PMC9773986_01
Timeline of clinical course.
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Postoperative pathology confirmed adenocarcinoma (1.8x1.5x1.2cm), with tumor thrombus in the interstitial vessels, and visceral pleura invasion ( Figure 1 ). In July 2021, disease progression was revealed by the chest CT scan, showing increase in the size of mediastinal and supraclavicular lymph nodes ( Figure 1 ). The CT-guided percutaneous lung biopsy revealed epithelial granulomas with multinucleated giant cells and cryptococcus spores stained positive with PAS ( Figure 1 ). On the chest CT scan, a cavitating mass with an air-fluid level was found in the left lower lobe, but the lesions of cryptococcal infection were partially absorbed ( Figure 1 ). On April 7, 2022, the patient complained of dyspnea, palpitations and fatigue, and the chest CT scan revealed pericardial effusion and bilateral pleural effusions ( Figure 1 ).