HLA Class I Loss and Resistance to Immunotherapy in Pulmonary Metastasis of Hypopharyngeal Cancer

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Figure 1.
Clinical examination. (A) Laryngofiberscopic findings: Right vocal fold paralysis is noted, and airway stenosis is present because of compression by the hypopharyngeal carcinoma. (B) T1-weighted contrast-enhanced magnetic resonance imaging (B: axial) of hypopharyngeal carcinoma, likely originating from the right pyriform sinus, shows destruction of the thyroid cartilage. Multiple metastatic lymph nodes are noted in both sides of the neck. Lymph node metastases are seen in both sides of the neck. (C) Lung window computed tomography (CT) of a metastatic lesion in the left lung field. (D) Lung window CT of a new metastatic lesion appearing approximately three years after starting nivolumab therapy.
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Figure 2.
Pathological examination. Additional pathological analyses were performed using resected primary biopsy specimens and surgically resected pulmonary metastatic lesions. Hematoxylin and eosin staining and immunohistochemistry for CD3, CD8, CD103, CD163, PD-L1, HLA class I (A/B/C), B2M, and HLA-DR were conducted on serial sections. Representative images of the corresponding areas are shown. Scale bars=20 μm.