PMC9876740_01
Treatment course.
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A 56-year-old male was admitted to the hospital because of dyspnea and chest tightness for 20 days (Figure 1).
(A) (A1) plain phase (A2) arteria phase
(A3) venous phase. Red arrows: tumor nodules. CT of the abdomen scan revealed that, nodules were observed with uneven density. On the enhanced scan, the nodules showed obvious enhancement, and no the venous and delayed scan showed slightly lower density. (B) (B1) plain phase (B2) arteria phase (B3) venous phase. Compared with the last CT, the nodules were bigger than before.
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On May 26, 2020, abdominal contrast-enhanced computed tomography (CT) reexamination revealed multiple nodular enhancements, which could suggest tumor recurrence (Figure 2A). CT scan revealed that the more enhanced nodules were bigger than before (Figure 2B). Consequently, he received treatment with the TACE again and started to use Camrelizumab injections (200mg/injection every 21 days as a cycle) on Dec 29, 2020.
(A) Immunohistochemical staining for CD3. (B) Immunohistochemical staining for CD4. (C) Immunohistochemical staining for CD8. (D) Immunohistochemical staining for CD68. (E) HE staining. (F) HE staining. Endomysium expressed an abundance of CD68-positive cells and was also positive for CD3, CD4, and CD8 expression. The main pathological characteristics of skeletal muscle included necrosis of myofibers, regeneration, and inflammatory cell infiltration. Diagnosis: PD-1 mediated immune myositis with the medical history.
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AST 146.3 U/L (normal value 15-40 U/L). A muscle biopsy was taken from the left anterior tibialis muscle, and surgical findings showed inflammatory muscle (Figure 3).
Changes of some indicators (2021/03/03-2021/03/10).
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His blood biochemical parameters, such as CK, CK-MB, and LDH have also gradually decreased (Figure 4).