PMC8632010_01
Contrast-enhanced chest computed tomography (CT) scan showing (A) a soft mass (45 x 43 mm) in the posterior segment of the right upper lobe and the enlarged right hilar and mediastinal lymph nodes (arrow) and (B) multiple pulmonary nodules with a maximum diameter of 20 x 14 mm (arrow).
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An enhanced computed tomography (CT) scan of the chest showed a mass (45 x 43 mm) in the posterior segment of the right upper lobe, multiple pulmonary nodules with a maximum diameter of 20 x 14 mm, and enlarged right hilar and mediastinal lymph nodes ( Figure 1 ).
(A) Hematoxylin and eosin staining (H&E) x 40 showing combined small-cell lung cancer (small-cell carcinoma and squamous cell carcinoma). (B) Same field as in Panel (A) with positive cytoplasmic staining for synaptophysin as typical neuroendocrine. (C) Same field as in Panel (A) with positive cytoplasmic staining for chromogranin A as typical neuroendocrine. (D) P40 brown nuclear staining. (E) H&E x 10 showing infiltrative squamous cell carcinoma component. (F) Same field as in Panel (E) with unclear staining for P40.
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An ultrasound-guided percutaneous puncture biopsy was performed against the right upper lobe mass, and the pathology was proved to be C-SCLC comprising SCLC and squamous cell carcinoma ( Figure 2 ).
(A) Chest computed tomography (CT) scan showing the initial tumor. (B) Two cycles after anlotinib initiation; the efficacy was evaluated as SD. (C) CT scan showing remarkable shrinkage of the tumor; the efficacy was evaluated as PR. (D) CT scan showing sustained shrinkage of the tumor and a small amount of additional effusion; the efficacy was evaluated as PR.
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Figure 3 ). From the beginning of treatment to the last follow-up, the patient had been receiving anlotinib treatment for more than 7 months.