PMC10248429_01
Chest CT on 05 March 2022. (A) Truncated bronchi in the upper lobe of the left lung, multiple small patchy and nodular high-density shadows in the surrounding lung. (B) Multiple small nodules and small patchy high-density shadows in the lower lobe of the left lung.
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Chest CT plain scan and enhanced scan: (Figures 1A, B, 05 March 2022): a mixed-density mass measuring approximately 12.6 x 7.6 cm was found on the left upper lobe of the lung, with truncated bronchi in the upper lobe of the left lung, localized thinning of the left pulmonary artery, and multiple small patchy and nodular high-density shadows in the surrounding lung; multiple small nodules and small patchy high-density shadows were found in the lower lobe of the left lung.
The timeline of treatment of the patient in our hospital.
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Treatment course: a brief description of the treatment course is shown in Figure 2.
Chest CT on 22 May 2022. (A) The lung cancer in the upper lobe of the left lung was less extensive than before. (B) Multiple small nodules and small patchy high-density shadows in both lungs were more extensive than before.
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On 21 May 2022, the patient began to cough up blood in phlegm with a volume of about 20 ml and he was reviewed using a chest CT on 22 May 2022 (Figures 3A, B), which showed that the lung cancer in the upper lobe of the left lung was less extensive than before, while multiple small nodules and small patchy high-density shadows in both lungs were more extensive than before, which could not exclude pneumonia or infection associated with ICIs.
Chest CT on 19 August 2022. (A) The primary focus of cancer in the right lung was stable. (B) The nodular and small patchy high-density shadows in both lungs were less extensive than before.
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After 3 months of anti-TB treatment, the patient was reviewed using an enhanced CT scan on 19 August 2022, which showed that the primary focus of cancer in the right lung was stable and the nodular and small patchy high-density shadows in both lungs were less extensive than before (Figures 4A, B).
The possible mechanisms through which ICIs treatment promotes the development of TB infection.
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Chest CT plain scan and enhanced scan: (Figures 1A, B, 05 March 2022): a mixed-density mass measuring approximately 12.6 x 7.6 cm was found on the left upper lobe of the lung, with truncated bronchi in the upper lobe of the left lung, localized thinning of the left pulmonary artery, and multiple small patchy and nodular high-density shadows in the surrounding lung; multiple small nodules and small patchy high-density shadows were found in the lower lobe of the left lung.