(d) MRI brain with contrast demonstrating resection of left frontal foci with expected postoperative changes.


MRI with contrast.


MRI T2WI.


Medical image.


ADC. MRI Head demonstrating right frontoparietal subdural collection with associated vasogenic edema and restriction on DWI and ADC maps.


(a) MRI T1W with contrast four-weeks post-surgical evacuation of subdural collection and initiation of platinum-based chemotherapy demonstrating marked improvement.


(b) MRI T1W with contrast eight-weeks following initiation platinum-based chemotherapy demonstrating marked progression of invasive tumor in the right parietal and posterior frontal lobes, extensive vasogenic edema extending to the atrium of the right lateral ventricle and midline shift.


MRI of sacrococcygeal mass prior to initial resection. Axial view of fat-saturated T2-weighted.


MRI of sacrococcygeal mass prior to initial resection. Contrast-enhanced T1-weighted sequences demonstrate a lobulated expansile mass confined to the soft tissues affixed between the gluteal muscles.


MRI of sacrococcygeal mass prior to initial resection. The mass on sagittal view is. T2 hyperintense well-encapsulated within the post-sacral soft tissues without invasion into the sacrococcygeal space.


MRI of sacrococcygeal mass prior to initial resection. Heterogeneously enhancing with central necrosis.


Restaging of recurrent soft tissue mass prior to and following resection. (A) Pre-resection sagittal view with contrast-enhanced T1-weighted image showing a multilobulated mass extending from the first through fourth coccygeal segments bordered by a thin plane of fat interposed between the tumor and coccyx without evidence of coccygeal invasion (black arrow).


Restaging of recurrent soft tissue mass prior to and following resection. (B) Status post-coccygectomy and resection cavity (black arrow) of the previously described associated lobulated mass.


CT plain and enhanced scan. (A) Hydatid lesion in liver and enlarged lymph node in the hepatogastric space with diameter of 2.13 cm.


CT plain and enhanced scan. Portal vein phase).


CT plain and enhanced scan. Delayed phase) showed circular enhancement.


MRI scan. (T1).


MRI scan. T2) Sequence.


MRI scan. Enhanced scan) showed enlarged lymph node in hepatogastric space with slightly longer T2 signal.


Postoperative microscopic findings. HE staining of lymph node, x10, showed that the central structure of lymph node was basically all hydatid tissue, and a small number of follicles under the capsule.


Radical cystectomy.


MR images showing solitary intrinsic lesion centred around the pre-central gyrus, confirmed to be metastatic deposit of MPM on histological assessment.


MR images showing solitary intrinsic lesion centred around the pre-central gyrus, confirmed to be metastatic deposit of MPM on histological assessment. /. Post-gadolinium T1-weighted images.


MR images showing solitary intrinsic lesion centred around the pre-central gyrus, confirmed to be metastatic deposit of MPM on histological assessment. . T2-weighted image.


Postoperative MR images confirming gross total resection.


Postoperative MR images confirming gross total resection. /. Post-gadolinium T1-weighted images showing some hyperintense material in the cavity that does not enhance compared to pre-contrast sequence.


Postoperative MR images confirming gross total resection. . T2-weighted image.


Extraoral facial asymmetry on left side of face.


Orthopantomograph revealed multilocular radiolucency on left side extending from 35 to condylar process.


Computed tomography scan revealing buccal and lingual cortical expansion with cortical perforation at 37 region.


Macroscopic specimen.


Specimen with impacted tooth.


Preoperative photograph shows swelling on the leftside of the face.


(a) Coronal CT scan section shows the lesion completely obliterating the maxillary sinus, extending in to the nasal cavity and floor of the orbit.


(b) Sagittal CT scan section shows the extension of the lesion toward the posterior surface of maxilla and pterygoid plates.


Histopathological examination using hematoxylin and eosin stain at 10X magnification shows diffused distribution of giant cells.


Unilateral Le fort I osteotomy with midpalatal split to access the lesion.


Curettage and complete removal of the lesion.


Stabilization of the Le Fort I segment with L-shaped miniplate and screws.


Postoperative orthopantomograph after 1 year.


Two-year postoperative follow-up CT scan.


Computed tomography scan shows well-defined and complex density mass in mesentery or adjacent proximal jejunum.


(A) Cells composing tumor are arranged in trabecular pattern and well encapsulated (H&E, x40).


(B) Cellular nucleus has coarsely granular chromatin pattern without mitosis (H&E, x400).


Tumor expresses strong positivity in immunohisochemical stain with synaptophysin.


Cytokeratin. (x200).


Cutaneous nodule.


Diffuse esophageal ulceration.


Fine needle aspiration cytology from cutaneous lesion.


Severe urticaria leading to excoriations presenting as a paraneoplastic manifestation of breast cancer in a 49-year-old woman.


Fundus photographs of the patient's right eye obtained before and after Gamma Knife. (GK) radiosurgery treatment. Choroidal melanoma was observed from the macular region to the temporal side (a).


Fundus photographs of the patient's right eye obtained before and after Gamma Knife. (GK) radiosurgery treatment. Although the tumor gradually shrank after GK treatment, hard exudates began to appear around the tumor at 6 months postoperatively (b).


Fundus photograph and optical coherence tomography (OCT) images obtained at 8 years after the initial treatment. A bullous retinal detachment with fixed folds occurred in the superior-nasal quadrants (a).


Fundus photograph and optical coherence tomography (OCT) images obtained at 8 years after the initial treatment. OCT revealed partial thinning of the macular retina, with the formation of a retinal inner break caused by traction resulting from the formation of preretinal membrane and posterior vitreous detachment (b).


MRI and 123I-IMP SPECT images obtained at 8 years after the initial treatment. MRI showed no increase in tumorous lesions.


MRI and 123I-IMP SPECT images obtained at 8 years after the initial treatment. 123I-IMP SPECT imaging revealed no photon accumulation , thus indicating no tumor activity.


FNA smear of skin lesion showing mix population of cells with abundant wispy cytoplasm, round and naked nuclei with prominent nucleoli.


Few large cells with less vacuolated cytoplasm The magnification for A, B, C, and D is x40, x60, x10, and x10, respectively.


Cell block is positive for AE1/AE3 The magnification for A, B, C, and D is x40, x60, x10, and x10, respectively.


For Pax8.


Core biopsy demonstrating infiltrating pattern of tumor cells with H&E stain.


Tumor cells are strongly positive for vimentin The magnification for A,. C is x10, and ,for D.


Medical image.


CD10 . And F is x20.


Negative for CK7.


(a) Magnetic resonance imaging of abdomen showing subcutaneous nodule in left iliac fossa (arrow) which was a recurrence at the margin of Gibson's incision.


(b) Contrast-enhanced computed tomography scan depicting two small nodules on the posterior wall of urinary bladder (arrow).


Biopsy of the patient's skin lesions. Haematoxylin and eosin stain reveals subepidermal bulla as well as fibrin net, numerous eosinophils, perivascular mixed infiltrate, and well-preserved dermal papillae within the bulla cavity.


Cutaneous melanoma lesion with surrounding vitiligo.


Clinical picture of ruptured bullae, erosions, and crusts of mild bullous pemphigoid exacerbation on low-dose corticosteroid treatment.


Mammography showed a dense ovoid opacity of 14 mm with irregular suspicious micro calcifications.


Ultrasound right nipple: suspect galactophoric dilatation of the right supero-external quadrant.


(A,B) Images coupe de biopsie. Biopsy concluded to a ductal multicentric carcinoma in situ, nuclear grade 2-3, HER2 (+), ER, and PRG (-), classification as B5a. Microscopic examination of the specimen using H&E staining. (A) The epidermis of the nipple infiltrated by large Paget's cells with pale abundant cytoplasm (magnification, x100).


(A,B) Images coupe de biopsie. Biopsy concluded to a ductal multicentric carcinoma in situ, nuclear grade 2-3, HER2 (+), ER, and PRG (-), classification as B5a. Microscopic examination of the specimen using H&E staining. (B) Single groups of Paget's cells with vesicular nuclei and prominent nucleoli (magnification, x400).


Chest CT scan. . A soft tissue mass in the left supraclavicular region consistent with metastatic lymph node (yellow arrow).


Abdominopelvic CT. . A soft tissue mass in the pelvic cavity with right external iliac and para-aortic lymphadenopathy.


The CT scan of the patients before surgery. The 4 cm tumor on the right upper lobe (Red arrow).


The CT scan of the patients before surgery. Metastatic right No.4 lymph node (Red arrow).


Immunohistochemical staining. Hematoxylin-eosin staining of the tumor tissue (40X, and ,400X).


Immunohistochemical staining. Immunohistochemical staining for Synaptophysin (Positive, 400X).


Immunohistochemical staining. Immunohistochemical staining for Chromogranin A (Positive, 400X).


Immunohistochemical staining. Immunohistochemical staining for Ki-67 (80% Positive, 400X).


Abdominal CT scan of the metastatic tumor in left adrenal gland before and during the treatment course. (A) Metastatic tumor in left adrenal gland before the treatment of nivolumab (Red arrow).


Abdominal CT scan of the metastatic tumor in left adrenal gland before and during the treatment course. Metastatic tumor in left adrenal gland after 4 cycles treatment of nivolumab (Red arrow).


Abdominal CT scan of the metastatic tumor in left adrenal gland before and during the treatment course. Metastatic tumor in left adrenal gland after 8 cycles treatment of nivolumab (Red arrow).


Abdominal CT scan of the metastatic tumor in left adrenal gland before and during the treatment course. Metastatic tumor in left adrenal gland after 12 cycles treatment of nivolumab (Red arrow).


Abdominal CT scan of the metastatic tumor in left adrenal gland before and during the treatment course. Metastatic tumor in left adrenal gland after 15 cycles treatment of nivolumab (Red arrow).


Abdominal CT scan of the metastatic tumor in left adrenal gland before and during the treatment course. Metastatic tumor in left adrenal gland after 3 months since the drug withdrawal (Red arrow).


Abdominal CT scan of the metastatic tumor in left adrenal gland before and during the treatment course. Metastatic tumor in left adrenal gland after 7 months since the drug withdrawal (Red arrow).


Abdominal CT scan of the metastatic tumor in left adrenal gland before and during the treatment course. Metastatic tumor in left adrenal gland after 12 months since the drug withdrawal (Red arrow).


Immunohistochemical staining of primary tumor in lung for PD-L1. (A) Hematoxylin-eosin staining of the tumor tissue (200X).


Immunohistochemical staining of primary tumor in lung for PD-L1. (B) Immunohistochemical staining for PD-L1 (Negative, 200X).


The efficiency of the treatment evaluated by blood test. (A) NSE detected in serum before and during the treatment course.


The efficiency of the treatment evaluated by blood test. (B) ctDNA tested via NGS before and after 2, 4 cycles after nivolumab treatment.


CT images of bilateral chest. (A,B) are CT scan images taken on June 5, 2019, Scanning model: GE BrightSpeed, scanning parameters: slice thickness: 5 mm, gap: 5 mm. (A) Round ground glass opacity in the posterior segment of the left superior lobe apex, the boundary is clear, in the center, there is a dot-like translucent shadow.


CT images of bilateral chest. (A,B) are CT scan images taken on June 5, 2019, Scanning model: GE BrightSpeed, scanning parameters: slice thickness: 5 mm, gap: 5 mm. (B) Round ground glass opacity in the anterior basal segment of the right lower lobe, the edge is smooth and clear, it can be seen that vascular shadow naturally passes through.


CT images of bilateral chest. (C,D) are CT scan images taken on January 13, 2021, scanning model: United image uCT, scanning parameters: slice thickness: 5 mm, gap: 5 mm. The 2 ground glass opacities of the posterior segment of the left upper lobe apex . (C) CT image of ground glass opacity in the posterior segment of the left superior lobe apex.


