Gross dissection of the left-sided lower anterior cervical region revealing a Virchow node (VN). The node was partially obscured at its superior pole by the superior belly of the omohyoid muscle (Sup Omo m) which has been retracted in this image. The node joined the thoracic duct (TD) which joined together with the internal jugular vein (Int Jug v) to contribute to the subclavian vein (Subclav v). The platysma and sternocleidomastoid muscles are reflected posteriorly and proximal half of the clavicle was resected to reveal the Virchow node and its surrounding vascular anatomy. The long axis of the VN was oriented parallel to the internal jugular vein and the distal thoracic duct.


Serial sections of the Virchow node. The cut surfaces are almost entirely replaced by a grossly evident metastatic tumor.


Transverse section of the lower lobe of the left lung showing a 4.2 x 4.0 x 3.5 cm solid, pale, indurated mass that encases the adjacent vasculature and abuts the hilum. The uninvolved parenchyma is tan with dilated air spaces and many areas of environmental pigmentation.


A: magnetic resonance imaging performed in the non-contrasting T1 sequence, showing an enlarged and irregular expansive lesion of the pancreas tail (red arrow) and thickening of the left adrenal (blue arrow).


B: magnetic resonance imaging performed in the contrasting T1 sequence.


C: nodular lesion in segment VI of the liver (yellow arrow).


Biopsy of the left adrenal mass: (a and b) Photomicrographs showing features of nonHodgkin's lymphoma with diffuse architecture composed of intermediate to large atypical lymphoid cells (H and E, x4 and x40 respectively). (c) Immunohistochemistry is positive for leukocyte common antigen (x40). (d) CD-3 (x40). (e) CD-56 (x40). Immunohistochemistry was negative for (f) CD-20 (x40). (g) CD-4 (x40). (h) CD-8 (x40).


Multiple ulcers seen over the left labia majus and a large ulcer on the mons pubis.


Preoperative antero-posterior view.


Acinar structures lined by epithelial cells admixed with myo-epithelial cells and myxoid matrix. (H&E. x100).


Dystrophic calcification (Hx&E, x400).


Nuclear positivity of ki67 in 2% of tumor cells (x40).


CT angiography (antero-posterior view).


Inferolateral incision.


Postoperative specimen.


Covering with Thiersch graft.


Pleomorphic adenoma shows alternating.


Chest CT scan. Massive pleural effusion and left breast mass (arrow).


Chest CT scan. Primary lung cancer in the left upper lobe (arrow).


Breast biopsy. Histology features.


Breast biopsy. TTF1-positive immunostaining profile. For breast metastasis of the lung adenocarcinoma.


Chest CT scan. Objective response after 2 months of afatinib (arrow; see fig. 2 for baseline).


Barium enema shows an encircling tumour in the sigmoid colon (arrows), 1b: Port sites for laparoscopy assisted sigmoid colectomy.


Computed tomographic scan shows a metastatic liver tumour (arrow).


Ultrasound (A) shows an oval cystic mass with an uneven wall thickness (white and black arrows). Magnetic resonance imaging shows a lobulated cystic mass with a cystic wall and septum of uneven thickness.


T1-weighted imaging. Show slightly high signal intensity (indicated by white arrows both in.


T2-weighted imaging. Show slightly high signal intensity (indicated by white arrows both in.


Short time inversion recovery imaging. Shows low signal intensity (white arrow).


Dynamic contrast-enhanced magnetic resonance imaging. Shows slight and localized enhancement on the cystic wall (white arrow).


Histological examination shows an undifferentiated adenocarcinoma with cystic wall and papillary architecture (H&E staining, x100) (F).


Positive immunohistochemical results for WT-1 (IHC, x400) (G).


Grayscale US showed a tumor with a snowman-like appearance and a relatively clear boundary in the S6 of the liver, with hypo- and hyperechoic areas in the lateral (arrowhead) and medial parts (arrow) of the lesion, respectively (a).


Contrast-enhanced CT showed a tumor prolonged enhancement in the equilibrium phases (arrow) (b).


MRI showed high intensity in the lateral part of the tumor (arrowhead) and higher intensity in the medial part of the tumor (arrow) on heavy T2-weighted imaging (c).


The lateral part of the lesion showed homogenous hyperenhancement (arrowhead) and the medial part of the lesion showed gradually stained from the margin toward the central region (arrow) in the vascular phase on contrast-enhanced US (16 s.


18 s.


20 s.


22 s. After injection).


A cut section of the resected liver showed a whitish nodular lesion in the medial part (white arrow) and a yellowish-white nodular lesion in the lateral part (black arrowhead) (a). The medial part comprised blood vessels formed by a single layer of flattened endothelial cells and an interstitium formed by thin connective tissue. In the lateral part, lymphocyte infiltration in a dense arrangement was observed (a; HE, x40).


On immunohistochemical staining, B lymphocytes expressing CD20. CD20, x100).


CD79alpha. CD79alpha, x400) were present.


(A) Contrast enhanced CT on day +70 after HSCT presented right cervical lymph nodes enlargement with central necrosis.


(B) Highresolution chest CT revealed old pulmonary scar lesions with pleural thickening in the right upper lobe.


Cervical lymph node biopsy wound on day +90 with purulent suppuration.


Haematoxylin and eosin stain of the lymph node showed granuloma formations with necrosis.


Fused PET/CT coronal image of the large hypermetabolic pelvic mass.


Metaplastic mammary carcinoma with osseous differentiation (Hematoxylin and Eosin 10x).


Levels of alkaline phosphatase (IU/L) at baseline and during the course of therapy. Levels corresponded to her radiological response, with initial partial response followed by stable disease.


High power image of the aspirate smear slides (left Diff-Quik, x400; right Papanicolaou, x400) showing cells with abundant, dense cytoplasm, well-defined cytoplasmic borders, cytoplasmic windows, occasional vacuoles, and round to oval nuclei, pale chromatin, and moderate variation in nuclear size.


Various vacuoles appreciated in the aspirate smears, varying from large, solitary vacuoles displacing the nucleus into an eccentric position (upper left, Papanicolaou, x400), large solitary perinuclear vacuoles with grey-light blue material suggestive of mucin (upper right, Papanicolaou, x400), or multiple small vacuoles, often overlying the nucleus (lower left and lower right, Diff-Quik, x400).


A 24-mm firm, hyperkeratotic, and ulcerated tumor in the scalp.


Infiltrated and ulcerated tumors in the anterior thorax.


Superficial erosion in the anterior thorax.


The irradiated gross tumor volume and the radiation dose plan.


Dynamic change curves of CEA in peripheral blood during the whole treatment process.


Resection samples of intestines and kidneys.


A computed tomography image, with intravenous contrast. . Note: The mass in the left renal middle pole is shown (white arrows).


Color ultrasound images of the space-occupying lesion in the left kidney. . Notes: (A) A hyperechoic mass was detected in the mid pole of the left kidney, with a definite boundary and an irregular shape.


Color ultrasound images of the space-occupying lesion in the left kidney. (B) A rod-like blood signal was detected in the mass, and renal perfusion was normal.


Immunohistochemistry. . Notes: (A) Cytokeratin 7 was strongly positively expressed in the cytoplasm of the papillary RCC cells (magnification, x400).


Immunohistochemistry. (B) Alpha-methylacyl coenzyme A racemase displayed weak positive expression in the cytoplasm of papillary RCC cells (magnification, x400).


Immunohistochemistry. (C) Cluster of differentiation 10 was slightly positively expressed in the papillary RCC cells (magnification, x400).


Immunohistochemistry. (D) WT1 exhibited strong positive expression in the WT nuclei (magnification, x400). . Abbreviations: RCC, renal cell carcinoma; WT, Wilms' tumor; WT1, Wilms tumor gene 1.


Pathological findings. Brain biopsy from the left frontal lobe. (A) Hematoxylin and eosin staining.


Pathological findings. Brain biopsy from the left frontal lobe. (B) CD20 immunohistochemical staining.


Pathological findings. Brain biopsy from the left frontal lobe. (C) Ki-67 immunohistochemical staining.


Pathological findings. Brain biopsy from the left frontal lobe. (D) CD3 immunohistochemical staining.


Contrast-enhanced brain MRI recorded 1 month after brain biopsy shows a spotty gadolinium enhancement in the left periventricular white matter (arrow) and post-biopsy scar (arrowhead).


With T2 hyperintensities.


(C) This lesion does not show abnormal hyperintensities on diffusion-weighted imaging (DWI).


Transverse T2 MRI section. The section shows well-defined complex lesion (arrow) with solid and cystic contents in the pelvis, extending on either side of the midline reaching to both sides of adnexa and measuring 13 x 9.4 x 8.1 cm. Ovaries are not seen separately from the lesion. Uterus shows mild deviation to the left side due to pressure effect from the mass. No obvious lymph nodes or signs of metastasis.


Low and High power hematoxylin and eosin-stained section. A; Low power hematoxylin and eosin-stained section (4x) demonstrates thyroid follicles of papillary carcinoma arising in benign thyroid follicles of SO.


Low and High power hematoxylin and eosin-stained section. B; High power hematoxylin and eosin-stained section (60x) demonstrates papillary thyroid carcinoma with follicular pattern. Nuclear features including nuclear groves, clearing, overlapping and enlargement, consistent with papillary thyroid carcinoma arising in a SO.


Thyroglobulin immunohistochemical stain. Low power thyroglobulin immunohistochemical stained section (4x) highlights the thyroid tissue in a background of ovarian tissue with SO.


Prenatal USG shows well-defined round lesion on left side of urinary bladder with foci of calcifications (multiple white markers along margin of lesion). Prenatal diagnosis of cryptorchid testicular teratoma was made (images of normal testis were not included due to limitations pertaining to PCPNDT).


Postnatal USG shows cystic lesion with calcifications on left side of urinary bladder with no internal vascularity on Doppler study. These findings were similar on prenatal USG and diagnosis of cryptorchid testicular teratoma was assured.


Intra-operative image shows lesion excised during surgery (excised lesion held with forceps).


Intraoperative finding showing enlarged bilateral ovaries, arrow pointing to enlarged left fallopian tube.


Total abdominal hysterectomy with bilateral salpingo-oophorectomy specimen, arrow pointing to enlarged left fallopian tube.


Cut section showing predominantly solid, homogenous, gray-white ovary with few small cysts, and ,areas of hemorrhage.


On low power microscopy, ovary shows diffuse dense infiltrate of monomorphic neoplastic lymphoid cells with intact capsule (arrow).


Low power microscopy of the left fallopian tube showing diffuse dense infiltrate of monomorphic neoplastic lymphoid cells consisting of medium-sized cells with round to oval nuclei, finely dispersed chromatin, and ,single to multiple small nucleoli.


Immunohistochemistry showing tumor cells were diffusely, and ,strongly positive for Tdt.


Immunohistochemistry showing tumor cells were negative for B-cell marker CD-20.


Whole body fluorodeoxyglucose-positron emission tomography/computed tomography (PET/CT) maximum intensity projection image.


Axial fused PET/CT showed a intense uptake in the soft-tissue lesion in the left breast.


Liver lesions.


Bone lesion.


Axial CT showing lytic bone lesion in D4 vertebra.


Immunohistochemistry staining showing positive for chromogranin.


Synaptophysin.


Fluorodeoxyglucose-positron emission tomography-computed tomography (FDG-PET-CT) in October 2017. FDG-PET-CT indicated low glucose metabolism of left frontal-parietal lobe, which was suggestive of an intracranial primary benign lesion.


Histological analysis. The pathological report gave a diagnosis of glioblastoma, WHO IV, without mutation of the isocitrate dehydrogenase 1 (IDH1) gene.


