nitric oxide synthase activity in primary non-small cell lung carcinoma

초록

Primary yolk sac tumor is a rare but highly malignant tumor, which accounts for the most frequent extragonadal nonseminomatous nonteratomatous germ cell tumor in the mediastinum. The majority of patients are males in their twenties and thirties. The tumor has a variety of histologic patterns, ranging from areas indistinguishable from embryonal carcinoma to papillary pattern and net-like reticular pattern. Because those features are usually not discernable as such in cytologic smears and aspirates might show papillary clusters of malignant epithelial cells arranged in papillary clusters in the mucoid background with necroinflammatory debris suggesting adenocarcinoma or embryonal carcinoma. In this report, we present a case of fine needle aspiration cytology of primary yolk sac tumor in mediastinum. The patient was 40-year-old man with chief complaint of vague chest pain and discomfort for a month accompanied by recently aggravated dyspnea. Physical examination disclosed enlargement of the left supraclavicular lymph node and decreased breathing sound. Computerized tomography revealed a huge mass in the left anterior mediastinum with severe right pleural effusion and multiple nodules in the visceral pleura. Radiologically, the mass was 12x9 cm in size with internal necrosis and calcifications along with a metastatic lesion in the right lung and multiple lymphadenopathy involving the mediastinal and paratracheal lymph nodes. Fine needle aspiration smearscontained mild to moderately collular aspirates showing papillary clusters or loose aggregates of neoplastic cells with ill-defined cell borders. The tumor cells had pleomorphic and hyperchromatic nucleiwith coarsely granular or vesicular chromatin. The nucleoli were prominent and mitosis was not infrequent. Hyaline droplets were not conspicuous.