CT images of bilateral chest. (C,D) are CT scan images taken on January 13, 2021, scanning model: United image uCT, scanning parameters: slice thickness: 5 mm, gap: 5 mm. The anterior basal segment of the right lower lobe. Are roughly similar to that of the film taken on June 05 2019. (D) CT image of ground glass opacity in the anterior basal segment of the right lower lobe.


The pathological images of two GGOs show that the heteromorphic cells are arranged in the form of acini, the cells are dense, the nucleus is hyperchromatic, the cytoplasm is abundant and eosinophilic, peripheral fibrous tissue and lymphocyte proliferate. (A) Lesions in the posterior segment of the left upper lobe apex, HE x200.


The pathological images of two GGOs show that the heteromorphic cells are arranged in the form of acini, the cells are dense, the nucleus is hyperchromatic, the cytoplasm is abundant and eosinophilic, peripheral fibrous tissue and lymphocyte proliferate. (B) Lesions in the posterior segment of the left upper lobe apex, HE x400.


The pathological images of two GGOs show that the heteromorphic cells are arranged in the form of acini, the cells are dense, the nucleus is hyperchromatic, the cytoplasm is abundant and eosinophilic, peripheral fibrous tissue and lymphocyte proliferate. (C) Lesions in anterior basal segment of right lower lobe, HE x200.


The pathological images of two GGOs show that the heteromorphic cells are arranged in the form of acini, the cells are dense, the nucleus is hyperchromatic, the cytoplasm is abundant and eosinophilic, peripheral fibrous tissue and lymphocyte proliferate. (D) Lesions in anterior basal segment of right lower lobe, HE x400.


Immunohistochemistry [TTF-1 (+), Napsin A (+)]. (A) TTF-1 x100. (A,B) Positive staining of TTF-1 in the nuclei of lung adenocarcinoma.


Immunohistochemistry [TTF-1 (+), Napsin A (+)]. (B) TTF-1 x400. (A,B) Positive staining of TTF-1 in the nuclei of lung adenocarcinoma.


Immunohistochemistry [TTF-1 (+), Napsin A (+)]. (C) NapsinA x100. (C,D) Positive staining of NapsinA in the cytoplasm of lung adenocarcinoma.


Immunohistochemistry [TTF-1 (+), Napsin A (+)]. (D) NapsinA x400. (C,D) Positive staining of NapsinA in the cytoplasm of lung adenocarcinoma.


Sagittal T1 flair showing an expansive tumor that affects the right parietal bone in a 42-years old patient with primary non Hodgkin's lymphoma of the cranial vault.


Diffuse large B cell lumphoma positive for CD20 (immunohistochemistry CD20 orginal magification x400).


Tumor appearance on nasopharyngeal endoscopy and magnetic resonance imaging (MRI). Endoscopic findings of the nasopharyngeal tumor viewed from the right.


Tumor appearance on nasopharyngeal endoscopy and magnetic resonance imaging (MRI). Left. Nasal cavities at the first visit to the previous hospital are shown. A pedunculated polypoid tumor originating from the posterior edge of the nasal septum was found in the epipharynx.


Tumor appearance on nasopharyngeal endoscopy and magnetic resonance imaging (MRI). Horizontal views of plain T1-weighted.


Tumor appearance on nasopharyngeal endoscopy and magnetic resonance imaging (MRI). T2-weighted magnetic resonance imaging. Of the head showed a tumor of ~20 mm in diameter located in the epipharynx originating from the posterior edge of the nasal septum without invasive or destructive findings (white arrows). T1- and T2-weighted images showed the same or slightly higher intensities compared to that of the nasal concha.


Tumor appearance on nasopharyngeal endoscopy and magnetic resonance imaging (MRI). Preoperative . In the preoperative view, the main portion of tumor had disappeared and only the pedunculated portion remained (E).


Tumor appearance on nasopharyngeal endoscopy and magnetic resonance imaging (MRI). Postoperative. Endoscopic findings of the nasopharyngeal tumor viewed from the right nasal cavity in our hospital. The tumor was endoscopically resected with a 5-mm safety margin (F).


Histopathological features of TL-LGNPPA. (A) Histological examination revealed a papillary structure with fibrovascular cores lined by cuboidal to columnar stratified cells with round to oval vesicular nuclei and eosinophilic cytoplasm. Psammoma bodies were not seen. The tumor showed invasive growth into the underlying fibrous connective tissue. (H&E staining, x 20).


Histopathological features of TL-LGNPPA. (B) An increase in nuclear chromatin and mild nuclear atypia were found, but no nuclear polymorphism was detected. Some cells had clear chromatin; however, the nuclear groove and nuclear pseudoinclusion were absent. No mitotic figures were found, and necrosis was not identified (H&E staining, x 40).


Histopathological features of TL-LGNPPA. (C) A streaming pattern lining of the tumor cells was also found in some areas (H&E staining, x 40).


Immunohistochemical features of TL-LGNPPA. (A) Positive staining for cytokeratin (CK) AE1/AE3 (x 20).


Immunohistochemical features of TL-LGNPPA. (B) Positive staining for vimentin (x 20).


Immunohistochemical features of TL-LGNPPA. (C) Positive nuclear staining for thyroid tissue factor-1 (TTF-1) (x 20).


Immunohistochemical features of TL-LGNPPA. (D) Negative staining for smooth muscle actin (SMA) (x 20).


Immunohistochemical features of TL-LGNPPA. (E) Negative staining for S100 (x 20).


Immunohistochemical features of TL-LGNPPA. (F) Negative staining for thyroglobulin (x 20).


Magnetic resonance imaging showing the right frontal mass as a ring-enhancing lesion on T1-weighted imaging with gadolinium contrast enhancement.


CT of the abdomen using pancreatic protocol.


EUS image of the pancreas with squamous cell carcinoma.


The neoplasm is composed of many malignant cells with round to oval nuclei (HE). A; Sheets of malignant cells with round to oval nuclei with thick nuclear membrane.


The neoplasm is composed of many malignant cells with round to oval nuclei (HE). B; Prominent nucleoli and high N/C ratio cytoplasm which are eosinophilic granular and moderate to abundant with rather well-defined borders.


The CEA marker. Is negative.


The CK5/6.


P63. Markers are positive.


Abdominal axial CT scan depicting a developed pancreatic SCC.


PET-CT before treatment. . PET-CT was performed after the biopsy of the nasal tumor. Accumulation of FDG was noted in the mesenteric nodes, mediastinal nodes, pleura and pelvic mass.


Changes in serum sodium level after irinotecan-cisplatin administration.


Preoperative magnetic resonance imaging showing a 35-mm sized mass in the left cerebellum that showed low intensity on T1-weighted image.


High intensity with perifocal oedema on T2-weighted image.


Heterogeneous enhancement on T1-weighted image with gadolinium administration.


Tumour containing proliferating signet ring cells floating in abundant mucin.


(a) Brain CT showing a 3 x 3x 4 cm 4th ventricle mass, predominantly hyperdense, causing active triventricular dilation.


T2WI. And associated edema Linear hypointense signal, in T2WI, along the pial surface/subarachnoid space of the convexity sulci, cerebellar folia, and brainstem and spinal surface, is typical of SS (b, d, e, f).


MRI showing a heterogeneous lesion with cystic areas in both T1WI , scarce areas of enhancement Signs of compensated hydrocephalus are also present (bulging suprasellar cistern, remodellation of the sella turcica) (c and d).


T2WI Linear hypointense signal, in T2WI, along the pial surface/subarachnoid space of the convexity sulci, cerebellar folia, and brainstem and spinal surface, is typical of SS (b, d, e, f). Signs of compensated hydrocephalus are also present (bulging suprasellar cistern, remodellation of the sella turcica) (c and d).


Linear hypointense signal, in T2WI, along the pial surface/subarachnoid space of the convexity sulci, cerebellar folia, and brainstem and spinal surface, is typical of SS (b, d, e, f).


Sequence of photographs obtained during the microsurgical procedure. (a and b) A bilateral telovelar approach was carried out. Notice the brownish colored pial surface of the cerebellum, typical of SS. After evacuation of xanthochromic CSF, a rubbery mass was identified occupying the fourth ventricular chamber. A friable xantochromic material covered both the tumor and the boundaries of the fourth ventricle.


Sequence of photographs obtained during the microsurgical procedure. Although this material facilitated the definition of a plane of dissection that allowed an en block resection of the tumor.


Sequence of photographs obtained during the microsurgical procedure. It precluded the identification of the anatomical structures of the floor of the fourth ventricle , except clear CSF gushing forth from the aqueduct.


Flow diagram of literature search strategy, according to the Preferred Reporting Items for Systematic Reviews and Meta-analysis (PRISMA) 2020 guidelines.


(Hematoxylin and eosin x100) Photomicrograph of the intra sellar mass showing fungal organisms with septate hyphae and spores, which was consistent with aspergillus.


Clinical photograph showing papular lesions on tongue.


Photomicrograph showing endothelial lined lymphatic channels filled with lymph [H & E stain].


Clinical photograph showing papular lesions on tongue with macroglossia.


Photomicrograph showing endothelial-lined lymphatic channels filled with lymph [H and E stain].


Photomicrograph showing endothelial-lined vessels filled with lymph and extravasated RBC [H and E stain].


CT Thorax showing bilateral pulmonary nodular infiltrates.


CT Thorax showing mediastinal lymphadenopathy.


CT Abdomen showing lesions in the pancreas.


18-FDG PET scanning presenting multiple pathological lesions in lungs, pancreas, lymph nodes, and bones.


Preoperative findings. A 70-year-old man with a tumor (7x7 cm) on his buttock.


(a) Axial T1-weighted MRI scan of the tumor.


(b) Axial T2-weighted MRI scan of the tumor.


(c) Sagittal T1-weighted MRI scan of the tumor.


(d) Sagittal T2-weighted MRI scan of the tumor.


(a) Design of the operation.


(b) Image obtained after the tumor was resected.


(a) Epithelial findings. The epithelium of the squamous cell carcinoma is contiguous with the epithelium of the epidermal cyst (hematoxylin and eosin staining, bar: 5 mm).


(b) Cellular findings. Numerous keratinized atypical cells are seen. The atypical cells have formed nests and cancer pearls (hematoxylin and eosin staining, bar: 1 mm).


(c) Postoperative findings obtained after the skin grafting.


(d) Postoperative 6-month findings.


Abdominal CT on admission. Abdominal CT shows a huge, 18-cm mass in the right upper abdomen (Fig. 1). The tumor is located very close to surrounding organs such as the duodenum (arrow) and right kidney (arrow head).


Colonoscopy findings. Colonoscopy shows a circumferential type 2 tumor at the transverse colon. The scope cannot pass through to the oral side of the tumor.


Histology of the biopsy specimen. HE stains show poorly differentiated adenocarcinoma with atypical epithelial cells that have proliferated solidly with focal glandular structure, and many apoptotic cells and mitotic figures.


Abdominal CT after 6 courses of neoadjuvant chemotherapy. After 6 courses of treatment, the primary tumor has shrunk remarkably to 5.0 cm. Invasion to surrounding organs is not observed.


Transverse . The mass was characterized by isointense signal on T1-weighted images . Note the ventricular asimmetry and the moderate deviation of the falx cerebri on the transverse images of the brain (a,b,c,d).


Transverse . High signal on T2-weighted . Note the ventricular asimmetry and the moderate deviation of the falx cerebri on the transverse images of the brain (a,b,c,d).


Transverse . FLAIR. Sequences. Note the ventricular asimmetry and the moderate deviation of the falx cerebri on the transverse images of the brain (a,b,c,d).


Transverse . Note the ventricular asimmetry and the moderate deviation of the falx cerebri on the transverse images of the brain (a,b,c,d).


