Figure Legends
Figure 1.
PET-CT revealed FDG accumulated in the fundus of the gallbladder (SUV max:4.2) (dotted arrow) and hepatoduodenal lymph nodes (SUVmax:3.2) (solid arrow) as well as lymph nodes of the mediastinum.
Figure 2.
CT images (a) before chemotherapy and (b, c) after ten courses of Nivolumab. After Nivolumab, the tumor had clearly shrunk (b, arrow), but limited lymphadenopathy proximal to the abdominal aorta emerged (c, arrow).
Figure 3.
NSE turned negative after ten courses of Nivolumab.
Figure 4.
There was a mass (15 x 8 x 10 mm) on the lower side of the gallbladder, which was atrophied, with a thickened wall overall.
Figure 5.
NEC (solid arrow) and adenocarcinoma (in situ) components (dotted arrow) were mixed (a). In the NEC component, the N/C ratio was increased, and abnormal mitosis was observed (b). Furthermore, glandular duct structure disappeared, and solid growth of NEC was observed (b). PD-L1 expression is rarely seen (c).