Contributed by Zhengbin Lu, MD, PhD and Karen Schoedel, MD
Published on line in April 2001
The patient is a 62-year-old woman who presents with back pain for two months. Chest X-ray was non-diagnostic. The CT scan showed a 1.4 cm pulmonary nodule in the basilar segment of the left lower lobe as well as a lytic lesion in the T10 vertebral body and a hypodense lesion within the right kidney. Two fine needle aspirates (FNA) of the lung lesion were non-diagnostic. The whole body PET scan confirmed increased uptake in the lung and lower thoracic spine (T10). Clinically, she reported weight loss of approximately 11 pounds over the past two months. She denied cough, hemoptysis, shortness of breath, fever, or night sweats. Her past history includes two benign right breast masses removed two years ago and total hysterectomy for fibroids 8 years ago. Her lung nodule was wedge resected first followed by the resection of vertebral lesion.
The wedge resection specimen consists of 6.0 x 2.5 x 1.8 cm of tan-pink, soft lung tissue, containing a 1.5 x 1.5 x 1.0 cm pink-grey rubbery mass approaching the stapled margin of resection within 0.2 cm. The vertebral specimen consists of multiple fragments of yellow-grey rubbery tissue with chips of bone, 2 x 1 x 0.6 cm in aggregate.