case_images: PMC10601780_01
case_images: a-c Chest CT showing multiple lamellar hyperintensities with blurred margins in both lungs, nodular foci in the right lung, bronchial inflation signs in some of the lesions, bilateral pleural effusions. d-f Right lung lamellar hyperintensity shadow, a nodular shadow is more than before, partly with ground-glass change, left pleural effusion is reduced, and with artificial pneumothorax.
case_images: cro-2023-0016-0001-533554_F01.jpg
case_images: PMC10601780_01_cro-2023-0016-0001-533554_F01.jpg
case_images: F1
case_images: On February 23, 2021, chest CT was performed and showed multiple lamellar hyperdense shadows with blurred margins in both lungs, nodular foci in the right lung, and bilateral pleural effusions (Fig. 1a-c). After 2 weeks of treatment, the patient's symptoms were relieved, the blood test was lower than before, and chest CT showed flaky high-density shadows in the right lungs, some of which showed ground-glass changes, and the pleural effusion on the left side was reduced, and with artificial pneumothorax (Fig. 1d, e), suggesting that the patient's lung lesions are in remission from before.
case_images: a Thoracoscopic pleural biopsy: yellowish tissue of variable size is visible in the mural pleura. b Pathology of the wall pleura biopsy. c Pathology of the left mural pleura: granulomatous tissue hyperplasia and mesothelial hyperplasia are seen.
case_images: cro-2023-0016-0001-533554_F02.jpg
case_images: PMC10601780_01_cro-2023-0016-0001-533554_F02.jpg
case_images: F2
case_images: On February 26, 2021, a thoracoscopic pleural biopsy was performed because of the orange-red color of the pleural fluid, and yellowish tissue of varying sizes was seen in the wall pleura (Fig. 2a, b). Pathology of the left mural pleura: granulomatous hyperplasia and mesothelial hyperplasia are seen (Fig. 2c).
case_images: a Pathology of the middle lobe of the right lung: alveolar structures are present, with Masson vesicle formation (red arrow) and partial widening of the alveolar septa visible in the alveolar lumen, with no obvious inflammatory cell infiltration. b Pathology of the left shoulder mass: spindle cell tumor, combined with immunohistochemistry, the lesion is consistent with a low-grade malignant myofibroblast sarcoma.
case_images: cro-2023-0016-0001-533554_F03.jpg
case_images: PMC10601780_01_cro-2023-0016-0001-533554_F03.jpg
case_images: F3
case_images: On March 5, 2021, we performed bronchoscopy, and pathology showed fibroblast proliferation with increased alveolar septa visible in the alveolar lumen and lesions consistent with organizing pneumonia (Fig. 3a). Surgical resection was performed for the left shoulder mass and pathology showed a spindle cell tumor (Fig. 3b).