A 72-year-old woman comes to the office due to a persistent cough over the last 2 months that is occasionally associated with scant, white sputum. She has also lost 4.5 kg (10 lb) since the onset of her symptoms. The patient is an ex-smoker with a 25-pack-year history. . Examination shows an enlarged right supraclavicular lymph node. Imaging reveals a large mediastinal mass causing tracheal deviation. The enlarged node is biopsied, and microscopy demonstrates clusters of small, ovoid cells with scant cytoplasm and a high mitotic count. Immunohistochemical staining is positive for chromogranin. This patient most likely has which of the following conditions?

Question

A 72-year-old woman comes to the office due to a persistent cough over the last 2 months that is occasionally associated with scant, white sputum. She has also lost 4.5 kg (10 lb) since the onset of her symptoms. The patient is an ex-smoker with a 25-pack-year history. .  Examination shows an enlarged right supraclavicular lymph node.  Imaging reveals a large mediastinal mass causing tracheal deviation.  The enlarged node is biopsied, and microscopy demonstrates clusters of small, ovoid cells with scant cytoplasm and a high mitotic count.  Immunohistochemical staining is positive for chromogranin.  This patient most likely has which of the following conditions?

Quizplus · Accepted Answer

Eductional Objective: Small cell lung cancer is strongly associated with smoking and is usually centrally located.  Histopathology shows small round/oval cells with scant cytoplasm, hyperchromatic (blue) nuclei, and granular chromatin; abundant mitoses are also usually seen.  Immunohistochemical stains are frequently positive for neuroendocrine markers (eg, chromogranin, synaptophysin, neural cell adhesion molecule [CD56]).

A 72-Year-Old Woman Comes to the Office Due to a Persistent