Contrast computed tomographic scan of head showing an ill-defined heterogeneously enhancing left CPA mass with mild perifocal edema (a).


Second day postoperative image demonstrates the craniectomy site, adequate decompression of left CPA region with no hemorrhage on the tumor bed (b).


Magnetic resonance (MR) image revealing T1 hypointense.


T2 hyperintense.


Intra-axial fairly marginated inhomogenously enhancing. Mass of size 24 x 21 x 24 mm in left CPA region with mild perilesional edema and mass effect, compressing the fourth ventricle causing mild outflow obstruction.


No evidence of restricted diffusion was seen in diffusion-weighted image (d).


Clinical examination. Intraoral image revealing a mass with an elastic, hard, well-defined swelling and a smooth surface in the right maxillary molar region. The lesion measured 31x25x15 mm in size.


Panoramic radiographic finding. Panoramic radiograph revealing the cystic radiolucent lesion in the right maxilla elevating the floor of the right maxillary sinus, indicating the presence of a cystic lesion or odontogenic tumor of the right maxilla.


FDG-PET images. Axial.


FDG-PET images. Coronal FDG-PET/CT images revealing a slight FDG uptake in the primary tumor of the right maxilla and bilateral superior internal jugular nodes.


FDG-PET images. (C) No abnormal uptake, which would indicate distant metastasis, was observed on FDG-PET images. FDG-PET, 18F-fluorodeoxyglucose-positron emission tomography; CT, computed tomography.


Microscopic examination. (A) The majority of the mass consisted of spindle tumor cells exhibiting a storiform, pseudosarcomatous pattern. The epithelial component demonstrated cytological malignancy, characterized by nuclear pleomorphism, an increased nucleus to cytoplasm ratio, hyperchromatic nuclei and a high mitotic rate.


Microscopic examination. (B) In the other area, the tumor cell nest exhibited peripheral palisading of columnar cells, with a vacuolated cytoplasm and reverse-polarized nuclei. These findings resemble those for ameloblastoma.


Microscopic examination. (C) The Ki-67 proliferation index was 5%, indicating that this tumor was of low malignancy.


Kaplan-Meier curves for. Disease-free survival (DFS).


Overall survival (OS). The five-year and 10-year DFS rates were 53.7 and 32.2%, respectively. The five-year OS rate was 83.2% and the 10-year rate was 32.2%, the same as the DFS rate.


H&E staining.


IHC result of CD8.


PD-L1. For the liver lesion. H&E staining, hematoxylin and eosin staining; IHC, immunohistochemistry; PD-L1, programmed cell death ligand 1.


Preoperative axial.


Coronal.


Sagittal. T1-weighted MRI studies showing a gadolinium enhancing extra-axial mass of the left tentorial incisure.


Temporal lobe edema is seen on the axial T2-weighted MRI studies (d).


Clinical features of the patient. . Note: The patient had typical OCA symptoms on the color of skin, hair, and iris. Abbreviation: OCA, oculocutaneous albinism.


HFSR was caused during Act-D chemotherapy. Pictures show different grades. . Notes: (A) After the 2 courses of Act-D chemotherapy, mild edema, blister, and obvious erythema were observed in the palmar and metatarsal part of the foot, and the surface of the erythema was covered with exudate, and the peripheral skin was dried and desquamated.


HFSR was caused during Act-D chemotherapy. Pictures show different grades. (B) After the 3 courses of Act-D chemotherapy, multiple ulcers were seen in the palmar and metatarsal area of both hands and feet, and the depth of ulcers varied from 1 to 3 mm. Bleeding and exudation were found on the surface of ulcer. The ulcer surface was covered with black scabs surrounded by a red halo, and the peripheral skin was dried and desquamated. . Abbreviation: HFSR, hand-foot skin reaction.


Histopathology in Act-D chemotherapy was associated with HFSR (H&E staining). 4x.


Medical image.


40x): Epidermal defect, ulcer formation, a great number of neutrophils, fibrinoid degeneration of the inferior vascular wall, infiltration of perivascular lymphoid cells, neutrophils, some eosinophilic leukocytes, and proliferation of fibroblasts. . Abbreviation: HFSR, hand-foot skin reaction.


MRI presentation of the tumor. MRI revealed a solid mass involved the nasal cavity and sinuses, destroying bone tissue.


Postcontrast T1 sagittal.


T2 sagittal.


T1 axial MRI images showing anterior compression of the spinal cord from epidural extension of the lesion at the T9 vertebra.


Asymptomatic enhancing lesions at the L1 spinous process and L5 vertebral body.


T7 to T11 instrumentation and fixation, T9 laminectomy and excision of tumor. Anterior-posterior film.


T7 to T11 instrumentation and fixation, T9 laminectomy and excision of tumor. Lateral film.


Contrast CT scan showed a 4.5 cm lobulated mass in the right upper lobe and multiple enlarged mediastinal lymph nodes (A).


The lung lesions regressed dramatically with administration of crizotinib for 1 month.


12 months.


Brain MRI revealed multiple metastases in the cerebral hemispheres and cerebellum bilaterally (not shown) (D).


However, the intracranial lesions progressed 12 months later (E).


A core needle lung biopsy specimen revealed trabecular and solid nests with moderately abundant eosinophilic cytoplasm, and was positive for neuroendocrine markers (F, H&E x200).


Histologic examination of primary peritoneal high-grade serous carcinoma (HGSC). . Hematoxylin and eosin (H&E) staining, original magnification 1A:X4; 1B:X10.


Strong and diffuse immunoexpression of p53 in primary peritoneal high-grade serous carcinoma (HGSC), original magnification X10.


Histologic examination of serous borderline tumor (SBT). . Hematoxylin and eosin (H&E) staining, original magnification 3A: X4; 3B:X10.


Wild-type immunoexpression of p53 in serous borderline tumor (SBT), original magnification X40.


Endoscopic ultrasound showing 2 periesophageal/perigastric lymph nodes (11.6 mm, 7.2 mm).


Staging CT scan of the abdomen showing thickening of the gastroesophageal junction corresponding to the primary lesion. Arrow indicates the neoplastic lesion at the gastroesophageal junction with a diameter of 10.30 mm (upper panel). Staging PET scan of the abdomen showing hypermetabolism in the corresponding primary lesion. The neoplastic lesion at the gastroesophageal junction demonstrates hypermetabolism (lower panel).


Large anaplastic cells with prominent nucleoli admixed with histiocytes and many eosinophils (A&B) show diffuse positive immunoreaction to Leukocyte common Antigen (LCA) (C).


Case 1 pathological figures. (A) Computed tomography of gastric stump after gastric cancer surgery.


Case 1 pathological figures. (B) Postoperative pathological biopsy result revealed moderately differentiated adenocarcinoma of cardia (Hematoxylin & Eosin staining, x20).


Case 2 pathological figures. (A) Preoperative computed tomography showed a oval nodule in the right breast (arrow).


Case 2 pathological figures. (B) Biopsy revealed breast invasive carcinoma (Hematoxylin & Eosin staining, x20).


Case 3 pathological figures. (A) Preoperative computed tomography showed round ground-glass nodule in the left lower lung (arrow).


Case 3 pathological figures. (B) Pathological biopsy revealed left lung moderately-differentiated adenocarcinoma (Hematoxylin & Eosin staining, x20).


Case 4 pathological figures. (A) Preoperative computed tomography of cervical occupying lesion (arrow).


Case 4 pathological figures. (B) Pathological biopsy result revealed poorly-differentiated squamous cell carcinoma of the cervix (Hematoxylin & Eosin staining, x20).


Case 5 pathological figures. (A) A hypoechoic mass can be seen in the left lobe of the thyroid gland, and a punctate lesion with strong echo was seen (arrow).


Case 5 pathological figures. (B) Thyroid biopsy result revealed papillary carcinoma (Hematoxylin & Eosin staining, x20).


Case 6 pathological figures. (A) The soft tissue mass near the right femur (arrow) at initial diagnosis.


Case 6 pathological figures. (B) After 4 courses of chemotherapy for multiple myeloma, the soft tissue mass near the right femur was significantly larger than that at initial diagnosis.


Case 6 pathological figures. (C) Pathologica biopsy result revealed lymphoma or plasmacytoma at initial diagnosis (Hematoxylin & Eosin staining, x20).


Case 6 pathological figures. (D) The second pathological biopsy result revealed lymphoma (Hematoxylin & Eosin staining, x20).


A) Non-enhanced CT shows a huge presacral homogenous mass displacing the vagina anteriorly and the rectum on the right side.


B) Sagittal multiplanar reformation of contrast-enhanced CT clearly depicts a fat plan between the heterogeneously enhancing mass and the sacrum.


A) Left panel (H&E, 20x): typical vascular pattern of the SFT. Right panel (H&E, 40x): SFT with extramedullary hematopoiesis (black arrows: megakariocytes; white arrow: an erythroid island).


B) Extramedullary hematopoiesis: immunohistochemical staining highlighting megakariocytes (CD61), nucleated erythroid cells (CD71) and granulocyte precursors (myeloperoxydase).


MRI images from Case 3:. Coronal section at level of iliofemoral vessels shows large, laterally encapsulated retroperitoneal tumor. Coronal section posterior to. Shows deformation of abdominal aorta (solid arrows) by tumor, and infiltration of left renal hilum (LRH) causing hydronephrosis.


Medical image.


Timelines for cases 1-3 summarizing treatment, recurrences and final outcome.


Chest CT showing the lesion. . Abbreviation: CT, computed tomography.


Surgical evidence. . Notes: (A) The tumor excised en-bloc with part of the adjacent ribs and manubrium.


Surgical evidence. (B) The mesh covering the defect before closure of the surgical wound.


Metastatic melanoma, H&E stain, x40. . Abbreviation: H&E stain, hematoxylin and eosin stain.


Preoperative computed-tomography images. Computed tomography of a horizontal dislocation and b coronal dislocation showing a large mass in the pericardium anterolateral to the main pulmonary artery (A).


Preoperative computed-tomography images. Horizontal dislocation also showed a mass in the posterior mediastinum posterior to the bronchi (B). PA pulmonary artery.


Intraoperative picture. A large tumor can be seen anterolateral to the main pulmonary artery (T). Ao ascending aorta, RV right ventricle.


Picture of the en bloc resected tumors. Two large masses were anterolateral to the main pulmonary artery, and one small mass was adjacent to the right ventricle. All of them were soft and mucinous.


Postoperative computed-tomography images. Computed tomography showed that the pericardial tumor was almost totally resected and there was no evidence of recurrence.


(a) T1 axial magnetic resonance imaging (MRI) with contrast revealing an enhancing mass in the left atrium.


(b) T1 sagittal MRI with contrast showing an enhancing mass in fourth ventricle.


Patient before treatment with vismodegib.


Patient after treatment with vismodegib.


Sagittal.


Axial. T1-weighted gadolinium- enhanced.


Axial. T2-weighted magnetic resonance imaging sequences showing a C1-C2 intramedullary expansive lesion (10 mmx15 mm), T2-hypointense and T1-hyperintense after gadolinium administration.


Axial abdominal contrast-enhanced computed tomography scan image showing a voluminous mass (about 85 mm) (black asterisk) involving the upper polar region and the middle third of the right kidney, the ipsilateral adrenal gland, and extends posteriorly to infiltrate the ipsilateral psoas muscle. This lesion, which presents an inhomogeneous hypodense aspect with hypervascular foci in this context, is associated with collateral circles in the peri- and pararenal space, with the infiltration of the upper right calyxes. A neoplastic thrombosis of the renal vein and inferior vena cava in the subhepatic tract is also present and may explain hematogenous spread through Batson's venous plexus.


Intraoperative findings during microsurgical removal of the lesion: a good exposure of the posterior surface of the spinal cord at level C1-C2 after opening the dura mater is performed (a).


