case_images: PMC10803636_01
case_images: Imaging on hospitalization. (A) Chest x-ray demonstrated a right-sided pleural effusion. (B, C) Computed tomography scan of the chest showing a substantial amount of pleural effusion on the right side, with incomplete expansion of the right lung.
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case_images: A chest computed tomography (CT) scan showed a substantial amount of pleural effusion on the right side, with incomplete expansion of the right lung (Figure 1).
case_images: Pathologic characterization of tumor. (A) Hematoxylin and eosin stain of a cell block from pleural effusion sample shows a large number of cancer cells. (B) In aspiration cytology of a mediastinal lymph node, some tumor cells are medium-sized and poorly differentiated with scanty cytoplasm and hyperchromatic nuclei. (C) Biopsy of a mediastinal lymph node shows monotonous tumor cells and hyperchromatic nuclei. (D) Immunohistochemistry shows nuclear expression of NUT in the histology of a mediastinal lymph node. (A-D): x400.
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case_images: Histopathological examination of the pleural effusion sample revealed the presence of cancer cells (Figure 2A). The results revealed the presence of metastatic malignant tumors (Figure 2B, C) with a positive staining for NUT in the IHC analysis (Figure 2D), while CD117, CD5, TdT were negative, and Ki67 was positive with a rate of 30%.
case_images: PET-CT highlights multiple hypermetabolic lesions. (A) Fused coronal PET-CT image shows an high metabolic foci in right lung cancer with lymph node, pleural and liver capsule, bone, as well as FDG-avid lesions in the right pleural effusion. (B-D) The right hilar and mediastinal lymph nodes with abnormal FDG uptake. SUVmax 4.4 - 7.8. (E) The abnormal FDG uptake in hepatic capsule with SUVmax 4.6 - 5.6. (F) The abnormal FDG uptake in retroperitoneal lymph nodes with SUVmax 3.4 - 3.6. (G) The abnormal FDG uptake in bone with SUVmax 3.9 - 5.8. CT, computed tomography; PET, positron emission tomography; FDG, fluorodeoxyglucose. SUVmax, maximum standardized uptake value.
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case_images: On June 12th, 2020, a positron emission tomography (PET)-CT scan was conducted to evaluate the patient's disease staging (Figure 3).
case_images: Computed tomography scan of the chest was performed during hers last hospitalization. (A) Chest x-ray imaging. (B, C) Computed tomography scan of the chest showing a right pneumothorax and left pleural effusion.
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case_images: The patient experienced continuous disease progression, as evidenced by a right pneumothorax and left pleural effusion on chest CT on December 10, 2020 (Figure 4).