PMC7445495_01
Computed tomography (CT) images of the patient during the whole diagnosis and treatment procedure. (A) CT images showing the infiltrations on the lower right lung at the patient's first visit on May 25; (B) CT images on June 7 showing a slightly progressed lesion on the lower right lung after moxifloxacin treatment. (C) CT images on July 27 showing marked progressed lesion on the lower right lung after voriconazole treatment. (D) CT images on July 27 showing a new ground grass opacity on the lower left lung. (E) CT images showing a significant reduced lesion on the lower right lung after 2 months of anti-tumor therapy. (F) CT images showed that the lesion on right lower lung continued to shrink after 4 months of anti-tumor therapy. (G) CT images showed that the lesion on right lower lung was reduced further after 7 months of anti-tumor therapy. (H) CT images showed that only a few ground glass shadows and fibrous lesions remained on the right lower lung after 10 months of anti-tumor therapy.
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A computed tomography (CT) scan of the chest on May 25 revealed a high-density shadow in inferior lobe of right lung (Figure 1A). The enhanced CT was performed after 2 weeks' treatment with oral moxifloxacin on June 7, which revealed a little progress of the lesion (Figure 1B). The re-checked CT on July 27 demonstrated marked progression of the lesion in inferior lobe of right lung (Figure 1C) and a new lesion of ground grass opacity (GGO) was also found in the lower left lobe (Figure 1D). She experienced sustained clinical improvement after anti-tumor therapy and a CT scan on October 13 revealed marked decrease of the infiltrations on the lower right lung (Figure 1E) and the absence of GGO on the left lung, assessed as partial remission. EGFR-TKI. Encouragingly, the lesion on the right lower lung continued to shrink during the treatment (Figure 1F-H).
Pathological results of tissue obtained through CT-guided percutaneous lung biopsy showing adenocarcinoma (hematoxylin and eosin; magnification x200).
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Then, voriconazole treatment was discontinued and the patient underwent CT-guided percutaneous lung biopsy and pathological results showed lung adenocarcinoma (Figure 2).
Integrative Genomics Viewer snapshot of EGFR-KIF5B fusion.
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The NGS reports revealed the KIF5B-EGFR, a novel rearrangement of the EGFR gene that has not been reported previously (Figure 3).