Thus, we detected mutually exclusive expression and distribution of B7-H4 (VTCN1) and PD-L1 (CD274) in five cases (83%, 5/6), whereas one HNSCC (S4) core was double-positive for B7-H4 (VTCN1) and PD-L1 (CD274). Here, CD274 is linked to head and neck squamous cell carcinoma.