After arachnoid dissection and preservation of the posterior spinal arteries, the posterior median sulcus is identified and the posterior myelotomy is performed, with access to the intramedullary lesion which shows a reddish-gray and highly vascularized appearance (b).


Axial. T2-weighted magnetic resonance imaging sequences showing a macroscopic total removal of the lesion and a physiological evolution of the operative field with the left median-paramedian malacic area.


Heterotopic calcification in prevertebral space after radiotherapy in 74-year-old woman. . A. Computed tomography (CT) scout image during admission shows curvilinear calcification (arrow) anterior to C2-3 with increase in size and change in configuration, in comparison to previous image. Slightly decreased soft tissue swelling is also noted (arrowhead).


Heterotopic calcification in prevertebral space after radiotherapy in 74-year-old woman. Axial contrast-enhanced CT images during admission on soft tissue. And bone.


Heterotopic calcification in prevertebral space after radiotherapy in 74-year-old woman. Axial contrast-enhanced CT images during admission on soft tissue. Windows with sagittal reformat on bone windows.


Heterotopic calcification in prevertebral space after radiotherapy in 74-year-old woman. Axial contrast-enhanced CT images during admission on soft tissue. Reveal increase in size of prevertebral calcification (arrows) anterior to C2-3. Radiation changes (arrowheads) in soft tissue are still noted. However, edematous change decreased slightly. Additionally, C2 and C3 demonstrate newly appearing osteopenia and trabecular coarsening suggesting osteoradionecrosis. Degenerative calcifications along intervertebral discs are also noted at C3-4 and C6-7 intervertebral disc levels.


Heterotopic calcification in prevertebral space after radiotherapy in 74-year-old woman. E. Initial CT scout image 7 years ago shows small ovoid calcification (arrow) anterior to C2 and associated with prevertebral soft tissue swelling (arrowhead).


Heterotopic calcification in prevertebral space after radiotherapy in 74-year-old woman. F, G. Initial axial contrast-enhanced CT images on soft-tissue.


Heterotopic calcification in prevertebral space after radiotherapy in 74-year-old woman. F, G. Bone. Windows reveal dense globular calcification (arrows) anterior to C2 and associated radiation changes (arrowheads) in retropharyngeal, prevertebral, parapharyngeal, and carotid spaces.


Heterotopic calcification in prevertebral space after radiotherapy in 74-year-old woman. H. Follow-up lateral radiograph after 1 year shows no change in calcification (arrow) and prevertebral soft tissue swelling (arrowhead).


(a) A 68-year-old patient was treated with total cystourethrectomy. Hematoxylin-eosin staining of the prostatic urethra reveals urothelial carcinoma. The arrow indicates groups of urothelial carcinoma cells invading into the vein.


(b) Hematoxylin-eosin staining of metastatic brain tumor shows groups of well-differentiated urothelial carcinoma cells with necrosis, which is the same pathological findings of the origin of the tumor, the prostatic urethra. The tumor was attached to the dura mater.


(a) Magnetic resonance image (MRI) before the operation shows an irregularly shaped, heterogeneously enhanced mass with Gadolinium enhancement on T1 images.


(b) MRI after the operation shows gross total removal of the tumor.


A-F. Histopathology features of the sinonasal carcinosarcoma in the incisional biopsy specimen showing proliferation of cuboid cells with nuclear and cytoplasmic pleomorphism. It was also possible to observe the appearance of the tumour from the respiratory epithelial tissue (stained with HE). Scale bars:. 200 mum.


A-F. Histopathology features of the sinonasal carcinosarcoma in the incisional biopsy specimen showing proliferation of cuboid cells with nuclear and cytoplasmic pleomorphism. It was also possible to observe the appearance of the tumour from the respiratory epithelial tissue (stained with HE). . 20 mum.


A-F. Histopathology features of the sinonasal carcinosarcoma in the incisional biopsy specimen showing proliferation of cuboid cells with nuclear and cytoplasmic pleomorphism. It was also possible to observe the appearance of the tumour from the respiratory epithelial tissue (stained with HE).


Axial fused 18F-FDG-PET/CT (SUV scale 0-6) demonstrating a FDG-avid (SUV max 7.8) nodule in the right lobe of the thyroid. . Abbreviations: 18F-FDG-PET/CT, 18F-fluorodeoxyglucose-positron emission tomography/computed tomography; SUV, standardized uptake value.


Treatment timeline.


Deep ulcer on lateral border of tongue with no exophytic growth.


Excessive keratin flakes seen in superficial epithelium with keratin filled crypts (x10).


Low magnification shows networking or anastomosing cords of epithelial proliferation (x5).


Keratin pearls in the connective tissue ,keratin plugging seen in the deeper portions of crypt. (x10).


Anteroposterior and lateral radiograph of the right leg showing lytic lesion with large soft-tissue component and hair-on-end periosteal reaction in mid-diaphysis of tibia.


Left eye. Total ptosis.


Left eye. Total ophthalmoplegia.


(a) H and E-stained section of nasopharyngeal punch biopsy specimen showing nests of small round blue cells, (b) Strong CD99 immunoreactivity.


Photograph of the ulcerative mucosal lesion of the lower left lip before treatment.


Placement of metal needles according to the Paris system is assisted by clear plastic templates held in place by a metal frame.


Stabilization of BT catheters using radiolucent buttons in the LL.


Simulation of HDRIB with 192Ir for irradiation of the patient's tumour.


Two-year post-treatment result, indicating mild atrophy and hypopigmentation. The patient was pleased with the aesthetic result.


Isodose curves of an inverse IMRT plan displayed on the axial plane at the level of the oral cavity.


Phorograph at the start of week of six of treatment, just prior to receiving a treatment break.


Photograph at the first followup visit five weeks after completion of treatment.


Pre-operative anterior-posterior X-ray view of the pelvis.


Proximal lateral X-ray view of the femur. Demonstrating a large, aggressive appearing lesion with mixed lytic and blastic features with a thin cortical rim over the margin medially about the proximal right femur.


Pre-operative coronal T1-weighted magnetic resonance imaging (MRI).


Coronal T2-weighted MRI. Of the pelvis demonstrating an aggressive lytic appearing lesion near the inferomedial femoral neck and lesser trochanter extending through the cortex with a softtissue mass of approximately 6cm in size. The soft tissue mass abuts the iliopsoas and vastus musculature appearing to cause an adjacent mass effect.


(a and b) High-power photomicrographs from curettage specimen stained with hematoxylin and eosin demonstrating proliferation of relatively uniform large polygonal cells (black arrow) with eccentric round nuclei and abundant eosinophilic cytoplasm. These cells were associated with the formation of new woven bone (white arrow) seen growing in large sheets.


Imaging at 1-year follow-up with anterior-posterior X-ray view of the right femur.


Proximal lateral X-ray view of the right femur. Confirmingthe placement of the short cephalomedullary intramedullary nailwith bony union. No hardware complications or lesion recurrence present.


Computer tomography scan images of lower abdomen. A. Axial CT with IMT (arrow and dotted) in the urinary bladder.


Computer tomography scan images of lower abdomen. B. Coronal CT with IMT (arrow and dotted) in the urinary bladder.


Inflammatory myofibroblastic tumor in the urinary bladder. A. Low-power view.


Inflammatory myofibroblastic tumor in the urinary bladder. B. High power view showing spindle cells (arrows) with interspersed inflammatory cells (notched arrows).


Immunohistochemical stains for inflammatory myofibroblastic tumor in the urinary bladder. A and B. Tumor cells show positive reactivity for pankeratin and smooth muscle actin.


Immunohistochemical stains for inflammatory myofibroblastic tumor in the urinary bladder. C-E. Tumor cells show negative reactivity for desmin, p63 and ALK.


FISH and immunohistochemistry studies for inflammatory myofibroblastic tumor in the urinary bladder. A. The tumor cells failed to show 2p23 ALK gene rearrangement. The arrows indicate the intact juxtaposed green and red signals in the tumor cells.


FISH and immunohistochemistry studies for inflammatory myofibroblastic tumor in the urinary bladder. B. Tumor cells showed no reactivity (lack of brown staining cells) for uroplakin II.


Primary pelvic and metastatic splenic tumors prior to and following chemotherapy. (A) Prior to chemotherapy, extensive lesions with vague boundaries were detected in the pelvic cavity and mixed cystic-solid masses were identified in the spleen.


Primary pelvic and metastatic splenic tumors prior to and following chemotherapy. Following. Two.


Primary pelvic and metastatic splenic tumors prior to and following chemotherapy. Four cycles of chemotherapy, changes occurred in the lesions in the pelvic cavity and spleen.


Primary pelvic and metastatic splenic tumors prior to and following chemotherapy. (D) Following six cycles of chemotherapy, the primary pelvic tumor was markedly degraded and the splenic mass gradually became cystic.


Postoperative pathological results of the lesions. (A) Ovarian pathology following cytoreductive surgery (H&E staining; magnification, x400).


Postoperative pathological results of the lesions. (B) CA-125 expression in ovarian clear cell carcinoma (immunohistochemical staining; magnification, x400).


Postoperative pathological results of the lesions. (C) Splenic pathology following splenectomy (H&E staining; magnification, x200). H&E, hematoxylin and eosin; CA-125, cancer antigen-125.


Pretreatment imaging evaluation. Ultrasonography showed an irregular hypoechoic mass at the 4-o'clock position, 1 cm from the nipple, measuring 3.9 x 3.3 cm. Malignancy was confirmed with a biopsy (A). Magnetic resonance imaging revealed a mass (3.4 x 2.2 cm) at the 4-o'clock position, 1 cm from the nipple in the left breast, which was concordant with the biopsy-confirmed malignancy.


Pretreatment imaging evaluation. Ultrasonography showed an irregular hypoechoic mass at the 4-o'clock position, 1 cm from the nipple, measuring 3.9 x 3.3 cm. Multiple enhanced nodules (1.4 cm in the longest diameter) were observed, and the total extent measured 5.8 cm (B).


Posttreatment imaging evaluation. Ultrasonography showed that the dimensions of the malignant mass had decreased to 2.1 x 1.0 cm (A).


Posttreatment imaging evaluation. Magnetic resonance imaging showed that the biopsy-confirmed malignant mass and multiple suspicious daughter nodules (total extent measuring 2.1 cm) in the left breast had decreased in size (B).


Aggressive angiomyxoma in 37-year-old woman. . A. Unenhanced CT image shows large abdominal mass (stars) being hypo-attenuated in relation to surrounding muscular tissue.


Aggressive angiomyxoma in 37-year-old woman. B. Contrast-enhanced CT image shows large homogeneous abdominal mass (stars). It directly invades inferior vena cava (long arrow), causing obstruction of inferior vena cava and formation of periaortic venous collaterals (short arrow).


Aggressive angiomyxoma in 37-year-old woman. C. Coronal reconstruction image from contrast-enhanced CT shows mass encasing colon (long arrow) and causing portion of loop of small bowel to deviate superiorly (short arrow).


Aggressive angiomyxoma in 37-year-old woman. D. Coronal reconstruction image from contrast-enhanced CT shows inferior vena cava filling defect (long black arrow) extending superiorly to level of right atrium (short black arrow). Image also shows prominent enhancing nodules within inferior vena cava (black arrowheads) and collateral vessels around aorta (white arrow).


Aggressive angiomyxoma in 37-year-old woman. E. Contrast-enhanced CT image shows heterogeneously enhancing mass in left lower lobe (long arrow) and apparent inferior vena cava filling defect (short arrow).


Aggressive angiomyxoma in 37-year-old woman. F. Low-power view shows vascular appearance of tumor, against myxoid, hypocellular background.


