case_images: PMC4712427_01
case_images: Histopathologic examination revealed (A) polygonal epithelioid cells and spindle cells with abundant eosinophilic cytoplasm arranged in nodular aggregates with central necrosis (H&E, x200). (B) Infiltration of metastatic proliferating epithelioid and spindle cells are observed in the wall of the bullae (H&E, x200).
case_images: kjim-31-1-191f1.jpg
case_images: PMC4712427_01_kjim-31-1-191f1.jpg
case_images: f1-kjim-31-1-191
case_images: A diagnostic biopsy revealed mild to moderate pleomorphic epithelioid and spindle cells arranged in nodular aggregates (Fig. 1A). His biopsy specimen are observed clusters of malignant epithelioid cells (Fig. 1B).
case_images: Chest computed tomography scan showing (A) massive pleural effusion on the left lung and (B) a small pneumothorax on the right lung (arrow). (C) Chest radiograph showing a large pneumothorax on the right lung and the tube drainage placed on the left lung because of the pleural effusion. (D) Chest axial computed tomography scan showing a large pneumothorax with small cystic (arrowheads) and nodular lesion on the right lung, and pleural thickening and effusion on the left lung.
case_images: kjim-31-1-191f2.jpg
case_images: PMC4712427_01_kjim-31-1-191f2.jpg
case_images: f2-kjim-31-1-191
case_images: Chest radiography revealed a left pleural effusion, and chest computed tomography (CT) showed a massive pleural effusion on the left lung and a small pneumothorax on the right lung (Fig. 2A and 2B). Chest radiography showed a right pneumothorax, and the chest CT scan demonstrated a right pneumothorax and multiple pulmonary cysts of various sizes (Fig. 2C and 2D).