case_images: PMC11832704_01
case_images: Pathological images of the lung biopsy and imageological examination. (A) Hematoxylin and Eosin (HE) staining; (B) P40 immunohistochemical staining; (C) Pan-cytokeratin (AE1/AE3) staining; (D) Ki-67 proliferation index showing expression levels up to 60% in tumor cells; (E) Thyroid Transcription Factor-1 (TTF-1) staining; (F) Napsin A staining. (G-L) Chest computed tomography (CT) scans: (G) Image acquired on December 5, 2023, revealing a soft tissue density shadow in the anterior segment of the left upper lobe, measuring approximately 3.4 x 3.1 cm (indicated by a red arrow); (H) Image acquired on February 20, 2024, demonstrating shrinkage of the soft tissue (indicated by a red arrow); (I) Image acquired on April 15, 2024, showing a small mass measuring 1.4 x 0.9 cm (indicated by a red arrow) in the anterior lobe of the left superior lung, with evidence of bronchial wall truncation, peripheral pleural stretch and bilateral pleural effusions; (J) Image acquired on July 9, 2024, pre-operatively; (K, L) Images acquired on August 27, 2024, post-operatively. (M-O) Cardiac MRI. (P, Q) Abdominal CT. (R) Head CT revealed encephalatrophy and demyelination in the white matter. (S, T) Head MRI. The brain MRI indicated old infarcts in the lateral ventricle, as denoted by the red arrow.
case_images: fimmu-16-1508293-g001.jpg
case_images: PMC11832704_02_fimmu-16-1508293-g001.jpg
case_images: f1
case_images: Postoperative chest CT found no metastasis ( Figure 1J , pre-operative;  Figures 1K, L , one month postoperatively).
case_images: PMC11832704_02
case_images: Pathological images of the lung biopsy and imageological examination. (A) Hematoxylin and Eosin (HE) staining; (B) P40 immunohistochemical staining; (C) Pan-cytokeratin (AE1/AE3) staining; (D) Ki-67 proliferation index showing expression levels up to 60% in tumor cells; (E) Thyroid Transcription Factor-1 (TTF-1) staining; (F) Napsin A staining. (G-L) Chest computed tomography (CT) scans: (G) Image acquired on December 5, 2023, revealing a soft tissue density shadow in the anterior segment of the left upper lobe, measuring approximately 3.4 x 3.1 cm (indicated by a red arrow); (H) Image acquired on February 20, 2024, demonstrating shrinkage of the soft tissue (indicated by a red arrow); (I) Image acquired on April 15, 2024, showing a small mass measuring 1.4 x 0.9 cm (indicated by a red arrow) in the anterior lobe of the left superior lung, with evidence of bronchial wall truncation, peripheral pleural stretch and bilateral pleural effusions; (J) Image acquired on July 9, 2024, pre-operatively; (K, L) Images acquired on August 27, 2024, post-operatively. (M-O) Cardiac MRI. (P, Q) Abdominal CT. (R) Head CT revealed encephalatrophy and demyelination in the white matter. (S, T) Head MRI. The brain MRI indicated old infarcts in the lateral ventricle, as denoted by the red arrow.
case_images: fimmu-16-1508293-g001.jpg
case_images: PMC11832704_02_fimmu-16-1508293-g001.jpg
case_images: f1
case_images: Postoperative chest CT found no metastasis ( Figure 1J , pre-operative;  Figures 1K, L , one month postoperatively).
case_images: Clinical course of the diagnosis and treatment.
case_images: fimmu-16-1508293-g002.jpg
case_images: PMC11832704_02_fimmu-16-1508293-g002.jpg
case_images: f2
case_images: Then the patient received methylprednisolone (80 mg daily for nine days, tapering gradually after two months), intravenous immunoglobulins (IVIG) (15 g daily for four days), and continuous renal replacement therapy (CRRT), with improvement leading to recovery, and was discharged from our hospital in May 2024 ( Figure 2 ).