case_images: PMC11128503_01
case_images: Chest radiograph showing multiple nodules and tumors in the bilateral lung fields a) on admission and b) on the 20th day of hospitalization.
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case_images: A chest radiograph showed an enlarged superior mediastinum and multiple nodules in the bilateral lung fields (Fig. 1a). However, his respiratory condition and performance status worsened rapidly, with rapid enlargement of the bilateral lung tumors noted on a chest radiograph (Fig. 1b).
case_images: Chest computed tomography obtained on admission showing a-e) a right upper lobe tumor with enlarged mediastinal lymph nodes (arrow), tumors in the bilateral lung fields and f) a low-density area within the liver (arrowhead).
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case_images: Chest computed tomography (CT) revealed multiple nodules in the bilateral lung fields, compression of the superior vena cava by a right upper lobe mass and enlarged mediastinal lymph nodes, enlarged right hilar lymph nodes, and a low-density area within the liver (Fig. 2).
case_images: Histological findings. An autopsy specimen of a right upper lobe tumor stained with hematoxylin and eosin shows a, b) cytotrophoblasts (arrow) and syncytiotrophoblasts (arrowhead) stained with hematoxylin and eosin. c) On immunostaining, tumor cells show positivity for human chorionic gonadotropin (hCG). d) Positive immunostaining results for cytokeratin AE1/AE3, anti-cytokeratin 5.2 (CAM5.2), sal-like protein 4 (SALL4) and hCG.
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case_images: Histological examination of the mediastinal tumor revealed polymorphous tumor cells with necrosis, indicative of cytotrophoblasts and syncytiotrophoblasts (Fig. 3a and b). Immunostaining revealed that the tumor cells were positive for human chorionic gonadotropin (hCG), sal-like protein 4 and cytokeratin, and negative for lung adenocarcinoma markers such as TTF-1, surfactant protein A and napsin (Fig. 3c and d).