Open AccessMediastinal small cell carcinoma with liver and bone marrow metastasis, mimicking lymphoma
Author(s) -
Napaporn Nawarawong,
Tawatchai Pongpruttipan,
Pitulak Aswakul,
Varayu Prachayakul
Publication year - 2015
Publication title -
world journal of clinical cases
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.368
H-Index - 10
ISSN - 2307-8960
DOI - 10.12998/wjcc.v3.i10.915
Subject(s) - medicine , chromogranin a , pathology , synaptophysin , malignancy , fine needle aspiration , bone marrow , small cell carcinoma , biopsy , carcinoma , metastasis , mediastinum , mediastinal lymphadenopathy , vimentin , radiology , immunohistochemistry , cancer
Primary mediastinal neuroendocrine tumors are a rare malignancy that accounts for < 10% of all mediastinal tumors. The case presented here involves a 52-year-old man who had been suffering for 3 mo from chronic cough, anorexia and substantial weight loss, as well as 2 wk of jaundice prior to his admission. A computed tomography scan showed a 4.3 cm × 6.6 cm mediastinal mass with multiple liver nodules scattered along both hepatic lobes. Endoscopic ultrasound showed a large heterogeneous hypoechoic mass at the mediastinum with multiple target-like nodules in the liver. Fine-needle aspiration specimens revealed numerous, small, round cells with hyperchromatic nuclei, scarce cytoplasm, and frequent mitotic features. Immunohistochemical study revealed positive results for AE1/AE3, CD56 and chromogranin A, with negative findings for synaptophysin, CK20, vimentin, CK8/18 and CD45. The patient was subsequently diagnosed with a poorly differentiated neuroendocrine carcinoma, small cell type. A bone marrow biopsy also revealed extensive involvement by the carcinoma.