PMC8348523_01
Dose distribution map of the radiation against the relapsed thymoma.. She received Volumetric Modulated Arc Therapy for a recurrent thymoma lesion with left pleural dissemination, avoiding her bone marrow; isodose line of radiation treatment. The green line represents 50 Gy, the light blue line represents 30 Gy, and the white line represents 10 Gy. (For interpretation of the references to colour in this figure legend, the reader is referred to the Web version of this article.)
gr1.jpg
PMC8348523_01_gr1.jpg
fig1
Radiotherapy was initiated for a recurrent thymoma lesion 2 weeks before her admission delivered to a total dose of 54 Gy in 27 fractions (Fig. 1).
Chest computed tomographic images upon hospitalization.. Chest computed tomography revealed centrilobular granular and infiltrative shadows and thickening of the bronchial wall in bilateral lung fields.
gr2a.jpg
PMC8348523_01_gr2a.jpg
fig2a
Chest computed tomography (CT) revealed infiltrations and a granular shadow in the bilateral lobes (Fig. 2A). However, after switching from piperacillin-tazobactam to an oral antimicrobial (levofloxacin), pneumonia reexercabted (Fig. 2B). After discontinuation of antimicrobial therapy, fever recurred and the oxygen demand increased, and CT revealed new consolidation in her lower lobe of the left lung (Fig. 2C).
Chest computed tomographic images upon pneumonia exacerbation.. The centrilobular granular and infiltrative shadows were re-exacerbated and extensive infiltrative shadows were observed around the bronchi in the right upper lobe.
gr2b.jpg
PMC8348523_01_gr2b.jpg
fig2b
Simultaneously, candidiasis was noted in the oral cavity (Fig. 3), and the decline in CD4-positive cells suggested T-cell immunodeficiency.
Chest computed tomographic images on the third onset of pneumonia.. Consolidation of the right upper lobe improved, and a novel extensive infiltrative shadow was observed from the upper region to the basilar region of the left lower lobe.
gr2c.jpg
PMC8348523_01_gr2c.jpg
fig2c
Her clinical course after admission is described in Fig. 4.