Sagittal. MRI images of the brain showing a large spheroideal mass in the sellar/parasellar region. High signal on T2-weighted.


Sagittal. MRI images of the brain showing a large spheroideal mass in the sellar/parasellar region. A circular lesion hypointense on T1-weighted (f) and hyperintense on T2-weighted images was observed in the dorso-lateral aspect of the mass. After contrast medium administration, the mass showed a heterogeneous intense enhancement.


Histological findings of the pituitary gland. (a) Histological examination showed a wide, infiltrative, unencapsulated, not well circumscribed, densely cellular neoplasm composed of polygonal cells arranged in nests and packets supported by a fine fibrovascular stroma with numerous small hyperemic vessels.


Histological findings of the pituitary gland. (b) Details of the neoplastic cells with severe anisokaryosis, anisocytosis and karyomegaly.


Calcified Schistosoma ova in fibro muscular stroma with characteristic terminal spine (Arrow).


Squamous cell carcinoma (superficial), transitional cell carcinoma (in deeper lay).


Polypoid mass in bottom of bladder (M).


Transverse ultrasound image of thyroid nodules. Ultrasound showing 0.6 cm nodule in index patient.


Transverse ultrasound image of thyroid nodules. Multiple 0.5 cm sized nodules in the index patient's mother.


Pedigree of the family showing the affected member (index patient). Circles and squares denote female and male family members, respectively.


Contrast-enhanced brain magnetic resonance imaging reveals a 2 cm enhancing lesion in the left frontal lobe with perifocal edema.


Microscopically, the metastatic carcinoma shows irregular sheets infiltrating the brain parenchyma. Immunohistochemistry reveals positive nuclear staining for carcinoma cells with anti-GATA3 antibody (x200).


Postoperative magnetic resonance images 3 months.


13 months. After the operation reveal focal encephalomalacia in the left frontal lobe with gyral enhancement with no interval variation which favors postoperative change.


Planar bone scintigraphy performed after I. V. injection of technetium labeled MDP showing very mild increase in the L 2 vertebra prompted a hybrid SPECT-CT imaging of the lumbar spine. Post Left nephrectomy status is also noticed.


Unenhanced, and . There is a 9 x 7 cm mass (arrows, a,b) in the anterior mediastinum, which had a lobular margin and showed heterogeneous enhancement without a demonstrable fat component, with extrinsic compression and/or early invasion of adjacent mediastinal great vessels and left upper lobe. AA, ascending thoracic aorta; dA, descending thoracic aorta; rMP, right main pulmonary artery.


Contrast-enhanced images of initial chest computed tomography. There is a 9 x 7 cm mass (arrows, a,b) in the anterior mediastinum, which had a lobular margin and showed heterogeneous enhancement without a demonstrable fat component, with extrinsic compression and/or early invasion of adjacent mediastinal great vessels and left upper lobe. AA, ascending thoracic aorta; dA, descending thoracic aorta; rMP, right main pulmonary artery.


Follow-up contrast-enhanced computed tomography (CT) imaging at three months. The anterior mediastinal mass (arrows) also shows marked interval growth and heterogeneous enhancement with a marked hypervascular portion (asterisk). Also the fat component within the tumor (arrowhead), which was not clear on baseline CT, is clearly demonstrated.


Microscopic findings of malignant teratoma in. First transthoracic needle biopsy (TTNB), and . The tumor. Had teratomatous features (hematoxylin-eosin [HE], original magnification x40).


Microscopic findings of malignant teratoma in. First transthoracic needle biopsy (TTNB), and . Showed. Immature neuroepithelial components (HE, original magnification x200).


Microscopic findings of malignant teratoma in. First transthoracic needle biopsy (TTNB), and . An immature cartilage component (HE, original magnification X200).


Liposarcoma in. Second TTNB. Several lipogenic tissues with dense collagenous tissue (HE, original magnification x40).


Liposarcoma in. Second TTNB. (e) The fat cells showed immunoreactivity for MDM2 (original magnification x200).


Double inversion-recovery (IR). T1 weighted,. A huge, prominent heterogeneous anterior mediastinal mass (arrows,. Contains a relatively large hemorrhagic and necrotic portion, which shows subtle high signal intensity on T1 weighted image (asterisk.


T2-weighted, and . A huge, prominent heterogeneous anterior mediastinal mass (arrows,. , a heterogeneous mixed area of strong high and dark signal intensities on T2 weighted imaging (asterisk.


Gadolinium-enhanced T1 weighted chest magnetic resonance imaging at one month follow-up. A huge, prominent heterogeneous anterior mediastinal mass (arrows,.low signal intensity without contrast enhancement on contrast-enhanced T1 weighted image (asterisk,. (c) The remaining portion of the mass shows heterogeneous enhancement, which is suggestive of malignant potential. AA, ascending thoracic aorta; dA, descending thoracic aorta; rMP, right main pulmonary artery.


FDG-PET/CT. FDG uptake was detected in almost all bone segments.


FDG-PET/CT. In breast lesions. Before treatment.


FDG-PET/CT. Completely disappeared bone.


FDG-PET/CT. Breast. Uptake was observed after five months of AI, LH-RHa and CDK4/6 inhibitor.


Relevant clinical data and therapies from diagnosis till now organized as a timeline.


Scintigraphic image showing a global but heterogeneous hyperfunctioning thyroid gland with excessive uptake at upper left lobe and upper right lobe.


CT image showing a right tracheal deviation by a left thyroid mass.


The CT scan shows a 3.5 cm2 x 4.0 cm2 expansive neoplasm located in the right TMJ region. Horizontal plane, white rectangular region).


With an expansile osteolytic process that was eroding the mandibular condyle. Coronal plan, white arrows).


MRI results confirmed an irregular neoplasm surrounding the mandibular condyle with an unclear joint space (c, coronal plan, white rectangular region).


The mandibular condyle and disc were surrounded and being eroded by the neoplasm (a, white dashed region). A reverse L-shaped osteotomy line was drawn at the posterior part of the ramus.


The proximal bone segment was then moved superiorly to reconstruct the mandibular condyle and fixed using an L-shaped miniplate (b, white dashed region shows temporal muscle).


(c) A 3D reconstruction of postoperative CT images show the reconstructed mandibular condyle.


(d) Depicts the neoplasm (black arrow) and damaged mandibular condyle (white arrow).


Histologically, the lesion consisted of both polygonal and round mononuclear chondroblasts with grooved nuclei as well as multinucleated giant cells (a, black arrows) in an eosinophilic cartilaginous matrix.


An immunohistochemical stain for S-100 protein was positive in the tumor cells (b).


Computed tomography (CT) scans with contrast enhancement (a-c) showed lymph node swelling of the neck, mediastinum, and left axilla.


18F-fluorodeoxyglucose positron emission tomography/CT (d) showed a hot spot in the right lobe of the thyroid.


A chest CT scan showed mosaic patterns with ground-glass opacities in both lungs (left). A chest X-ray taken on day 35.


Diffuse infiltrative shadows were observed in both lung fields (right).


Clinical course of the patient. Day 1 is the starting date of the first cycle of lenvatinib administration. CBDCA, carboplatin; PTX, paclitaxel.


CT head pre- and post-corticosteroid therapy. (A,B) Initial CT head pre-corticosteroid therapy revealed a large hypodense lesion in the right parietal lobe with vasogenic edema.


CT head pre- and post-corticosteroid therapy. (C,D) Repeat CT head 4 weeks after post-corticosteroid therapy revealed a decrease in vasogenic edema and apparent size of the lesion.


Histopathology demonstrating pleomorphic glial cells, nuclear atypia, palisading necrosis, mitoses, and vascular proliferation consistent with a diagnosis of glioblastoma. (A,B) Palisading necrosis at 4x and 10x magnification, respectively.


Histopathology demonstrating pleomorphic glial cells, nuclear atypia, palisading necrosis, mitoses, and vascular proliferation consistent with a diagnosis of glioblastoma. (C) Mitoses at 40x magnification.


Histopathology demonstrating pleomorphic glial cells, nuclear atypia, palisading necrosis, mitoses, and vascular proliferation consistent with a diagnosis of glioblastoma. (D) Vascular proliferation at 10x magnification.


Post-operative imaging. (A,B) Post-operative CT Head demonstrated expected post-operative changes without evidence of acute pathology.


Selected axial computed tomography images demonstrated.


An eccentric thickened wall of the distal transverse colon (black arrow). With a focal, walled-off intra-abdominal fluid collection, extending from the wall of the transverse colon to the left anterior abdominal wall (white arrow). Invasion and thickening of the transversalis and rectus abdominis muscles was noted (white arrow). There was associated increased density and stranding in the pericolic fat and adjacent abdominal wall fat from the inflammation (arrowhead).


Selected coronal.


Sagittal. Images of the patient demonstrates the thick-walled distal transverse colon and associated walled-off collection closely related to normal appearing small bowel loops (white arrows).


Multiple sections were sampled, all of which revealed soft tissue, consistent with inflammatory granulation tissue, and an abscess.


A small opening was identified in the bowel wall (arrow).


Further sectioning in this area revealed a 3 cm fish bone (arrow).


Intraoral photograph showing diffuse ulceroproliferative growth on the left alveolar mucosa in the third molar region.


(a) Intraoral periapical radiograph shows well-defined radiolucency with irregular border (arrow) in relation to 25 and the alveolar ridge irt 26, 27 region shows diffuse rarefactions (arrowhead) around the surrounding bone.


(b) Occlusal radiograph showing well-defined radiolucency (arrow) in the left alveolar ridge in relation to 26 and 27.


Spiral computed tomography showed a soft density lesion involving alveolar process of the left maxilla which is extending into the adjacent pharyngeal mucosal space.


(a) Photomicrograph showing tumor cells with a thin rim of cytoplasm and few cells with clear cytoplasm arranged in pseudoalveolar pattern (H&E stain, x40).


(b) Photomicrograph showing large uninucleated cells with eosinophilic cytoplasm (H&E stain, x200).


(a) Photomicrograph showing cytoplasm of tumor cells to be positive for positivity with phosphotungstic acid hematoxylin (PTAH stain, x100).


(b) High power view showing positivity for Masson trichrome with the cytoplasm of the cells taking up the red stain (Masson trichrome stain, x100).


Photomicrograph showing strap cells positive for phosphotungstic acid hematoxylin stain (PTAH stain.


X400). Photomicrograph showing tumor cells to be positive for vimentin (IHC stain, x100).


(a) Photomicrograph showing tumor cells to be positive for Myo-D (IHC stain,x200). (b) Photomicrograph showing tumor cells being negative for epithelial membrane antigen (IHC stain, x100). (c) Photomicrograph showing tumor cells to be negative for S-100 (IHC stain, x200).


Intraoral photograph showing an erythematous swelling.


Fine needle aspiration cytology showing epithelial cells with hyperchromatic nuclei and abundant eosinophilic cytoplasm suggestive of malignant neoplastic cells (x10).


Section showing intact surface epithelium of stratified squamous variety (H&E, x10).


Section showing individual tumor cells in single file pattern (H&E, x10).


Section showing minor salivary glands (H&E, x10).


Section showing perineural invasion (H&E, x40).


Picture on the lesional tissue (isomorphic small tumor islands) that helped us to identify it as polymorphous low-grade adenocarcinoma other than the single file pattern (x40).


Section of the lesion stained with carcinoembryonic antigen showing strong positivity for tumor cells (x10).


Immunohistochemical stain showed E-cadherin positivity (x10).


Section of the lesion stained with vimentin showing strong positivity for tumor cells (x10).


Section of the lesion stained with cytokeratin 7 showing strong positivity for tumor cells (x10).


Histopathological picture of the recurrent lesion in the same site after surgery (x10).


Clinical picture of recurrent lesion.


