Primary Pleural Angiosarcoma Treated with Nivolumab and Ipilimumab: A Case Report

Figures

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  Fig. 1.. Chest computed tomography (CT) images throughout the course of the treatment. a, c Chest contrast-enhanced CT axial view following the drainage of the right pleural effusion before chemotherapy on day 11. A large mass is detected in the right thoracic cavity with contrast enhancement. Pleural effusion is found in the right-sided chest cavity and passive atelectasis in the right lung. b, d Chest CT axial view after 37 days of chemotherapy, showing a remarkable reduction of the tumor size and pleural effusion.

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  Fig. 2.. Levels of hemoglobin (Hb) (solid line) and serum C-reactive protein (CRP) (dashed line) throughout the treatment course. R with a circle denotes red blood cell transfusion, N with a circle denotes nivolumab administration (360 mg), and I with a circle denotes ipilimumab administration (1 mg/kg). Following admission, several red blood cell transfusions were required because of progressive anemia. However, owing to chemotherapy, anemia improved, and blood transfusions were no longer required. The CRP level also reduced with treatment.

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  Fig. 3.. Histological results of the specimen obtained via thoracoscopy. The bars show 100 µm. a Photomicrograph of hematoxylin and eosin staining (× 200 magnification). Epithelioid cells with enlarged hyperchromatic nuclei and prominent nucleoli composed the sheets. The tumor contained vascular lumen-like structures with abundant red blood cells scattered. Immunohistochemistry results (× 400 magnification): (b) CD31, (c) calretinin, and (d) PD-L1. The tumor cells were positive for CD31, negative for calretinin, and diffusely positive for PD-L1.