case_images: PMC10824526_01
case_images: Chest CT imaging showing a slightly high-density shadow with a narrow lumen in the left bronchus, as indicated by the red arrow in both CT pulmonary window image (a) and mediastinal window image (b).
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case_images: F1
case_images: Thickness and adhesion were also detected in the left pleura (shown in Fig. 1).
case_images: a-d Observation of new organisms obstructing part of the lumen in the left main bronchus, 0.5 cm from the carina (indicated by yellow arrow). No apparent abnormalities were found in the right main bronchus or any other bronchial segments, except for bronchitis changes.
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case_images: F2
case_images: Importantly, the lower end of the left main bronchus and the bronchial openings in each lobe of the left lung remain unobstructed (shown Fig. 2).
case_images: Pathological biopsy of tissue specimen. Special staining results: silver staining (+). Immunohistochemical results: PMS-2 (+), MSH6 (+), MSH2 (+), MLH1 (+), CK5/6 (+), Her-2 (2+), PD-L1 (TPS: 0%), Ki-67 (20%), SSTR2 (focal+), CD56 (focal+), CgA (-), -Syn (-), P63 (+), P40 (+), Villin (-), CK20 (-), CK7 (+), CKL (focal+). a, b Tumor morphology with glandular cavity-like changes, irregular and infiltrative growth. c CK5/6.
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case_images: F3
case_images: Upon tracheoscopic biopsy, the pathology report indicated the patient was diagnosed with PACC (shown in Fig. 3).
case_images: Follow-up bronchoscopy at 8 months after surgery. a The left main bronchus is completely blocked by granulation tissue and sputum. b Interventional therapy such as balloon dilation for airway stenosis. c, d Left main bronchus recanalization after interventional treatment.
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case_images: F4
case_images: However, the left main bronchus is completely blocked by granulation tissue and sputum (shown in Fig. 4).
case_images: Timeline of the diagnostic process.
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case_images: F5
case_images: Figure 5 presents the event timeline.