Physical findings consistent with Cushing's syndrome:both new and progressive for the 6 months before diagnosis. (A) Easy bruisability.


Physical findings consistent with Cushing's syndrome:both new and progressive for the 6 months before diagnosis. (B) Buffalo hump.


(A) Endoscopic ultrasound of pancreatic mass.


(B) CT abdomen of the pancreatic mass, also demonstrating a concerning perihepatic lymph node that was proven positive on final pathology.


(C) PET-CT demonstrating mild PET avidity of the pancreatic mass. CT, computed tomography; PET-CT, positron emission technology-CT.


Sections contain a circumscribed high-grade neuroendocrine neoplasm with variable morphology, including areas of small monotonous cells with abundant eosinophilic or clear cytoplasm arranged in nests, cords, and trabeculae. Magnification 400 x.


Areas of monotonous cells with a higher nuclear:cytoplasmic ratio growing in sheets. Magnification 400 x ). The cells have round to oval nuclei with dispersed chromatin. There is no nuclear molding or large cells with abundant cytoplasm. Mitotic figures are frequent (B, arrows) with mitotic count of at least 27 mitoses per 10 high-power fields. Small patches of necrosis are present (<5% of tumor).


Immunohistochemical stain for Ki-67 demonstrates a proliferative index of 21% (C, magnification 400 x ). The overall features are those of a high-grade neuroendocrine carcinoma, but not those of a typical small cell carcinoma or large cell neuroendocrine carcinoma, which usually exhibit unique morphological features, as well as abundant necrosis and very high Ki-67 proliferative index. Based on AJCC TNM system eighth edition this tumor fits the criteria for a "well-differentiated neuroendocrine tumor grade 3.


MRI view of the abdomen shows large multicystic mass in the body and tail of the pancreas with enhancement.


Gross examination shows already opened cystic mass of the pancreas.


Microscopic section shows large and dilated lymphatic channels lined with thin endothelium and lymphoid aggregates in the septa. (H&E, x100).


Top left: HE (Magnification x200); DNT simple form with oligodendroglial-like cells. Top right: GFAP (Magnification x400); immunostaining GFAP is negative in tumour cells. Bottom left: S100 (Magnification x400); immunostaining S100 is positive in tumour cells. Bottom right: Ki-67 (Magnification x600); immunostaining Ki-67 proliferative index is low <1%.


(a-c) Axial, coronal and sagittal 3D T1 FFE MR images of the lesion for preoperative planning in 2002, showing the lesion's inferior extension in the white matter to within a few millimetres of the superolateral edge of the left lateral ventricle.


Top left: HE (Magnification x200); DNT complex form tumour pattern resembling low grade glioma with multicystic (pilocytic like) pattern. Top right: GFAP (Magnification x400); immunostaining GFAP is negative in tumour cells. Bottom left: S100 (Magnification x400); immunostaining S100 is positive in tumour cells. Bottom right: Ki-67 (Magnification x600); immunostaining Ki-67 proliferative index is low <1%.


(a-c) Stereotactic sagittal T1, sag CET1, axial T2 MR images for Gamma Knife treatment planning demonstrates partial, solid contrast enhancement in the T2 hyperintense, residual DNT in the left postcentral gyrus (2002).


(a and b) Preoperative axial and coronal T2 weighted MR images demonstrate the well-delineated hyperintense mass in the right medial temporal lobe and hippocampus (1994).


Top left: HE (Magnification x100); DNT complex form with specific glioneuronal element. Top right: HE (Magnification x400); DNT complex form with specific glioneuronal element. Bottom left: GFAP (Magnification x200); immunostaining GFAP is negative in tumour cells. Bottom centre: S100 (Magnification x200); immunostaining S100 is positive in tumour cells. Bottom right: Ki-67 (Magnification x600); immunostaining Ki-67 proliferativ index is low <1%.


(a-c) 2001 axial T2, axial and coronal CE T1 MR images post subtotal resection demonstrate residual contrast enhancing DNT.


(a-d) MRI 2013: axial T2, axial and coronal T1 MR images show dramatic decrease in DNT size and contrast enhancement 8 years after GKRS.


Clinical image showing swelling in the neck.


Gross specimen of the excised lesion.


Photomicrograph showing cystic lesion lined by stratified squamous epithelium. (H&E stain, x40).


Photomicrograph showing cystic cavity lined by thin stratified squamous epithelium with the underlying connective tissue showing abundant lymphoid tissue aggregate (H&E stain, x40).


Photomicrograph showing the germinal center within the lymphoid aggregate (H&E stain, x100).


Photomicrograph showing cystic lumen lined by thin stratified squamous epithelium with flat rete ridges and underlying connective tissue showing abundant lymphoid tissue aggregate (H&E stain, x100).


Kidney biopsy showing pigmented dihydroxyadenine crystals.


Kidney biopsy showing pigmented dihydroxyadenine crystals (higher magnification).


Representative computed tomography images of the patient. Baseline (before administration of apatinib) showing a left pulmonary lesion.


Representative computed tomography images of the patient. 3 weeks later revealing a substantial shrinkage.


Representative computed tomography images of the patient. 2 months after chemotherapy demonstrating an excellent tumor response.


Representative computed tomography images of the patient. 4 months after chemotherapy illustrating stable disease.


Representative magnetic resonance imaging images of the brain metastatic lesions at different time points. Prior to the treatment showing lesions in the left occipital lobe, right temporo-occipital lobe junction and a large region of edema according to enhanced T1-weighted MRI.


Representative magnetic resonance imaging images of the brain metastatic lesions at different time points. And T2-weighted FLAIR MRI.


Representative magnetic resonance imaging images of the brain metastatic lesions at different time points. On the first day after finishing the whole course of brain radiotherapy, showing shrinkage of tumors in enhanced T1-weighted MRI.


Representative magnetic resonance imaging images of the brain metastatic lesions at different time points. T2-weighted MRI , along with marked alleviation of cerebral edema.


Representative magnetic resonance imaging images of the brain metastatic lesions at different time points. Enhanced T1-weighted MRI.


Representative magnetic resonance imaging images of the brain metastatic lesions at different time points. T2-weighted MRI.


Representative magnetic resonance imaging images of the brain metastatic lesions at different time points. T2-weighted FLAIR MRI. Performed at 1, 3, 12 months after brain radiotherapy showed the brain tumors were well controlled. RT, radiotherapy.


Immunohistochemical staining of VEGFR-1, VEGFR-2, PDGFR, and c-kit. VEGFR-1.


Immunohistochemical staining of VEGFR-1, VEGFR-2, PDGFR, and c-kit. VEGFR-2.


Immunohistochemical staining of VEGFR-1, VEGFR-2, PDGFR, and c-kit. PDGFR. Were strongly positive.


Immunohistochemical staining of VEGFR-1, VEGFR-2, PDGFR, and c-kit. While c-kit. Was negative.


Axial 18F-FDG PET/CT fusion images. Foci of markedly increased 18F-FDG uptake are shown in the peritoneal cavity, and in exophytic lesions in the kidneys bilaterally.


Magnetic resonance imaging. . Notes: (A) MRI revealed a large mass with markedly hyperintense signal intensity on T2WI, with a low signal linear lace and high signal on sac variable region.


Magnetic resonance imaging. (B) On T1WI, the mass showed a low signal intensity.


Magnetic resonance imaging. (C and D) The solid component of the mass lesion showed diffuse enhancement on enhanced scan, and the cystic component demonstrated no enhancement. . Abbreviations: MRI, magnetic resonance imaging; T1WI, T1-weighted imaging; T2WI, T2-weighted imaging.


Computed tomography scan: Mass in right maxillary antrum, extending to right nasal cavity.


Gross morphology of the specimen: Multiple pieces of grayish yellow-colored firm tissue.


Scanner view of tumor showing the overall variegated appearance (H&E stain, x40).


Photomicrograph of sarcomatous component with chondroid differentiation (H&E stain, x200).


Photomicrograph of carcinomatous component (adenocarcinoma) (H&E stain, x200).


Photomicrograph of primitive neuroectodermal component (H&E stain, x400).


Photomicrograph of squamous component (H&E stain, x100). Inset: High power view of keratin pearl (H&E stain, x400).


Initial preoperative imaging showing pelvi abdominal mass.


Gross specimen after total abdominal hysterectomy and salpingo oophorectomy.


Teratomatous elements in the tumour.


Yolk sac elements.


Karyotype showing 46, XY pattern.


Residual lesion after four cycles of chemotherapy.


Radiotherapy planning image with the dose distribution illustrated in color. . Notes:. Axial.


Radiotherapy planning image with the dose distribution illustrated in color. Coronal.


Radiotherapy planning image with the dose distribution illustrated in color. Sagittal images. The planning target volume was the whole-brain parenchyma excluding HA region. . Abbreviation: HA, hippocampus-avoiding.


Brain magnetic resonance images showing a 36x31 mm metastatic mass in the right perihippocampal area. . Note:. Axial.


Brain magnetic resonance images showing a 36x31 mm metastatic mass in the right perihippocampal area. Coronal.


Brain magnetic resonance images showing a 36x31 mm metastatic mass in the right perihippocampal area. Sagittal images.


Abdomen computed tomography showed diffuse distension of gallbladder (GB) with irregular intraluminal polypoid masses - possible GB cancer rather than xanthogranulomatous cholecystitis.


Microscopic finding. (A) Well differentiated squamous cell carcinoma components (H&E, x200).


Microscopic finding. (B) High-grade spindle cell sarcoma components (H&E, x400).


Immunohistochemical stain. (A) Strong cytokeratin positivity in malignant glands forming the epithelial component (Cytokeratin, x200).


Immunohistochemical stain. (B) Strong vimentin positivity in the sarcoma component (Vimentin, x200).


Abdomen computed tomography showed huge metastatic mass involving liver S4.


Duodenum 1st portion.


Multiple variable sized masses with central necrosis in the dependant portion of the abdominal cavity (C).


Black arrow showing tumor cells with cytoplasmic PSA positivity (x 100).


(A) CT scan of the patient neck with IV contrast. Compared to 4.5 cm x 4.3 cm before anti-PD-1 treatment.


Irregular infiltrative mass in the left side of the neck adjacent to the base of the tongue, invading the oropharynx and extending caudally to supraglottic and glottic larynx was shown both before and after the fifth cycle of anti-programmed cell death protein-1 (PD-1) treatment [(B,D) respectively.


It shows mild increase in size measuring about 5.1 cm x 4.6 cm 10 days after the fifth cycle.


Compared tp PET CT obtained at 10 days after the fifth cycle.


PET CT carried out at day 239 after fifth cycle (7 months, 25 days) of anti-PD-1 treatment showing progression of the disease.


Antibody response to the NY-ESO-1 antigen as measured in the plasma by enzyme-linked immunosorbent assay (ELISA). (A) The results are expressed as the mean OD value and error bars indicate the SD for the triplicate values in each dilution. Out of the four different plasma dilutions tested (1:100, 1:400, 1:1,600, and 1:6,400), 1:100 and 1:400 were found to be the optimum dilutions to differentiate the anti-NY-ESO-1 antibody level before and after nivolumab treatment.


Antibody response to the NY-ESO-1 antigen as measured in the plasma by enzyme-linked immunosorbent assay (ELISA). (B) Bar graph represents the mean OD values were measured at 1:400 dilution. Each ELISA experiment was repeated six times and the shown data corresponds to one representative experiment.


Antibody response to the NY-ESO-1 antigen as measured in the plasma by enzyme-linked immunosorbent assay (ELISA). (C) Enzyme-linked immunospot (ELISPOT) assay for interferon-gamma production to investigate T cell response to the NY-ESO-1 antigen in patient's peripheral blood mononuclear cells against NY-ESO-1 overlapping peptides (PepMix). The assay was repeated three times and the shown data corresponds to one representative experiment. Statistical analysis for ELISA and ELISPOT were performed using non-parametric unpaired ANOVA followed by multiple comparison Dunnet's test and p values <0.05 were considered statistically significant.


