Kenza yemapapu inopararira mumasero madiki-01

Muna Chikumi 2022, murwere wechirume ane makore 65 okuberekwa akaongororwa muviri nguva dzose, uye CT scan yakaratidza kuti pane bundu riri pasi pe pleura muchikamu chepamusoro cherudyi chemapapu. Muna Ndira 2023, murwere akatanga kuona zviratidzo zvakaita sekunzwa kurira, kukosora, uye kufema kushoma. Pakazosvika Chivabvu 2023, kukosora kwake uye kufema kushoma kwakanga kwawedzera kuipa. Kuongororwa kwakaratidza kuti metabolic activity yakawedzera zvakanyanya muchikamu chepamusoro chemapapu cherudyi, zvichiratidza kenza yemapapu. Pamusoro pezvo, kuwedzera kwe metabolic activity kwakaonekwa muma lymph nodes akawanda, kusanganisira right supraclavicular region, mediastinum, trachea, para-aortic area, uye inferior vena cava. Mifananidzo yakaratidzawo kuti ma nodular thickenings akawanda mu right pleura anowedzera kushanda kwe metabolic. Mhedzisiro yekuongororwa yakaratidza kuti right pleural metastasis ine pleural effusion, uye kuongororwa kwekupedzisira kwe metastatic small cell lung cancer kwakasimbiswa kuburikidza nekuongororwa kwepathological, imaging, uye immunohistochemistry. Murwere akazogamuchira kurapwa.

Mwedzi mishanu gare gare, huwandu hwebundu hwakanga hwadzikira zvakanyanya, uye maronda mazhinji akapararira akanga anyangarika. Kurapwa kwacho kwaisanganisira kutanga kwekurapa kwe immunotherapy ye atezolizumab pamwe chete ne anlotinib. Atezolizumab yakapihwa mushonga we 1200 mg pazuva rekutanga, zvichiteverwa nekumbomira kurapwa. Anlotinib yakapihwa nemuromo we 10 mg zuva nezuva kwemavhiki maviri akatevedzana, zvichiteverwa nenguva yekuzorora kwemazuva manomwe, zvichiita kuti kurapwa kuve kwemazuva makumi maviri nerimwe. Mushure mezvikamu gumi nezvishanu zve radiotherapy, mifananidzo yeCT yakaratidza kudzikira kukuru kweronda mumapapu ekurudyi, uye right mediastinum ne lymph nodes zvakadzikirawo zvakanyanya. CT scan yakatevera musi wa10 Gunyana, 2023, yakaratidza shanduko dzakanaka: kudzikira kwe right pleural effusion, kudzikira kwekukora kwe right pleural, uye diki mediastinal ne right supraclavicular lymph nodes, pasina kuwedzera kwe abdominal ne retroperitoneal lymph nodes.

Zvichienzaniswa nekuongororwa kwakaitwa musi wa7 Chivabvu 2023, kuongororwa kwakaitwa musi wa10 Gumiguru 2023, kwakaratidza kudzikira kukuru kwebundu iri. Kunyanya, kudhonzeka kwakaonekwa mubundu riri kurudyi rwepamusoro uye muma lymph nodes akawanda ari pedyo ne trachea, mitsipa yeropa, para-aortic area, uye inferior vena cava. Kukora kwema nodular kwakamboonekwa kare mu local peritoneum, right anterior chest wall, uye 11th-12th intercostal space kwakadzikira zvakanyanya. Pamusoro pezvo, mumvuri wema nodular wakaderera zvishoma mutsandanyama yefudzi rerudyi wakanga wadzikirawo zvakanyanya. Izvi zvinoratidza kuti nzira yekurapa yaishanda, maronda mazhinji akapararira achinyangarika uye mamwe maronda achidzikira zvakanyanya. Kuongorora kwemifananidzo kunoratidza kuti nzira yekurapa yakabudirira, uye bundu iri ikozvino riri muchikamu chekurerukirwa zvishoma.