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A Case with Small Cell Carcinoma of the Lung Expressing Alpha-Smooth Muscle Actin

An 80-year-old man was admitted to hospital on June 16th, 1994, for closer examination of right-sided chest pain. Chest roentgenograms and computed tomograms (Fig. 1) showed multiple tumors of the right side of the chest and abdominal walls as well as swelling of mediastinal lymph nodes. Physical examination revealed a thumb-sized subcutaneous mass of the right lateral chest region, and laboratory data showed abnormal values of serum LDH, 252 IU/L ( < 220 IU/L), CEA, 6.9 ng/ml ( < 6.7 ng/ml), and NSE, 18.3 ng/ml ( < 10 ng/ml). The histologic diagnosis of the biopsied specimen obtained from the subcutaneous mass was small cell carcinoma, intermediate cell type. In the immunohistochemical study, the tumor showed