Flow cytometry was used to determine the expression of programmed cell death protein-1 (PD-1) in the patient CD3+, CD4+, and CD8+ T cells before nivolumab treatment. Panels (A,B) are dot plots for isotype control and for PD-1 staining in CD3+, respectively.


Flow cytometry was used to determine the expression of programmed cell death protein-1 (PD-1) in the patient CD3+, CD4+, and CD8+ T cells before nivolumab treatment. Isotype control and PD-1 staining in CD4+ and CD8+ cells are represented in panels (C,D).


Multiplex analysis of cytokines/chemokines in patient plasma before and after nivolumab treatment, and after progression. (A,B) Significant downregulation of the immune activation biomarkers (IL-10 and CX3CL-1 also known as Fractalkine) at progression (fifth cycle-226 days).


Multiplex analysis of cytokines/chemokines in patient plasma before and after nivolumab treatment, and after progression. (C,D) Significant upregulation of the immune inhibition biomarkers (IL-6 and IL-8) at progression (fifth cycle-226 days). The assay was repeated three times and the shown data corresponds to one representative experiment. Statistical analysis was performed using non-parametric unpaired ANOVA followed by multiple comparison Dunnet's test and p values <0.05 were considered statistically significant.


Pleural effusion showing large and pleomorphic cells with immunoblastic or anaplastic features in cytospin or cell block preparation, which were positive for CD20 and MUM-1 with weak-to-moderate intensity, but negative for CD138, human herpesvirus 8 (HHV8), and Epstein-Barr virus-encoded small RNA, showing a high Ki-67 proliferating index: Papanicolaou (PAP) (x100).


PAP (x400).


H&E (x400).


Epstein-Barr virus.


Imaging study at the time of diagnosis and after completion of chemotherapy: computed tomography (CT) at diagnosis.


Positron emission tomography-computed tomography (PET-CT) at diagnosis.


CT after six cycles of rituximab plus cyclophosphamide, doxorubicin, vincristine, and prednisolone (R-CHOP).


PET-CT after six cycles of R-CHOP.


MRI of the thoracic spine. Sagittal T1.


MRI of the thoracic spine. Sagittal T2-weighted image shows isointense extradural mass (yellow arrow) in thoracic spinal canal lying from T2 until T4 levels.


MRI of the thoracic spine. (c) Axial T2-weighted imaging shows severe thoracic canal narrowing due to compression by the mass (yellow arrow).


MRI of the thoracic spine. Axial T1 MRI after injection of contrast agent show strong homogenous enhancing mass (yellow arrow).


Medical image.


Epidural tumor. After total resection, it showed intact duramater.


Pattern of perivascular hypercellularity and slight intraluminal herniation on x40 zoom.


X100 zoom.


Sagittal T1.


T2. Sagittal T2-weighted image thoracic MRI showed spinal cord swelling on the T2-T3-T4 levels.


CXR. Widened mediastinum.


CT chest. Anterior mediastinal mass with minimal contrast enhancement.


CT chest. Thyroid gland enlargement (right) with inhomogeneous contrast enhancement.


Initial transthoracic echocardiography (apical 4-chamber view). Arrows denote hyperechoic mass occupying right atrium.


CT angiography with reconstruction showing tumor invasion into right atrium. A; Axial view.


CT angiography with reconstruction showing tumor invasion into right atrium. B; Sagittal view.


CT angiography with reconstruction showing tumor invasion into right atrium. C; Coronal view; arrow noting transcardiac hepatic feeding vessel.


CT angiography with reconstruction showing tumor invasion into right atrium. D; Coronal 3-D reconstruction; red denotes tumor mass.


Histological appearance of the primary sigmoid carcinoma revealing infiltration of malignant cells into all layers of the intestinal wall.


Histopathologic findings of the hypermetabolic deltoid mass showing atypical glands lined by malignant cells concomitant with inflamed fibrotic stroma suggestive of muscle metastasis from the colon cancer.


Histopathologic findings of the hypermetabolic deltoid mass showing atypical glands lined by malignant cells concomitant with inflamed fibrotic stroma suggestive of muscle metastasis from the colon cancer. : Skeletal muscle fibers surrounded by inflammatory cells : Atypical glandular tissue with muscular fascicles in the top of the field.


Histopathologic findings of the hypermetabolic deltoid mass showing atypical glands lined by malignant cells concomitant with inflamed fibrotic stroma suggestive of muscle metastasis from the colon cancer. (C): Atypical glands lined by malignant cells.


Histopathologic findings of the hypermetabolic tumoral mass in the right chin, involving muscular and bone structures. Fibrocollagenous and skeletal muscle tissue are infiltrated by proliferating atypical neoplastic cells showing glandular differentiation. (A, B): Fibrocollagenous and muscular tissues infiltrated by atypical cells, glandular structures as well as inflammatory cells.


Histopathologic findings of the hypermetabolic tumoral mass in the right chin, involving muscular and bone structures. Fibrocollagenous and skeletal muscle tissue are infiltrated by proliferating atypical neoplastic cells showing glandular differentiation. (C): Glandular differentiation.


Histopathologic findings of the hypermetabolic tumoral mass in the right chin, involving muscular and bone structures. Fibrocollagenous and skeletal muscle tissue are infiltrated by proliferating atypical neoplastic cells showing glandular differentiation. (D): Atypical glandular structure formation.


High-powered hematoxylin and eosin stain photomicrograph of the left ovary, omentum, and posterior cul de sac peritoneum (a, b and c, respectively) all showing diffuse sheet-like architecture of small round cells with scant cytoplasm, hyperchromatic nuclei and small nucleoli.


Timeline of disease progression and treatment. Black bordered months indicate diagnosis or definitive progression on surveillance MRI. The graph shows CAR T-EGFRvIII levels in the peripheral blood as measured by qPCR.


42-year-old man diagnosed with adenoid cystic carcinoma. Lateral radiograph of neck shows a broad-based polypoidal mass arising from the posterior wall of proximal end of trachea causing luminal narrowing (arrows).


42-year-old man diagnosed with adenoid cystic carcinoma. High magnification (hematoxylin and eosin, x100) photomicrograph of stained biopsy specimen shows neoplastic, moderately uniform round cells with hyperchromatic nuclei arranged in typical cribriform pattern of growth (arrows).


42-year-old man diagnosed with adenoid cystic carcinoma. (a) Contrast-enhanced axial computed tomography (CT) scan of neck shows a broad-based soft tissue mass (arrows) arising from posterior wall of upper end of trachea with both intraluminal and extraluminal components. Less than 180 degree circumference of trachea is involved.


42-year-old man diagnosed with adenoid cystic carcinoma. (b) CT scan obtained at the level of cricoid cartilage shows extension of tumor to subglottis (arrow).


A 42-year-old man diagnosed with adenoid cystic carcinoma. Serial sagittal reformatted CT images (a-c) of neck show longitudinal extent of tumor (arrows) located at upper end of trachea extending to subglottis with both intraluminal and extraluminal components. Tracheostomy tube is seen inferior to the mass (arrowhead).


42-year-old man diagnosed with adenoid cystic carcinoma. (a) Axial magnetic resonance post-contrast T1-weighted image of neck shows broad-based soft tissue mass (arrow) arising from posterior wall of upper end of trachea causing near total luminal narrowing and having both intraluminal and extraluminal components.


42-year-old man diagnosed with adenoid cystic carcinoma. (b) Magnetic resonance image obtained at the level of cricoid cartilage shows extension of tumor to subglottis.


42-year-old man diagnosed with adenoid cystic carcinoma. Sagittal magnetic resonance Short Tau Inversion Recovery image of neck shows longitudinal extent of tumor (arrow) located at the level of upper end of trachea extending to subglottis causing almost complete luminal narrowing. Tracheostomy tube is seen below the level of tumor (arrowhead).


Intraoperative view of the patient's cerebral surface with the naked eye.


Under blue light exposure.


By using IRT brain mapping.


Conventional histological analysis of the lesion revealing prominent cellular polymorphism, microvascular proliferation, and pseudopalisading necroses. HE. x100.


Panoramic radiograph showing a diffuse radiolucent lesion in lower left molar region.


Computed tomagraphy showing a wide osteolytic area in the left part of the mandible.


Computed tomography showing a wide osteolytic area in the left part of the mandible.


Photomicrograph of immunohistochemical stain shows sheets of large mononuclear cells positive for CD20.


Clinical course. beta-hCG = human beta subunit of chorionic gonadotropin; Cre = creatinine; im = intramuscular injection; MTX = methotrexate; PSL = prednisolone; RB = renal biopsy; UP = urinary protein.


Light microscopy of initial renal biopsy specimens shows thickening of the glomerular capillary walls, thrombus-like structures within the glomerular capillary lumina, and a double-contour appearance along the glomerular capillary walls. Masson's trichrome stain x 400.


Light microscopy of initial renal biopsy specimens shows thickening of the glomerular capillary walls, thrombus-like structures within the glomerular capillary lumina, and a double-contour appearance along the glomerular capillary walls. Periodic acid-methenamine-silver stain x 400).


C: Immunofluorescence microscopy shows positive staining for IgM along the glomerular capillary walls.


D: Electron microscopy shows the expansion of the glomerular subendothelial space with electron-dense aggregates.


Light microscopy of follow-up renal biopsy specimens shows normal glomerular structures. Masson's trichrome stain x 400.


Light microscopy of follow-up renal biopsy specimens shows normal glomerular structures. Periodic acid-methenamine-silver stain x 400).


The Clinical course of the disease, treatment history, and response evaluation. (A) Timeline of treatment and molecular profiling based on tissue and liquid biopsies.


The Clinical course of the disease, treatment history, and response evaluation. (B) Duration of disease response evaluated by CT and PET/CT. CT, computed tomography; PET/CT, positron-emission tomography/computed tomography.


An overview of somatic mutation profiles within tissue and liquid biopsies using the next-generation sequencing technique. (A) Each row represents one individual biopsy sample, and each column represents one somatic genetic alteration.


An overview of somatic mutation profiles within tissue and liquid biopsies using the next-generation sequencing technique. (B) Dynamic changes in the gene abundance of plasma ctDNA. Solid lines represent ALK mutations, and dashed lines represent concomitant mutations. CtDNA, circulating tumour DNA.


MRI of the pituitary gland, coronal view. (A) T1-weighted initial study showed a 1.5 cm x 1.6 cm x 1.1 cm adenoma (white arrow) on the right side of the pituitary invading the right cavernous sinus and encasing the right internal carotid artery.


MRI of the pituitary gland, coronal view. (B) on T2-weighted imaging, the tumor appeared hypointense, suggestive of dense granulation.


MRI of the pituitary gland, coronal view. (C) follow-up study showed reduction in size of the pituitary adenoma to 0.5 cm x 0.6 cm x 0.3 cm (thin gray arrow) after 6 months of octreotide LAR.


(a) Preoperative photo of the patient.


(b) Photo showing tumor arising from the lateral thoracic nerve.


(c) Photo showing lateral thoracic meningoceles.


(d) Postoperative photo of the patient.


X-Ray of the chest showing meningoceles as a mass lesion.


(a) CT scan of the tumor.


(b) MRI showing both the tumor and the meningoceles.


(c) CT scan showing lateral meningocele with a spinal defect and the tumor.


(d) MRI lateral view showing the meningoceles.


IHC positive for vimentin.


Brain magnetic resonance imaging with cerebrospinal fluid flowmetry revealed an irregular pattern at the level of the Sylvian aqueduct, resulting in its reduced diameter due to compression by the right tentorial meningioma.