Aggressive angiomyxoma in 37-year-old woman. G. Medium-power view shows bland cytological appearance of spindle cells.


Histological and immunohistochemical findings. Heteromorphic cells were seen to be nest-like or lamellar with dense arrangement, and ,hyperchromatic nuclei (hematoxylin, and ,eosin staining, x100).


Histological and immunohistochemical findings. Immunohistochemical staining for CK shows focal positivity (x100).


Histological and immunohistochemical findings. Immunohistochemical staining for CK7 shows focal positivity (x100).


Histological and immunohistochemical findings. Immunohistochemical staining for PAS-AB shows focal positivity (x100).


Histological and immunohistochemical findings. Immunohistochemical staining for Vimentin shows focal positivity (x100).


Histological and immunohistochemical findings. Immunohistochemical staining for Hepatocyte shows focal positivity (x100).


Histological and immunohistochemical findings. Immunohistochemical staining for TTF-1 shows negativity (x100).


Histological and immunohistochemical findings. Immunohistochemical staining for Ki-67 shows 60% positivity (x100).


The changes in complete blood count (WBC, lymphocyte and granulocyte) depended on the date (days 0-30).


Gross view of the milky-like liquid collected on the drainage of the ascites.


Microscopic examination of the specimen after excisional biopsy of the right supra-clavicular mass.


Microscopic examination of the surgical specimen after total thyroidectomy.


CT image.


Representative clinical images, carcinoembryonic antigen (CEA), and cancer antigen 125 (CA-125) monitoring during the course of treatment. (A) Computed tomography (CT) scans showed the patient's tumor mass (arrows) during alectinib treatment.


Representative clinical images, carcinoembryonic antigen (CEA), and cancer antigen 125 (CA-125) monitoring during the course of treatment. The levels of. CEA.


Ultrasonographic view.


Computerized tomography scan.


Frozen section material.


Foci of squamous cell carcinoma. HE. x5.


Atypical mitotic figures and giant cells with storiform pattern-clustered and scattered polygonal cells to spindle cells with markedly pleomorphic characteristics (inflammatory cell infiltration).


Cells show CD68 positivity on immunohistochemistry.


CT scan of the abdomen and pelvis with abdominal ascites.


HHV-8 immunostain showing positive nuclear staining. HHV-8 is required for an unequivocal diagnosis of PEL.


High-power view of the cell block highlighting background single-cell necrosis (arrows) admixed with the malignant lymphocytes. H&E. x40.


Colposcopes view of the lesion. (A) An 8-millimeter-diameter intravascular papillary endothelial hyperplasia in the right apical angle of the vagina with medium amount of blood. The lesion is red to purple coloration, and a medium amount of blood was seen.


Colposcopes view of the lesion. (B) Iodine staining of the lesion.


On CT, a slightly low-density and ill-defined mass in the body of pancreas was detected on plain CT scan. Red arrow), with a size of 4.1 cm x 2.8 cm, likewise, a left adrenal lesion measuring 2.8 cm x 2.8 cm can be observed, with relatively well-defined margin, and . Mixed-density. White arrow).


The left adrenal lesion showed continuously nonuniform enhancement in the portal venous phase. White arrow),. The same enhancement pattern can be observed in the pancreatic tumor. Red arrow).


When compared with the previous CT scans 1 month ago. Portal venous phase).


3 months ago. Portal venous phase) respectively, the size and density of pancreatic tumor (red arrow) and adrenal lesion (white arrow) presented no significant changes through the whole timeline.


On MRI, T2-weighted sequences showed a mixed hyperintense lesion located in the left adrenal.


Partly restricted diffusion in DWI.


In contrast-enhanced T1 weighted sequences, this lesion manifested a thin capsular-rim arterial phase hyperenhancement with slow heterogeneous centripetal enhancement.


Histological view at low magnification.


High magnification. Showing a multi-cystic lesion of the left adrenal (hematoxylin and eosin staining, x100 and x200), the entire picture is consistent with benign lymphangioma.


The levels of serum CA19-9 (normal range, 0-22 U/mL) before and after apatinib treatment. CA19-9, cancer antigen 19-9; DDP, cisplatin; GEM, gemcitabine; CAPE, capecitabine; CPT-11, irinotecan; L-OHP, oxaliplatin.


A 66-year-old female with neuroendocrine tumor metastasis to the breast detected on mammogram. Screening mammogram craniocaudal.


A 66-year-old female with neuroendocrine tumor metastasis to the breast detected on mammogram. Mediolateral oblique. Views demonstrates a 5 mm partially obscured mass (arrows) in the upper outer left breast.


A 66-year-old female with neuroendocrine tumor metastasis to the breast detected on screening mammogram. Ultrasound of the left breast demonstrates a 5 mm irregular hypoechoic mass (arrows) at 2:00 position, corresponding to mass seen on the screening mammogram.


A 66-year-old female with neuroendocrine tumor metastasis to the breast detected on screening mammogram. Solid area of tumor demonstrates uniform cells with moderate amounts of pink granular cytoplasm and uniform round to oval nuclei (arrows). Tumor cells are supported by delicate fibrovascular cores (x400).


A 66-year-old female with neuroendocrine tumor metastasis to the breast detected on screening mammogram. (a) Subtraction postcontrast images of breast magnetic resonance imaging show a 9 mm microlobulated enhancing mass (arrows) at 2:00 position of the left breast corresponding to the biopsy proven metastatic well-differentiated neuroendocrine tumor.


A 66-year-old female with neuroendocrine tumor metastasis to the breast detected on screening mammogram. (b) An enlarged lymph node (arrows) is present between the left pectoralis major and minor muscles (Rotter's node) consistent with Level II lymphadenopathy.


A 66-year-old female with neuroendocrine tumor metastasis to the breast detected on screening mammogram. (a) Cross-section images from abdominal computed tomography scan show 2 cm irregular enhancing mass (arrow) at the ileocecal valve with central calcification consistent with primary well-differentiated neuroendocrine tumor.


A 66-year-old female with neuroendocrine tumor metastasis to the breast detected on screening mammogram. (b) Two hypoenhancing lesions (arrows) were noted in the liver most compatible with metastases.


A 66-year-old female with neuroendocrine tumor metastasis to the breast detected on screening mammogram. (a) Fused image of OctreoScan shows intense radiotracer activity in the lymph node (dashed arrow) between the left pectoralis major and minor muscles (Rotter's node), consistent with Level 2 lymphadenopathy and metastatic lesion in the left breast (solid arrow). There is also a focus of increased activity in the distal small bowel (dotted arrow), consistent with primary well-differentiated neuroendocrine tumor.


A 66-year-old female with neuroendocrine tumor metastasis to the breast detected on screening mammogram. (b) Planar image of OctreoScan reveals foci of increased activity in the liver (dashed arrow) compatible with liver metastases as well as demonstration of increased activity in the distal small bowel (solid arrow), consistent with primary well-differentiated neuroendocrine tumor.


Monophasic SVS of the thyroid: radiological aspects. A; Before chemotherapy: enhanced cervical axial CT scan showing the mass (white star) with invasion of the thyroid cartilage and in contact with the frontal parts of the left primitive carotid artery and internal jugular vein.


Monophasic SVS of the thyroid: radiological aspects. B; After chemotherapy: enhanced axial cervical CT scan (left) showing an increase of the necrotic part (asterisk) in the tumor; sagittal cervical CT scan (right) showing persisting contact with the left jugular vein and no visible margin relative to the thyroid cartilage.


Monophasic SVS of the thyroid: perioperative images. A; Surgical photograph after tumor resection (left lateral view). A = Anterior; S = superior; 1 = cricoid cartilage; 2 = trachea; 3 = carotid artery; 4 = internal jugular vein; 5 = phrenic nerve; 6 = thyroid cartilage (after removal of the superior horn); 7 = hypoglossal nerve; 8 = superior laryngeal nerve; 9 = vagal nerve; 10 = sternocleidomastoid muscle.


Monophasic SVS of the thyroid: perioperative images. B; Aspect of the tumor after removal. 1 = Tumor; 2 = thyroidectomy area with fat and lymph nodes of the upper mediastinum; 3 = cutaneous scar resection.


Coronal.


Axial. CT of the abdomen in a 10-year-old girl with a primary osteosarcoma of the distal femur. The abdominal mass presented 6 months after completion of chemotherapy. Subsequent biopsy confirmed the diagnosis of osteosarcoma metastasis to the peritoneal cavity. CT, computed tomography.


B Coronal. And axial.


CT of the abdomen and pelvis in a 45-year-old man with metastatic osteosarcoma to the lungs, abdomen, and retroperitoneal space. Note the large volume of ascites, prominent enhancement of the peritoneal surfaces, and omental caking. Nodular lesions could be seen in the liver, adrenal gland, and pericolonic gutters.


C; The patient's thigh resection specimen demonstrated a high-grade malignant osteoid-producing neoplasm, consistent with conventional osteosarcoma with both fibroblastic and osteoblastic features. H&E stain, x20.


D; A biopsy of the colon at the hepatic flexure showed malignant cells within the lamina propria with similar morphology to the original specimen. H&E stain, x20. There was no overlapping epithelial dysplasia or keratin expression within the cells, arguing against a new colorectal primary. Biopsy of an omental nodule showed similar histologic features. CT, computed tomography.


Preoperative picture of giant ovarian tumor.


Intraoperative picture of mucinous cystadenocarcinoma of ovary.


Intraoperative picture of ovarian tumor.


Gross specimen of mucinous cystadenocarcinoma of ovary.


Macroscopic findings of the vaginal tumor. A) Before radiotherapy, a dark red, fragile, hemorrhagic mass without continuity with the uterine cervix was recognized on the vaginal wall.


Macroscopic findings of the vaginal tumor. B) After radiotherapy, the tumor contracted markedly and was scarred (circled in red).


Pre- and postoperative MRI and histopathological diagnosis for patient 1. . Notes: (A and B) Preoperative T2-weighted sagittal and T1 contrast-enhanced axial images showed a space occupying lesion with T2 heterogeneous hyperintensity and central dotty enhancement in the right parietal lobe.


Pre- and postoperative MRI and histopathological diagnosis for patient 1. (C) Postoperative histopathological section (HE staining, magnification x400) showed features of anaplastic astrocytoma (WHO grade III) with increased cellularity, nuclear atypia and mitotic activity.


Pre- and postoperative MRI and histopathological diagnosis for patient 1. (D) T1 contrast-enhanced axial image at 3 months after operation showed an irregular mass with gross enhancement in the right basal ganglia and temporal lobe. . Abbreviations: MRI, magnetic resonance imaging; HE, hematoxylin-eosin; WHO, World Health Organization.


MRI during the second relapse for patient 1. . Notes: T1 contrast-enhanced axial images showed multiple oval and patchy nonhomogeneous enhancement lesions in the left cerebellar hemisphere.


MRI during the second relapse for patient 1. And parietal lobe . Abbreviation: MRI, magnetic resonance imaging.


Pre- and postoperative MRI between the first and second operation and histopathological diagnosis for patient 2. . Notes: (A) T1 contrast-enhanced axial image showed an irregular occupying mass with nonhomogeneous enhancement accompanied with necrosis and peripheral edema at the right parieto-occipital lobes before the first operation.


Pre- and postoperative MRI between the first and second operation and histopathological diagnosis for patient 2. (B) Histopathological section (HE staining, magnification x200) after surgery showed the features of glioblastoma multiforme (WHO grade IV), with highly increased cellularity, marked nuclear atypia and mitotic activity, hemorrhage and pseudopalisading necrosis.


Pre- and postoperative MRI between the first and second operation and histopathological diagnosis for patient 2. (C) At 6 months after the first operation, T1 contrast-enhanced axial image showed that a mass with nonhomogeneous enhancement reappeared at the primary location, accompanied with central necrosis and peripheral edema.


