PMC4843098_01
Radiological evaluation by CT. A: Before treatment. A 38 mm tumor in the left superior lingular segment and a 25 mm tumor in the left inferior lingular segment were observed. B: After treatment. A radiological CT evaluation revealed remarkable shrinkage of both tumors. C: The histological findings of the resected primary tumor (hematoxylin-eosin stain) showed poorly differentiated adenocarcinoma cells admixed with a small number of nonviable swollen carcinoma cells, suggestive of a very slight therapeutic effect. No brittleness of the vessels around the main tumor or those around the pulmonary artery was seen.
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fig1
Chest computed tomography (CT) showed a 38 mm tumor, which was located in the left superior lingular segment; a 25 mm tumor, which was located in the left inferior lingular segment; and bilateral swollen lymph nodes in the hilum and mediastinal, suggesting lymph node metastasis (Fig. 1A). After 3 weeks of chemotherapy, a radiological CT evaluation revealed remarkable shrinkage of both tumors and no change in the hilum and mediastinal lymph nodes swelling (Fig. 1B). No brittleness of the vessels around the main tumor or those around pulmonary artery was seen (Fig. 1C).
PMC4843098_02
A: After three course of chemotherapy. Chest CT showed a tumor adjacent to the pulmonary artery and veins in the left lower lobe were observed. B: After four additionally courses of chemotherapy. A radiological CT evaluation revealed prominent shrinkage of the tumor. C: The histological findings of the resected primary tumor showed a moderately differentiated tubular adenocarcinoma, without brittleness of the vessels around the main tumor and pulmonary artery.
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After three courses of chemotherapy, a CT evaluation revealed a 10 mm tumor, which was located in the right S2, a 9 mm tumor in the right S8, and a 32 mm tumor in the left S9-10 (Fig. 2A). After a total of seven courses of intensive chemotherapy, the right lesions disappeared and prominent shrinkage of the left tumor was observed (Fig. 2B). No brittleness of the vessels around the main tumor remained and no fragile vessels around the pulmonary artery was observed, similar to case 1 (Fig. 2C).