CTICasesNUT Carcinoma of the Lung
Imaging findings
Chest CT in an 18-year-old female reveals a large, infiltrative, hyperattenuating mass centered in the left hilum with adjacent mediastinal lymphadenopathy, mucoid impaction of obstructed bronchi, and septal lines reflecting lymphatic obstruction or pulmonary venous congestion. FDG-PET/CT demonstrates intense metabolic activity within the primary tumor and metastatic left supraclavicular lymph nodes. Immunohistochemistry of the biopsy specimen confirmed NUT midline carcinoma.
Key takeaways
NUT carcinoma is an extremely aggressive, poorly differentiated squamous cell epithelial cancer characterized by a chromosomal rearrangement of the NUTM1 gene. It typically presents as a large, rapidly growing, infiltrative mediastinal or pulmonary mass in young patients, mimicking lymphoma or germ cell tumors, and carries an exceptionally poor prognosis with limited response to conventional therapies.
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