PMC8059039_01
Chest CT image. (a) Interstitial exudation and mass lesions of both lungs can be seen before treatment. (b) Lung lesions were significantly diminished after four cycles of EPOCH chemotherapy combined with chidamide treatment.
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Reexamination of chest CT showed interstitial exudation in both lungs, mass lesions, and left pleural effusion, still considering fungal infection (Figure 1(a)). Additionally, the chest CT showed that the lung lesions were significantly diminished (Figure 1(b)), and the right thigh magnetic resonance imaging (MRI) showed no obvious abnormal signal in subcutaneous and layers of muscle group (Figure 4).
Showing images of the patient's right thigh. (a) The patient exhibited prominent right thigh swelling. (b) Pathological biopsy showed gray-white and gray-yellow neoplasm in intermuscular space.
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A of biopsy of the lung tissue was performed and revealed a high number of inflammatory cells infiltration in the pleural. Anti-infective treatment was ineffective, and her fever was unremitting, along with right thigh redness, swolling, heat, and painful (Figure 2(a) and (b)).
Histopathological findings. (a) Focal rimming of individual adipocytes by infiltrating small to medium-sized atypical lymphocytes. (b-d) Immunostaining showed infiltrating lymphocytes positive for CD8 (b), granzyme B (c), and T-cell intracellular antigen-1(TIA)-1 (d).
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Immunohistochemistry exhibited positivity for CD3, CD8, granzyme B (GB), CD43, and T-cell intracellular antigen-1 (TIA-1), and negativity for CD4, CD56, CK, and CD79, Ki67 staining positive was 50% (Figure 3(a)-(d)), which led to a pathological diagnosis of SPTCL.
Right thigh MRI showed no obvious abnormal signal in subcutaneous and layers of muscle group.
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Additionally, the chest CT showed that the lung lesions were significantly diminished (Figure 1(b)), and the right thigh magnetic resonance imaging (MRI) showed no obvious abnormal signal in subcutaneous and layers of muscle group (Figure 4).