case_images: PMC10823784_01
case_images: A,B) An intensely FDG avid lobulated soft tissue lesion (white arrow) in the superior segment of the left lung lower lobe with an FDG avid enlarged left hilar lymph node (black arrow) on the trans-axial CT and fused PET-CT imaging. C) The epithelial component displays complex acinar and glandular growth pattern with moderately pleomorphic nuclei (H&E; x200). D) The mesenchymal component appeared oval-to-spindle shaped, and displayed a mild degree of pleomorphism, hyperchromatic nuclei, and inconspicuous nucleoli (H&E; x200).
case_images: TurkPatolojiDerg-40-12403-g001.jpg
case_images: PMC10823784_01_TurkPatolojiDerg-40-12403-g001.jpg
case_images: F89105461
case_images: Computed tomography (CT) and positron emission tomography and computed tomography (PET-CT) scan of the whole body revealed a fluorodeoxyglucose (FDG) avid lobulated soft tissue mass in the superior segment of the lower lobe of the left lung (Figure 1). The epithelial component showed complex acinar and glandular growth patterns (Figure 1). The mesenchymal component appeared oval-to-spindle shaped, and displayed a mild degree of pleomorphism, hyperchromatic nuclei, and inconspicuous nucleoli (Figure 1).
case_images: A) On serial slicing, the left lower lobectomy specimen showing a solitary, ill-defined, grey-white, firm tumour mass. B) The epithelial cells, arranged predominantly as elongated glands, show nuclear pseudo-stratification and overcrowding with subnuclear vacuolation (H&E; x200). C) The primitive mesenchymal cells exhibit high cellularity, moderately pleomorphic nuclei, and brisk mitotic figures (H&E; x200). D) Lymphovascular space emboli is seen (H&E; x20). E) Epithelial component expressing TTF-1 immunostain (Peroxidase; x100). F) beta-catenin showing nuclear and cytoplasmic positivity in the epithelial cells (Peroxidase; x200).
case_images: TurkPatolojiDerg-40-12403-g002.jpg
case_images: PMC10823784_01_TurkPatolojiDerg-40-12403-g002.jpg
case_images: F42855241
case_images: On serial slicing, a solitary, ill-defined, grey-white, firm tumor mass was seen measuring 5x3x3 cm (Figure 2). The epithelial cells were arranged predominantly as elongated glands and few discrete foci of solid sheet and cribriform growth patterns (Figure 2). The primitive mesenchymal cells were highly cellular and moderately pleomorphic (Figure 2). Lymphovascular emboli and visceral pleural invasion was present (Figure 2). TTF-1 (Cell Marque, clone 8G7G3/1, dilution 1:300), respectively (Figure 2). The cytoplasmic and nuclear expression of beta-catenin (Cell Marque, clone 14, dilution 1:100) was noted in glandular component (Figure 2).
case_images: A,B) The coronal reformatted CT and PET-CT images of the head shows an FDG avid soft tissue mass in the scalp with lytic destructive changes in the skull and minimal intracranial extension. C) The scalp metastasis contains only the mesenchymal element in variable sized nodules and islands with similar morphology as primary lung tumor (H&E; x100). No epithelial element is identified. D) Brisk mitotic activity is visible (H&E; x400).
case_images: TurkPatolojiDerg-40-12403-g003.jpg
case_images: PMC10823784_01_TurkPatolojiDerg-40-12403-g003.jpg
case_images: F39616121
case_images: Two months after lobectomy, the patient developed a scalp lesion which showed an FDG avid uptake with lytic destructive changes in the skull and minimal intracranial extension on the coronal reformatted CT and PET-CT images of the head (Figure 3). Microscopically, the tumor showed only mesenchymal component with primitive cells arranged in variable-sized nodules and islands (Figure 3).