PMC6609783_01
Hematoxylin-eosin staining. a Low-power field; primary tongue squamous cell carcinoma, b High-power field.
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In his past medical history, he received surgical treatment for primary tongue cancer, at the age of 19 years, and the pathological diagnosis was squamous cell carcinoma (Fig. 1).
a CT showing a ground glass opacity-lesion in the right S6 segment. b A thin-walled cavity appeared in the center of the lesion. c The cavity extended, and its wall thickened. d The GGO-like lesion with the cavity gradually increased in size.
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S6 segment 18 months after surgical treatment for primary tongue cancer (Fig. 2a). Subsequently, a thin-walled cavity appeared in the center of the lesion (Fig. 2b) and extended (Fig. 2c). The size of the GGO-like lesion increased from 0.78 cm to 2.37 cm in the chest CT over eight months (Fig. 2d).
a Chest X-ray showed a cavity-lesion in the right middle field. b CT showing a GGO-like lesion with a thin-walled cavity. c Contrast chest CT showing no finding of an abnormal hilar lymph node metastasis. d PET examination showing SUV up take in the lesion with the thin-walled cavity and hilar lymph node.
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He underwent a careful examination at our department, and a chest X-ray revealed a pulmonary lesion (Fig. 3a) with no solid component. The wall of the cavity lesion gradually thickened (Fig. 3b). Lymphadenopathy was not detected in the chest CT examination (Fig. 3c), but suspected from the high FDG up take in the PET examination (Fig. 3d).
Hematoxylin-eosin staining. a Low-power field; cavity (asterisk) and thick-wall (red double-headed arrow) b High-power field of the red square of Fig. 4a.
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Postoperative pathological diagnosis was pulmonary metastasis (Fig. 4a) and hilar lymph node metastasis deriving from primary tongue cancer. The cancer cells were invading and destroying the alveolar walls, with a surrounding pulmonary hemorrhage (Fig. 4b).