--- a
+++ b/processing/MACCROBAT/21129213.txt
@@ -0,0 +1,15 @@
+A 48 year-old female presented with vaginal bleeding and abnormal Pap smears.
+Upon diagnosis of invasive non-keratinizing SCC of the cervix, she underwent a radical hysterectomy with salpingo-oophorectomy which demonstrated positive spread to the pelvic lymph nodes and the parametrium.
+Pathological examination revealed that the tumour also extensively involved the lower uterine segment.
+5 months after this surgery, the woman underwent external beam radiotherapy and intracavitary brachytherapy.
+Two years later, the patient presented with a three-month history of a productive cough, shortness of breath, and a 2-3 week history of progressive exertional dyspnea.
+X-rays of the chest demonstrated a reticular nodular pattern, and CT scans revealed multiple bilateral patchy areas of ground glass opacity scarring with focal areas of subsegmental atelectasis within both lungs.
+A differential diagnosis included interstitial pneumonia versus non-cardiogenic edema.
+The woman underwent a bronchoscopy, left thoracoscopy, and an open wedge left lung biopsy.
+Pathological examination of the left lung biopsy confirmed the presence of neoplastic sheets of cells classically distributed along the septal vessels, perivascular, peribronchial, and subpleural lymphatics.
+Subpleural nodules were also identified with the presence of neoplastic cells distending the subpleural lymphatics confirming LC (Figures 1A, 1B, 1C).
+On immunohistochemical analysis, the lesional cells were strongly positive to p16 (Figure 1D), high and low molecular weight keratins (Figure 1E), cytokeratin-7 (CK7) (Figure 1F), CK19, and pan keratin, and negative to CK20, p63, and EGFR.
+Based on these findings, she was diagnosed to have lymphangitic carcinomatosis in the lung metastatic from SCC of the cervix.
+She was started on chemotherapy (Carbo/Taxol) with corticosteroids while in the hospital, and was discharged ten days later.
+Post-treatment improvement of clinical symptoms was paralleled by radiographic imaging that showed marked interval improvement of the nodular opacifications and the interstitial thickening that had previously been noted.
+Despite this improvement, she subsequently died 13 months after the initial diagnosis.