PMC6610690_01
Series of chest computerized tomography (CT) images from March 2016 to May 2016. The images show that lesions in the puncture site of the right lung were significantly reduced, and the lymph nodes in the right hilum and mediastinum were still swollen. Two CT scan-guided percutaneous biopsies were performed in the area indicated by the white arrow in A.
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The CT scan-guided percutaneous biopsy in the right pulmonary apex and right upper lobe (area indicated by the white arrow in Fig. 1 A) was performed twice in 2016-03-25 and 2016-03-30, and pathology results showed chronic pneumonia and OP with local necrosis. A chest CT scan in 2016-04-11 showed that lesions in the upper lobe of the right lung had shrunk, but other lesions enlarged, and the lymph nodes in the right hilum and mediastinum were still swollen (Fig. 1 B). However, the follow-up chest CT scan in 2016-05-18 showed that lesions in the puncture site of the right lung were significantly reduced, but other lesions expanded, and the lymph nodes remained swollen (Fig. 1 C, D).
Pathology of lung and lymph node from March 2016 to May 2016.. (A) Pathology of CT scan-guided percutaneous lung biopsy in the apical segment of the right lung's upper lobe. HE staining of the lung biopsy showed organizing pneumonia lesions (white arrow).. (B) TBLB pathobiology from the posterior segment of the right upper lobe showed alveolar septal fibrous tissue hyperplasia (yellow arrow), with organizing pneumonia lesions (white arrow) in some areas.. (C) TBNA from 4R mediastinal lymph nodes showed atypical cells. (For interpretation of the references to colour in this figure legend, the reader is referred to the Web version of this article.)
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The pathological sections from the local hospital were rechecked by our pathology department, considering OP with eosinophil infiltration and scattered hemosiderin deposition (Fig. 2 A). TBLB was performed under the guidance of ultrasound in the shadow of the posterior segment of the right upper lobe, and pathobiology showed alveolar septal fibrous tissue hyperplasia, with organizing pneumonia lesions in some areas (Fig. 2 B). TBNA from 4R mediastinal lymph nodes showed atypical cells (Fig. 2 C).