case_images: PMC3539111_01
case_images: (A) Chest computed tomography scan shows high density mass in right upper lobe. (B) Liver magnetic resonance imaging scan shows 1 cm sized nodule in segment 2.
case_images: jkss-84-57-g001.jpg
case_images: PMC3539111_01_jkss-84-57-g001.jpg
case_images: F1
case_images: Six months earlier, he was diagnosed with lung cancer and liver metastasis (Fig. 1A, B).
case_images: Abdomen computed tomography scans show liver metastasis with pneumoperitoneum (A) and small bowel edematous change with fluid collection in distal ileum (B).
case_images: jkss-84-57-g002.jpg
case_images: PMC3539111_01_jkss-84-57-g002.jpg
case_images: F2
case_images: CT and it showed pneumoperitoneum and aggravation of hepatic metastasis (Fig. 2A, B). Considering disease status and physical status we decided to do an emergency laparotomy.
case_images: Microscopic findings of small bowel. (A) The small bowel mucosa shows infiltration of tumor cells (H&E, x100). (B) The malignant cells show positive stain for cytokeratin 7 (CK7), suggesting not primary colon origin (immunohistochemical [IHC] stain, x100). (C) Negative satin for thyroid transcription factor-1, suggesting lung cancer origin (IHC stain, x100). (D) Negative stain for CK20 (IHC stain, x100).
case_images: jkss-84-57-g003.jpg
case_images: PMC3539111_01_jkss-84-57-g003.jpg
case_images: F3
case_images: Immunohistochemical (IHC) staining revealed that the tumor cells were positive for cytokeratin 7 (CK7) and thyroid transcription factor (TTF) but negative for CK20 (Fig. 3A-D).