case_images: PMC11224440_01
case_images: Pathological and immunohistochemical examination of surgical specimens. (A) Timeline of the treatment process. Hematoxylin and eosin (HE) staining revealed moderate to poorly differentiated squamous cell carcinoma. Magnification: 20x (B) and 40x (C). Immunohistochemistry showed positivity for PD-L1. Magnification: 20x (D) and 40x (E).
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case_images: The main course of diagnosis and treatment of the patient is shown in  Figure 1A . T2N0M0 IB ( Figures 1B, C ). Since positive PD-L1 expression was observed in the tumor tissue [10% of the tumor cell proportion score (TPS) and 20% of the combined positive score (CPS)] ( Figures 1D, E ), ICI was considered.
case_images: The patient experienced severe thrombocytopenia and hyperprogression after RT combined with camrelizumab treatment. (A) Longitudinal changes in platelet count over time. The pulmonary and liver metastases before and after RT combined with ICI. After receiving RT and camrelizumab on March 11, 2021, the development of liver (B) and pulmonary (C) metastases rapidly increased, and new metastases appeared.
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case_images: After treatment with ICI combined with RT, the platelet count rapidly decreased (<25x109/L) ( Figure 2A ), and TPO was ineffective at treating this condition. Figures 2B, C ). Finally, the patient developed multiple organ failure and died.
case_images: Immunofluorescence and immunohistochemical staining were used to assess the expression of CD68 (A) and JAK2 (B) and in surgical specimens. Positive staining for CD68 or JAK2 is indicated by arrows on the respective slides.
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case_images: Figure 3A ). Furthermore, to analyze the potential cause and prognosis, we performed next-generation sequencing (NGS) of DNA from surgical specimens. We detected and confirmed the positive expression of JAK2 by IHC and IF in tumor cells from surgical specimens ( Figure 3B ).