PMC8544264_01
Computed tomography findings before and after treatment with alectinib. A computed tomography scan before treatment revealed a solitary tumor in left upper lung (A). A computed tomography scan 1 months after commencing treatment with alectinib revealed that dramatic reduction in tumor size (B and C), almost no presence of tumor lesion (D).
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Computed tomography (CT) of the chest showed a lobulated mass of 3.2x2.4 cm under the pleura in the left upper lung, with mediastinal and left hilar lymphadenopathy (Figure 1A). CT of the chest showed that the size of the left upper lobe lobulated mass was 1.7x1.4cm, which was significantly smaller than before (Figure 1B). After the second cycle of treatment, the chest CT showed that the tumor lesions were further reduced (Figure 1C). After three cycles (84 days) of neoadjuvant treatment, no solid lesions were found on chest CT, the tumor achieved complete remission (CR) (Figure 1D), and no adverse drug reactions were seen.
Percutaneous lung biopsy specimen from tumor lesions (A and B, hematoxylin-eosin). Pathology showed a lot of mucus filling the alveolar space.
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A CT-guided percutaneous lung biopsy of the lung lesion was performed, and a diagnosis of invasive mucinous adenocarcinoma (IMA) of lung was made by pathologists (Figure 2A and B), a lot of mucus fills the alveolar space.
Pathological examination of tissue specimens from thoracoscopic left lobectomy (A and B, hematoxylin-eosin). Pathology showed a small amount of scattered high-grade atypical glands in the interstitium, and fibrous tissue proliferation, foam cell aggregation, lymphocyte infiltration, multinucleated giant cell reaction, necrotic hemicalcium can be seen in the remaining lung tissue.
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Postoperative pathology revealed a small amount of scattered high-grade atypical glands in the interstitium, and fibrous tissue proliferation, foam cell aggregation, lymphocyte infiltration, multinucleated giant cell reaction, necrotic hemicalcium can be seen in the remaining lung tissue (Figure 3A and B).
Immunohistochemical staining (20-X) revealed Ki61 positivity (A), cytokeratin 7 (CK7) and thyroid transcription factor-1 (TTF-1) positivity (B).
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And the immunohistochemistry revealed that Ki61, cytokeratin 7 (CK7) and thyroid transcription factor-1 (TTF-1) were positive (Figure 4).