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![The percutaneous lung biopsy tissue
in the lower lobe of the left lung was observed by H&E staining
and magnifications at (A) ×50 and (B) ×400. (C) Programmed cell
death ligand 1 test result: Positive, with tumor cell
interpretation indicating 30%. Quality control demonstrated an
assessable tumor cell count of 50%. Both positive and negative
controls were successful. Combined with the results of
immunohistochemistry [(D) thyroid transcription factor-1 (+)
(nuclear staining). (E) Napsin A (+) (cytoplasmic granular
staining). (F) Cytokeratin 7 (+) (diffuse cytoplasmic staining).
(G) Ki-67:10% (labeling index). (H) P40 (−) (no nuclear staining)
(magnification, ×200)], and the pathological diagnosis was
non-small cell lung cancer, which was consistent with the type of
pulmonary adenocarcinoma. (I) Emission CT bone scintigraphy. Four
panels show whole-body bone scans from different views. Panel I
(far left, anterior view): Increased radioactivity in the parietal
bone, right shoulder joint and left humerus. Panel II (left middle,
posterior view): Increased radioactivity in the left clavicle,
multiple ribs, and T2-T4 vertebrae. Panel III (right middle,
anterior view): Increased radioactivity in the sacrum, right
sacroiliac joint, and right ilium. Panel IV (far right, posterior
view): Increased radioactivity in the bilateral hip joints and
right femur. Remaining bones and joints show normal physiological
distribution. (J) NGS results: The EGFR p.L858R mutation, with a
frequency of 15.5% in the transthoracic lung biopsy tissue. (K) NGS
results: The EGFR p.E709K mutation, with a frequency of 21.2% in
the transthoracic lung biopsy tissue. (L) Serum tumor marker
levels: A line chart depicting changes in serum CEA levels during
the course of treatment (reference range, 0–5 ng/ml). Endobronchial
ultrasound-guided transbronchial needle aspiration biopsy was
performed to obtain tissue in the lower lobe of the left lung was
observed by H&E staining at magnifications of (M) ×50 and (N)
×400. PCK, phosphoenolpyruvate carboxykinase; INSM1,
insulinoma-associated protein 1; NGS, next-generation
sequencing.](/article_images/ol/30/5/ol-30-05-15255-g00.jpg)
