PMC6817713_01
Chest CT scan (11.30.2017) shows a 4.1 x 3.9-cm lung mass in the left pulmonary hilum area. (A) Lung window. (B) Mediastinal window.
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Emergency chest CT examination showed that the left pulmonary hilum area was occupied (4.1cmx3.9cm) and malignant tumor was possible (Figure 1).
Chest CT scan (05.16.2018) shows a 7.5 x 6.7-cm lung mass in the left pulmonary hilum area. (A) Lung window. (B) Mediastinal window.
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ANCA were negative. After admission, the chest CT was examined and a mass (7.5cmx6.7cm) was found in the left pulmonary hilum area, which was considered as malignant tumor and there were ground hyaline nodules in the lower lobe of the right lung (Figure 2).
(A) The bronchoscopy examination showed tumor of the left lower superior segment obstructed bronchus. (B) Tumor of the left upper lobe obstructed bronchus.
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The bronchoscopy examination showed new organisms of the left upper lobe and left lower superior segment obstructed bronchus (Figure 3a-3b).
Immunohistochemical examination: (A, B) The left lower superior segment was squamous cell carcinoma and it was positive for (C)P40, P63, CK(Pan), negative for TTF-1, CK7, NapsinA. (D) The left upper lobe was small cell lung carcinomas and the tumor cells were positive for (E) Ki67(+80%), CD117, CK(Pan), P53, CgA, (F) CD56, (G) TTF-1, (H) SYN, and negative for LCA.
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While the left upper lobe was SCLC and the tumor cells were positive for Ki67(+80%), CD117, CK(Pan), P53, CgA, CD56, TTF-1, SYN, and negative for LCA (Figure 4).
PMC6817713_02
Chest CT scan (08.22.2018) shows a 7.1 x 4.0-cm lung mass in the left pulmonary hilum area. (A) Lung window. (B) Mediastinal window.
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The reexamination of chest CT scan after two cycles of therapy showed that the mass in the left pulmonary hilum area (7.1cmx4.0cm) was smaller than the first admission (Figure 5) with stable disease (SD).
Chest CT scan (11.06.2018) shows a 7.1 x 6.2-cm lung mass in the left pulmonary hilum area. (A) Lung window. (B) Mediastinal window.
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After another two cycles of therapy, the chest CT scan showed that the left hilar mass (7.1cmx6.2cm) was larger than the last examination with progressive disease (PD) (Figure 6).