PMC9149516_01
At diagnosis, CT revealed a nodule in the upper lobe of the right lung (a) with multiple pleural dissemination in the left lung (b, c). PET-CT showed hyperaccumulation of fluorodeoxyglucose, consistent with the nodal shadows seen on CT (d-g).
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F1
Computed tomography (CT) revealed a pulmonary mass in the right upper lobe, multiple pleural nodules, enlarged mediastinal lymph nodes, and bone metastases, suggesting advanced-stage lung cancer (Fig. 1a-c). Positron emission tomography (PET)-CT showed a region of fluorodeoxyglucose hyperaccumulation that was consistent with the abnormal shadows (Fig. 1d-g).
Lung tissue shows conglomerations of round cells with round nuclei and acidophilic sporangia, surrounded by melanin deposits (hematoxylin & eosin staining, x100 (a)). Immunostaining shows positive staining for Melan-A (x100 (b)).
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F2
The lung tissue histologically consisted of (Fig. 2a, b) conglomerations of round cells with round nuclei and acidophilic sporangia, surrounded by melanin deposits.
After four cycles of immunotherapy, CT showed a reduction in the size of the nodule in the upper lobe of the right lung (a) with multiple pleural dissemination in the left lung (b, c).
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F3
After four cycles of immunotherapy, the patient exhibited a partial response (Fig. 3a-c).