Pre- and postoperative MRI between the first and second operation and histopathological diagnosis for patient 2. (D) At 43 days after the second operation, T1 contrast-enhanced axial image showed a recurrent nodular enhanced lesion in the front edge of the operative cavity accompanied with obvious peripheral edema. . Abbreviations: MRI, magnetic resonance imaging; HE, hematoxylin-eosin; WHO, World Health Organization.


MRI comparison between pre- and post-apatinib for patient 2. . Notes: Before oral apatinib, FLAIR axial.


MRI comparison between pre- and post-apatinib for patient 2. T1 contrast-enhanced axial images. Showed an enlarged recurrent lesion accompanied with central necrosis and obvious peripheral edema.


MRI comparison between pre- and post-apatinib for patient 2. At 4 weeks medication of apatinib, FLAIR axial.


MRI comparison between pre- and post-apatinib for patient 2. T1 contrast-enhanced axial images. Showed that the lesion and peripheral edema were significantly reduced compared with pre-apatinib MRI. . Abbreviations: MRI, magnetic resonance imaging; FLAIR, fluid attenuated inversion recovery.


Calcification of the falx cerebri. Brain computed tomography scan showing lamellar calcifications of the falx cerebri (white arrow). A; Axial view.


Calcification of the falx cerebri. Brain computed tomography scan showing lamellar calcifications of the falx cerebri (white arrow). B; Sagittal view.


In this patient with caecal adenocarcinoma, enlarged lymph nodes in the small bowel mesentery were resected and subjected to histologic and pharmacologic study. Drug concentrations in peritoneal fluid (PF) and plasma (PL) were also determined. Doxorubicin concentration in lymph nodes (LN) was markedly increased over that in plasma and was very similar to the intraperitoneal drug concentration between 60-90 min.


In this patient with malignant peritoneal mesothelioma, doxorubicin concentrations in peritoneal fluid (PF), plasma (PL), mesothelioma tumor nodules (TN) and lymph nodes (LN) within the small bowel mesentery were determined. High concentrations of drug were present within small tumor nodules bathed by the chemotherapy solution. Similar high concentrations of doxorubicin were present in lymph nodes buried within the mesenteric fat of the small bowel.


Chest X-ray and CT findings. (A) Chest X-ray at the first visit to our hospital revealed bilateral diffuse shadows and a small cavity in the left lung.


Chest X-ray and CT findings. (B) CT at the time of EBUS-TBNA showed small, discrete, rounded pulmonary nodules of uniform size diffusely distributed throughout both lung fields. A suspected cavitary primary lesion was identified in the left upper lobe.


Chest X-ray and CT findings. (C) Three months after the start of treatment with alectinib, the miliary metastasis shadows had decreased considerably.


Pathological findings of biopsies obtained from the mediastinal lymph node and left upper lobe of the lung. (A) Cancer cells forming solid nests and acinar structure were observed in EBUS-TBNA specimens of the mediastinal lymph node.


Pathological findings of biopsies obtained from the mediastinal lymph node and left upper lobe of the lung. (B) Adenocarcinoma cells forming an ambiguous acinar structure were found in TBLB specimen of the cavity in the left upper lobe of the lung.


Pathological findings of biopsies obtained from the mediastinal lymph node and left upper lobe of the lung. (C) ALK protein was diffusely positive in the cytoplasm of the adenocarcinoma cells in the TBLB specimens.


Results of colonoscopy. (A) Colonoscopy showed an ulcer-like neoplasm situated 6 cm from the anal margin with a little bleeding, covering half of the lumen in September 2011 (arrows).


Results of colonoscopy. (B) The re-examination of colonoscopy showed an ulcer type neoplasm on dentate line with erosion, which was brittle and subjected to hemorrhage, covering half of the lumen in November 2011 (arrows).


Results of colonoscopy. (C) In February 2012, the re-examination of colonoscopy, which showed a 2 x 2 cm2 ulcer on distal rectal wall (near the dentate line) with white tongue coating (arrows).


Results of colonoscopy. (D) In August 2012, the colonoscopy showed a scar with smooth surface on distal rectal wall (near the dentate line, arrows).


Results of colonoscopy. (E) In March 2013, the colonoscopy showed a 2 cm x 4 cm neoplasm on the dentate line with erosion, which was brittle and subjected to hemorrhage (arrows).


Colonoscopy showed multiple small polyps over the terminal ileum and multiple indurated ulcerations over the rectum and cecum.


Focal aggregations of amoeba trophozoites were demonstrated by periodic acid-Schiff stain.


Follow-up colonoscopy 8 months post treatment showed complete remission.


Imaging studies performed in September 2017 for the 58-year-old female with choroidal metastasis from primary breast carcinoma. A; The yellow-colored mass (yellow arrows) located superior and temporal to the macula appeared to have slightly regressed.


Imaging studies performed in September 2017 for the 58-year-old female with choroidal metastasis from primary breast carcinoma. B; Subretinal fluid associated with the choroidal lesion in June 2017 appeared to have resolved.


Imaging studies performed in September 2017 for the 58-year-old female with choroidal metastasis from primary breast carcinoma. C; Ultrasound demonstrated a stable size of the choroidal mass at 2.47 mm (yellow arrows).


Keratotic, micaceous scaly lesion over the glans with meatal involvement.


Post partial penectomy.


Contrast enhanced cardiac magnetic resonance imaging at the time of initial diagnosis (left) confirmed the finding of a mass measuring 5.5x3.9x4.8 cm in the left ventricle which involved the entire thickness of the myocardium from the endocardial surface to the pericardium. The image in the right panel demonstrates development of central necrosis within the tumor, consistent with response to sunitinib.


The scar from a previously excised nevus located 4 cm below the metastatic inguinal lymphadenopathy.


A; At low power, nevoid melanoma has the architecture of a banal compound nevus (HE staining, x20). Diagnostic clues included.


B; The presence of dermal mitotic figures (5 mitoses/mm2) at high power (HE staining, x80).


C; A high Ki-67 immunoreactivity (Ki-67 index 20%) in the lower parts of the lesion (x80).


Progression and examination of the clinical course. PTE, pulmonary thromboembolism; BNP, brain natriuretic peptide; CTPA, computed tomography pulmonary angiography; TTE, transthoracic echocardiogram; CMR, cardiac magnetic resonance; PET, positron emission tomography; CCTA, coronary computed tomography angiography.


Laryngeal squamous carcinoma was diagnosed from a small biopsy.


That revealed well differentiated epithelial tumour with slight atypia and invasive growth into the fibrous stroma.


Lymph node biopsy showed small, atrophic germinal centres surrounded by expansion of mantle zone and prominent interfollicular region (C).


Typical "onionskin" pattern is visible at the germinal centre (D).


A; Abdominal contrast computed tomography showed pancreatic head cysts and pancreatic head and tail tumors (arrows).


B; In another slice from the abdominal contrast computed tomography, a tumor was found in the pancreatic body (arrow).


C; Magnetic resonance cholangiopancreatography showed huge cysts in the pancreatic head, but there was no irregularity or deviation of the pancreatic duct.


D; In endoscopic ultrasonography, the tumor showed clear margins, had low marginal echo, and internal high echo.


A; Cytology showed a strong variance of acinar cells and pancreatic ductal epithelium.


B; The resected specimen showed three tumorous lesions in addition to the huge cyst, and each lesion was independently present with pancreatic tissue interposed.


C; Morphologically, the cells showed strong polymorphism, such as having a spindle shape or polynuclear formation, and proliferated densely; cancer and sarcoma components were mixed.


D; Immunostaining for keratin CAM5.2 was negative.


Row A: CT scan four months prior to recto-sigmoid DLBCL diagnosis showcasing mild irregular wall thickening of the recto-sigmoid colon (red arrows) and bladder (yellow arrow). Row B: CT at the time of diagnosis demonstrating significant irregular wall thickening of the recto-sigmoid colon with a large stool-containing collection superimposed on matted loops of inflamed large bowel (blue circle). Center image exhibits a colo-colonic fistula between cecum and rectum (green circle). Third image displays worsening circumferential wall thickening of the bladder (yellow arrow). Row C: Six months post-chemotherapy CT illustrates less wall thickening of the sigmoid colon in the colorectal junction with a smaller area of involvement. The tumor burden is moderately to significantly lower due to smaller soft tissue involvement.


Row A: Pre-chemotherapy PET scan showed intense FDG activity in the sigmoid colon and rectum, mesenteric lymph nodes, and the left lateral posterior aspect of the prostate. Row B: Six months post-chemotherapy PET scan denotes decreased intensity of FDG activity in the sigmoid colon and colorectal junction and resolution of small lesions in the lower abdomen and pelvis.


Case 3 demonstrating stomach mass before.


After.


Nivolumab treatment. Extensive necrosis with no viable tumor (H&E, x100).


Contrast-enhanced magnetic resonance imaging, T1-weighted fat saturated coronal image shows a large isointense signal intensity mass admixed with hyperintense signal intensity.


Immunohistochemistry - CD 31 - positive staining of atypical endothelial cells.


Tumor response to treatment. The metastatic mass in the posterior chest wall, before.


Tumor response to treatment. After. HDLRT on October 18th. (Permission by Radiation Research to extract from Figure 3 in Wu X et al. . 2021 Radiation Research Society).


The LATTICE dose distribution in a 3D view.


In an axial plane.


In a sagittal plane.


In a coronal plane The high-dose vertices (total of six) received 20 Gy to the 69% isodose line. The doses between the dose-vertices (valley) were in the order of 25% of the maximum (peak) dose. (Permission by Radiation Research to extract from Figure 3 in Wu X et al. . 2021 Radiation Research Society).


The dose-volume histograms (DVHs) of high dose-vertices, GTV, and normal tissue. D99.3% of the vertices was 20 Gy. The doses to the ribs and spinal cord were effectively minimized.


(A) Dose distribution in a coronal plane. Along the green line marked in panel , showing the peak to valley dose ratio of about 4. (Permission by Radiation Research to extract from Figure 3 in Wu X et al. . 2021 Radiation Research Society).


The peak-valley dose profile.


CE CT of thorax revealed that there was a spiculated lung nodule in the superior segment of left lower lobe, adjacent to the left oblique fissure, measuring 2.6 x 1.8 x 2.5 cm (AP x W x CC) associated with thickening of the adjacent left oblique fissure.


Histopathologic examination of the left iliac bone showed (A) thickening and disorganized trabecular pattern (H & E, 40x).


(B) Cement lines along the coarsened and enlarged trabeculae are characteristically seen. The marrow was calcified and replacement of the marrow space by fibrous tissue was seen (H & E, 40x).


Radiation treatment plan for metastatic pulmonary tumor. Isodose lines reflect predicted radiation delivered to tumor and surrounding tissues.


Four month post-radiotherapy computed tomography scan of pulmonary metastatic fibrolamellar hepatocellular carcinoma tumor.


Six month post-radiotherapy computed tomography scan of pulmonary metastatic fibrolamellar hepatocellular carcinoma tumor.


An exophytic growth, 4 cm across, present over the dorsal aspect of the right hand, adhered to the underlying subcutaneous tissue. The surface of the growth was marked by ulceration in the centre.


Positron emission tomography-computed tomography (PET-CT). A. Colon cancer (SUV; 12.6) without evidence of distant metastasis (cT3N0M0).


Positron emission tomography-computed tomography (PET-CT). B. Gastric cancer (SUV; 11.8) in upper body of stomach without evidence of distant metastasis (cT3N1M0).


Positron emission tomography-computed tomography (PET-CT). C. Local recurrence (SUV; 9.4) of previous stomach cancer without metastasis.


