Computed tomography images: A. Axial slice showing a heterogeneously enhancing left parotid mass with deep lobe involvement B. Coronal reconstruction showing the same enhancing mass.


A) Photomicrograph showing discohesive high grade tumors cells with irregular nuclei and prominent nucleoli. There are no light microscopic features of squamous or glandular differentiation (eg. Intercellular bridges, keratinization or mucin production) but the cells stained positively for broad spectrum keratin, consistent with a carcinoma. There are small mature lymphocytes in the background (H&E 400x).


B) Immunohistochemistry for the p63 antibody, consistent with squamous differentiation (400x).


The pathological images of primary breast cancer and the colonic mass. . Notes: (A) Mastectomy specimen obtained in 2001, showing lobular infiltrating carcinoma, are similar to infiltrating ductal carcinoma (hematoxylin and eosin stain, x100).


The pathological images of primary breast cancer and the colonic mass. (B) Right-colectomy specimen obtained in 2011, showing poorly differentiated ductal adenocarcinoma. Tumor emboli can be found in some lymph vessels (hematoxylin and eosin stain, x100).


Schematic procedure showing isolation of adipose-derived stem cell.


The Goldman visual field test showed constriction of visual fields in both eyes.


Two years after surgery and radiotherapy no recurrence.


(a and b) showing remote recurrence five years after first surgery and radiotherapy. The primary site is free of tumour.


Bone marrow morphology showing acute myeloid leukemia.


Ultrasound showing increased volume of the left epididymis with heterogeneous echogenicity.


Pathological findings of the resected specimen. . Notes: The image shows the focal proliferation of cuboidal atypical cells with round nuclei and prominent nucleoli surrounded by fibrous tissue. Keratinization, plasmodesmata, and glandular construction are absent (A).


Pathological findings of the resected specimen. . Notes: The image shows the focal proliferation of cuboidal atypical cells with round nuclei and prominent nucleoli surrounded by fibrous tissue. Tumor invasion of the sternum (B).


Pathological findings of the resected specimen. . Notes: The image shows the focal proliferation of cuboidal atypical cells with round nuclei and prominent nucleoli surrounded by fibrous tissue. Immunohistochemical staining for KIT protein was positive in nesting tumor cells (C). *Bone trabeculae.


Osseous metastases presenting as foot joint pain. . Notes: Magnetic resonance imaging performed after the patient developed joint pain shows bone lesions (low-signal areas are indicated by arrows) in the right tibia.


Osseous metastases presenting as foot joint pain. And talus.


Osseous metastases presenting as foot joint pain. Bone scintigraphy shows no obvious lesion 8 years after palliative radiotherapy (C).


(a) Noncontrast enhanced computed tomography shows a hypodense nodule (size: 4.1 cm x 3.6 cm x 4.5 cm) in the right lobe of thyroid gland.


(b) This nodule shows minimal homogeneous enhancement on contrast enhanced computed tomography imaging. The trachea, vessels and soft tissues in the right neck are under pressure and displaced toward the left side.


(a) Transverse sonogram of the neck reveals a heterogeneous hypoechoic mass with an irregular border in the right lobe of thyroid gland. Note posterior acoustic enhancement under the nodule.


(b) The color Doppler ultrasound shows abundant twisted blood flow signals in the tumor.


(c and d) Note a nodular goiter in the left lobe of thyroid gland with minimal blood flow signals.


(a) The gray-scale ultrasonography shows no significant decrease of the tumor size (transverse diameters: 4.79 cm x 4.73 cm. 3.95 cm x 3.01 cm; <25% extent).


(b) The color Doppler ultrasound shows reduction of twisted blood flow signals in the primary thyroid lymphoma after three cycles of rituximab plus bendamustine.


(c) Color Doppler ultrasonographic image of the left thyroid gland is shown.


(a) After three cycles of rituximab, cyclophosphamide, vincristine, prednisone, the primary thyroid lymphoma disappears on the color Doppler and gray-scale ultrasonography.


(b) Complete remission of the primary thyroid lymphoma is confirmed on the positron emission tomography computed tomography (left) and whole-body positron emission tomography scan (right) after three cycles of rituximab, cyclophosphamide, vincristine, prednisone regimen.


Liver tumor on T2.