Postoperative head computed tomography scan showed correct catheter positioning and stability of the ventricular diameters.


Clinical presentation of the tumor.


Skin with epidermis and dermis, tubulocystic tumor with clear cell morphology in dermis, Hematoxylin-Eosin X2,5.


Immunohistochemical staining with PAX8, positive nuclear reaction, typical in kidney tumors. Magnification x20.


Kidney tumor with clear cell morphology, Hematoxylin-Eosin x10.


Computed tomography findings. The perforated sigmoid colon cancer and Fournier gangrene observed 5 years ago.


Computed tomography findings. And the current abdominal wall metastasis (arrowhead) near the left inguinal region.


Intraoperative findings. Abdominal wall metastasis is observed as a mass covered with normal peritoneum (a).


Intraoperative findings. A surgical margin of 2 cm along the tumor contour is marked using a dye (b).


Intraoperative findings. An entire circumferential incision of the peritoneum is performed for tumor resection.


Intraoperative findings.the resulting abdominal wall defect is approximately 8 cm in diameter.


Finally, plate fixation and cementation were performed (left).


After the cryoablation, contrast-enhanced CT showed the frozen region (middle).


On CT, the density of right metastatic femur was different from that of opposite side (right).


In the histopathological findings of curettage tissue, tumor cells were not observed.


An 85-year-old male with history of prostate cancer status post radiation treatment presented with rising prostate- specific antigen level of 6.1 ng/mL. (a) Axumin positron emission tomography-computed tomography axial image showing increased radiotracer uptake (standardized uptake value maximum of 5.3) in the left internal iliac lymph node (yellow arrow).


An 85-year-old male with history of prostate cancer status post radiation treatment presented with rising prostate- specific antigen level of 6.1 ng/mL. (b) Magnetic resonance imaging pelvis T1 weighted axial image depicting a few enlarged bilateral internal iliac lymph nodes (red arrow) which were otherwise inconclusive for recurrence.


A 76-year-old male with history of prostate cancer status post brachytherapy with rising prostate-specific antigen level of 6.4 ng/mL. (a) Axumin positron emission tomography-computed tomography (CT) axial image showing focal asymmetric tracer activity in the prostate with standardized uptake value maximum (SUVmax) 2.1 (yellow arrow) in contrast to marrow activity (SUVmax 1.4).


A 76-year-old male with history of prostate cancer status post brachytherapy with rising prostate-specific antigen level of 6.4 ng/mL. (b) Non-contrast CT of pelvis for radiation planning axial image showing brachytherapy seeds but no visible mass (red arrow).


An 88-year-old male with history of prostate cancer status post prostatectomy presented with progressive back pain and prostate- specific antigen level of 6.9 ng/mL concerning for recurrence. (a) Bone scan was negative.


An 88-year-old male with history of prostate cancer status post prostatectomy presented with progressive back pain and prostate- specific antigen level of 6.9 ng/mL concerning for recurrence. (b) Axumin positron emission tomography- computed tomography axial image demonstrating intense tracer uptake (standardized uptake value maximum 6.4) in the left posterolateral aspect of the T8 vertebral body (red arrow).


An 88-year-old male with history of prostate cancer status post prostatectomy presented with progressive back pain and prostate- specific antigen level of 6.9 ng/mL concerning for recurrence. (c) Pre-biopsy magnetic resonance imaging performed showing T2 hypointense lesion (yellow arrow) measuring 2.2 cm which was consistent with osteoblastic metastasis on biopsy.


Peripheral blood smear (Wright Giemsa, 100X) demonstrating pleomorphic atypical lymphocytes (red arrows).


Dual fusion FISH for CCND1 and IGH, demonstrating a variant abnormal signal pattern with three copies of CCND1-IGH fusion (yellow signals).


Red rashes over the abdomen and the back of hands after admission (D7).


Histopathologic findings included dense deposit of melanin, intense tumoral necrosis and nuclear atypism with surrounding secondary lesions (H and E, x300).


Axial fluid-attenuated inversion recovery (FLAIR) magnetic resonance imaging (MRI) demonstrating progression of the lesion over the patient clinical course. (a) The initial MRI before the first operation showing a hyperintense lesion in the right frontal lobe.


Axial fluid-attenuated inversion recovery (FLAIR) magnetic resonance imaging (MRI) demonstrating progression of the lesion over the patient clinical course. (b) Postoperative MRI of the first surgery showing total removal of the FLAIR high lesion.


Axial fluid-attenuated inversion recovery (FLAIR) magnetic resonance imaging (MRI) demonstrating progression of the lesion over the patient clinical course. (c) MRI of 5 years after the first operation demonstrating recurrence of the lesion around the removal cavity.


Axial fluid-attenuated inversion recovery (FLAIR) magnetic resonance imaging (MRI) demonstrating progression of the lesion over the patient clinical course. (d) Postoperative MRI showing total removal of the recurring lesion.


Axial fluid-attenuated inversion recovery (FLAIR) magnetic resonance imaging (MRI) demonstrating progression of the lesion over the patient clinical course. (e) MRI at 4 years after the second surgery showing another recurrent lesion in the right lower frontal lobe.


Axial fluid-attenuated inversion recovery (FLAIR) magnetic resonance imaging (MRI) demonstrating progression of the lesion over the patient clinical course. (f) Postoperative MRI of the third surgery showing residual hyperintense lesion in the medial side of the temporal lobe.


Axial fluid-attenuated inversion recovery (FLAIR) magnetic resonance imaging (MRI) demonstrating progression of the lesion over the patient clinical course. (g) MRI 2 years after the third operation showing hyperintense lesion reaching near the pyramidal tracts.


Axial fluid-attenuated inversion recovery (FLAIR) magnetic resonance imaging (MRI) demonstrating progression of the lesion over the patient clinical course. (h) Carmustine wafers were placed in the removal cavity.


Axial fluid-attenuated inversion recovery magnetic resonance imaging at. 3 days.


1 month after administration of bevacizumab. Lesion was shrunk and edema decreased.


Microscopic finding of autopsy in hematoxylin and eosin staining. Histopathological patterns consistent with the World Health Organization. Grade II.


Microscopic finding of autopsy in hematoxylin and eosin staining. Grade III.


Microscopic finding of autopsy in hematoxylin and eosin staining. Grade IV are confirmed extensively from each part of the brain.


Microscopic finding of autopsy in hematoxylin and eosin staining. (d) Invasion also seen in the subarachnoid space at the specimen where the arachnoid membrane was removed together with the brain tissue.


Superimposition of the histopathological finding on the macroscopic photography of. Coronal slice of the cerebrum.


Brainstem from the autopsy with corresponding T1 magnetic resonance imaging (MRI). Respectively) that taken 3 months after administration of bevacizumab. Within the superimposed images, red color indicating histopathological finding consistent with the World Health Organization (WHO) Grade IV. Blue color indicating histopathological finding consistent with the WHO Grade III. Gray color indicating histopathological finding consistent with the WHO Grade II. Green line indicating subarachnoid space. Histopathological analysis revealing widespread tumor invasion in cerebrum, cerebellum, brainstem, and pituitary region that is not seen on MRI. Around the WHO Grade IV lesion, the WHO Grade II and III lesions are widely identified, except in the superolateral part of the right temporal lobe that bordering with the right frontal lobe.


Axial slices of cerebellum.


Case 1: CT scan showing a retrovesical tumor.


(A) Chest enhanced CT before treatment: an anterior segment of the right upper lobe with an irregular soft tissue density of approximately 22 mm x 19 mm in shape.


(B) Multiple burr shadows on the edges, and multiple enlarged lymph nodes in the right hilum.


Chest enhanced CT after neoadjuvant immunotherapy: (A) The area of the anterior segment of the right upper lobe of the lung was significantly smaller than that of the anterior, with a maximum cross-section of about 11 mm x 7 mm.


(B) The mediastinal and right hilar swollen lymph nodes were smaller than before, and the adjacent pulmonary vessels were more compressed Before remission.


Chest CT before and after video-assisted wedge resection of left upper lung lobe. The lung tumor located in the left upper lung lobe.


Chest CT before and after video-assisted wedge resection of left upper lung lobe. Fourteen months after resection of lung tumor in the left upper lung lobe.


Histopathology of lung and urethra cancer. (A) Primary adenocarcinoma of lung (Hematoxylin and Eosin, original magnification x 100).


Histopathology of lung and urethra cancer. (B) Metastatic urethral adenocarcinoma (Hematoxylin and Eosin, original magnification x 100). Black arrows indicated adenocarcinoma.


Tumor located in the membranous urethra under transurethral endoscopy. The black arrow indicated urethral tumor, while white arrow indicated normal posterior urethra.


Gd-EOB-DTPA enhanced MRI of this patient. (A) T1-weighted MRI showing that the liver nodules (red arrows) were highly intense.


Gd-EOB-DTPA enhanced MRI of this patient. (B) T2-weighted MRI, showing that the liver nodules were iso-intense.


Gd-EOB-DTPA enhanced MRI of this patient. (C) Gd-EOB-DTPA-enhanced MRI, showing the showed were highly intense during the hepatobiliary phase.


Gd-EOB-DTPA enhanced MRI of this patient. (D) Plain-CT examination 1 year before liver biopsy, showing small, high-density nodules.


Gd-EOB-DTPA enhanced MRI of this patient. (E) FDG-PET CT examination at liver biopsy. No abnormal FDG uptake was detected.


Gd-EOB-DTPA enhanced MRI of this patient. Dynamic CT examination during the. Arterial.


Gd-EOB-DTPA enhanced MRI of this patient. Portal phase.


Gd-EOB-DTPA enhanced MRI of this patient. Equivalent phases. No enhancement was detected.


Histological findings. Hematoxylin-eosin (HE) staining. X4.


Histological findings. . X200).


Histological findings. (C) Melan-A staining (X400).


Histological findings. (D) MIB-1 staining (X400).


Histological findings. CD4 staining. X100.


Histological findings. . X400); T indicates tumor area, N indicates non-tumor area.


Histological findings. CD8 staining. X100.


Histological findings. . X400).


Histological findings. (I) Number of infiltrating cells. Y-axis represents the number of infiltrating cells. The average number of cells in three high power fields is shown. Black bar means the number of cells in tumor area, whereas white bar means that of non-tumor area. Asterisk indicates statistical significance (p<0.05).


Clinical course of present case with images. Red arrow and arrow head indicate the metastatic tumors detectable with imaging studies.


(A) Immunohistochemical staining (IHC) of programmed cell death ligand 1 (PD-L1) from biopsy specimens after treatment with osimertinib as the eighth-line treatment showed PD-L1 tumor proportion score (TPS). 90.


(B) IHC of PD-L1 from surgical specimens before chemotherapy and epidermal growth factor receptor tyrosine kinase inhibitors showed PD-L1 TPS 1%-24.


Pembrolizumab followed by gemcitabine therapy showed antitumor effects. . Notes: Chest computed tomography scan images obtained before administration of pembrolizumab.


Pembrolizumab followed by gemcitabine therapy showed antitumor effects. And at 2 months after three cycles of pembrolizumab showing stable disease.


Pembrolizumab followed by gemcitabine therapy showed antitumor effects. And after 2 months of administration of gemcitabine showing a partial response Arrowheads indicate pulmonary metastatic lesions.


Defect postexcision with prospective rhomboid flap design.


Closure with rhomboid local flap.


Defect with prospective design of bilobed flap (case 3).


Closure with bilobed flap (case 3).


Defect after excision of recurrent invasive ductal carcinoma.


Closure with rotational flap.


(a) Apical four-chamber view of transthoracic echocardiogram showing a left atrial mass (*) protruding into the left atrial cavity and across the mitral valve into the left ventricle.