Images of fiberoptic bronchoscopy and histopathology. (a and b) Obstruction of the right upper bronchial lobe.


Images of fiberoptic bronchoscopy and histopathology. (c and d) Histopathology of fibrobronchoscopy showed squamous cell carcinoma. Immunohistochemistry: TTF-1 (-), p63 (+), CD5/6 (+), P40 (+), and CK7.


Images of chest CT enhanced scan. (a,b) Bronchial stenosis and occlusion in the right upper lobe of the lung.


Images of chest CT enhanced scan. (c,d) Histopathology of enhanced CT showed soft tissue mass shadow, the size was about 4.2 cm x 2.6 cm x 2.2 cm, the lesion was smaller and the necrotic area was larger compared to previous scan.


Images of fiberoptic bronchoscopy and histopathology post-treatment. (a and b) Right upper lobe bronchus unobstructed, tracheobronchial bronchitis.


Images of fiberoptic bronchoscopy and histopathology post-treatment. (c and d) Histopathology of the tumor after surgery showed necrosis, histiocyte reaction, cholesterol crystal, inflammatory cell reaction under a microscope, and no residual tumor cells.


Histopathology slide shows papillae with fibrovascular core lined by tumor cells with round to oval nuclei, vesicular chromatin, prominent nucleoli and scant eosinophilic cytoplasm. (Hematoxylin and eosin, x20).


MRI study of the patient's metastatic lesion. Initial sagittal.


MRI study of the patient's metastatic lesion. Axial. Magnetic resonance imaging (MRI) scans with contrast of the head demonstrating a well-circumscribed enhancing lesion with surrounding edema in the pons.


MRI study of the patient's metastatic lesion. Postoperative MRI (C-D) with contrast demonstrating a gross total resection of the solitary lesion with no evidence of residual disease.


MRI study of the patient's metastatic lesion. MRI with contrast at 10 years (E-F) after the original craniotomy showed no signs of recurrent disease. Used with permission from Barrow Neurological Institute, Phoenix, Arizona.


CT scan of a patient with an SPT. Abdominal contrast-enhanced CT scan shows an enlarged pancreatic head containing a well-defined, encapsulated solid cystic mass about 4 cm in diameter (arrow). CT, computed tomography; SPT, solid pseudopapillary tumor.


Gross examination of an SPT. Photograph of the.


Gross examination of an SPT. Gross specimen shows the. Smoothly encapsulated tumor with areas of necrosis and hemorrhage. The ruler shows distance in centimeters.


The immunohistochemical features of an SPT. The tumor cells showed positive for. Vimentin.


The immunohistochemical features of an SPT. CD10.


The immunohistochemical features of an SPT. Alpha-antichymotrypsin.


The immunohistochemical features of an SPT. Alpha-antitrypsin.


The immunohistochemical features of an SPT. Beta-catenin.


The immunohistochemical features of an SPT. Neuron-specific enolase.


The immunohistochemical features of an SPT. Synaptophysin.


The immunohistochemical features of an SPT. Progesterone receptor.


Contrast-enhanced computed tomography scan of thorax showing huge right sided pleural based heterogeneous intraparenchymal mass occupying almost whole of the right hemithorax with contralateral shifting of the mediastinum.


Body temperature change after CAR T-cell therapy. . Abbreviation: CAR, chimeric antigen receptor.


CRP change after CAR T-cell therapy. . Abbreviations: CRP, C-reactive protein; CAR, chimeric antigen receptor.


Expansion of CAR T-cell from peripheral blood after therapy. . Abbreviation: CAR, chimeric antigen receptor.


Pelvic ultrasound results of the patient before and after CAR T-cell therapy. . Notes:. Ultrasound results from day -7 before CAR T-cell therapy.


Pelvic ultrasound results of the patient before and after CAR T-cell therapy. Day +28, day +60, day +90, day +120, and day +360 ultrasound results after CAR T-cell therapy. . Abbreviation: CAR, chimeric antigen receptor.


Pathological features: heteromorphic large lymphocyte proliferation, HE staining, magnification, 400x.


PET/CT scan results before chemotherapy: multiple hypermetabolic lymph nodes along bilateral inguinal regions.


External iliac vessels The red arrow points to hypermetabolic lymph nodes.


In-situ hybridization for Epstein-Barr virus-encoded RNA is scattered positive, HE staining, magnification, 400x.


PET/CT scan results after the 4th chemotherapy: slightly larger lymph nodes lacking significant metabolic increases along the inguinal regions.


The external iliac vessels The red arrow points to slightly larger lymph nodes.


Heterogenous ill-defined soft-tissue attenuation mass involving the pancreatic head and uncinate process.


With multiple liver metastases.


Incidentally noted one of the large relatively defined mass in segment 7 of the liver is showing subtle arterial phase enhancement.


Washout in portal venous phase. Likely hepatocellular carcinoma.


CT of cranial bones. . Notes: (A) Bony window of cranial CT scan showed a 5 x 5 cm2 soft tissue mass within the irregularly destructive area of the right parietal-occipital region of the skull.


CT of cranial bones. (B) Contrast-enhanced CT scan showed a hypervascular enhancement with osteolytic pathological change in the parietal-occipital region of the skull. . Abbreviation: CT, computed tomography.


MRI of cranial bones. . Notes:. T2-weighted MRI.


MRI of cranial bones. T1-weighted MRI demonstrated a homogeneous, well-defined, and isosignal intensity carcinoma in the right parietal-occipital region.


MRI of cranial bones. (C) Gadolinium enhanced T1-weighted MRI images showed a strong enhancement of the carcinoma. . Abbreviation: MRI, magnetic resonance imaging.


Abdominal B ultrasound showed a large mass in the right lobe of the liver.


Computed tomography (CT) of breast showed no lung metastases.


Single-photon emission computed tomography of total skeletal bones showed no other metastases.


Axial CT post contrast image.


Sagittal reconstruction. Shows an irregular extra-axial solid mass with heterogeneous enhancement and deep cystic change (arrow) adjacent to the falx extending into the right frontal lobe. There is significant peritumoral oedema and mass effect involving the right frontal lobe with displacement of the midline. These findings, together with tumour interdigitating with the brain substance, are consistent with an aggressive frontal meningioma.


Axial thorax CT post contrast image showing an ill-defined soft tissue mass (arrow) superficially located in the left trapezius muscle with peripheral enhancement and low signal in the centre.


Sagittal T2.


Axial T1.


Axial T2 fat saturated. MR images demonstrate a solid well defined soft tissue mass in the medial left trapezius muscle which returns isointense T1-W (between arrow heads) and heterogeneous predominantly high T2-W signal relative to skeletal muscle. There is mass effect on the deeper paravertebral muscles and peripheral feeding vessels along the lateral aspect of the lesion (arrow).


PET-CT confirms the presence of an FDG avid soft tissue mass in the left trapezius muscle.


Section from the thigh mass (10x, H&E) shows a hypercellular tumor, with spindle cells in sheets and fascicular arrangement. . The spindle-shaped nuclei have clumped chromatin. These features are compatible with a malignant peripheral nerve sheath tumor.


The area on the right shows two populations of tumor cells that are intermingling with each other, representing a collision tumor (20x, H&E). . One population is composed of hypercellular malignant spindle cells with hyperchromatic nuclei (blue arrow) that are infiltrating the adjacent adrenal tissue. This is morphologically compatible with malignant peripheral nerve sheath tumor. The other population is composed of the nests of polygonal cells with abundant eosinophilic cytoplasm (green arrow), compatible with pheochromocytoma.


Graphic summary of the case.


Clinical course after administration of crizotinib. d = Day; CEA = carcinoembryonic antigen.


ILC metastasis with airway involvement before brachytherapy.


ILC metastasis with airway involvement after radiotherapy.


IMAP tube design. Clinical photographs demonstrating the process of IMAP tubing, de-epithelialization and inset. (A) The medial extension of the flap is de-epithelialized and the lateral portion is tubed with the epithelial surface forming the internal tube lining.


IMAP tube design. Clinical photographs demonstrating the process of IMAP tubing, de-epithelialization and inset. This is diagrammatically represented with the measurements of the flap design used in this case in (B).


IMAP tube design. Clinical photographs demonstrating the process of IMAP tubing, de-epithelialization and inset. (C,D) The flap was then rotated superiorly and a wide subcutaneous tunnel created, insetting the tubed IMAP proximally to the pharynx (previous tubed ALT flap) and distally to the esophagus.


Post-operative Images and swallow at 6 weeks. (A) Depicts a post-operative swallow study demonstrating a patent pharyngeal tube with flow of contrast into the esophagus.


Post-operative Images and swallow at 6 weeks. (B) Post-operative clinical photograph demonstrating a well healed wound and donor site with no evidence of persisting pharyngocutaneous fistula.


Pre-operative MRI of brain showing a solitary heterogeneously enhancing solid mass at the right temporal-parietal junction with surrounding edema, mass effect, and early uncal herniation (a and b).


Immediate post-operative MRI of brain showing post-operative changes in right temporal-parietal area with gross total resection of the lesion (c and d).


MRI of brain seven weeks after surgical resection showing no evidence of tumor progression, significantly improved edema around the resection area, and partially entrapped right occipital horn likely from intraventricular adhesive disease (e and f).


Pre-operative MRI of brain, showing a new enhancing dural based lesion anterior to the prior resection cavity (a-d).


Immediate post-operative MRI of brain, demonstrating gross total resection of the lesion (e and f).


Ultrasonic left breast showing a hypoechogenic-spiculated mass with the acoustic shadow of 29 x 24 x 14 mm3 in correspondence with the mammographic image.


Staging image study. (A) Axial view of PET/CT showing a hypermetabolic left breast nodule of 18 mm at the LIQ, compatible with primary neoplasia.


Staging image study. Axial.


Staging image study. Sagittal views of PET/CT demonstrating extensive substitutive hypermetabolic sternal compromise with cortical osteolysis (maximum SUV 7.7).


Re-staging imaging study, after 6 months of ST. (A) Axial view of PET/CT with size decrease and hypermetabolism resolution at the left breast nodule.


Re-staging imaging study, after 6 months of ST. Axial.


Re-staging imaging study, after 6 months of ST. Sagittal views of PET/CT showing hypermetabolism resolution at the sternal body lesion.


Chest radiography revealed consolidation in the right lower lung field at the initial visit.


Pulmonary findings of chest high-resolution computed tomography. (A) At the initial visit, subpleural consolidation with volume reduction in the right lower lobe and localized ground-glass opacity in the left lower lobe were present.


Pulmonary findings of chest high-resolution computed tomography. (B) Two weeks after she began receiving prednisolone (PSL), consolidation had not improved.


Pulmonary findings of chest high-resolution computed tomography. (C) Two months after discontinuation of PSL, bilateral consolidation developed. Then, a surgical lung biopsy (SLB) of the right upper lobe was performed (arrow).


(A) Mechanic's hand (arrows).


(B) Gottron's papules on the dorsum (arrowheads).


Pulmonary findings of chest high-resolution computed tomography. (A) One month after the surgical lung biopsy, bilateral subpleural consolidation and ground-glass opacity had worsened.


Pulmonary findings of chest high-resolution computed tomography. One month.


Pulmonary findings of chest high-resolution computed tomography. Six months after starting the treatment, these findings had improved.


A coronal contrast-enhanced MRI of the brain demonstrating the heterogeneously enhancing left temporal lobe mass (glioblastoma multiforme) with an associated cystic component (arrow).


A contrast-enhanced T1 weighted sagittal MRI of the spine demonstrating multiple enhancing lesions in the vertebral bodies in keeping with bony metastases and cord compression at T7 level (arrow).


