PMC9995582_01
Timeline and treatment process. The blue line in the figure indicates time points in the progression of the patient's condition. The boxes on the left indicate treatment events. The connect boxes indicates HRCT examinations of the chest.
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F1
The course of its treatment is shown in Figure 1.
Representative HRCT images of the lungs before neoadjuvant chemotherapy. (A)HRCT on 13 December 2021: multiple grid-like density increases in and around the subpleural and lung bases, blurred borders, peripheral distribution, double lower lung, subpleural and lung base and peripheral areas, trachea, and lobes, bronchial opening segments displayed, no stenosis, no significant expansion in the distal part, no fibrosis. (B)HRCT on 7 January 2022, multiple grid-like density increases under the pleura of both the lungs, slightly more than before, the boundaries blurred, and multiple hair-like and small patchy blurred shadows are visible in both lungs. On the 52nd day, due to inflammation of the lungs, (C)HRCT on 18 January 2022, multiple grid-like density increases under the pleura of both the lungs increased when compared with the second time, peripheral distribution, considering the possibility of interstitial inflammation of both the lungs, aggravation of lung symptoms during chemotherapy. Diagnosis of IPF by respiratory study therapy.
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F2
The boundary was fuzzy, presenting interstitial inflammation of both the lungs (Figure 2A), but the patient had no pulmonary symptoms. Numerous cord-like clouds were seen, which were more evident than before, mainly in the lower lungs, and interstitial pneumonia was considered (Figure 2B). A repeat HRCT scan showed the possibility of bilateral lung interstitial inflammation (Figure 2C), and a set of antinuclear antibodies and immune tests showed no abnormality.
Representative HRCT images after 1 week of anti-fibrosis treatment. HRCT on 7 February 2022, bilateral pulmonary interstitial pneumonia and pulmonary fibrosis, both the lungs are primarily scattered in spot-like, cord-like dense opacities, with multiple grid-like density increases seen below the pleura of both lungs and blurred boundaries.
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F3
One week after chemotherapy, HRCT re-examination revealed bilateral pulmonary interstitial pneumonia, bilateral pleural thickening, and fibrosis (Figure 3), and IPF was diagnosed.
Representative HRCT images of ovarian cancer after ablation surgery with nab-PTX 400 mg chemotherapy. Postoperative pulmonary symptoms not considered to be an adverse reaction caused by nab-PTX, which was administered with 400 mg of chemotherapy on the first postoperative day following OC reduction. HRCT on 16 March 2022, 36 h after chemotherapy: chronic bronchitis with emphysema, interstitial lung lesions, and bronchiectasis in both lower lobes. Both lobes have chronic bronchitis, emphysema, interstitial lung lesions, and bronchiectasis.
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F4
HRCT examination showed chronic bronchitis with emphysema, interstitial disease of both the lungs, and bronchiectasis of both the lower lobes of the lungs (Figure 4).