case_images: PMC11033314_01
case_images: Tumor and lymph nodes shrank significantly after immuno-chemo conversion therapy.
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case_images: Tomography Computed Tomography (PET-CT) revealed a 40*35 mm mass located in the inferior lobe of the left lung, along with the presence of multiple enlarged lymph nodes in mediastinal regions 4L and 6 (Figure 1). These findings were concomitant with heightened 18F-FDG uptake, suggestive of malignancy. After this, a contrast-enhanced thoracic CT scan revealed a substantial reduction in both tumor size and lymph nodes (Figure 1), yielding a noteworthy achievement of a substantial partial response (PR).
case_images: Histopathological assessment of tumor tissue. (A) HEx400 (B) HEx100 (C) CK positive (D) Vim positive (E) Bcl-2 negative (F) PD-L1 expression positive on 95% of tumor cell.
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case_images: Notably, immunohistochemistry revealed the following results: Cytokeratin (CK) positivity (+), Vimentin (Vim) positivity (+), B-cell lymphoma-2 (Bcl-2) negativity (-), and a high programmed death ligand 1 (PD-L1) tumor proportion score (TPS) of 95% (Figure 2).
case_images: The change of tumor on CT imaging. (A) The CT images before any treatment. (B) The CT images after 3 cycles of neoadjuvant therapy and before surgery. (C) CT taken at 3 months after surgery. (D) CT taken at 9 months after surgery. (E) CT taken at 22 months after surgery. (F) CT taken at 28 months after surgery.
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case_images: CT imaging showed no signs of recurrence, as depicted in Figure 3.
case_images: Treatment timeline.
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case_images: The comprehensive timeline of the patient's diagnosis and treatment is depicted in Figure 4.