An axial contrast-enhanced CT scan of the liver demonstrating multiple liver metastases of varying sizes (the largest marked with an asterisk).


The H&E stained histopathological slide of the liver biopsy demonstrating a) abnormal sheets of small round 'blue' cells with high nucleocytoplasmic ratio and pleomorphism in keeping with glioblastoma multiforme metastases (slide magnification x200); b) the normal appearance of the hepatocytes obtained from a normal part of the liver tissue (slide magnification x500).


Surgical approach to the spinal tumor through a laminectomy performed at the Th8/9 level. Spinal canal exposure revealed no macroscopic infiltration of the dura mater (a).


Surgical approach to the spinal tumor through a laminectomy performed at the Th8/9 level. After durotomy, an infiltrating, highly vascularized intradural intramedullary tumor lacking recognizable edges in regard to the normal tissue was observed (b, c).


Surgical approach to the spinal tumor through a laminectomy performed at the Th8/9 level. After durotomy, an infiltrating, highly vascularized intradural intramedullary tumor lacking recognizable edges in regard to the normal tissue was observed (b, c). A biopsy was carefully performed and further histological examination confirmed the diagnosis of GBM metastasis (c).


Surgical approach to the spinal tumor through a laminectomy performed at the Th8/9 level. Duroplasty using a graft interposition was performed with the aim of widening the spinal canal and ameliorate the local compressive effect induced by the tumor (d).


Microscopically, the pigmented nodular tumor was composed of sheets, nests, and trabeculae of brown pigment-containing spindles and occasionally rounded cells (black arrows).


(A) Gross appearance of the vulva. Pedulculated cystic mass arising from the left vulva.


(B) Microscopic findings. Dilated lymphatic vessels, often cystic and ectatic, were lined by flattened endothelial cells with the paucicellular fibrous background in the mid and the deep dermis (hematoxylin-eosin, x100).


Medical image.


Preoperative CT Scan of thorax showing anterior mediastinal mass.


Resected specimen. Postoperative CT scan of thorax.


Preoperative CT Scan of thorax showing posterior mediastinal mass.


Ultrasound sonogram of the thyroid showed a non-homogenous mass with an unclear boundary, low and moderate echo and rich blood flow signal (A).


Enlarged lymph nodes were found in the right neck (B).


CT of the neck showed a tumor occupying almost the entire right lobe of the thyroid gland.


Imaging and histological findings of spinal hemangioblastoma during puerperium. . Notes: (A, B) MRI presentation of the tumor in the immediate postpartum period. (A) Contrast-enhanced T1-weighted sagittal section showing a hyperintense solid nodule at D11-D12 (white arrow). Tumor volume of 1.7 cm3.


Imaging and histological findings of spinal hemangioblastoma during puerperium. . Notes: (A, B) MRI presentation of the tumor in the immediate postpartum period. (B) T2-weighted sagittal section showing bulbocervical edema (*) and extensive hydrosyringomyelia (dotted white arrow).


Imaging and histological findings of spinal hemangioblastoma during puerperium. (C, D) MRI presentation of the tumor after 55 days. (C) Reduction in tumor size (tumor volume of 1.0 cm3) but showing the same image characteristics: intense contrast enhancement (solid white arrow).


Imaging and histological findings of spinal hemangioblastoma during puerperium. (C, D) MRI presentation of the tumor after 55 days. (D) Same caudal and cranial hydrosyringomyelia at C3 (dotted white arrows) but complete disappearance of medullary edema.


Imaging and histological findings of spinal hemangioblastoma during puerperium. (E) Histopathology (H&E) showing vascular proliferation surrounded by stromal cells with clear nuclei, a characteristic feature of hemangioblastoma (total magnification: 400x).


Imaging and histological findings of spinal hemangioblastoma during puerperium. (F) Immunohistochemical staining that was positive for inhibin in stromal cells and negative for estrogen and progesterone receptors (the positivity for estrogen and progesterone receptors would be demonstrated by brown staining in the cell nuclei; total magnification: 400x). . Abbreviation: MRI, magnetic resonance imaging.


Positive immunohistochemical stains and Ki-67 proliferation index of liver biopsy sample (20x magnification). (A) Neuron-specific enolase.


Positive immunohistochemical stains and Ki-67 proliferation index of liver biopsy sample (20x magnification). (B) Synaptophysin.


Positive immunohistochemical stains and Ki-67 proliferation index of liver biopsy sample (20x magnification). (C) Ki-67 proliferation index 98.


Image obtained one year after nipple-sparing mastectomy with immediate deep inferior epigastric perforator flap breast reconstruction.


Image obtained after salvage mastectomy with simultaneous tissue expander placement.


Image obtained one year after the second breast reconstruction using a superior gluteal artery perforator flap.


Image of the donor site one year after the second breast reconstruction.


Bladder inverted papilloma (H&E stain, magnification 100x).


Urothelial-type adenocarcinoma of prostate (H&E stain, magnification 40x).


Diffusely positive staining for CK7 (magnification 100x).


Diffusely positive staining for CK 20 (magnification 100x).


Complete negative staining for p63 (magnification 200x).


Weak positive staining for P504S (magnification 200x).


Diffusely positive staining for 34betaE12 (magnification 200x).


CECT abdomen showing mass replacing the right ovary with nonvisualization of the uterus.


(a) Microphotograph showing islands of large polygonal tumor cells surrounded by lymphoid cells. The tumor cells possess clear cytoplasm and centrally placed nuclei with vesicular chromatin and prominent nucleoli.


(H&E 400x) and (b) Microphotograph showing tumor cells arranged in papillary fronds having vesicular coffee bean nuclei. (H&E 100x).


Radiological evaluation of CG postoperatively. Post-contrast MRI images of the residual tumor 1 month (a,b).


Radiological evaluation of CG postoperatively. The size of the residual tumor decreased following GKRS (c-f).


A; Tissue removed from the tumour zone showing cubic cells resembling thyroid follicular cells (hemotoxylin and eosin, original magnification 9400).


B; Immunohistochemistry showing positive staining for tyroglobulin. (Original magnification 9400).


Clinical image showing bilateral sixth nerve palsy in the patient.


MRI images showing multiple lesions within the brain at different phase of resolution.


MRI angiography showing absence of any vascular blush or major arterial feeder to the lesions.


Chest X-ray revealing right sided apical lung lesion.


Post-operative CT image showing complete excision of the lesion in the posterior fossa.


Histology image confirming the diagnosis of invasive choriocarcinoma.


CT chest confirming presence of an enhanced and highly vascular lesion in the upper lobe of the right lung.


Firm, nonulcerated reddish-blue tumor in the maxilla.


Computed tomography scan showing lobed extensive tumor of the anterior maxilla and central hypodense area.


Gross specimen showing a well-circumscribed soft mass.


Peripheral melanin-containing epitheloid cells showing positivity (Masson' Fontana, x4).


IHC staining showing HMB-45 positivity in peripheral epitheloid cells.


IHC staining showing synaptophysin positivity in central small neuroblast-like cells (x10).


CT from March 1, 2018 shows extensive ascites with small bowel clumped from mesenteric retraction by cancer.


Case 1. Pre-chemotherapy imaging findings. The tumor was 2 cm in size.


Case 1. Pre-chemotherapy imaging findings. And had a maximum standardized uptake value (SUVmax) of 5.1 in positron emission tomography findings.


Image of the inflammatory breast lesion in June 2005.


Breast biopsy - sheets of malignant ductal cells in an invasive ductal carcinoma moderately differentiated (G2), H&E stain, 100x. . Abbreviation: H&E, hematoxylin and eosin.


Breast biopsy - positive nuclear immunostaining for estrogen receptors (semiquantitative evaluation is 40%-50%), LSAB technique, 200x. . Abbreviation: LSAB, labeled streptavidin biotin.


Breast biopsy - positive nuclear immunostaining for progesterone receptors (semiquantitative evaluation is 10%-15%), LSAB technique, 100x. . Abbreviation: LSAB, labeled streptavidin biotin.


Breast biopsy - positive incomplete membrane immunostaining for c-erbB2 protein (score 2+), LSAB technique, 100x. . Abbreviation: LSAB, labeled streptavidin biotin.


Magnetic resonance imaging of the left brachial plexus demonstrating a heterogeneous T1-hyperintense.


Homogeneously enhancing. Well-circumscribed lesion located in the posterior brachial plexus (white arrows).


Magnetic resonance imaging of the brachial plexus demonstrating a T1-isointense.


Avidly enhancing. Soft tissue mass along the left C7/T1 and T1/T2 neuroforamina (white arrows).


Chest CT in case 1 after chemo- and radiotherapy treatment. After 1 year of treatment, the patient showed a complete remission of the disease.


Chest X-ray revealed a large soft-tissue opacity over the medial aspect of the left upper zone.


Abdominopelvic CT scan revealed 16 mm enhancing mass lateral to right psoas major muscle which could be metastatic mass.


The H&E (10X & 40 X microscopic powers) slides showed infiltrative atypical nests with vague gland-like features.


Significant heterogeneous enhancement is observed with evident edema after gadolinium administration (A-C).


A follow-up MRI, 3 months after surgery (D-F), showed that the lesion was completely removed, without any signs of recurrence.


Giant cell glioblastoma is composed of large, closely-arranged cells, with an eosinophilic cytoplasm and obvious nuclear atypia. There are also scattered multinucleated giant cells. Local necrosis and vascular proliferation are observed (A).


Giant cell glioblastoma is composed of large, closely-arranged cells, with an eosinophilic cytoplasm and obvious nuclear atypia. There are also scattered multinucleated giant cells. FISH detection suggests no loss of heterozygosity in 1p.


Giant cell glioblastoma is composed of large, closely-arranged cells, with an eosinophilic cytoplasm and obvious nuclear atypia. There are also scattered multinucleated giant cells. Or 19q
 chromosomes.


Giant cell glioblastoma is composed of large, closely-arranged cells, with an eosinophilic cytoplasm and obvious nuclear atypia. There are also scattered multinucleated giant cells. Primary intracranial leiomyosarcoma showing spindle-shaped cells.


Giant cell glioblastoma is composed of large, closely-arranged cells, with an eosinophilic cytoplasm and obvious nuclear atypia. There are also scattered multinucleated giant cells. Abundant mitotic activity. Through the tumor, hematoxylin, and eosin staining.


Giant cell glioblastoma is composed of large, closely-arranged cells, with an eosinophilic cytoplasm and obvious nuclear atypia. There are also scattered multinucleated giant cells. Immunohistochemical examination was positive for H-caldesmon (F).


Pyrosequencing demonstrates that no O6-methylguanine-DNA methyltransferase promoter methylation was found.


Hypointense signal is seen on T1WI.


Isointense and slightly hyperintense signals were seen on T2WI.


Isointense signal on FLAIR.


Significant enhancement was seen after gadolinium administration, without uniform enhancement in the center of the lesion (D-F).


Immediate postoperative CT ,follow-up MRI.


3 months after surgery. Demonstrated complete removal of the tumor and no signs of recurrence.


Pulmonary function testing with a bronchodilator revealing severe obstructive and restrictive failure without bronchodilator response.


Pulmonary ventilation and perfusion scintigraphy revealing a mosaic pattern of radio-isotope uptake decrease without ventilation-perfusion mismatch.


Axial T1-weighted spin-echo imaging (491/11) (TR/TE) performed before radiotherapy demonstrated an isointense tumor in the right orbital space and the right ethmoid sinus (arrow). The right optic nerve was involved by the tumor.


Histological section showing Kimura' s disease. HE.


Dose distribution. One oblique field is shown.


Eighty-four months after radiotherapy, axial T1-weighted spin-echo imaging (440/150) (TR/TE) demonstrated the disappearance of the right orbital tumor.


