case_images: PMC10492232_01
case_images: Endoscopic images at the time of the first admission. The descending duodenum was seen with thickening of the intestinal wall and surrounding ulceration.
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case_images: PMC10492232_01_fonc-13-1240013-g001.jpg
case_images: f1
case_images: Gastroscopy showed a mass in the descending duodenum ( Figure 1 ).
case_images: Contrast-enhanced CT images at first admission and 2 weeks after three cycles of chemotherapy. (A) The wall of the descending duodenum was thickened at the first admission. (B) Bronchus occlusion in the lingual segment of the left upper lobe of the lung on the first admission. (C) Irregular thickening of partial peritoneum, omentum, and mesentery at 2 weeks after the third cycle of chemotherapy. (D) New solid nodule in the right lung 2 weeks after the third cycle of chemotherapy. (E) On the first admission, thickening of the intestinal wall of the descending duodenum and multiple mediastinal and inguinal lymphadenopathy were seen.
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case_images: PMC10492232_01_fonc-13-1240013-g002.jpg
case_images: f2
case_images: Contrast-enhanced CT of the chest and abdomen ( Figure 2 ) was considered to be lymphoma, and the possibility of sarcoidosis and lung cancer could not be excluded.
case_images: Preoperative pathological images of the descending duodenal mass, left lung mass, left upper bronchus, and left supraclavicular lymph node. (A) The pathological image of the mass in the descending duodenum showed mucus and a small amount of signet ring cells. (B) Pathological image of the left lung mass, showing mucus and signet ring cell mass. (C) Pathological image of the left upper bronchus, poorly cohesive carcinoma. (D) Left supraclavicular lymph node, lymph node cancer metastasis, poorly cohesive carcinoma was considered.
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case_images: f3
case_images: The biopsy results ( Figure 3 ) indicate the presence of PCC in various locations: (1)Descending duodenum: Mucus and a few signet ring cells were observed, consistent with PCC (including signet ring cell carcinoma). (2)Left upper bronchus: Diagnosed as PCC.
case_images: Preoperative immunohistochemical staining of descending duodenum, left lung mass, and left upper bronchus. (A) Immunohistochemical staining for cytokeratin (CK) expression in the descending duodenum. (B) Immunohistochemical staining for CK20 expression in the descending duodenum. (C) Immunohistochemical staining of P53 expression in the descending duodenum. (D) Immunohistochemical staining of caudal-type homeobox transcription factor 2 (CDX2) expression in the left lung mass. (E) Immunohistochemical staining of CK7 expression in the left lung mass. (F) Immunohistochemical staining for CDX2 expression in the left upper bronchus.
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case_images: PMC10492232_01_fonc-13-1240013-g004.jpg
case_images: f4