PMC10130361_01
Pathological images of the pulmonary blastoma patient. (A-C) Representative images showing spindle-shaped or oval tumor cells with diffuse infiltrative growth, necrosis of limited cartilage components, and loose interstitium. (A) Microscopic magnification x100. (B, C) Microscopic magnification x400.
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The mesenchymal component, on the other hand, exhibited characteristics of sarcoma with cartilage metaplasia, as illustrated in  Figure 1 .
Immunohistochemical images of the pulmonary blastoma patient. (A) CK positive(Microscopic magnificationx100). (B) CK positive (Microscopic magnificationx200). (C) EMA positive (Microscopic magnificationx200). (D) TTF-1 positive (Microscopic magnificationx200). (E) Desmin positive (Microscopic magnificationx200). (F) Ki-67 positive (Microscopic magnificationx200). (G) S-100 positive (Microscopic magnificationx200). (H) Vimentin positive (Microscopic magnificationx400).
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Des small (+), CD99 individual (+), CD34 vascular (+), MC (-), Napsin A (-), and Ki-67 (30% +) ( Figure 2 ). Due to the limited tissue sample available, certain immunotherapy predictors, including PD-L1, tumor mutation burden (TMB), and microsatellite stability (MSS), were not evaluated.
Radiologic images of the pulmonary blastoma patient. (A) Baseline image. (B) Image obtained following completion of first-line chemotherapy and radiotherapy. (C) Image obtained prior to anti-PD-1 immunotherapy. (D) Image obtained after anti-PD-1 immunotherapy.
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Based on imaging evaluations, the patient's disease state remained stable, classified as stable disease (SD) (see  Figure 3 ).