Lung adenocarcinoma harboring rare epidermal growth factor receptor L858R and V834L mutations treated with icotinib: A case report

Figure 1 Next generation sequencing result and immunoassay of epidermal growth factor receptor and programmed death-ligand 1. A: Next generation sequencing result of the patient’s tissue sample, showing variation in epidermal growth factor receptor exon 21; B: Epidermal growth factor receptor immunoassay; C: Programmed death-ligand 1 immunoassay.

Figure 2 Representative images of hematoxylin and eosin-stained lung adenocarcinoma. A and B: The tumor cells were characterized by the variation in nucleus size and shape, the deep staining and the increased nucleoplasm index, which was marked by a closed curve; Also, hematoxylin and eosin staining showed that the tumor cells invaded the surrounding tissue (A: 100 × and B: 200 ×).

Figure 3 Primary lung cancer and mediastinal metastases before and after icotinib therapy. A: Panel 1: Ground-glass nodules in the right upper lung; Panel 2: Multiple small nodules in both lungs; Panel 3: A mass shadow in the left lower lung dorsal segment; Panel 4: Soft tissue mass shadow in the left lower hilum of lung; Panel 5: Multiple swollen lymph nodes in the mediastinum, with largest located beside the aortic arch; B and C: Multiple small pulmonary nodules gradually reduced and disappeared, mediastinal lymph node metastasis decreased and periclavicular lymph node metastasis decreased and disappeared.

Figure 4 Structural analysis of epidermal growth factor receptor L858R and V834L mutants.