(b) Transesophageal echocardiogram showing a large, broad-based, multilobed, irregular shaped, heterogeneous mass with multiple hypoechoic areas (*) arising from the posterosuperior aspect of interatrial septum and infiltrating into the septum and surrounding myocardium (arrows). LA = Left atrium, LV = Left ventricle, RA = Right atrium, RV = Right ventricle.


(a) Gross specimen of the excised mass revealing a cherry-red colored, elongated and multilobed mass.


(b) Hypercellular areas on histopathology examination showing sheets of neoplastic cells with moderate nuclear atypia, pleomorphism, and atypical mitoses.


(c) Hypocellular areas on histopathology examination showing myxoid degeneration with thin-walled staghorn blood vessel proliferations.


Transthoracic echocardiogram revealing a 29 mm x 22 mm heterogeneous mass (arrows) attached to the interatrial septum and protruding into the left atrial cavity. Both the mitral leaflets are thickened. LA = Left atrium, LV = Left ventricle, RA = Right atrium, RV = Right ventricle.


Diagnostic imaging. (A) Ultrasound imaging identified a lobulated, solid tumor measuring >=3 cm of the left mammary gland.


Diagnostic imaging. (B) Computed tomography of the chest indicated a mass lesion in the apocrine carcinoma region of the left mammary duct exhibiting heterogeneous and moderately enhanced microcalcifications.


Macroscopic images. (A) The predominant lesion of the tumor was white and solid, measuring 61x27 mm and was associated with a cutaneous ulcer.


Macroscopic images. (B) The tumor exhibited an extensive area of necrosis.


Cancer cells formed nests and exhibited keratinization. (A and C) The histological analysis showed structures comprising of predominantly solid and nest patterns, with keratinization (H&E; magnification, x100).


Cancer cells formed nests and exhibited keratinization. The tumor cells were positive for. Cytokeratin 5/6 (magnification, x100).


Cancer cells formed nests and exhibited keratinization. P63 (magnification, x100).


Areas exhibiting apocrine features within the tumor cells. (A) Hematoxylin and eosin staining identified that the areas with apocrine features were abundant in eosinophilic cytoplasm.


Areas exhibiting apocrine features within the tumor cells. (B) Gross cystic disease fluid protein-15 was positive in the areas exhibiting apocrine features.


Areas exhibiting apocrine features within the tumor cells. (C) The androgen receptor was expressed in the cytoplasm and the nucleus of the tumor cells, which exhibited apocrine features.


CT scans. A; The tumor has spread into the deep bladder wall layer.


CT scans. B; The arrow indicates external iliac lymph node swelling.


Pathological findings. A; The tumor cells have a clear nuclear body and karyomitosis. They show a syncytial pattern and are surrounded by infiltrated lymphocytes. Hematoxylin-eosin staining. X400.


Pathological findings. B; The tumor cells and stromal lymphocytes are not stained by EBER1. Immunohistochemical staining. X400.


Pathological findings. C; The stromal lymphocytes are stained by CD3. Immunohistochemical staining. X100.


Pathological findings. D; The tumor cells are stained by cytokeratin AE1/AE3. Immunohistochemical staining. X200.


Multiple intraperitoneal dissemination.


Intrapelvic lymph node metastases. Were observed before treatment (arrows).


After eight cycles of weekly paclitaxel plus bevacizumab therapy, the antitumor effect was evaluated as a complete response (D-F).


Values of CA 19-9.


Endoscopic view of the left ear. Not only reddened and swelling tympanic membrane, but also a partial defect of the posterior ear canal wall can be observed.


Photomicrograph of the biopsy specimen shows large neoplastic cells with clear cell type-cytoplasm (arrow), which suggests metastasis of RCC (HE stain, x200). RCC, renal cell carcinoma.


Sagittal.


Transverse. View of the scapular mass (arrow), histopathologically confirmed to be a metastatic carcinoma.


Malignant pilomatricoma (left flank mass). Neoplastic lobule composed of epithelial cells with high nuclear/cytoplasmic ratio and occasional intracytoplasmic melanin (thick arrows). Neoplastic cells surround a central area of keratin accumulation with numerous ghost cells with faded nuclei (thin arrows). Haematoxylin and eosin, 10x magnification.


Bone metastasis of malignant pilomatricoma (biopsy from left scapula). Epithelial cells (arrows) with high nuclear/cytoplasmic ratio and hyperchromatic nuclei infiltrate the space between trabeculae of remodeled woven bone. Haematoxylin and eosin, 10x magnification.


Transverse view of the right orbital bone metastasis (arrow).


Sagittal view of bilateral scapular metastases at the time of the patient's last restaging. Note the arrow indicating the bone metastasis involving the right scapular bone (previously identified on radiographs) and progression of the left scapular mass when compared to the initial CT study (Fig. 1).


Images of computed tomography before . (A) Cardiac wall thickness and connected lymph node swelling was observed.


Images of computed tomography before . (B) Paraaortic lymph node metastasis (#16) showed distant metastasis of 30 mm in size (indicated by a red arrow).


After. Chemotherapy. (C) The lymph node of the gastric cardia had shrunk.


After. Chemotherapy. (D) The paraaortic lymph node metastasis (#16) had shurunk to 19 mm in size (a blue arrow), showing a partial response.


Changes in tumor markers during the course of the treatment. CEA and AFP sharply decreased after chemotherapy but re-elevated after three cycles. Surgery failed to reduce CEA, but nivolumab was effective. Tumor markers remained in their normal ranges after discontinuation of all treatment. HXP, Herceptine, Xeloda, and Cisplatin; Nivo, nivolumab; CT, computed tomography.


Images of computed tomography 1 month after surgery Lymph node metastasis was observed. In the subclavicle (#104L, yellow arrowhead).


Images of computed tomography 1 month after surgery. Mediastinum (#108L, yellow arrow).


Images of computed tomography 1 month after surgery. Paraaorta (#16b1, red arrow), indicating distally metastatic recurrence of the carcinoma (progressive disease).


After finish of the nivolumab threatment Lymph node metastasis of. The subclavicle (#104L).


After finish of the nivolumab threatment. Mediastinum (#108L).


After finish of the nivolumab threatment. Paraaorta (#16b1) had vanished, indicating a complete response.


Nests of monomorphic cuboidal poroid cells with prominent nucleoli (hematoxylin & eosin stain).


Eccrine porocarcinoma composed of basaloid cells with focal infiltration into the dermis (hematoxylin & eosin stain).


Ultrasound and cytological features of the thyroid nodule in our patient. (A) Ultrasound image showing an isoechoic solid nodule with a hypoechoic cranial component with blurred margins located in the isthmus of the thyroid.


Ultrasound and cytological features of the thyroid nodule in our patient. (B) Medium power magnification showing a hypercellular smear featuring thyrocytes arranged in microfollicular structures (DiffQuik staining, 100X).


Enhanced CT scan demonstrates a transverse colon tumor.


With liver abscess.


Type 2 tumor was identified in the transverse colon. (A) Lower gastrointestinal endoscopy.


Type 2 tumor was identified in the transverse colon. (B) Gastrointestinal endoscopy angiography. Pathologic finding revealed well-differentiated adenocarcinoma.


Percutaneous transhepatic drainage of the liver abscess (7 French pigtail catheter) was performed 2 weeks after the start of treatment.


Resected specimen. T, Type2; 50 x 45 mm, tub1, stage pT3, INFb, ly1a, v0, Pn0, pN0, pPM0, pDM0, pStageIIa.


Low-power photomicrograph depicting granular layer with associated keratinization consistent with epidermoid-infundibular cyst. HE staining.


Medium-power view showing atypical squamous epithelium with focal infiltration and associated stromal response. HE staining.


Medium-power view demonstrating keratinizing tumor cells with mitotic figure. HE staining.


Gross view of the tumor showing multiloculated solid-cystic mass filled with blood.


(A) Colonoscopic finding showing a mixed-nodular type laterally spreading tumor measuring 5.6 cm in diameter.


(B) Gross endoscopic submucosal dissection (ESD) specimen of the primary lesion.


(C) Pathological findings for the ESD specimen showing multiple foci of adenocarcinoma component in the bulky laterally spreading adenoma. The least-differentiated component is highlighted by a dashed line (H&E stain, x10). Higher magnification of the least-differentiated area, showing solid and cribriform architecture and multiple foci of the invasive front, consisting of small, infiltrative tumor glands (arrowheads) (inset: H&E stain, x200).


(D) Follow-up sigmoidoscopy in 8 months shows a scar.


(E) Sigmoidoscopy performed 17 months after ESD, showing mucosal elevation with central ulceration at the previous procedure site, which is suggestive of extrinsic infiltrative cancer.


(F) Endoscopic biopsy obtained from the previous ESD site, showing a poorly differentiated adenocarcinoma sitting under normal colonic crypts (H&E stain, x100). Needle biopsy specimen of a pulmonary metastasis showing similar morphology of tumor glands to that of the previous ESD specimen in terms of solid and cribriform architecture (inset: H&E stain, x200).


(A) Colonoscopic finding showing a mixed-nodular type laterally spreading tumor measuring 6.0 cm in diameter.


(B) Severe cauterization at the margin and the middle of the tumor is suspected in the endoscopic image (arrows).


(C) Pathological findings for the endoscopic submucosal dissection (ESD) specimen showing a laterally spreading adenoma with a frankly invasive adenocarcinoma component (dashed line, H&E stain, slide scan without magnification). At higher magnification, invasive tumor cells form large, irregularly shaped tubules and have occasional goblet cells. The surrounding stroma is desmoplastic (inset: H&E stain, x200).


(D) Follow-up colonoscopy at 12 months shows only a scar.


(E) Colonoscopy at 34 months after ESD shows an ulcerofungating mass that encircles the lumen at the previous ESD site.


(F) Pathological findings of resected tumor show an "undermining" invasion pattern without surrounding mucosal change (H&E stain, x10). The cytomorphology of the resected tumor is similar to that of the invasive component of the previous ESD specimen (inset: H&E stain, x200).


Computed tomography (CT) findings. A; Local recurrence of thymoma at the first relapse.


Computed tomography (CT) findings. B; A pleural dissemination of thymoma at the second relapse.


Computed tomography (CT) findings. C; Complete remission following cyclosporine therapy.


Flow cytometry of mantle cell lymphoma in the peripheral blood (2015) shows CD19/CD5 coexpression (depicted in dark blue).


Lambda light-chain restriction.


Flow cytometry of T-cell large granular lymphocytic leukemia in bone marrow (2018) shows CD3+/TCR gammadelta+ (depicted in green).


CD5-/TCR gammadelta.


CD7+/TCR gammadelta+. Expression.


(a and b) Multiple erythematous papules over the face.


(c) Multiple erythematous papules and edematous urticarial plaques over the back.


(d) Purpuric lesion over the thenar aspect of right palm.


(a) Moderately dense perivascular and interstitial infiltrate of lymphocytes, eosinophils, and neutrophils with spongiosis in the superficial and mid-dermis. (Hand E staining, x10).


(b) Interstitial infiltrate of many mature eosinophils intermixed with neutrophilswith areas of leukocytoclasia without vasculitis (Hand E staining, x40).


(a and b) Resolution of facial lesions after treatment.


(c) Significant decrease in the number and size of lesions after treatment.


(d) Clearance of palmar lesion after treatment.


CT scan images demonstrate a decrease in size of surgical site nodules, inferior vena cava tumor thrombus, paraaortic lymph node metastasis, and lung nodules after eight and fifteen infusions of nivolumab. (A) Before nivolumab therapy initiation.


CT scan images demonstrate a decrease in size of surgical site nodules, inferior vena cava tumor thrombus, paraaortic lymph node metastasis, and lung nodules after eight and fifteen infusions of nivolumab. (B) After eight infusions of nivolumab.


