PMC7552097_01
Findings of the chest computed tomography imaging during the patient's course: (A, B, and C) at the first visit and (D, E, and F) at the time of diagnosis; mediastinal/hilar lymph nodes had rapidly enlarged at 6 months.
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Chest computed tomography (CT) showed only the nodular shadow in the lower right lobe (Fig. 1 A-C), but CT at 6 months showed rapidly enlarging mediastinal lymph nodes (Fig. 1 D-F).
Histopathological features. (A) Histological examination of ultrasound-guided biopsy specimens obtained from the mediastinal lymph nodes revealed adenocarcinoma. (HE staining). (B, C) Immunohistochemical staining of TTF-1 and CK7 was positive. (D) CK20 staining was negative. HE: hematoxylin and eosin, TTF-1: thyroid transcription factor 1, CK: cytokeratin.
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Moreover, immunohistochemical staining indicated positive results for thyroid transcription factor 1 (TTF-1) and cytokeratin 7 (CK7) and negative results for CK20 (Fig. 2A-D).
Findings of the chest computed tomography imaging during the treatment course: (A, B, and C) after chemoradiotherapy, the left pulmonary lesion and mediastinal/hilar lymph nodes showed stable disease; (D, E, and F) after the fourth round of durvalumab, the left pulmonary lesion and mediastinal/hilar lymph nodes exhibited a partially good response; (G, H, and I) 6 months after durvalumab administration for 1 year, the left pulmonary lesion and mediastinal/hilar lymph nodes did not show recurrence.
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He showed stable disease at the primary tumor site (Fig. 3 A-C). Routine CT 2 months after the start of durvalumab showed a good response (Fig. 3 D-F). Six months after durvalumab administration for a period of 1 year, no recurrence was noted (Fig. 3G-I).