Figure legends
Fig. 1 Frontal chest x-ray shows bilateral innumerable nodules
with a miliary pattern resembling miliary tuberculosis. No evidence of
hilar lymphadenopathy is seen.
Fig. 2 Axial images of non-contrast enhanced computed
tomography of both lungs show numerous small lung nodules with a random
distribution, and a confluent mass within the right lung, indicating
disseminated lung metastasis (a-d).
Fig. 3 FNA biopsy of solid thyroid nodule demonstrates isolated
and loose clusters of ovaloid atypical cells.
Fig. 4 Trans-bronchial lung biopsy (TBLB) shows that lung
parenchyma is infiltrated by sheets and nests of rather monotonous
atypical cells with round to oval nuclei, inconspicuous nucleoli, finely
dispersed chromatin and moderate amount of eosinophilic cytoplasm. These
cells are strongly positive for CK7 (a) and TTF1 (b) by
immunohistochemistry (IHC). Atypical cells exhibit a strong and diffuse
positive reaction for CEA (c), chromogranin (d), calcitonin (e) and CD56
(f). IHC for P63, Pax8 and NapsinA did not show a positive reaction.