case_images: PMC10601769_01
case_images: a-c Right upper lobe endobronchial lesion biopsy. Infiltrating glandular epithelial cells are noted below bronchial type mucosa. The tumor cells show nuclear pleomorphism, prominent nucleoli, irregular nuclear contours, and coarse chromatin. Mitotic figures and apoptotic cells are readily seen. H&E x20 (a); H&E x40 (b); the tumor cells are positive for a TTF-1 immunostain. TTF-1 x20 (c). d-e Pancreatic head mass fine needle aspiration biopsy. Pleomorphic glandular epithelial cells are noted on the cellblock material. The tumor cells show prominent nucleoli, irregular nuclear contours, and coarse chromatin. H&E x20 (d); H&E x40 (e); the tumor cells are positive for a TTF-1 immunostain. TTF-1 x20 (f).
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case_images: F1
case_images: Bronchoscopy-attained tissue sample showed that the RUL mass was a NSCLC, consistent with adenocarcinoma (Fig. 1a-c). TTF-1, and Napsin-A positivity on immunohistochemical staining, a pattern consistent with pulmonary origin (Fig. 1d-f). Tumor cells were negative for CDX-2, KOC, and synaptophysin. Overall, the cytomorphology and immunoprofile support the finding of a lung adenocarcinoma metastasized to the pancreas (Fig. 1).
case_images: PET/CT scan. Stented common bile duct(A). FDG-avid pancreatic head mass (B). FDG, fluorodeoxyglucose.
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case_images: PMC10601769_01_cro-2023-0016-0001-531841_F02.jpg
case_images: F2
case_images: A PET/CT scan was performed and showed fluorodeoxyglucose-avid mass in the pancreatic head with an SUV max of 13.3 and increased uptake in the porta hepatis with an SUV max of 4.2; however, no other regions of metastases were appreciated, and no lymphadenopathy was noted (September 2022) (Fig. 2-4a,b).
case_images: CT scan showing pancreatic mass. Stented common bile duct(A). Pancreatic head mass (B).
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case_images: F3
case_images: A PET/CT scan was performed and showed fluorodeoxyglucose-avid mass in the pancreatic head with an SUV max of 13.3 and increased uptake in the porta hepatis with an SUV max of 4.2; however, no other regions of metastases were appreciated, and no lymphadenopathy was noted (September 2022) (Fig. 2-4a,b).
case_images: a MIP image showing FDG-avid pancreatic head mass and no lung mass in September 2022. b MIP image showing FDG-avid lung mass and no abdominal masses in April 2020. FDG, fluorodeoxyglucose.
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case_images: F4
case_images: A PET/CT scan was performed and showed fluorodeoxyglucose-avid mass in the pancreatic head with an SUV max of 13.3 and increased uptake in the porta hepatis with an SUV max of 4.2; however, no other regions of metastases were appreciated, and no lymphadenopathy was noted (September 2022) (Fig. 2-4a,b).
case_images: Timeline of case.
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case_images: PMC10601769_01_cro-2023-0016-0001-531841_F05.jpg
case_images: F5
case_images: The patient subsequently passed peacefully under comfort measures on the eighth day of admission (Fig. 5).