case_images: PMC10692419_01
case_images: Chest radiograph showed pneumothorax on the right hemithorax, ovoid density on left upper lobe possibly bullous changes, and possible segmental atelectasis on the left hilum.
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case_images: Chest radiograph (Figure 1) revealed right pneumothorax.
case_images: CT scan showing a heterogeneously large lesion replacing the normal looking thyroid lobes. The mass exhibits encroachment to the adjacent jugular veins (A) as well as the SVC (B). There is also a pneumothorax along with multiple pulmonary bleb and bullae with thin septations (C) and hepatomegaly with multiple cysts (D).
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case_images: Computed tomography scan of the neck and chest (Figure 2) revealed thyroid mass with malignant features and local mass effect, invading the right internal jugular vein and superior vena cava.
case_images: Photomicrographs of an oil power objective showing oval neoplastic cells with grooved nuclei (red arrow) with abundant amphophilic to eosinophilic cytoplasm (A), S100 stain showing strong diffuse nuclear and cytoplasmic positivity (B), CD1a stain showing strong diffuse membranous positivity (C), and positive Langerin staining (D).
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case_images: These atypical cells are admixed with abundant eosinophils and showed strong immunoreactivity to CD1a, S100, and Langerin (Figure 3), which strongly supports a diagnosis of LCH.
case_images: Midline sagittal T1 weighted image demonstrates the normal posterior pituitary bright spot.
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case_images: Cranial MRI was requested showing a normal pituitary bright spot (Figure 4).