PMC8349001_01
(A) Chest computed tomography (CT) on lung cancer recurrence. Chest CT revealing a nodular shadow (arrowhead) and pleural effusion in the left lung (arrow). (B) Osimertinib-induced interstitial lung disease (ILD), on the 46th day after the initiation of osimertinib. Chest CT revealing diffuse ground-glass opacities in both lungs. Left pleural effusion decreased. (C) Chest CT 2 weeks after osimertinib-induced ILD developed. Chest CT revealing improvement in the diffuse ground-glass opacities in both lungs. (D) Osimertinib-induced ILD on the 15th day after re-administration of osimertinib. Chest CT revealing diffuse ground-glass opacities in both lungs. (E) Chest CT 2 months after the initiation of afatinib. Chest CT revealing a decrease in the size of the left nodular shadow (arrowhead) without ILD relapse.
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Chest computed tomography (CT) revealed a nodular shadow and pleural effusion in the left lung (Fig. 1A). Although CEA levels decreased to 41.3 ng/mL, the level of Krebs von den Lungen-6 (KL-6) was high at 717 U/mL, and the chest CT revealed diffuse ground-glass opacities (GGOs) in both lungs (Fig. 1B). Five days later, GGOs on CT imaging and edema of the lower extremities improved; therefore, we discontinued corticosteroid therapy (Fig. 1C). However, 15 days later, she developed dyspnea again without edema of the lower extremities, and chest CT also revealed diffuse bilateral GGOs (Fig. 1D). On the 77th day after initiating afatinib treatment, CEA levels dramatically decreased to 17.9 ng/mL, and chest CT revealed a decrease in the size of the left nodular shadow (Fig. 1E), and the only adverse event was a mild rash.