case_images: PMC11064645_01
case_images: The picture shows the changes in the chest CT images during treatment. (A) the first CT scan in the hospital taken on 29 June 2023. The patient underwent a CT scan of the chest to observe the therapeutic effect on (B) 12 July 2023 and (C) 31 July 2023. Outpatient re-examinations using a repeat CT scan on (D) 25 August 2023, (E) 3 October 2023, and (F) 14 November 2023. The red arrow represents the inflammatory lesion, the black arrow shows the cavity, the blue arrow indicates fluid accumulation, and the green arrow represents residual striped shadows.
case_images: fmed-11-1357714-g001.jpg
case_images: PMC11064645_01_fmed-11-1357714-g001.jpg
case_images: fig1
case_images: Complete chest computed tomography (CT) showed streaks and clumps of high-density shadows in the middle and lower lobes of the right lung with cavity formation and a small amount of fluid in the right chest cavity and interlobar fissure (Figure 1A). CT showed increased density in the middle and lower lobes of the right lung with stripy and clump shapes, a larger cavity area than before, and increased pleural effusion on the right side (Figure 1B). Considering the worsening of the patient's hemoptysis symptoms, chest CT indicated progressive inflammation and pleural effusion. CRP of 28.85 mg/L, and PCT of <0.05 ng/mL. Chest CT showed that the cord-like and flaky-like high-density shadows in the middle and lower lobes of the right lung were reduced in scope, and the pleural effusion on the right side was less than that of the previous lesions (Figure 1C). CRP level was 2.51 mg/L. Chest CT showed that the extent of inflammation and pleural effusion both significantly improved (Figure 1D). On the 101st day of follow-up, chest CT indicated that most of the inflammatory lesions had been absorbed (Figure 1E), so antibiotics were discontinued. On the 144th day of follow-up, chest CT showed that the inflammatory lesions had basically resolved, though a few traces remained (Figure 1F).
case_images: Cytological results of pleural fluid and alveolar lavage fluid by hematoxylin-eosin staining. (A,B) the pleural fluid Thinprep cytologic test showed inflammatory cells, with a small number of mesothelial cells and tissue cells, but no clear atypical tumor cells were observed. (C,D) alveolar lavage fluid under the microscope indicated ciliated columnar epithelial cells and inflammatory cells in the right middle lobe bronchial lavage fluid, but no clear atypical tumor cells were observed. The red arrow represents inflammatory cells, the green arrow shows mesothelial cells, and the blue arrow indicates ciliated columnar epithelial cells.
case_images: fmed-11-1357714-g002.jpg
case_images: PMC11064645_01_fmed-11-1357714-g002.jpg
case_images: fig2
case_images: Cytological staining of alveolar lavage fluid and pleural fluid via hematoxylin-eosin staining showed inflammatory cells (Figure 2).