case_images: PMC6207227_01
case_images: The aspirate smears (A) and cellblock (B) sections from pleural effusion consist of numerous groups of malignant epithelial cells with highly pleomorphic nuclei, irregular nuclear contours, prominent nucleoli, and moderate to abundant foamy cytoplasm.. Notes: These malignant cells are positive for BerEp4 (C) and TTF-1 (D) immunohistochemical stains. The findings are consistent with a metastatic adenocarcinoma of lung primary.
case_images: lctt-9-085Fig1.jpg
case_images: PMC6207227_01_lctt-9-085Fig1.jpg
case_images: f1-lctt-9-085
case_images: Thoracentesis was performed, and fluid cytology was positive for malignant cells consistent with adenocarcinoma (Figure 1A-D).
case_images: The core biopsy of left lung mass reveals sheets of malignant epithelial cells exhibiting pleomorphic and hyperchromatic nuclei, salt-and-pepper chromatin, and scant cytoplasm (A).. Notes: Nuclear molding, apoptotic bodies, and mitotic activity are easily seen. These malignant cells are positive for CAM 5.2, synaptophysin (B), and CD56 immunohistochemical stains. Ki-67 labels (C) ~70%-80% of the tumor cells. The findings are consistent with a small cell carcinoma.
case_images: lctt-9-085Fig2.jpg
case_images: PMC6207227_01_lctt-9-085Fig2.jpg
case_images: f2-lctt-9-085
case_images: CT-guided core biopsy of the left lung mass was done showing tumor cells positive for synaptophysin, CD56, and CAM 5.2 and negative for chromogranin immunostains, which was consistent with SCLC (Figure 2A-C).
case_images: PMC6207227_02