PMC3975753_01
Radiological evaluation by CT and PET scans. a-c Before treatment. a A mediastinal lymph node (#5) is observed. b A primary lesion in the left upper lobe can be seen invading the main pulmonary artery. c A PET scan image shows positive accumulation of FDG in the tumor. d-f After gefitinib treatment. d The mediastinal lymph node (#5) shows good regression. e Mild regression of the primary lesion and lymph node metastasis can be seen. f A PET scan image shows positive accumulation of FDG in the tumor.
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F1
Chest computed tomography (CT) revealed a 4.4-cm primary mass in the left upper lobe beside the main pulmonary artery and the growth of mediastinal lymph nodes (cT2aN2M0 stage IIIA) (fig. 1a, b). SUV of 6.6 (fig. 1c). She was diagnosed with lung adenocarcinoma (fig. 2a) by a transbronchial lung biopsy. After 3 months of gefitinib treatment, a radiological CT evaluation revealed that there was a PR to gefitinib (regression rate was 35%) (fig. 1d, e), and a PET scan image showed positive accumulation of FDG (SUV max. 4.0) in the tumor (fig. 1f).
The histological evaluation. a The histological findings of a section obtained by transbronchial lung biopsy (hematoxylin-eosin stain) reveal the proliferation of atypical cuboid-columnar epithelial cells with enlarged hyperchromatic nuclei, arranged predominantly in a papillary growth pattern. b The histological findings of the resected primary tumor (hematoxylin-eosin stain) show a papillary proliferation of viable adenocarcinoma cells, admixed with a small number of nonviable swollen carcinoma cells, thus suggestive of a slight therapeutic effect.
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F2
SUV of 6.6 (fig. 1c). She was diagnosed with lung adenocarcinoma (fig. 2a) by a transbronchial lung biopsy. The pathologically therapeutic effect was considered to be slight or of no response (fig. 2b).