PMC9911826_01
Variations of the primary lesions in lung by chest CT scans during the treatment (red arrowheads). (A, B), June 6th, 2022. (C, D), August 27th, 2022.
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Chest CT on June 6th, 2022 showed a large space-occupying lesion (size as 8.8 x 5.1 cm) in the superior lobe of left lung, which was closed to mediastinum, presented as obstructive pneumonia, accompanied with vein and artery in left superior pulmonary involvement ( Figure 1A ). In addition, chest CT scan also revealed multiple enlargements of mediastinal lymph nodes ( Figure 1B ). AUC 5 on day 1, every 21 days) as initial treatment. After three cycles' treatment, restaging chest CT scans showed significant improvement on the primary lesion, as well as metastatic mediastinal lymph nodes ( Figures 1C, D ).
Histological findings with hematoxylin and eosin-stained biopsy specimen from biopsy on June 6th, 2022 (A, x 200), and surgery on September 6th, 2022 (B, x 400).
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Figure 2A ) according to the imaging findings and immunohistochemistry outcomes presented as: TTF-1 (negative), NapsinA (negative), P40 (negative), P63 (negative), CK5/6 (negative), CK(AE1/AE3) (positive), Syn (negative), CgA (negative), CD56 (negative), INI-1 (negative), Ki-67 50% (positive), programmed cell death ligand-1 (PD-L1) negative. Furthermore, via next-generation sequencing (NGS) was performed using tissue sample (tumor cellularity 25%, including 550 cancer-related genes, Pathologic findings from the surgery confirmed the diagnosis of dedifferentiated lung carcinoma ( Figure 2B ).