PMC5458763_01
Pleural effusion.
gr1.jpg
PMC5458763_01_gr1.jpg
fig1
A 59 year old woman was diagnosed with NSCLC adenocarcinoma from malignant pleural effusion and which was positive to EGFR exon 19 (Fig. 1).
Lung lymphagiomatosis.
gr2.jpg
PMC5458763_01_gr2.jpg
fig2
After nine months of erlotinib 150mg administration with a new CT thorax lymphagiomatosis is observed within the lung parenchyma (Fig. 2).
Lung lymphagiomatosis with mediastinal lymphnode enlargement.
gr3.jpg
PMC5458763_01_gr3.jpg
fig3
After six months of gefitinib 250mg again there is disease relapse with a new CT thorax and bone scan (Fig. 3).
PMC5458763_02
Left lung mass ct biopsy.
gr4.jpg
PMC5458763_02_gr4.jpg
fig4
A 76 year old woman was diagnosed with NSCLC adenocarcinoma from a CT thorax guided biopsy, which was positive to EGFR exon 19 (Fig. 4).
PMC5458763_03
Pleural effusion during medical thoracoscopy.
gr5.jpg
PMC5458763_03_gr5.jpg
fig5
A 56 year old woman was diagnosed from medical thoracoscopy (positive pleura infiltration) with adenocarcinoma and EGFR exon 19 (Fig. 5).
White arrow indicates pleural effusion, while red arrow lymph node.
gr6.jpg
PMC5458763_03_gr6.jpg
fig6
After 12 months of afatinib 20mg administration new bone metastasis occurred, however; the administration continued for another four months until mediastinal lymphadenopathy was observed along with pleural effusion (Fig. 6).
Endobronchial ultrasound performed by Dr. Paul Zarogoulidis with a Pentax EB-1970UK lymph node 11 RS biopsy.
gr7.jpg
PMC5458763_03_gr7.jpg
fig7
Endobronchial ultrasound re-biopsy was performed and T790M was investigated with negative results (Fig. 7).
PMC5458763_04
Left lung mass ct biopsy.
gr8.jpg
PMC5458763_04_gr8.jpg
fig8
A 76 year old woman is diagnosed by CT thorax guided biopsy (left lung mass) with NSCLC adenocarcinoma EGFR exon 19 positive (Fig. 8).
Disease relapse with lymph node number 7 enlargement (red arrow).
gr9.jpg
PMC5458763_04_gr9.jpg
fig9
After ten months the dosage is increased to 50mg and she continues this dosage for twelve months, until disease progression with mediastinal lymphadenopathy and eye metastasis (Fig. 9).
Endobronchial ultrasound performed by Dr. Paul Zarogoulidis with a Pentax EB-1970UK lymph node 7 biopsy.
gr10.jpg
PMC5458763_04_gr10.jpg
fig10
Endobronchial ultrasound re-biopsy was performed and T790M was positive (Fig. 10).