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Updated: Sep 2, 2025
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Author Spotlight: Advancing 3D Modeling for Enhanced Diagnosis and Treatment of Pulmonary Nodules in Early-Stage Lung Cancer
Published on: October 13, 2023
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[Multiple pulmonary nodules with interstitial changes].
1Department of Pulmonary and Critical Care Medicine, Beijing Chao-Yang Hospital, Capital Medical University, Beijing Institute of Respiratory Medicine, Beijing 100020, China.
Summary
A 53-year-old female with advanced lung adenocarcinoma and a venous thromboembolic event showed significant improvement with sequential ALK inhibitors crizotinib and alectinib. This case highlights effective treatment for ALK-positive lung cancer with metastasis.
Area of Science:
- Oncology
- Pulmonology
- Genetics
Background:
- A 53-year-old female presented with a 4-month history of worsening cough, sputum, and dyspnea on exertion.
- Initial imaging over 2.5 years showed stable pulmonary nodules, followed by significant interval growth and interstitial changes.
Observation:
- The patient experienced a venous thromboembolic event (VTE) with elevated D-dimer upon admission.
- Diagnostic workup included bronchoscopy, gastroscope, PET-CT, and MRI, revealing lung adenocarcinoma with extensive metastasis.
Findings:
- Pathological diagnosis confirmed lung adenocarcinoma (solid, mucus-secreting) with mediastinal, hilar, intrapulmonary, and gastric metastasis.
- Genetic analysis revealed a positive EML4-ALK fusion gene in both lung and stomach tissues.
- The patient responded well to sequential treatment with crizotinib and alectinib, along with anticoagulation.
Implications:
- This case demonstrates the efficacy of sequential ALK tyrosine kinase inhibitors in managing advanced, metastatic ALK-positive lung adenocarcinoma.
- Early detection and management of VTE are crucial in patients with advanced lung cancer.
- Targeted therapy offers a favorable prognosis, maintaining quality of life for patients with complex oncological presentations.
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