case_images: PMC5449746_01
case_images: Computed tomography. (a) A conglomerate of lymph nodes in the left supraclavicular fossa measuring 3 cm (arrow). (b) A 2 cm left mid lung mass posterior to the left main stem bronchus (arrow). (c and d) A 3.8 cm hypodense mass in the pancreatic body with associated ill-defined soft tissue inseparable from the distal celiac axis and its branches (arrow).
case_images: CRIGM2017-3212056.001.jpg
case_images: PMC5449746_01_CRIGM2017-3212056.001.jpg
case_images: fig1
case_images: It also showed a 3 cm lung mass posterior to the left main stem bronchus (Figure 1).
case_images: (a) Endoscopic ultrasound (EUS) demonstrating a 3 cm hypoechoic mass in the left lung. (b) EUS-guided fine needle biopsy (FNB) of the left lung nodule with a 25-gauge needle. (c) EUS demonstrating a 3.8 cm hypoechoic mass in the pancreatic body abutting the splenic artery. It shows the same internal echotexture as the lesion in the mediastinum. (d) EUS-FNB of the pancreatic mass with a 25-gauge needle.
case_images: CRIGM2017-3212056.002.jpg
case_images: PMC5449746_01_CRIGM2017-3212056.002.jpg
case_images: fig2
case_images: EG-3870UTK) revealed two well-defined hypoechoic lesions with similar echotexture firstly in the mediastinum posterior to the left main stem bronchus and secondly in the pancreatic body. EUS-FNB of these two lesions was performed (Figure 2) with a 25-gauge needle using a novel fine needle biopsy system (Beacon SharkCore, Medtronic Corp., Boston, USA).
case_images: (a) Hematoxylin and eosin staining of a specimen obtained from lung mass with EUS-guided fine needle biopsy. (b) Small core biopsy fragments show invasive carcinoma with clusters and cords of cells that show squamous morphology. (c and d) Immunostains showed that the neoplastic cells express p63 (c) and CK 5/6 (d).
case_images: CRIGM2017-3212056.003.jpg
case_images: PMC5449746_01_CRIGM2017-3212056.003.jpg
case_images: fig3
case_images: Immunostains performed on both specimens showed positivity for CK5/6 and p63 (Figures 3 and 4).
case_images: (a) Hematoxylin and eosin staining of a specimen obtained from pancreatic mass with EUS-guided fine needle biopsy. (b) Biopsy fragments show invasive carcinoma morphologically similar to the carcinoma identified in the supraclavicular lymph node and the mediastinal mass. (c and d) Immunostains show that the neoplastic cells express p63 (c) and CK 5/6 (d).
case_images: CRIGM2017-3212056.004.jpg
case_images: PMC5449746_01_CRIGM2017-3212056.004.jpg
case_images: fig4
case_images: Immunostains performed on both specimens showed positivity for CK5/6 and p63 (Figures 3 and 4).