PMC6807370_01
(a) Chest X-ray at the time of the patient's referral showing a mass in the left hilum. (b) The first bronchoscopy showing a mass with distended vessels in the left main bronchus that was identified as lung squamous cell carcinoma. (c, d) Positron emission tomography showing high uptake of fluorodeoxyglucose with mediastinal lymphadenopathy in the mass in the left main bronchus [maximum standardized uptake value (SUVmax) = 11.5]; however, minor uptake was observed in a small cavity in the left upper lobe (SUVmax = 1.9).
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Left vocal cord paralysis was discovered, and chest X-ray revealed a mass in the left hilum (Fig. 1a). Bronchoscopy revealed a mass with distended vessels in the left main bronchus (Fig. 1b), and the mass was revealed to be lung squamous cell carcinoma. Positron emission tomography revealed high uptake of fluorodeoxyglucose in the mass in the left main bronchus [maximum standardized uptake value (SUVmax) = 11.5]; however, minor uptake was observed in the lung cavity (SUVmax = 1.9) (Fig. 1c and d).
Clinical and radiological course.. The small cavity in the left upper field rapidly increased and gradually improved after long-term administration of antibiotics. Continuous arrows represent the points considered for CXR and dashed arrows represent those for CT shown below.. ABPC, ampicillin; ABPC/SBT, ampicillin/sulbactam; AMPC, amoxicillin; wCBDCA, weekly carboplatin; CT, computed tomography; CXR, chest X-ray; FBS, fiberoptic bronchoscopy; GRNX, garenoxacin; MEPM, meropenem; wPTX, weekly paclitaxel.
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Although the administration of garenoxacin was continued, the lung cavity with infiltration drastically increased (Fig. 2). Continuous administration of durvalumab and amoxicillin for 4 months suppressed the lung squamous cell carcinoma and gradually improved the lung cavity with infiltration (Fig. 2).