Figure 2.

The imaging of the patient during this therapy. (A,B,C) Enhanced chest and abdominal CT scan was performed before anti PD-1 therapy. This CT scan showed the lesion which was a slightly lobulated mass about 5.0 cm × 4.0 cm with uneven enhancement in the right upper lobe. And at this time, we did not find any metastatic sign in liver. And the enhanced CT scan showed that the margin of the pancreas was clear and the form was also normal. Signs of chronic pancreatitis or cancer metastasis did not show up. (D) CT showed the lesion after being treated with 3 cycles of this anti PD-1 agent. Size of the lesion reduced to 4.2 cm × 3.2 cm and it was defined as stable disease. (E,F) Enhanced CT performed before the 10th cycle of the therapy showed the primary lesion in the right lung was still about 4.2 cm × 3.2 cm. And nothing abnormal in the pancreas was detected through this scan. (G,H) This scan was performed after stopping the anti PD-1 therapy for a month because of diabetic ketoacidosis. The primary lesion became smaller which was about 3.7 cm × 2.6 cm and still abnormalities were not found in pancreas. (I,J,K) The chest CT scan before the 18th cycle of therapy found that a nodule about 1.4 cm × 1.1 cm occurred in lingular segment of left lung but the size of primary lesion got slightly smaller which was about 3.1 cm × 2.5 cm. Abdominal CT found a low density mass about 5.0 cm × 3.8 cm at right lobe of liver. The margin of the mass was not very clear and in the enhanced scan it showed an apparent enhancement at the peripheral region of the mass.