PMC5997179_01
Changes in CT in the ESCC.. Notes: (A and D) the well-circumscribed mass in right pleura (yellow arrows) and thickened esophageal wall (red arrow) prior to treatment, respectively. (B and E) Reduction in the lesions for the esophageal wall (red arrow) and stabilization of the lesion for the right pleura (yellow arrows) after two cycles of TP chemotherapy. (C and F) Esophageal wall (red arrow) thickness decrease and pleural lesion (yellow arrows) size stability after four cycles of TP chemotherapy.. Abbreviations: CT, computed tomography; ESCC, esophageal squamous cell carcinoma; TP, cisplatin-docetaxel.
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Contrast-enhanced computed tomography (CT) scans of the chest revealed a significantly thickened esophageal wall, which was considered to be an esophageal neoplasm (red arrows in Figure 1D); the pleural soft tissue at the eighth right posterior rib was perceived to be metastasis (yellow arrows in Figure 1A and D). According to response evaluation criteria in solid tumors criteria, the patient achieved partial remission and stable disease (SD) of the original esophageal mass after two and four cycles of chemotherapy, respectively (Figure 1B, C, E, and F).
(A) Pathocytology of esophageal tissue revealed squamous cell carcinoma. (B and C) Pathocytology of pleural soft tissue showed a few of lymphocytes, erythropoiesis, megakaryocytes, and degraded cells.. Notes: (A and B) H&E staining x100. Scale bar: 100 microm and (C) H&E staining x200. Scale bar: 100 microm.. Abbreviation: H&E, hematoxylin and eosin.
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Pathological analysis of a gastroscopic biopsy revealed squamous cell carcinoma (Figure 2A). Pathological analysis revealed a few lymphocytes, erythropoiesis, megakaryocytes, and degraded cells (Figure 2B and C).
Immunohistochemical of pleural mass revealed EMH.. Notes: Immunohistochemical staining x200. Scale bar: 200 microm. (A) CD15+; (B) CD20+; (C) CD34+; (D) CD30+; (E) CD38+; (F) CD68+; (G) CD7+; (H) Ki67+ (80-90%); (I) lysozyme+; (J) CK5-; and (K) CK7-.. Abbreviation: EMH, extramedullary hematopoiesis.
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Immunohistochemical findings revealed positive staining for CD68, lysozyme, CD15, CD7, CD20, CD30, CD38, and CD34, while CK7 and CK5 staining was absent, and the Ki-67 index was 80-90%, supporting a diagnosis of EMH (Figure 3).
Variations in CT in the ESCC 1 month after finishing all the treatments.. Note: (A and B) The stabilization of the right pleural mass (yellow arrows) and decrease of the thickened esophageal wall (red arrow) after the treatment, respectively.. Abbreviations: CT, computed tomography; ESCC, esophageal squamous cell carcinoma.
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During the whole course of chemotherapy and radiotherapy, the pleural EMH did not alter in size and the patient had no chest pain or shortness of breath (Figures 4A and B and 5).
T2W/TSE sagittal MRI image 1 month after the completion of all the treatments, showing no considerable change in the size of the right pleural lesion (yellow arrow).. Abbreviations: MRI, magnetic resonance imaging; T2W/TSE, T2 weighted/turbo spin echo.
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During the whole course of chemotherapy and radiotherapy, the pleural EMH did not alter in size and the patient had no chest pain or shortness of breath (Figures 4A and B and 5).