case_images: PMC4142298_01
case_images: CT chest: right lung lower lobe peripheral mass.
case_images: CRIPA2014-509086.001.jpg
case_images: PMC4142298_01_CRIPA2014-509086.001.jpg
case_images: fig1
case_images: His chest radiograph and computerized tomography (CT) scan (Figure 1) showed a right lung lower lobe heterogeneous mass (3.9 x 3.3 x 3.2 cm) and right middle lobe atelectasis without pleural effusion.
case_images: Circumscribed solid tumor mass surrounded by lung tissue.
case_images: CRIPA2014-509086.002.jpg
case_images: PMC4142298_01_CRIPA2014-509086.002.jpg
case_images: fig2
case_images: Its cut surface was heterogeneously gray-white with focal areas of hemorrhages and cartilaginous tissue (Figure 2).
case_images: Islands of mature and immature hyaline cartilage. H&E: x100.
case_images: CRIPA2014-509086.003.jpg
case_images: PMC4142298_01_CRIPA2014-509086.003.jpg
case_images: fig3
case_images: Microscopically, it was composed of many lobules of hyaline cartilage (Figure 3) in which the constituent chondrocytes varied from bland to moderately pleomorphic (Figure 4) with areas of necrosis (10%).
case_images: Interface of chondrosarcoma and rhabdomyosarcoma. H&E: x200.
case_images: CRIPA2014-509086.004.jpg
case_images: PMC4142298_01_CRIPA2014-509086.004.jpg
case_images: fig4
case_images: Microscopically, it was composed of many lobules of hyaline cartilage (Figure 3) in which the constituent chondrocytes varied from bland to moderately pleomorphic (Figure 4) with areas of necrosis (10%).
case_images: Nodules of blastema-like cells separated by loose tissue. H&E: x100.
case_images: CRIPA2014-509086.005.jpg
case_images: PMC4142298_01_CRIPA2014-509086.005.jpg
case_images: fig5
case_images: The intervening stroma varied from blastema-like to fibromyxoid to dense spindle cell type (Figure 5), harboring an occasional microscopic cyst lined by ciliated cuboidal to columnar cells with subepithelial condensation of blastema-like to spindle shaped neoplastic cells (Figure 6).
case_images: Ciliated columnar epithelium lining the microcyst and underlying condensation of small round cells. H&E: x200.
case_images: CRIPA2014-509086.006.jpg
case_images: PMC4142298_01_CRIPA2014-509086.006.jpg
case_images: fig6
case_images: The intervening stroma varied from blastema-like to fibromyxoid to dense spindle cell type (Figure 5), harboring an occasional microscopic cyst lined by ciliated cuboidal to columnar cells with subepithelial condensation of blastema-like to spindle shaped neoplastic cells (Figure 6).
case_images: Anaplastic large bizarre cells amidst malignant pleomorphic cells. H&E: x200.
case_images: CRIPA2014-509086.007.jpg
case_images: PMC4142298_01_CRIPA2014-509086.007.jpg
case_images: fig7
case_images: There were focal areas of skeletal muscle differentiation, bizarre multinucleate giant cells, and many scattered mitoses throughout (Figures 7 and 8).
case_images: Scattered ovoid eosinophilic rhabdomyoblasts. H&E: x200.
case_images: CRIPA2014-509086.008.jpg
case_images: PMC4142298_01_CRIPA2014-509086.008.jpg
case_images: fig8
case_images: There were focal areas of skeletal muscle differentiation, bizarre multinucleate giant cells, and many scattered mitoses throughout (Figures 7 and 8).
case_images: Desmin: cytoplasmic staining: x400.
case_images: CRIPA2014-509086.009.jpg
case_images: PMC4142298_01_CRIPA2014-509086.009.jpg
case_images: fig9
case_images: Immunohistochemically, the rhabdomyoblasts were positive for Desmin and muscle specific actin (MSA) (Figures 9 and 10).
case_images: MSA: cytoplasmic staining: x200.
case_images: CRIPA2014-509086.010.jpg
case_images: PMC4142298_01_CRIPA2014-509086.010.jpg
case_images: fig10
case_images: Immunohistochemically, the rhabdomyoblasts were positive for Desmin and muscle specific actin (MSA) (Figures 9 and 10).
case_images: S100: nuclear staining in cartilage tissue: x200.
case_images: CRIPA2014-509086.011.jpg
case_images: PMC4142298_01_CRIPA2014-509086.011.jpg
case_images: fig11
case_images: The chondrocyte nuclei were positive for S100 (Figure 11) and the epithelium lining the cysts was positive for CK19 (Figure 12).
case_images: CK19 cytoplasmic staining of cyst lining epithelial cells: x200.
case_images: CRIPA2014-509086.012.jpg
case_images: PMC4142298_01_CRIPA2014-509086.012.jpg
case_images: fig12
case_images: The chondrocyte nuclei were positive for S100 (Figure 11) and the epithelium lining the cysts was positive for CK19 (Figure 12).
case_images: MRI brain: large right frontal lobe mass.
case_images: CRIPA2014-509086.013.jpg
case_images: PMC4142298_01_CRIPA2014-509086.013.jpg
case_images: fig13
case_images: CT done three months earlier) with central area of necrosis causing compression of the ipsilateral lateral ventricle and significant midline shift (Figure 13). Craniotomy was performed and the resected mass was received in the laboratory as multiple fragments collectively measuring 7 x 5 x 1 cm.
case_images: Metastatic sarcoma and edematous brain tissue interface. H&E: x200.
case_images: CRIPA2014-509086.014.jpg
case_images: PMC4142298_01_CRIPA2014-509086.014.jpg
case_images: fig14
case_images: Microscopically, the tumor was composed of dense spindle cell proliferation with areas of hemorrhages, necrosis, and scattered anaplastic bizarre giant cells (Figure 14).
case_images: Brain metastasis, Desmin cytoplasmic staining: x400.
case_images: CRIPA2014-509086.015.jpg
case_images: PMC4142298_01_CRIPA2014-509086.015.jpg
case_images: fig15
case_images: The tumor cells were positive for Desmin and MSA (Figure 15).