed the tumor cells to be negative for CD3 (Fig. 4A), CD56, synaptophysin, and AE1/AE3 (data not shown), while they were positive for CD20 (Fig. 4B) and leukocyte common antigen.
Computed tomographic images of the chest with the mediastinal (A) and lung window settings (B) obtained after one cycle of R-CHASE treatment.
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The patient was treated with R-CHASE (rituximab, cyclophosphamide, high-dose arabinoside, steroids, and etoposide) chemotherapy and achieved a tumor response (Fig. 5).