Brain imaging. (a) Magnetic resonance imaging (+- GAD): A heterogeneous high signal mass in the left frontal lobe with peripheral sulci effacement and pressure on the left lateral ventricle and mild midline shift to the right side with involvement of the genu of corpus collusion is seen.


Brain imaging. (b) Magnetic resonance imaging (+- GAD): Left frontal lobe and corpus callosum postsurgical porencephaly with peripheral gliosis with old hemorrhage were detected.


Brain imaging. (c) Computed tomography scan: Postsurgical effect, no sign of recurrences was detected after pregnancy termination.


(a) Axial contrasted computed tomography (CT) scan demonstrates a small ovoid iso-attenuating mass in the left tonsil. The large mixed solid-cystic nodal-mass conglomerate in the left side of the neck exerts mass effect on the left carotid space and displaces it medially.


(b) Coronal contrasted CT scan demonstrates the cranio-caudal extent of the nodal-mass conglomerate in the left side of the neck. The cranial aspect is solid and enhancing, and the caudal portion is cystic and multiseptated.


(a) Sagittal T1-weighted, post-gadolinium, fat-saturated magnetic resonance (MR) image shows the mixed solid-cystic nature of the cervical nodal-mass with enhancement of the cranial solid portion. Superficial parotid gland infiltration was suspected based on MR imaging findings.


Axial T1-weighted MR images with. Gadolinium.


Fat suppression demonstrating heterogenous enhancement of the solid cranial portion of the cervical nodal-mass conglomerate. The left carotid arteries and internal jugular vein were not infiltrated.


Intra-operative image of the left cervical nodal-mass conglomerate. It was dissected off the left common carotid artery, with ligation of the left internal jugular vein.


Follicular dendritic cell sarcoma of the left tonsil:. The tumour appears very cellular, displaying a typical storiform, and ,whorled growth pattern (haematoxylin, and ,eosin, 100x).


By immunohistochemistry, the tumour shows diffuse membranous positivity with follicular dendritic cell markers D2-40 (haematoxylin and eosin, 400x), as well as CD21, CD23, CD35 (not shown).


Clinical picture of the patient. Elevated, keloid-like, fine nodules coalescing into diffuse sclerodermoid plaques in a background of erythema were found on the right upper arm, chest wall, and abdomen.


Brain MRI. The solitary metastatic lesion was shown, which was 4.5 cm x 3 cm in diameter, occupying the left occipital lobe (before operation).


H&E staining showed solid and tubular tumor cells with large, bizarre nuclei, coexisted with hemorrhage (magnification, x 100). Immunohistochemical staining showed tumor cells to be positive with CD30 and AFP that suggested the embryonal carcinoma with yolk sac tumor component, and partially positive with HCG, suggesting syncytiotrophoblastic cells.


Gross Pathological Findings: Cut surface of the kidney shows that the tumour was firm grey white, 7.5 x 5.5 x 4.5 cm in size, replacing most of the kidney.


Microphotograph of neoplasm showing slightly nodular architecture due to varying cellularity and was composed of spindle cells with thin tapered bland nuclei an indistinct cytoplasm (hematoxylin and eosin stain, x100).


Microphotograph of neoplasm showing concentric arrangement around entrapped tubules, imparting 'onion skin appearance' (hematoxylin and eosin stain, x200).


Microphotograph of neoplasm showing well demarcation from the adjacent kidney but without a definite capsule (hematoxylin and eosin stain, x200).


Immunohistochemical staining for CD 34 showing focal positivity (x200).


CT scans of both cases. A; In case 1, a focal patch of subpleural consolidation was observed after nivolumab re-administration.


CT scans of both cases. B; Pneumonitis gradually improved with corticosteroids.


CT scans of both cases. C; In case 2, diffuse ground glass opacity was observed in the lungs.


CT scans of both cases. D; Pneumonitis had clearly improved.


CT scans of both cases. E; Diffuse bilateral pneumonitis recurred in the lungs after nivolumab re-administration.


(A) Ultrasonographic image showing multiple hypoechoic lesions in the right breast. The large masses comprising nearly the entire right breast, with lobulated irregular margin, the banded median-high echogenic septum was seen inside the mass.


(B) Color flow Doppler image showing abundant blood flow signals.


(C, D) Different spliced images of the tumor showed irregular margin with multiple septa.


Full-field digital mammography. Craniocaudal position.


Full-field digital mammography. Mediolateral oblique position showed multiple high-density irregular masses, some of which were integrated with obscured septa, with multiple lobulations. Note the red arrow in panel A; the margin of the lesion was obscured by surrounding structures. Breast Imaging-Reporting and Data System (BI-RADS) 3.


(A-D) Craniocaudal position of digital breast tomosynthesis. The red arrow shown in panels. Demonstrated that the margin of the mass was obscured, however.


(A-D) Craniocaudal position of digital breast tomosynthesis. The red arrow area in panels. Showed unshielded margin of the mass, which was more obvious compared with that in
Figure 3A.


(A-D) The mediolateral oblique position of digital breast tomosynthesis demonstrated improvement in sharpness and internal septa of the large mass; it measured 7.8 cm x 9.1 cm x 7.4 cm in size, with irregular margins and multiple lobulations. Breast Imaging-Reporting and Data System (BI-RADS) 4A.


(A) Low power, the tumor lacked obvious leaflike processes while it partially retained the lobular architecture. The tumor infiltrated peripheral tissues, including fat (right middle margin).


The red box indicated the corresponding area shown in panel (B) Internal bar = 6 mm. (B) Higher power showed high stromal cellularity with obvious dysplasia, active mitoses, and pathologic mitosis [middle in the insert (embraced with red box, located left upper corner)]. The ducts in the tumor kept a nearly normal contour, and the stromal cellularity adjacent to the epithelium did not obviously increase. Internal bar = 500 mum.


Contrast-enhanced computed tomography revealed a 4.4-cm mass at the head of the pancreas, as indicated by the arrow.


The peripheral blood smear showed macrocytic hypochromic anemia with schistocytes, as indicated by the arrows.


The view of the 28 x 25 cm sacral defect before debridement. It was treated with gluteus maximus myocutaneous flap from the left gluteal area following sacrectomy. Postoperative suture detachment in the midline yielded the large defect with radionecrosis.


The omentum flap based on the right gastroepiploic artery was raised.


The omentum was passed through the Petit triangle and adapted to the sacral defect.


Postoperative result of the omentum flap 1 year after reconstruction of the lumbosacral area.


Extraoral photograph showing swelling and extension over right buccal region.


Intraoral photograph showing no significant finding.


Computed tomography (CT) suggestive of heterogeneously enhancing lesion in close proximity to superficial lobe of right parotid gland without invasion of the adjacent structures.


Scanner view showing lesional tissue which is encapsulated (H&E stain, x40) H&E = Hematoxylin and eosin.


Scanner view showing duct like spaces with eosinophilic coagulum. (H&E stain, x40).


Low-power view showing myxochondroid areas having clear cells with eccentric nuclei (H&E stain, x100).


Low-power view showing pleomorphic and hyperchromatic cells with few mitotic figures (H&E stain, x100).


Low -power view showing the clear cells and hyalinized areas. (H&E stain, x200).


Higher-power view showing the numerous malignant pleomorphic and hyperchromatic cells with osteoid tissue and squamous metaplasia (H&E stain, x400).


Higher-power view showing spindle-shaped cells with duct-like spaces and eosinophilic coagulum with few clear cells (H&E stain, x400).


Higher-power view showing spindle-shaped cells with duct-like places filled with eosinophilic coagulum, with necrotic areas and clear cells at places (H&E stain, x400).


Higher-power view showing spindle-shaped cells with duct-like places filled with eosinophilic coagulum (H&E stain, x400).


Bone marrow aspirate showing plasma cells actively producing immunoglobulins "Mott cells.


Hemophagocytosis of RBC and neutrophils.


Lymph node biopsy showing: large histiocytes with emperipolesis (black arrows) and plasma cells with large inclusions containing immunoglobulins "Russel body" (yellow arrow).


Immunohistochemical staining of lymph node biopsy, positive for S100.


Immunohistochemical staining of lymph node biopsy, positive for CD68.


Immunohistochemical staining of lymph node biopsy, negative for CD1a.


Immunohistochemical staining of lymph node biopsy, negative for CD21.


Significant performance differences between the WBRT patient and the healthy subjects were observed for cognitive domains with a component of executive functioning (TMT-. Attention/ processing speed.


The appearance of the lesion in the upper lip.


Microphotograph showing characteristic ductal tubules which are lined by cuboidal cells and contain eosinophilic material.


Peripheral blood cell counts before, during, and after Ra-223 treatment. White and red blood cell (WBC, RBC, respectively) and platelet (PLT) counts are normal before and decreased during and after Ra-223 therapy. The patient has thrombocytopenia (with PLT of 11.9x104/muL at the third injection of Ra-223 therapy) and anemia (with a hemoglobin of 9.9 g/dL four weeks after the third injection of Ra-223 therapy), which rapidly gets worse. He became transfusion-dependent, presenting with a hemoglobin of 7.7 g/dL and requiring monthly red-cell transfusions.


Prostate-specific antigen (PSA) and serum total alkaline phosphatase (ALP, marker indicating osteoblastic activity) trends and the response to Ra-223, with concomitant use of hormonal therapy. The PSA level is 64 ng/ml before Ra-223 therapy, and it increases by twice a month, with PSA peaking at 1303 ng/ml eight weeks after the third injection of Ra-223 therapy. ALP decreases from 506 to 361 U/L during Ra-223 therapy, compatible with a favorable response to radiotherapy and concordant with the general decrease of Tc-99m HMDP uptake in bone lesions.


(a) Computed tomography of the head showing soft tissue lesion on scalp in the frontal region with destruction of underlying bone.


(b) Cytological smear showing cells arranged in microfollicular structures and having monotonous enlarged hyperchromatic nuclei (Leishman, x100).


(c) Immunocytochemistry showing positivity for Thyroglobulin (IHC, x200).


Abdominal computed tomography at the first administration. A; A 4.2-cm multilocular cystic mass (arrowhead) was observed in the pancreatic head.


Abdominal computed tomography at the first administration. B; A 4.6-cm solid mass (arrow) was detected in the pancreatic tail.


Abdominal computed tomography 1 month after the first administration revealed two solid masses in the gastric wall of the antrum. Arrowhead).


The upper body. Arrow).


Esophagogastroduodenoscopy revealed a submucosal tumor with normal mucosa in the posterior wall of the upper body of the stomach, suggesting the gastric hematogenous metastasis of pancreatic cancer.


Pathological results of the breast. Haematoxylin-eosin (H&E) staining of biopsy samples (40x) magnification.


Pathological results of the breast. Haematoxylin-eosin (H&E) staining of biopsy samples (40x) magnification. Immunohistochemical staining results of breast showed ER 10.


Pathological results of the breast. Haematoxylin-eosin (H&E) staining of biopsy samples (40x) magnification. And PR 5.


Pathological results of the breast. Haematoxylin-eosin (H&E) staining of biopsy samples (40x) magnification. And HER-2 2.


Pathological results of the breast. Haematoxylin-eosin (H&E) staining of biopsy samples (40x) magnification. And Ki-67 30.


Computed tomography of the chest and breast before treatment. (A) First whole body assessment. Abnormal high-density shadows can be seen on magnetic resonance imaging of the head.


Computed tomography of the chest and breast before treatment. (B) Computed tomography before modified radical mastectomy of left breast cancer.


Computed tomography of the chest and breast before treatment. (C) Magnetic resonance imaging of the second intracranial mass before surgery.


Computed tomography of the chest and breast before treatment. (D) First computed tomography image revealing the hepatic space-occupying lesions.