08 January 2025
: Case report
Radiological and Pathological Analysis of Pembrolizumab-Associated Lung Lesions: Diagnostic Challenges and Management
Unusual clinical course, Challenging differential diagnosis, Unusual or unexpected effect of treatment, Adverse events of drug therapy, Clinical situation which can not be reproduced for ethical reasons
Tomohito Okano1BDEF, Hajime Fujimoto1ABC, Toshiyuki Ito1BDE, Atsushi Tomaru1BDE, Haruko Saiki1BDE, Tatsuki Tsuruga1ABE, Taro Yasuma23BCD, Corina N. D'Alessandro-Gabazza23CDE, Esteban C. Gabazza

DOI: 10.12659/AJCR.945022
Am J Case Rep 2025; 26:e945022
Table 1. Clinical and laboratory profile of the patient.
Values | Normal range | Values | Normal range | Values | Normal range | |||
---|---|---|---|---|---|---|---|---|
White blood cells (/μL) | 8050 | 4,000–11,000 | Total protein (g/dL) | 6.7 | 6.0–8.3 | Urine specific gravity | 1.02 | |
Red blood (cells×10/μL) | 4.09 | 4.1–5.1×10 | Albumin (g/dL) | 4.8 | 3.4–5.4 | pH | 5.5 | |
Hemoglobin (g/dL) | 14.1 | 12–16 | BUN (mg/dL) | 21 | 6–20 | Urine protein | (–) | |
Hematocrit (%) | 40.7 | 36–48 | Creatinine (mg/dL) | 0.63 | 0.59–1.04 | Urine sugar | (–) | |
Platelets (×10/μL) | 223 | 150–450 | eGFR (ml/min/1.73 m) | 78.7 | 90–120 | Ketone bodies | (–) | |
Neutrophils (%) | 72.3 | 40–60 | Na (mEq/L) | 134 | 135–145 | Occult blood | (–) | |
Lymphocytes (%) | 18.6 | 20–40 | K (mEq/L) | 4.7 | 3.5–5.2 | Urobilinogen | Normal | |
Monocytes (%) | 7.5 | 2–8 | Cl (mEq/L) | 97 | 96–106 | Bilirubin | (–) | |
Eosinophils (%) | 1.2 | 0–6 | Ca (mg/dL) | 9.4 | 8.6–10.2 | Nitrous acid | (–) | |
Basophils (%) | 0.4 | 0.5–1 | AST (U/L) | 21 | 8–33 | Urine WBC | (–) | |
ALT (U/L) | 13 | 4–36 | Color | Straw | ||||
LDH (U/L) | 185 | 140–280 | Urine turbidity | (–) | ||||
HBs antigen | (–) | γ-GTP (U/L) | 10 | 13–64 | SP-A (ng/mL) | 55.1 | <43.8 | |
HBs antibody | (–) | ALP (U/L) | 54 | 44–147 | SP-D (ng/mL) | 198.9 | <110 | |
HbC antibody | (–) | T-Bil (mg/dL) | 0.5 | 0.1–1.2 | KL-6 (U/mL) | 325 | <500 | |
HCV antibody | (–) | T-Chol (mg/dL) | 382 | <200 | RF | (–) | ||
RPR | (–) | TG (mg/dL) | 149 | <150 | MPO-ANCA | (–) | ||
TP antibody | (–) | BS (mg/dL) | 160 | 70–100 | PR3-ANCA | (–) | ||
HIV antibody | (–) | HbA1c (%) | 6.3 | <5.7 | ANA | (–) | ||
T-SPOT | (–) | CPK (U/L) | 159 | 22–198 | CCP antibody | (–) | ||
Coagulation test | UA (mg/dL) | 4.7 | 2.6–6.0 | SSA antibody | (–) | |||
APTT (seconds) | 29.1 | 25–35 | CRP (mg/dL) | 0.1 | <0.3 | Scl70 antibody | (–) | |
PT (seconds) | 11.2 | 10–13 | IgG antibody (mg/dL) | 473 | 600–1700 | ARS antibody | (–) | |
PT-% | 100.2 | 85–100 | IgA antibody (mg/dL) | 38 | 70–400 | sIL-2 receptor | (–) | |
PT-INR | 1 | 0.8–1.1 | IgM antibody (mg/dL) | 79 | 40-250 | Aspergillus Ag | (–) | |
HBs – hepatitis BS; HbC – hepatitis C; HCV – hepatitis C virus; TP – total protein; HIV – human immunodeficiency virus; PT – prothrombin time; PT-INR – prothrombin time-international normalized ratio; BUN – blood urea nitrogen; eGFR – estimated glomerular filtration rate; AST – aspartate aminotransferase; ALT – alanine aminotransferase; LDH – lactate dehydrogenase; GTP – gamma-glutamyl transpeptidase; ALP – alkaline phosphatase; T-Bil – total bilirubin; T-Chol – total cholesterol; TG – triglycerides; BS – blood sugar; HbA1c – hemoglobin A1c; CPK – creatine phosphokinase; UA – uric acid; CRP – C-reactive protein; WBC – white blood cell count; SP-A – surfactant protein A; SP-D – surfactant protein D; KL-6 – krebs von den lungen-6; RF – rheumatoid factor; MPO-ANCA – myeloperoxidase-anti-neutrophil cytoplasmic antibody; PR3-ANCA – proteinase 3-anti-neutrophil cytoplasmic antibody; ANA – antinuclear antibody; CCP – cyclic citrullinated peptide antibody; SSA – Sjögren syndrome-related antigen A; ARS – minoacyltRNA synthetase. |