Loading
Life sciences · Journal article
Frontiers in Immunology · October 23, 2026
No summary has been generated for this record yet. What follows is drawn from its source metadata only.
Journal article.
No findings were extractable from the material analysed.
Safety was not reported in the material analysed. Check the source before drawing any conclusion about harm.
The source did not state who this applies to in practice.
Graded across the dimensions that decide whether you should act, each from what the source actually supports. There is no single score, and where a dimension was not assessed it says so.
This record has not been graded across any dimension yet. Treat the label above as provisional and read the source.
What is missing. This record has no bottom line, key findings, reported figures, evidence dimensions. That is a gap in the analysis, not a judgement about the study.
Background Heterogeneous responses across disease sites may occur after systemic therapy for biliary tract cancer (BTC), but their pathological and immune features remain poorly characterized. We report a case with pathological complete response (pCR) at the primary and pulmonary metastatic sites but persistent nodal disease after sequential chemotherapy and immunotherapy. Case presentation A man in his 50s with metastatic perihilar cholangiocarcinoma received gemcitabine plus cisplatin. Cisplatin was discontinued because of an allergic reaction without radiographic progression, followed by gemcitabine plus durvalumab, gemcitabine alone, and durvalumab maintenance. Resection demonstrated pCR in the primary biliary lesion and a pulmonary metastasis, whereas viable carcinoma persisted in 3 of 22 regional lymph nodes. All three metastatic lymph nodes showed prominent keratinizing squamous differentiation with p40 expression and loss of CK7 expression. Spatial analysis of one lymph node showed higher CD8-positive cell abundance at the tumor margin than in the core by both positive-cell proportion and cell density. FoxP3-positive cells also showed a margin-predominant distribution, whereas LAG-3 expression and PD-L1 H-score were higher in the core and TIM-3 was broadly distributed. Another lymph node showed a different CD8 distribution, indicating inter-nodal heterogeneity. Conclusion This case shows site-specific pathological heterogeneity after chemoimmunotherapy for BTC, with persistent nodal disease despite pCR at the primary and pulmonary metastatic sites. Residual nodal metastases showed keratinizing squamous differentiation and inter-nodal heterogeneity in immune-cell distribution. Because paired pretreatment nodal tissue, molecular or clonality analyses, cell type-specific checkpoint assessment, and spatial immune profiling were unavailable, the biological basis and generalizability remain unresolved.