A Young Woman With a Rapidly Growing Thoracic Tumor Yu Kuang Lai, MD, Brittany Holmes, MD, Haiwei Henry Guo, MD, PhD  CHEST  Volume 155, Issue 5, Pages e145-e148 (May 2019) DOI: 10.1016/j.chest.2018.12.014 Copyright © 2019 American College of Chest Physicians Terms and Conditions

Figure 1 A, CT chest scan at initial presentation shows a 5.7 × 6 × 6.6 cm left hilar mass. B, CT chest scan after 45 days reveals marked interval tumor progression, which largely fills the left hemithorax with postobstructive atelectasis, large pleural effusion, and rightward mediastinal shift. CHEST 2019 155, e145-e148DOI: (10.1016/j.chest.2018.12.014) Copyright © 2019 American College of Chest Physicians Terms and Conditions

Figure 2 A-D, Histopathology of a mediastinal lymph node (A) demonstrates sheets of undifferentiated malignant cells with foci of necrosis (right). B, On higher power, the tumor cells (center) demonstrate enlarged nuclei with prominent nucleoli and syncytial cytoplasm, in contrast to normal lymphocytes (bottom right). By immunohistochemistry, the malignant cells are (C) negative for cytokeratins AE1 and Cam5.2 and (D) exhibit speckled nuclear positivity for nuclear protein in testis. CHEST 2019 155, e145-e148DOI: (10.1016/j.chest.2018.12.014) Copyright © 2019 American College of Chest Physicians Terms and Conditions