PMC8278452_01
Comparison of chest CT scans before and after treatment, bilateral pleural and interlobar pleural thickening with pleural effusion (arrow).
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The CT scan showed (Figure 1) bilateral pleural thickening with bilateral pleural effusion, which were consistent with pleural malignant tumor.
Changes in serum tumor markers (CYFRA 21-1 reference: 0-3.3 ng/ml; NSE reference: 0-16.3 ng/ml; CA125 reference: 0-35 U/ml; CEA reference: 0-5.2 ng/ml; CA724 reference: 0-6.9 U/ml; Ferritin reference: 24-336 ng/ml).
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The patient had obvious dyspnea, cough, expectoration, and laboratory tests (Table 1) (Figure 2) showed platelet aggregation, hypoproteinemia, and abnormal coagulation function.
Histopathological examination results of cervical lymph nodes. (a, b) Hematoxylin and eosin-stained shows squamous cell carcinoma with neuroendocrine function. (c, d) Tumor cells staining positive for p40. (c) 200x, (d) 400x, (e) Tumor cells staining positive for p63.
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The immunohistochemical results supported the neuroendocrine function of squamous cell carcinoma (Figure 3): Ki67 (+, 70%), CD56 (-), Syn (++), P40 (+++), P63 (++), CD20 (-), Vim (-), EMA (++), TTF1 (++), NaspinA (-), CD99 (-), and PD-L1 (+, 80%).
Treatment timeline of the patient.
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Fortunately, the tumor had a high expression of PD-L1; thus, we decided to administer camrelizumab according to the recommended intravenous dose of 200 mg (once every 3 weeks) for a total of six times from October 20, 2019 to February 11, 2020 (Figure 4).