case_images: PMC10821729_01
case_images: Disease status after three months of targeted therapy. (A) Pre-treatment CT images showed a substantial presence of pericardial and pleural effusion, accompanied by a right lung mass (Use 3 red arrows for indication). Furthermore, multiple hilar and mediastinal lymphadenopathies were observed. (B) After three months of targeted therapy, the patient demonstrated complete resolution of pericardial and pleural effusion, and a significant reduction in the size of the right lung mass, hilar and mediastinal lymph nodes. The tumor response evaluation indicated a partial response (PR).
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case_images: Imaging tests revealed a solid mass in the lower lobe of his right lung, multiple lymph node metastases in the mediastinum, significant pericardial and pleural effusion, and metastases to the left adrenal gland and multiple bones (Figures 1A and S1).  Next-generation sequencing (NGS) analysis of pericardial effusion samples revealed BRAF mutation in exon 11, c.1397G>T, p.G466V, with variant allele frequency (VAF) of 62.85% (Figure S3 and Table S1). Tumor response evaluation demonstrated a partial response (PR)(Figures 1B and S1).
case_images: Histopathologic examination of a paraffin-embedded tissue section from pericardial effusion. (A) Hematoxylin-eosin (HE) staining. Scale bars: 50mum. Black arrow: cancer cells; Green arrow: immune cells. (B) TTF-1 (+). (C) P40 (-). (D) NapsinA (+). (E) Muc4 (+). (F) MOC31 (+). (G) CK7 (+). (H) PD-L1 tumor proportion score (TPS)=0. Technical details are provided in Table S2.
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case_images: TTF-1 (+), Muc4 (+), PD-L1 tumor proportion score (TPS)=0 (Figure 2). The patient's pathological diagnosis was metastatic lung adenocarcinoma. Due to unbearable low back pain, we performed vertebral radiotherapy for him (Figure S2), and symptoms improved after radiotherapy.