PMC9253631_01
Findings of chest computed tomography (CT) before and after neoadjuvant radiation chemotherapy.. (a) Chest CT revealed a mass in the left lower lobe, infiltrating the left upper lobe. Invasion of the left pulmonary artery and the descending aorta was suspected. (b) Chest CT after neoadjuvant therapy showed a reduction in the size of the tumor in the left lung and lymph nodes of the left hilum and mediastinum.
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Chest contrast-enhanced computed tomography (CT) revealed a 7.6 x 6.2 x 6.0 cm mass with uniform contrast effect in the left lower lobe of the lungs, infiltrating S2 from S6 as the main lesion (Fig. 1a). On chest CT 11 days after the last neoadjuvant therapy, the tumor diameter in the left lower lobe shrunk to 3.7 cm, and the size of the lymph nodes in the left hilum and mediastinum also diminished (Fig. 1b).
Findings of 18-fluorodeoxyglucose-positron emission tomography (FDG-PET) before and after neoadjuvant radiation chemotherapy (color required).. (a, b) FDG-PET showed elevated uptake in the mass in the left lower lobe and lymph nodes of the left hilum. There was also diffuse uptake in the bone marrow. (c, d) FDG-PET after neoadjuvant therapy revealed decreased uptake in the tumor in the left lower lobe and disappearance of the uptake in the bone marrow. (For interpretation of the references to color in this figure legend, the reader is referred to the Web version of this article.)
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FDG-PET showed elevated uptake in the mass in left lower lobe, with maximum standardized uptake value (SUVmax) of 17.8, and in the lymph node of the left hilum (Fig. 2a). Diffuse uptake in the bone marrow and localized uptake of the benign tumor in the right thyroid were also identified (Fig. 2b). FDG-PET nearly 1 month after the last neoadjuvant therapy revealed decreased uptake in the primary tumor, with SUVmax of 6.62, and the uptake in the bone marrow disappeared (Fig. 2c and d).
Histological findings of the resected specimen (color required).. (a, b) Hematoxylin and eosin staining showed that most of left lung squamous cell carcinoma has degenerated and there were only a few residual tumor cells. (c, d) The immunohistochemical analysis for Granulocyte colony-stimulating factor antibody of the resected specimen revealed positive. (For interpretation of the references to color in this figure legend, the reader is referred to the Web version of this article.)
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On histological examination, the tumor was 5.2 x 4.0 x 2.1 cm in size, and there were only a few residual atypical cells with nuclear swelling (Fig. 3a and b). G-CSF antibody of the resected specimen was positive (Fig. 3c and d). Genetic tests revealed that the tumor cells were negative for an activating mutation of the epidermal growth factor receptor (EGFR) gene and positive for ROS1 rearrangements.