PMC8389505_01
Chest CT scan of the right upper lobe of the bronchus. The right upper lobe bronchus was occluded and the surrounding soft tissue mass was about 7.9 cm x 6.7 cm x 6.0 cm.
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On April 13, 2020, a chest CT examination showed bronchial obstruction in the right upper lobe surrounded with soft tissue mass, with a size of about 7.9 cm x 6.7 cm x 6.0 cm (Figure 1).
Images of fiberoptic bronchoscopy and histopathology. (a and b) Obstruction of the right upper bronchial lobe. (c and d) Histopathology of fibrobronchoscopy showed squamous cell carcinoma. Immunohistochemistry: TTF-1 (-), p63 (+), CD5/6 (+), P40 (+), and CK7 (-).
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Fiberoptic bronchoscopy also revealed a bronchial obstruction in the right upper lobe of the lung (Figure 2a and b). Histopathological examination of the tumor in the upper lobe of the right lung showed a squamous cell carcinoma (Figure 2c and d).
Images of chest CT enhanced scan. (a,b) Bronchial stenosis and occlusion in the right upper lobe of the lung. (c,d) Histopathology of enhanced CT showed soft tissue mass shadow, the size was about 4.2 cm x 2.6 cm x 2.2 cm, the lesion was smaller and the necrotic area was larger compared to previous scan.
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The CT scan showed the presence of bronchial stenosis and occlusion in the right upper lobe along with soft tissue mass shadow with a size of about 5.0 cm x 3.2 cm x 2.8 cm (Figure 3).
Images of fiberoptic bronchoscopy and histopathology post-treatment. (a and b) Right upper lobe bronchus unobstructed, tracheobronchial bronchitis. (c and d) Histopathology of the tumor after surgery showed necrosis, histiocyte reaction, cholesterol crystal, inflammatory cell reaction under a microscope, and no residual tumor cells.
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The clinical efficacy evaluation performed on July 9, 2020, with fiberoptic bronchoscopy showed that after treatment with neoadjuvant immunotherapy and chemotherapy, the right upper lobe of the right lung, the bronchus of the right upper lobe, was unobstructed, and tracheobronchitis occurred (Figure 4a and b). No residual tumor cells were found, in line with the post-treatment reaction (Figure 4c and d).