case_images: PMC10601749_01
case_images: Clinical course of the case patient. a Shows the clinical course after the first pegfilgrastim administration. b Shows the clinical course of the second pegfilgrastim administration. c Shows the clinical course after the filgrastim administration during amrubicin monotherapy. AMR, amrubicin; BT, body temperature; CDDP, cisplatin; CRP, C-reactive protein; CT, computed tomography; MEPM, meropenem; PSL, prednisolone; PZA, pyrazinamide; VP-16, etoposide.
case_images: cro-2023-0016-0001-533375_F01.jpg
case_images: PMC10601749_01_cro-2023-0016-0001-533375_F01.jpg
case_images: F1
case_images: First-course systemic chemotherapy for 3 days was initiated in September 201X + 1, as shown in Figure 1a. Second-course systemic chemotherapy for 3 days was initiated in November 201X + 1, as shown in Figure 1b. The clinical course of second-line chemotherapy for LCNEC is shown in Figure 1c.
case_images: CT scan findings: The two left images were taken before the start of chemotherapy. The two in the right show wall thickening and periaortic soft tissue infiltration of the aorta (a) and left subclavian artery (b) on day 18 after the first pegfilgrastim administration.
case_images: cro-2023-0016-0001-533375_F02.jpg
case_images: PMC10601749_01_cro-2023-0016-0001-533375_F02.jpg
case_images: F2
case_images: However, a contrast-enhanced CT scan on day 21 did not show any evidence of a fever source (Fig. 2, 3).
case_images: CT scan findings: the bilateral common carotid artery and the bilateral subclavian arteries (yellow arrows). a Before administration of G-CSF agents, (b) on day 18 after the first pegfilgrastim administration, (c) on day 11 after the second pegfilgrastim administration, (d) on day 9 after the start of filgrastim administration.
case_images: cro-2023-0016-0001-533375_F03.jpg
case_images: PMC10601749_01_cro-2023-0016-0001-533375_F03.jpg
case_images: F3
case_images: However, a contrast-enhanced CT scan on day 21 did not show any evidence of a fever source (Fig. 2, 3). C. Contrast-enhanced CT on day 14 showed wall thickening of the aorta and left subclavian artery and contrast effects on the surrounding soft tissues, which were not seen before the start of chemotherapy (Fig. 3c). No obvious signs of infection were noted and contrast-enhanced CT on day 21 showed recurrence of vessel wall thickening in the aorta and left subclavian artery (Fig. 3d).