case_images: PMC6854212_01
case_images: OGDS showed multiple polypoidal lesions with central ulceration at the second part of duodenum.
case_images: CRIM2019-3437056.001.jpg
case_images: PMC6854212_01_CRIM2019-3437056.001.jpg
case_images: fig1
case_images: In consideration of melena and anemia, he underwent an oesophago-gastroduodenoscopy (OGDS), which showed multiple polypoidal lesions with central ulceration at the second part of duodenum (Figure 1).
case_images: CT thorax showed a right upper intrabronchial neoplastic lesion (red arrow) with right pleural effusion.
case_images: CRIM2019-3437056.002.jpg
case_images: PMC6854212_01_CRIM2019-3437056.002.jpg
case_images: fig2
case_images: A computed tomography (CT) scan of the thorax revealed a right upper lobe bronchogenic tumor with liver, mesenteric, and contralateral lung metastases (Figure 2).
case_images: Immunohistostaining of the duodenal biopsies demonstrated (a) CK7-positive, (b) CK20-negative, and (c) TTF1-positive.
case_images: CRIM2019-3437056.003.jpg
case_images: PMC6854212_01_CRIM2019-3437056.003.jpg
case_images: fig3
case_images: Histopathological examination of the duodenum revealed lung adenocarcinoma in which immunohistostaining was positive for both cytokeratin 7 (CK7) and thyroid transcription factor 1 (TTF1), but negative for CK20 (Figure 3).
case_images: PMC6854212_02
case_images: CT thorax showed a left upper lobe neoplastic lesion (red arrow) with multiple lymphadenopathies in the mediastinum.
case_images: CRIM2019-3437056.004.jpg
case_images: PMC6854212_02_CRIM2019-3437056.004.jpg
case_images: fig4
case_images: CK7 but negative for TTF1 expression. CT thorax was performed (Figure 4) and showed left upper lobe lung mass measuring 3.9 x 3.2 x 4.0 cm with multiple mediastinal and abdominal lymphadenopathies as well as evidence of liver metastases.
case_images: Immunohistostaining of neoplastic lesion in the lung demonstrated a positive for CK-7 (a), negative for CK-20 (b), and positive for TTF-1 (c).
case_images: CRIM2019-3437056.005.jpg
case_images: PMC6854212_02_CRIM2019-3437056.005.jpg
case_images: fig5
case_images: Histopathological examination of her lung mass (CT guided biopsy) was consistent with lung adenocarcinoma which was CK7 and TTF1-positive and CK20-negative (Figure 5).