Fig.1 A,ChestX-rayfilm demonstratingatumorshadow intherightlowerlungfield.b,chestct scan demonstratingtherightmiddlelobemass,measuring9.0 7.3cm.C,AbdominalCT scanshowingfree airintheabdominalcavityanddirtyfatsignaroundthesigmoidcolontumor. Table1 Laboratorydataonadmission WBC 22,200/μl T.Bil 0.4mg/dl RBC 410 10 4 /μl AST 19IU/l Hb 9.1g/dl ALT 16IU/l Hct 30.4% ALP 333IU/l PLT 74.9 10 4 /μl LDH 321IU/l Na 134mEq/l CK 16IU/l K 4.1mEq/l CRP 18.45mg/dl Cl 95mEq/l CEA 2.7ng/ml TP 7.1g/dl CA19-9 22.3U/ml Alb 3.7g/dl CYFRA <1.0ng/ml UN 4mg/dl SLX 29U/ml CRTN 0.34mg/dl Pro-GRP 10.9pg/ml Fig.2 Theresectedcolontumor.Arrow:perforation.
Fig.3 A,B,Histologyoftheresectedcolontumorshowingundiferentiatedcarcinomawithoutsquamous orglandulardiferentiation.c,immunohistochemicalstainingofthecolontumor:ttf-1widelypositive; D,CK 7positiveinasmalportionofcels. Fig.4 Histologyofthelungtumoratautopsy.Spindle-shapedcelswithoutsquamousorglandulardiferentiationandmultinucleatedgiantcels.H.E.staining.