Volume 140, Issue 1, Pages (July 2011)

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Volume 140, Issue 1, Pages 253-257 (July 2011) A 19-Year-Old Woman With Progressive Dyspnea and Multiple Pulmonary Nodules  Don Hayes, MD, FCCP, Melissa V. Kesler, MD, Sean C. Skinner, MD, Anil K. Attili, MD  CHEST  Volume 140, Issue 1, Pages 253-257 (July 2011) DOI: 10.1378/chest.10-3094 Copyright © 2011 The American College of Chest Physicians Terms and Conditions

Figure 1 CT scan of the chest demonstrating multiple pulmonary nodules ranging in size from a few millimeters to 2 cm. CHEST 2011 140, 253-257DOI: (10.1378/chest.10-3094) Copyright © 2011 The American College of Chest Physicians Terms and Conditions

Figure 2 CT scan of the abdomen with coronal reformation demonstrating a large right-side lower-quadrant soft-tissue mass involving the right-side iliacus muscle and extending into the upper thigh. CHEST 2011 140, 253-257DOI: (10.1378/chest.10-3094) Copyright © 2011 The American College of Chest Physicians Terms and Conditions

Figure 3 Fluorodeoxyglucose-PET scan of the pelvis demonstrating intense uptake in the right-side lower-quadrant mass. CHEST 2011 140, 253-257DOI: (10.1378/chest.10-3094) Copyright © 2011 The American College of Chest Physicians Terms and Conditions

Figure 4 Fluorodeoxyglucose-PET scan of the lower lungs demonstrating intense uptake in the larger lung nodule in the left-side lower lobe in proximity of the heart. CHEST 2011 140, 253-257DOI: (10.1378/chest.10-3094) Copyright © 2011 The American College of Chest Physicians Terms and Conditions

Figure 5 Malignant cells in an organoid or pseudoalveolar pattern with eosinophilic granular cytoplasm, vesicular nuclei, and prominent nucleoli (hematoxylin-eosin stain, original magnification × 200). CHEST 2011 140, 253-257DOI: (10.1378/chest.10-3094) Copyright © 2011 The American College of Chest Physicians Terms and Conditions

Figure 6 Diastase-resistant intracytoplasmic crystals that are periodic acid-Schiff positive (periodic acid-Schiff stain with diastase, original magnification × 1,000). CHEST 2011 140, 253-257DOI: (10.1378/chest.10-3094) Copyright © 2011 The American College of Chest Physicians Terms and Conditions