case_images: PMC10475830_01
case_images: Tumor characteristics before and after conversion therapy. Relationship between the tumor and (A1, B1, C1, D1) the second porta hepatis; (A2, B2, C2, D2) the middle hepatic vein; (A3, B3, C3, D3) the first porta hepatis; and (A4, B4, C4, D4) the right hepatic artery. (A1-A4) Abdominal CT before conversion therapy shows tumor invasion of the middle hepatic vein, left branch of the portal vein, and the right hepatic artery. (B1-B4) After two cycles of conversion therapy, there are no significant changes in the tumor. (C1-C4) After four cycles of conversion therapy, the tumor is significantly smaller. (D1-D4) After six cycles of conversion therapy, the tumor is further reduced.
case_images: fimmu-14-1230261-g001.jpg
case_images: PMC10475830_01_fimmu-14-1230261-g001.jpg
case_images: f1
case_images: Chest and abdominal enhanced computed tomography (CT) performed on May 21, 2020 ( Figures 1A1-A4 ) revealed enlargement of the left lobe of the liver, internal and surrounding patchy low-density areas, blurred borders, uneven contrast enhancement, dilated intrahepatic bile duct, and enlarged lymph nodes in the porta hepatis and retroperitoneum. After two cycles of conversion therapy, there are no significant changes in the tumor ( Figures 1B1-B4 ). But after four cycles of conversion therapy, the tumor is significantly smaller than before ( Figures 1C1-C4 ). After six treatment cycles, abdominal CT showed that the tumor had reduced and no longer invaded the first porta hepatis, second porta hepatis, middle hepatic vein, or right hepatic artery ( Figures 1D1-D4 ).
case_images: (A) HE staining of puncture tissue; (B) PD-1 staining is negative; (C) PD-L1 staining is positive in 30% of tumor cells and 5% of stromal cells; (D) Postoperative HE staining; (E) Ki-67 index 80%; (F-I) Tumor size 6.5 x 4 x 4 cm with capsular invasion.
case_images: fimmu-14-1230261-g002.jpg
case_images: PMC10475830_01_fimmu-14-1230261-g002.jpg
case_images: f2
case_images: Chest and abdominal enhanced computed tomography (CT) performed on May 21, 2020 ( Figures 1A1-A4 ) revealed enlargement of the left lobe of the liver, internal and surrounding patchy low-density areas, blurred borders, uneven contrast enhancement, dilated intrahepatic bile duct, and enlarged lymph nodes in the porta hepatis and retroperitoneum. Pathological examination ( Figures 2A-C ) revealed bile duct cell carcinoma (moderately to poorly differentiated). After two cycles of conversion therapy, there are no significant changes in the tumor ( Figures 1B1-B4 ). But after four cycles of conversion therapy, the tumor is significantly smaller than before ( Figures 1C1-C4 ). After six treatment cycles, abdominal CT showed that the tumor had reduced and no longer invaded the first porta hepatis, second porta hepatis, middle hepatic vein, or right hepatic artery ( Figures 1D1-D4 ). Postoperative pathological examination ( Figures 2D, E ) revealed moderate-to-poorly differentiated cholangiocarcinoma with multiple foci of calcification, extensive fibrosis, and collagen degeneration in the stroma, locally infiltrated by a large number of lymphocytes and plasma cells. The tumor had a volume of 6.5 x 4 x 4 cm and exhibited capsular invasion, but no obvious cancer emboli were observed in the vessels ( Figures 2F-I ).
case_images: Tumor marker expression levels before and after chemotherapy. (A) CA125 levels before and after chemotherapy. (B) CA19-9 levels before and after chemotherapy.
case_images: fimmu-14-1230261-g003.jpg
case_images: PMC10475830_01_fimmu-14-1230261-g003.jpg
case_images: f3
case_images: Chest and abdominal enhanced computed tomography (CT) performed on May 21, 2020 ( Figures 1A1-A4 ) revealed enlargement of the left lobe of the liver, internal and surrounding patchy low-density areas, blurred borders, uneven contrast enhancement, dilated intrahepatic bile duct, and enlarged lymph nodes in the porta hepatis and retroperitoneum. After two cycles of conversion therapy, there are no significant changes in the tumor ( Figures 1B1-B4 ). But after four cycles of conversion therapy, the tumor is significantly smaller than before ( Figures 1C1-C4 ). After six treatment cycles, abdominal CT showed that the tumor had reduced and no longer invaded the first porta hepatis, second porta hepatis, middle hepatic vein, or right hepatic artery ( Figures 1D1-D4 ). Tumor marker expression gradually decreased ( Figure 3 ).