Electronic ISSN 2287-0237

VOLUME

DIFFUSE PULMONARY NEUROENDOCRINE CELL HYPERPLASIA WITH TUMORLETS AND ELEVATED SERUM CEA

FEBRUARY 2011 - VOL.1 | CASE REPORT
Keywords:

Pulmonary tumorlets, CEA, F18-FDG-PET/CT,(DIPNECH).

DOI

10.31524/bkkmedj.2011.02.005

MEDIA
Figure 1:
Graph shows rising serum CEA
Figure 2:
Chest x-ray (a) and Chest Tomosynthesis (b, c) show subsegmental atelectasis and reticular infiltration at right middle lobe.
Figure 3:
CT Chest shows small pulmonary atelectasis at right middle lobe.
Figure 4:
The F18-FDG-PET/CT show non-FDG avid lesion in right middle lobe, which could be a benign lesion. Pulmonary tumorlets and bronchioalveolar carcinoma may also be non-FDG avid lesion.
Figure 6a-6c:
Figure 6a: The right middle lobe shows one accessory lobe (arrow ) superior to a minor fissue (arrow head) Figure 6b: Serial near horizontal sections of the right middle lobe show no visible tumor nodule. Figure 6c: The accessory lobe shows areas hemorrhage, atelectasis and clusters of dilated brochi.
Figure 7:
Lung shows areas of hemorrhage, several blood vessels, focal fibrosis and dilated bronchi (HE x20).
Figure 8a:
Lung tissue shows three microscopic tumorlets with hemorrhage and mild focal fibrosis in the stroma. (HE x100).
Figure 8b:
One tumorlet composing of spindle, polyhedral to oval shape tumor cells with scanty to clear, vacu- olated cytoplasm and elongated to oval nuclei with speckled chromatin (HE x200).
Figure 8c:
In this fibrotic, hemorrhagic and vascularized area, there are four terminal bronchi showing neuroendo- crine cell hyperplasia (HE x100).
Figure 8d:
One tumorlet and three terminal bronchi show neuroendocrine cell hyperplasia (chromogranin A x100).
Figure 8e:
The tumorlet and foci of neuroendocrine cell hyper-plasia are also CEA positive (CEA x100).
Figure 9:
Single, small clusters and one small nodule of chro- mogranin A positive neuroendocrine cells in the mu- cosa of one small brochus (Chromogranin A x200).
Figure 10:
Two small nodules of neuroendocrine cells (neuro- endocrine bodies) in the bronchiolar mucosa (chro- mogranin A x200).
Figure 11:
Lung tissue shows areas of vascular malformation and mild hemorrhage (HE x100).
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