CD8A and cholangitis: The proposed immunological mechanisms underlying ICI-PI involves neutrophil and CD8+ T-cell-predominant infiltrates, which induce acinar cell atrophy and acinar-ductal metaplasia while preserving the pancreas' lobular architecture.6,7 In a report by Rawson et al, neutrophilic infiltrates were also observed in the pancreatic ducts.8 Moreover, ICI-induced cholangitis has been associated with periductal lymphocytic infiltration and fibrosis.9 These findings highlight the potential for ICIs to simultaneously affect the PD and CBD as seen with our patient.