PMC7245476_01
Chest-CT scans showed tumor mass at different stages of the disease including before anti-PD-1 therapy and anti-PD-1 therapy. (A) Lung window and (B) mediastinal window views of CT scan showed a PD after multiline chemotherapy with an increase in the size of the left lung (7x5.1 cm, green arrow) and right lung (9.2x4.6 cm, red arrow). During anti-PD-1 therapy, (C, D) showed the patient received an SD with the size of the left lung (7.7x5.1 cm, green arrow) and right lung (9.6x4.6 cm, red arrow) in February 2019. (E, F) showed the patient achieved a PR with a decrease in the size of the left lung (5.6x3.8 cm, green arrow) and right lung (8.4x3.2 cm, red arrow) in April 2019 and (G, H) showed the size of the left lung (5.1x3.3 cm, green arrow) and right lung (8.7x3.4 cm, red arrow) in June 2019.
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A 65-year-old female with no smoking or alcohol consumption history was initially diagnosed with stage IV bilateral lung adenocarcinoma in February 2015 (Figure 1). The patient was subjected to the treatment of docetaxel (80 mg) plus sintilimab (200 mg) in January 2019, then, the chest-CT showed an SD (Figure 1B). Lesions in right and left lung showed significant partial response (PR) (Figure 1C).
Pathologic analysis of primary tumor biopsy, indicating hepatoid adenocarcinoma of the lung. (A) The hematoxylin and eosin stain of the lung masses showed morphologic features similar to hepatocytes with large, nucleated and centrally located nuclei (200x). (B-D) Immunohistochemical stains showed tumor cells to be positive for SALL4, AFP and GPC3 (200x).
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In contrast, TTF, napsin A and Hept1 were negative (Figure 2).