case_images: PMC10627209_01
case_images: a. The anteroposterior (AP) view of the patient's chest X-ray film on 31 December 2021. Before using pembrolizumab, multiple metastatic tumors were in both lungs, and the border of each tumor was sharp and distinct. Bilateral pleural effusions were noted. Besides, the patient also had subcutaneous emphysema in the lower neck and upper chest wall, a complication of radiotherapy to his mediastinal lymphadenopathy in Dec 2021. b. AP view of the patient's chest X-ray film on 7 January 2022. The border of metastatic tumors became blurred with increasing infiltration. This phenomenon might be due to the clearance of HCC by T cells and inducing inflammatory reactions. c. AP view of the patient's chest X-ray film on 14 January 2022. The infiltration area, especially in the left lung, became more prominent than that one week ago. There was no apparent ground glass pattern in the right upper lobe. This phenomenon might be because there were no evident metastatic nodules in this area. Ten days later, left tension pneumothorax developed. This event might result from the necrosis of metastatic tumors in the left lung.
case_images: bmed-13-03-057f1.jpg
case_images: PMC10627209_01_bmed-13-03-057f1.jpg
case_images: f1-bmed-13-03-057
case_images: One day after DC-CIK cell infusion, shortness of breath developed, and his chest radiograph (CXR) showed increased infiltration in the left lung [Fig. 1ac].