21129213 Visualization

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