Fig. 1

a Before treatment, tumors of the lung (posterior segment of upper lobe of right lung) and the ipsilateral femoral neck, as well as a small amount of axillary and cervical lymph nodes, were found by positron emission tomography-computed tomography. b After chemoradiotherapy, the tumors in the lung and femoral neck were controlled. However, the tumor of axillary and cervical lymph nodes progressed. Meanwhile, immunochemistry detection showed that programmed death-1 and programmed death-ligand 1 expression were more than 50% in the tumor cells and immune cells of biopsy tissues of the cervical lymph node and primary lung tumor. c After three cycles of pembrolizumab and 5 weeks of stereotactic body radiotherapy therapy, the patient presented with pericardial effusion and interstitial pneumonia. PD-1 programmed death-1, PD-L1 programmed death-ligand 1, SBRT stereotactic body radiotherapy