PMC7728662_01
Chest CT scan and fused PET-CT images of the masses on October 9th, 2019. (A-D) The SUVmax of the mass adjacent to the hilum was 25.3 and the size of it was 3.6 cm x 5.2 cm x 4.8 cm; (E-H) The SUVmax of the mass on the basal segment was 12.5 and the size of it was 3.8 cm x 3.6 cm x 3.8 cm. White arrows indicate the locations of the masses.
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F1
The chest CT scan on October 9th, 2019 showed a soft tissue shadow on his left lower lobe and a left hilum space-occupying lesion (Figure 1). The CT scan also showed an inflammatory lesion and obstructive lesion on the left lower lobe (Figure 1). PET-CT scan on October 9th, 2019 indicated a dorsal segment soft tissue mass on the left lower lobe adjacent to the hilum, with a size of 3.6 cm x 5.2 cm x 4.8 cm and an SUVmax of 25.3, and a basal segment soft tissue mass, with a size of 3.8 cm x 3.6 cm x 3.8 cm and an SUVmax of 12.5 (Figure 1); the masses had an increased metabolic rate and were considered to be malignant lesions.
Chest CT scan of the masses on December 6th, 2019 (A-D) and March 15th, 2020 (E-H). (A,B) The size of the mass adjacent to the hilum was 2.2 cm x 3.3 cm x 2.1 cm on December 6th, 2019; (C,D) The size of the mass on the basal segment was 2.9 cm x 3.0 cm x 2.1 cm on December 6th, 2019; (E,F) The size of the mass adjacent to the hilum was 2.1 cm x 2.5 cm x 1.9 cm on March 15th, 2020; (G,H) The size of the mass on the basal segment was 2.0 cm x 1.9 cm x 1.8 cm on March 15th, 2020. White arrows indicate the locations of the masses.
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F2
December 6th, 2019 after two cycles of neoadjuvant therapy and March 15th, 2020 after four cycles of neoadjuvant therapy showed shrinking masses on the left lower lobe (Figure 2). During the treatment, the adverse effects in this patient included vomiting, thrombocytopenia, and occasional chest distress.
Chest CT scan and fused PET-CT images of the masses on April 28th, 2020. (A-D) The SUVmax of the mass adjacent to the hilum was 8.4 and the size of it was 1.7 cm x 2.3 cm x 2.0 cm; (E-H) The SUVmax of the mass on the basal segment was 8.4 and the size of it was 1.7 cm x 1.8 cm x 1.6 cm. White arrows indicate the locations of the masses.
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F3
The PET-CT scan on April 28th, 2020 showed the mass adjacent to the hilum on the left lower lobe to be 1.7 cm x 2.3 cm x 2.0 cm, with the SUVmax being 8.4 (Figure 3). The mass on the basal segment was 1.7 cm x 1.8 cm x 1.6 cm, with an SUVmax of 8.4 (Figure 3).
Timeline of the diagnosis and treatment. M1, the mass adjacent to the left hilum; M2, the mass on the basal segment; chemo, chemotherapy; pembr, pembrolizumab; CA-125, carbohydrate antigen 125; CEA, carcino-embryonic antigen; i.v., intravenously.
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F4
Major events of this case were summarized in Figure 4.