case_images: PMC9440277_01
case_images: Brain MRI showed symmetric increased fluid-attenuated inversion recovery signals in the basal ganglia and medial temporal lobes.
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case_images: Figure 1 ).
case_images: Full-body CT revealed a mass in the right hilar region.
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case_images: Full-body CT revealed a mass in the right hilar region, consistent with a diagnosis of SCLC ( Figure 2 ). Fluorine-18 fluorodeoxyglucose [(18)F-FDG]-positron emission tomography (PET) revealed increased uptake of tracer in the right hilum but no apparent distant metastasis.
case_images: Microscopic images for the globus pallidus (A, C) and lung tumor (B). Blue and orange squares indicate perivascular regions and parenchyma with neurons, respectively. Bars, 50 mum. (D) RT-PCR using total RNA derived from the indicated organs of the patient (D). GAPDH, glyceraldehyde 3-phosphate dehydrogenase; GrB, granzyme B; GRIN1, glutamate ionotropic receptor N-methyl-D-aspartate type subunit 1; Synapt, Synaptophysin; TIA-1, T-cell intracytoplasmic antigen-1.
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case_images: Activated neuronophagic cytotoxic T cells (CTL) that were positive for CD3, CD8, TIA-1, and granzyme B were diffusely spread throughout the brain parenchyma, whereas CD20-positive B cells were localized in the perivascular regions ( Figures 3A, C ). The right lung tumor was diagnosed pathologically as a neuroendocrine marker-positive SCLC with scant cytoplasm and salt-and-pepper nuclei ( Figure 3B ). Furthermore, we conducted quantitative polymerase chain reaction (qPCR) which revealed GluN1 gene expression in the SCLC tissue ( Figure 3D ).