case_images: PMC11257856_01
case_images: The iconography and pathology of lung adenocarcinoma. (A) PET-CT evaluation suggested the possibility of multiple metastases throughout the body (multiple lymph nodes throughout the body, posterior segment of the right lobe of liver, bone, and pleura). (B) CT-guided pleural biopsy. (C) HE staining indicated lung adenocarcinoma. (D) Immunohistochemistry (IHC) staining of the PD-L1 (22C3) of the lung adenocarcinoma. Significant abnormal findings were noted (red triangle).
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case_images: Positron emission tomography/computed tomography (PET/CT) evaluation suggested the possibility of multiple metastases throughout the body (multiple lymph nodes throughout the body, posterior segment of the right lobe of liver, bone, and pleura) ( Figure 1A ). Exfoliated cell embedding pathology was performed, and CT-guided pleural mass puncture was performed on 03/08/2021 ( Figure 1B ). IVB) according to the eighth edition AJCC staging system ( Figure 1C ). Immunohistochemistry (IHC) staining of the PD-L1 (22C3) showed that both the tumor proportion score (TPS) and combined positive score (CPS) were 0% ( Figure 1D ). Figure 1 ). Following the third and fourth cycle treatments, acute liver insufficiency appeared and was improved by using a hepatoprotective drug.
case_images: B-mode ultrasonography indicated a high echo in the right lateral wall of the bladder.
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case_images: Chest CT on 07/2022 revealed that the tumor in the right lung showed progressive disease (PD) ( Supplementary Figure 2 ). There was a high echo in the right lateral wall of the bladder, approximately 5.6 x 4.5 mm in size, protruding into the bladder cavity with a papillary shape ( Figure 2 ).
case_images: Enhanced CT of urinary system indicated multiple strips of slightly high density in both kidneys.
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case_images: Meanwhile, MRI of the brain showed new metastasis in the brain ( Supplementary Figure 3 ). CT of the urinary system indicated multiple strips of slightly high density in both kidneys on plain CT scan, possible inflammatory changes, and thickening of bladder wall ( Figure 3 ). Cystoscopy in other hospital indicated diffuse congestion with edema and thickening of the posterior wall and top of the bladder, and adenocarcinoma could not be ruled out.
case_images: Biopsy of bladder occupation. (A) HE staining indicated depicting edematous and expanded lamina propria containing a mixed inflammatory infiltration (predominantly lymphocytes, plasma cells, and eosinophils) and focal lymphoid follicle formation. (B) Eosinophil infiltration. (C) Immunohistochemistry staining indicated lymphocyte infiltration.B lymphocytes, positive staining for CD20; T lymphocytes, positive staining for CD3. Significant abnormal findings were noted (Red triangle).
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case_images: All the above pathological evidence supported the diagnosis of chronic cystitis, reflecting the abnormal immunological functioning status ( Figure 4 ).