PDF(Pubmed)
Abstract：
Pseudoprogression of malignancy in patients treated with systemic immunotherapy is a well- recognised phenomenon and has also been seen in patients treated with combined chemoimmunotherapy. Neoadjuvant chemoimmunotherapy prior to surgery is a relatively new treatment strategy for the management of many malignancies. We report the case of a patient who was suspected to have primary lung squamous cell carcinoma progression following neoadjuvant chemoimmunotherapy. Tissue histopathology from biopsies demonstrated granulomatous sarcoid-like inflammation rather than progression or metastatic disease. The patient proceeded to have successful surgical clearance of residual tumour. Significantly, failure to suspect granulomatous reactions and pseudoprogression has profound influence on the trajectory of patient care, such as, the potential for patients to miss out on curative surgery. In this case report and review of the literature, we evaluate the role of pseudoprogression and the need for radiologists to be aware of this phenomenon so that they do not mistakenly report new metastases and derail the treatment paradigm for patients with curable malignant conditions.
摘要：
在用全身免疫疗法治疗的患者中恶性肿瘤的假性进展是公认的现象,并且在用联合化学免疫疗法治疗的患者中也观察到。手术前的新辅助化学免疫疗法是许多恶性肿瘤的相对较新的治疗策略。我们报告了一例新辅助化学免疫疗法后怀疑患有原发性肺鳞状细胞癌进展的患者。活检的组织病理学显示肉芽肿样结节病样炎症，而不是进展或转移性疾病。患者继续成功地手术清除了残留的肿瘤。重要的是,未能怀疑肉芽肿反应和假性进展对患者护理的轨迹有深远的影响，例如,患者错过治愈性手术的可能性。在这个案例报告和文献综述中，我们评估了假性进展的作用,以及放射科医师意识到这一现象的必要性,这样他们就不会错误地报告新的转移和破坏可治愈恶性疾病患者的治疗模式.