CT scan images demonstrate a decrease in size of surgical site nodules, inferior vena cava tumor thrombus, paraaortic lymph node metastasis, and lung nodules after eight and fifteen infusions of nivolumab. (C) After fifteen infusions of nivolumab.


Levels of serum creatinine rose 2 weeks after the fifth infusion of nivolumab. Nivolumab therapy was discontinued and immediately prednisone treatment was initiated. Serum creatine levels diminished and nivolumab could be restarted.


Three biopsy pathological diagnosis results of the patient.


Chest CT scan evolution of the tumors.


Coronal fused PET/CT.


Transaxial images. Showing fluoro-deoxyglucose (FDG) uptake in multiple skin and subcutaneous nodules in abdominal wall on the right side.


Transaxial image (c) showing FDG uptake in sternum.


EUS-FNA of a lymph node.


EUS-FNA showing a few heterotypic cells.


(a) The gastroscope entered into the abdominal cavity after incision of the full thickness of the gastric wall.


The prelabeled lymph node was found, (b) The removed lymph node tissues.


Immunohistochemical staining: CD3(large cell-); Vimentin(+); PAX-5(-); CD15(-); CD20(large cell+); CD21(+); Ki-67(large cell8%+); CD30(-); CD68(partly+); CK(-); MUM-1(-); CD10(-); Bcl-6(+); Bcl-2(+). The diagnosis was non-Hodgkin lymphoma, germinal center B-cell-like diffuse large B-cell lymphoma.


Management of primary lung cancer and brain metastasis during icotinib treatment. Chest computed tomography (CT) on admission (July 2014).


Management of primary lung cancer and brain metastasis during icotinib treatment. Showing a 3.7x2.8 cm irregularly shaped lesion in the left lower lobe (LLL); the repeated CT one month after icotinib treatment.


Management of primary lung cancer and brain metastasis during icotinib treatment. Showing a clear reduction in size of the lesion in the LLL; chest CT revealing dramatic shrinkage of LLL mass after one-year maintenance icotinib treatment.


Management of primary lung cancer and brain metastasis during icotinib treatment. ; enhanced brain magnetic resonance imaging (MRI) scan on admission (July 2014) revealing brain metastasis to the right parietal lobe.


Management of primary lung cancer and brain metastasis during icotinib treatment. ; brain MRI obtained in July 2015 showing the intracranial lesion vanished following maintenance icotinib treatment.


Histology of the primary lung cancer. The hematoxylin and eosin staining revealed that the left lower lobe lesion was a moderately differentiated adenocarcinoma (magnification x100).


A; Appearance of the breast mass at presentation. Image of the breast lesion illustrating the fungating breast ulcer on a large and irregularly shaped right breast mass.


B; Computed tomography image at presentation revealing a large right breast tumor with skin ulceration and bilateral axillary lymph node metastases.


A; Appearance of the breast mass after the administration of eribulin.


B; Computed tomography image after the use of Mohs' paste and the administration of eribulin.


C; Appearance of the breast mass after mastectomy and skin grafting.


Photomicrograph with MGG stain (40X) showing clusters of neoplastic cells with irregular hyperchromatic nuclei and variable amount of cytoplasm suggestive of metastatic squamous carcinoma.


Transvaginal ultrasound image. A pelvic mass is seen of approximately 11 cm in diameter and is suspected to contain hair because of the presence of hyperechoic lines.


Magnetic resonance images. A; A T1-weighted image shows a cystic tumor containing a fat-fluid level.


Magnetic resonance images. B; A fat-suppression image reveals fat suppression on the abdominal side of the niveau.


Lower gastrointestinal tract endoscopy image. Hair and a submucosal tumor-like protrusion with redness at its apex are seen.


Surgical images. A; An ovarian tumor with a smooth surface occupies the pelvic cavity.


Surgical images. B; After left salpingo-oophorectomy, a fistula of approximately 1 cm in diameter is seen on the surface of the rectum at the site of adhesion.


Histopathological images. A; A histological section of the mature cystic teratoma reveals abundant inflammatory cell invasion (circled section) and hair-shaft tissue (arrows).


Histopathological images. B; A section of the rectal-fistula site shows hair-shaft tissue in the serous membrane of the rectum (arrow).


External swelling of the patient.


Coronal computed tomography scan showing the extent of the tumor.


The mass removed in toto.


The postoperative specimen weighing 0.42 kg.


Cavity seen after removal of tumor.


Histopathological image showing mixture of epithelial and mesenchymal components typical of pleomorphic adenoma.


Post operative picture of the patient after six months follow up.


Evolution of the disease in case presentation. CT, computed tomography; HE, hematoxylin and eosin; Syn, synaptophysin; Rx, treatment.


CECT of brain showing right parietal parasagittal metastatic tumor.


MRI of cervico-dorsal spine demonstrating C6-D2 spinal tumor with dumbbell like extension into upper thorax.


MRI axial images demonstrating spinal tumor at D-1 extending outside.


Histopathology showing densely cellular tumor arranged in sheets, and ,lobules with minimal intervening stroma.


Immunohistochemistry showing membranous positivity for CD99.


Post-operative CECT brain at nine months after surgery showing no evidence of tumor.


Large mass in the right lobe of the thyroid displacing the trachea medially, common carotid artery posteriorly, and sternocleidomastoid muscle laterally.


Hypercellular smear with prominent single cells, insular pattern, and transgressing vessels (Diff-Quik, x40).


Cells have delicate eosinophilic cytoplasm (Pap, x400).


Cells have a high nuclear/cytoplasmic ratio, nuclei are round, slightly hyperchromatic and relatively uniform with macronucleoli (Pap, x400).


Diffuse nuclear TTF-1 positivity (x40).


Nuclear p53 positivity (x40).


Treatment history of our case and schematic diagram of tumor evolution. (A) Clinical treatment history and gene tests results of the patient. Numbers indicate time (in months) from the diagnosis of lung adenocarcinoma (LADC). Scale bar in histopathologic picture indicates 100 mum.


Treatment history of our case and schematic diagram of tumor evolution. (B) Presumed clonal evolution of our case which refers to Lee et al. 's study. The horizontal axis suggests the clinical history, and the vertical axis represents tumor volume.


Preoperative photograph of case 1 showing expansile swelling over the left anterior maxilla.


Orthopantomograph showing a well-defined unilocular radiolucent lesion affecting left maxilla with multiple displaced teeth.


Intraoperative photograph showing the tumor involving the left maxilla exposed via modified Weber-Ferguson incision.


Resected tumor after sub-total maxillectomy.


Postoperative photograph after 6 months.


Preoperative photograph of Case 2 showing swelling over left mid and lower face.


Case 2: Intraoral view showing the swelling involving left mandibular alveolus, obliterating the vestibule with buccal cortical expansion.


Orthopantomograph showing multiple ill-defined radiolucencies over the angle and ramus region of left side of mandible with displaced adjacent teeth.


Operated site after the resection of tumour (hemimandibulectomy) done followed by placement of 2.4 mm titanium reconstruction plate.


Resected hemi-mandible with 2 cm margin.


Case 2: Recurrence with marked swelling over left side lower face extending to the neck after 8 months of surgery.


Calretinin-positive staining.


CK5/6 positive staining.


CD15 negative staining.


BerEP4 negative staining.


Radiological evaluation of diffuse malignant peritoneal mesothelioma with 18 (fludeoxyglucose) positron emission tomography-computed tomography scan performed 6 months after first-line chemotherapy. (a) Axial pelvic follow-up computed tomography demonstrates only fibrotic changes scattered throughout small bowel.


Radiological evaluation of diffuse malignant peritoneal mesothelioma with 18 (fludeoxyglucose) positron emission tomography-computed tomography scan performed 6 months after first-line chemotherapy. (b) Axial abdominal follow-up computed tomography scan (intestine opacified with amidotrizoate) showing enlarged spleen, with smooth parietal peritoneal thickening.


Radiological evaluation of diffuse malignant peritoneal mesothelioma with 18 (fludeoxyglucose) positron emission tomography-computed tomography scan performed 6 months after first-line chemotherapy. (c) Positron emission tomography-fused-axial chest computed tomography scan without signs of increased (18) fludeoxyglucose uptake in thoracic cavity.


Radiological evaluation of diffuse malignant peritoneal mesothelioma with 18 (fludeoxyglucose) positron emission tomography-computed tomography scan performed 6 months after first-line chemotherapy. (d) Positron emission tomography-fused-axial abdominal computed tomography scan without detectable (18) fludeoxyglucose peritoneal uptakes.


T1-weighted. MRI showing synchronous tumour in the left frontal and temporal regions with solid and necrotic-cystic areas with significant perilesionaledema.


(c) T1-weighted image post-gadolinium contrast showed heterogenous enhancement.


(a and b) Magnetic resonance images of the T1-weighted image with contrast demonstrated enhancing suprasellar mass.


(c and d) Postoperative magnetic resonance images showed no residual tumor.


Histological sections of excised lymph node showing increased volume. Histiocyte containing numerous lymphocytes (emperipolesis) (hematoxylin and eosin at 400x magnification);. Immunohistochemical staining for protein S100 expression (400x magnification).


MRI brain images at 3 months follow-up. T2 axial image shows decrease in the number of T2-isointense lesions.


Perilesional edema (arrow).


DWI does not show any restriction. Post-contrast images show fewer enhancing nodular lesions in the subependymal regions and deep gray nuclei (arrows).


Tumor cells are immunoreactive for CD34 around tubules forming a concentric "onion skin" rings (x100).


Case 1. 58-year-old male with difficulty in swallowing was diagnosed with squamous cell carcinoma of right tonsil. A) Maximum Intensity Projection (MIP) image shows tonsillar SCC infiltration in both lobes of the thyroid gland (arrows).


Case 1. 58-year-old male with difficulty in swallowing was diagnosed with squamous cell carcinoma of right tonsil. B) Axial CT image for attenuation correction and anatomic localization.


Case 1. 58-year-old male with difficulty in swallowing was diagnosed with squamous cell carcinoma of right tonsil. C) Axial PET image shows diffuse tracer uptake in both lobes of the thyroid gland (arrows).


Case 1. 58-year-old male with difficulty in swallowing was diagnosed with squamous cell carcinoma of right tonsil. D) Axial PET/CT fusion image reveals SUVmax of the right and left thyroid lobes was 7.5 and 5.9, respectively (arrows).


Case 2. 66-year-old male complaining of a mass in the neck was diagnosed with supraglottic squamous cell carcinoma. A) Maximum Intensity Projection (MIP) image shows supraglottic SCC metastasis in both lobes of the thyroid gland (arrows).


Case 2. 66-year-old male complaining of a mass in the neck was diagnosed with supraglottic squamous cell carcinoma. B) CT image for attenuation correction and anatomic localization.


Case 2. 66-year-old male complaining of a mass in the neck was diagnosed with supraglottic squamous cell carcinoma. C) Axial PET image shows intense metabolic activity in both lobes (arrows).


Case 2. 66-year-old male complaining of a mass in the neck was diagnosed with supraglottic squamous cell carcinoma. D) Axial PET/CT fusion image reveals SUVmax of the right thyroid lobe was 20.3 and SUVmax of the left lobe was 7 (arrows).


(a) T2 sagittal MRI cervical spine showing complete destruction C4 with partial destruction of C3 and C5 body with anterior epidural collection with compression of cervical spinal cord between C3 and C5.


(b) T1 gadolinium contrast-enhanced sagittal MRI cervical spine showing contrast-enhanced epidural lesion anterior to C3-C5.


(c) Axial contrast-enhanced cervical MRI at C4 showing canal compromise.


(d) Postoperative NCCT cervical spine shows adequate decompression between C3 and C5 with expandable titanium cage in situ.


Negative anaplastic lymphoma kinase-1 staining in the atypical cells (Immunoperoxidase, x400).