case_images: PMC5167281_01
case_images: An axial contrasted computed tomography scan of the chest showing enlarged main pulmonary trunk suggesting pulmonary hypertension and extensive mediastinal lymphadenopathy.
case_images: RCR2-5-0-g001.jpg
case_images: PMC5167281_01_RCR2-5-0-g001.jpg
case_images: rcr2209-fig-0001
case_images: Significantly, the CT scan did not show evidence of intraluminal pulmonary thrombi or features of parenchymal lung disease (Fig. 1).
case_images: Microscopic slides of sections of the lungs showing intravascular collections of fibrin and markedly anaplastic tumour cells consistent with poorly differentiated adenocarcinoma. (A) A slide showing tumour cells with associated thrombus in the pulmonary vessels (arrows). Haematoxylin and eosin stain. Original magnification 100x. (B) A slide showing recanalization of a thrombosed pulmonary blood vessel. Note the individual tumour cells (arrows). Haematoxylin and eosin stain. Original magnification 200x. (C) A slide illustrating intracytoplasmic mucin vacuoles in tumour cells (arrows). Periodic acid-Schiff stain treated with diastase. Original magnification 400x. (D) A slide illustrating positive staining (brown stain) of tumour cells with an immunohistochemical stain (cytokeratin cocktail) for AE1/AE3 in keeping with a carcinoma rather than a lymphoma or melanoma. Original magnification 100x.
case_images: RCR2-5-0-g002.jpg
case_images: PMC5167281_01_RCR2-5-0-g002.jpg
case_images: rcr2209-fig-0002
case_images: Examination of the lungs demonstrated multiple organized tumour emboli occluding the pulmonary vessels (Fig. 2).