PMC3883584_01
Histology of the primary tumor. The tumor cells have clear-cut cytological atypia of polygonal nuclei with eosinophilic cytoplasm, and are arranged in broad zones separated by fibrohyaline stroma. (A) (HE staining). Immunohistochemical examination reveals that tumor cells are strongly positive for TS in the cytoplasm (B), weakly positive for DPD (C), and negative for OPRT (D).. Abbreviations: HE, hematoxylin and eosin; TS, thymidylate synthase; DPD, dihydropyrimidine dehydrogenase; OPRT, orotate phosphoribosyltransferase.
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Immunohistochemical staining for the enzymes related to 5-FU metabolism was also performed: thymidylate synthase (TS) was strongly positive, dihydropyrimidine dehydrogenase (DPD) was weakly positive, and orotate phosphoribosyltransferase (OPRT) was not stained (Figure 1).
Chest computed tomography before the first-line treatment (A and B), after the first treatment followed by radiotherapy (C and D), and after the S-1 chemotherapy (E and F). The sizes of the anterior mediastinal tumor and the multiple pleural dissemination are remarkably reduced.
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The S-1 therapy was effective, since the main tumor and the pleural dissemination showed remarkable reduction in their sizes, and the serum CYFRA level became 1.7 ng/mL after two cycles of chemotherapy in September 2009 (Figures 2 and 3).
The serum CYFRA level during treatment is shown. It declines drastically after S-1 treatment.. Abbreviation: CYFRA, cytokeratin 19 fragment; ADOC, cisplatin, doxorubicin, vincristine, and cyclophosphamide.
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The S-1 therapy was effective, since the main tumor and the pleural dissemination showed remarkable reduction in their sizes, and the serum CYFRA level became 1.7 ng/mL after two cycles of chemotherapy in September 2009 (Figures 2 and 3).