PMC8334716_01
Chest radiograph at the first visit. Chest radiograph showing the right mediastinal lymph node protruding into the right lung (arrow).
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On chest radiography, the right mediastinal lymph node appeared to protrude into the right lung (Fig. 1).
Chest contrast computed tomography (CT) at the first visit. Dynamic CT reveals a significantly enlarged lymph node in the right supraclavicular fossa.
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Dynamic CT revealed a significantly enlarged lymph node in the right supraclavicular fossa (Fig. 2), a small nodule (maximum diameter, 13 mm) in the upper lobe of the right lung, and an enlarged lymph node in the right supraclavicular fossa and mediastinum.
Fluorodeoxyglucose (FDG)-positron emission tomography (PET)/CT performed over time. FDG-PET/CT shows high FDG accumulation in the longitudinal and right supraclavicular fossa lymph nodes, whereas no FDG uptake is observed in the right upper lobe lesion.
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Fluorodeoxyglucose (FDG)-positron emission tomography/CT performed at the first visit showed high FDG accumulation in the longitudinal and right supraclavicular fossa lymph nodes, whereas little FDG uptake was observed in the right upper lobe lesion (Fig. 3).
Image changes from hospitalization to post-treatment. CT images taken after radiotherapy and chemotherapy show a reduction in the enlarged right supraclavicular lymph nodes. This is well recognized by comparing the anterior and posterior diameters of the tumors. The tumor volume has decreased and the patient is in the supine position, which results in a lateral tumor pushing the orbit laterally, and a sheath-shaped airway is captured on CT. The nodule in the right lung field has not changed after treatment.
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CYFRA (10.19 ng/mL), and NSE (28.13 mg/dL). CT showed further enlargement of the right supraclavicular fossa lymph nodes and airway displacement (Fig. 4). CT images acquired after radio- and chemotherapy showed resolution of the airway displacement due to the enlarged right supraclavicular lymph node (Fig. 4).