PMC9894331_01
Imaging and pathological data of lung lesions at initial diagnosis. (A) Left side: the contrast-enhanced mediastinal chest CT window showed a mass of high-density shadow in the left lower lobe of the lung. Middle: the pulmonary window in the arterial phase of chest contrast-enhanced CT revealed a shallow 25-mm lobular mass in the left lower lobe. The boundary was clear and regular. Right side: the mediastinal arterial window of chest contrast-enhanced CT revealed a mass of high-density shadow in the left lower lobe that exhibited mild-to-moderate progressive enhancement and noticeable marginal enhancement. (B) Left side: PET-CT showed a soft tissue mass in the left lower lobe of the lung. It increased FDG uptake, and the maximum SUV is 15.57. Right side: an enlarged lymph node with increased FDG metabolism is observed below the left pulmonary hilum. The diameter is about 1 cm, and the maximum SUV is 4.38. (C) Pathological analysis of tumor biopsies in the left lower lobe of the lung. The morphology of tumor cells was observed after staining with H&E.
fgene-14-1085549-g001.jpg
PMC9894331_01_fgene-14-1085549-g001.jpg
F1
In February 2022, a 74-year-old woman was presented with a mass shadow in the lower lobe of her left lung during a periodic review after a breast cancer operation. (Figure 1A). Tumor cells appeared as cords and trabeculae with fibrous tissue hyperplasia (Supplementary Figure S1). PET-CT showed that the nodules in the left lower lobe of the lung were well demarcated and had morphological rules that were not typical of lung cancer (Figure 1B). On 4 March 2022, the left lower lobe tumor biopsy of the patient's lung showed poorly differentiated carcinoma (Figure 1C). Results showed that a malignant tumor is considered in the lower lobe of the left lung, and lymph node metastasis should be considered under the left pulmonary hilum (Figure 1B).
Imaging and pathological data of ascending colon lesions. (A) PET-CT of ascending colon lesions. There was more content in the ascending colon, and the local nodular FDG metabolism was increased. SUVmax = 12.61 for early imaging, and SUVmax = 14.11 for delayed imaging. (B) Pathological analysis of tumor biopsy in ascending colon lesions. The morphology of tumor cells was observed after staining with H&E.
fgene-14-1085549-g002.jpg
PMC9894331_01_fgene-14-1085549-g002.jpg
F2
It was worth noting that PET-CT found a malignant space-occupying lesion in the initial segment of the ascending colon (Figure 2A). Pathological analysis after laparoscopically assisted right hemicolectomy confirmed mucinous adenocarcinoma of the colon again (Figure 2B).
Tumor tissue traceability expression assay results. The maximum similarity score for tumor tissue traceability was 100.
fgene-14-1085549-g003.jpg
PMC9894331_01_fgene-14-1085549-g003.jpg
F3
The results showed that the malignant tumor in the lower lobe of the left lung originated from breast cancer (Figure 3). The maximum tumor tissue similarity score was 100, and the results suggested that lung and colorectal cancer similarity scores were deficient, at only 0.7 and 1.9, respectively.
CT imaging of the patient before and after the initial chemotherapy and radiotherapy. The left side is the lung CT scan window, and the right side is the mediastinum CT scan window. The CT image of the patient before receiving chemotherapy on 4 April 2022; the CT image of the patient receiving chemotherapy but not radiotherapy on 18 July 2022; and the CT image of the patient receiving chemotherapy and radiotherapy on 20 September 2022.
fgene-14-1085549-g004.jpg
PMC9894331_01_fgene-14-1085549-g004.jpg
F4
A partial response (PR) was achieved, with lesion diameters decreasing by 51.72% (Figure 4).