case_images: PMC9355298_01
case_images: CT-guided percutaneous lung biopsy (CT-PTNB). CT = computed tomography.
case_images: fgene-13-949989-g001.jpg
case_images: PMC9355298_01_fgene-13-949989-g001.jpg
case_images: F1
case_images: Under CT guidance, the tip was determined to be located in the lesion (Figure 1).
case_images: Microscopic findings of lung biopsy specimens. Routine biopsy showed: poorly differentiated adenocarcinoma. Immunohistochemistry showed: tumor cells Vimentin (+), Ki67 (about 50%+), CK-pan (scattered weak +), CK-L (+), CKH (-), CK7 (scattered weak+), NapsinA (-), TTF1 (-), CK5/6 (-), P63 (-), P40 (-), Syn (-), EMA (-), CD34 (-), Desmin (-), S100 (-), MelanA (-), FLI1 (-), SOX10 (-), INI-1 (scattered weak +), and tended to sarcomatoid carcinoma.
case_images: fgene-13-949989-g002.jpg
case_images: PMC9355298_01_fgene-13-949989-g002.jpg
case_images: F2
case_images: Immunohistochemistry showed: tumor cells Vimentin (+), Ki67 (about 50%+), CK-pan (scattered weak +), CK-L (+), CKH (-), CK7 (scattered weak +), NapsinA (-), TTF1 (-), CK5/6 (-), P63 (-), P40 (-), Syn (-), EMA (-), CD34 (-), Desmin (-), S100 (-), MelanA (-), FLI1 (-), SOX10 (-), INI-1 (scattered weak +), and tended to sarcomatoid carcinoma (Figure 2).
case_images: Chest computed tomography (CT). Imaging findings during the patient's course (A,B) at baseline (solid tumor, dmax = 13.2 cm x 11.1 cm), (C,D) after one cycle of Tislelizumab and two cycles of chemotherapy (solid tumor, dmax = 11 cm x 8.7 cm), (E,F) after three cycles of Tislelizumab (solid tumor, dmax = 9.5 cm x 8.1 cm), (G,H) after five cycles of Tislelizumab (solid tumor, dmax = 7.4 cm x 7.0 cm), (I,J) after ten cycles of Tislelizumab (cavity, dmax = 3.9 cm x 3.2 cm), and (K,L) after thirteen cycles of Tislelizumab (cavity, dmax = 3.6 cm x 2.8 cm); (M,N) in recent recheck (cavity, dmax = 3.3 cm x 2.5 cm), Anlotinib is in continuous use.
case_images: fgene-13-949989-g003.jpg
case_images: PMC9355298_01_fgene-13-949989-g003.jpg
case_images: F3
case_images: Tislelizumab for the third cycle. There was no liver injury in the follow-up, and the patient was treated with Anlotinib combined with Tislelizumab every month (Figure 3).