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case_images: Chest P-A shows blunting of right costophrenic angle, accentuation of pulmonary vascular markings, and slight enlargement of right superior mediastinum
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case_images: CEA and alpha feto protein were 6.42 ng/ml and 5 ng/ml, respectively. Chest P-A showed blunting of right costophrenic angle, accentuation of pulmonary vascular markings, and slight enlargement of right superior mediastinum (Fig. 1).
case_images: Perfusion lung scan shows multiple segmental perfusion defects in right lower lung.
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case_images: The perfusion lung scan showed multiple segmental perfusion defects in right lower lung (Fig. 2), but the ventilation lung scan showed no significant ventilation defect, suggestive of V/Q mismatch on right lower lung (Fig. 3).
case_images: Chest CT scan shows an irregular marginated non-enhancing low-density mass with pleural effusion in the left lower lung, and ipsilateral mediastinal lymph nodes enlargement. And round, small, lower-density was detected in SVC, suggestive of thrombosis of SVC.
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case_images: SVC was partially filled with a small, low-density mass, which was suggestive of a thrombus (Fig. 4).
case_images: Fine needle aspiration cytology shows a cluster of large atypical cells with prominent nucleoli on inflammatory background.
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case_images: Some of the cells disclosed phagocytoses of the neutrophils (Fig. 5).
case_images: Histologic findings of lymph node show sinusoidal infiltration of large cell carcinoma with many neutrophils
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case_images: Many neutrophils were infiltrated among the tumor cells (Fig. 6).
case_images: Echocardiogram shows severe pericardial effusion.
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case_images: EKG showed low voltage and electrical alterance on all leads and echocardiogram revealed severe pericardial effusion (Fig. 7).