Liver tumor on T1 in-phase.


Liver tumor on T1 out-of -phase.


Tumor histopathology.


Positive CD34. Monoclonal Mouse Anti-Human CD34 Class II Clone QBEnd 10 DK-2600 Glostrup, Denmark.


Immunohistochemistry CK (+). Monoclonal Mouse Anti-Human Cytokeratin Clone MNF 116 DK-2600 Glostrup, Denmark.


Positive CD99. Rabbit Monoclonal Primary Antibody EPR3097Y RabMAb.


Abdomino-pelvic computed tomography scan with intravenous contrast (transverse view). Arrows point on the right renal mass.


T2-weighted sagittal image of cervical vertebrae. Metastatic tumour spreading from C7 vertebra body.


T1-weighted sagittal image of thoracic vertebrae. Patholocigal fracture of L1 vertebra body.


Histology photomicrograph of the excised right thigh soft tissue mass showing a malignant mesenchymal tumor with markedly pleomorphic spindle to bizarre cells exhibiting marked nuclear pleomorphism, coarse chromatin and abundant eosinophilic cytoplasm (H&E, 200x).


Immunohistochemistry for anti-programmed death ligand-1 antibody showing membranous positivity in tumor cells (Ventana SP263 assay).


Computerized tomography scan prior to wound washout. The scan reveals mild extra and intracranial fluid collection along the craniotomy with diffuse intracranial leptomeningeal enhancement.


Axial CT with mass measuring ~11 cm x 10 cm.


Sagittal CT with mass measuring ~9 cm x 7.5 cm.


Coronal CT with mass measuring ~12.5 cm x 8.5 cm.


Endoscopic evidence of narrowing due to external compression in sigmoid colon.


Mucosal ischemia at level of stenosis from external compression.


Gross pathology demonstrating mass with intimate association to sigmoid colon with involved mesentery and ileum resection. Posterior view.


Gross pathology demonstrating mass with intimate association to sigmoid colon with involved mesentery and ileum resection. Anterior view.


Squamous portion of the tumor. Demonstrates keratinization and intracellular bridges. There is a variation in size of the nuclei, there is nuclear atypia and prominent nucleoli.


Chondroid portion of the tumor as well as cartilaginous matrix and various shapes/sizes of chondrocytes.


Spindle cell sarcoma component of the tumor.


Adenocarcinoma features with gland formation by cuboidal to columnar cells. Nuclei with intracytoplasmic mucin droplets and some very large, atypical nuclei are seen.


Clinical picture of the patient.


Intra-operative pictures of right toilet mastectomy with complete axillary dissection and left simple mastectomy.


Patient in post-operative follow up.


Ulcerated lesion along the left lateral border of the tongue.


Immunostain for HMB-45 showing strong positivity (IHC, x100).


The patient was engaged in shaving ring-shaped aluminum material, such as the upper 2 images, and making camera parts, like the one below.


With a curving machine Workers are required to pour cutting oil on the material while cutting, as in (b), but our patient failed to do so, suggesting he might have inhaled a larger amount of aluminum-containing fumes than other worker in this occupation.


Chest X-ray showing bilateral pleural thickening in the upper and middle lung fields. The lung volume was reduced and reticulonodular shadows extended from the sub-pleura to deep inside the lungs, suggesting pulmonary fibrosis. The tracheal bifurcation was widened by traction of the upper lobes.


High-resolution computed tomography showing severe bilateral pleural thickening with shrunken and distorted upper lobes (a, c). There was mediastinal emphysema (a).


On the other hand, reticulonodular shadows and bronchiectasis were distributed deep inside the lower lung (b, c).


High-resolution computed tomography showing severe bilateral pleural thickening with shrunken and distorted upper lobes (a, c). On the other hand, reticulonodular shadows and bronchiectasis were distributed deep inside the lower lung (b, c).


Elemental analysis of the biopsy specimen by electron probe X-ray microanalysis (EPMA). Aluminum was identified in a fragment of bronchial wall obtained by trans-bronchial lung biopsy (TBLB), after staining with hematoxylin and eosin (a). Deposition of elements in the specimen was shown by red to yellow colours. The green colour indicated deposition of nitrogen as a control.


Elemental analysis of the biopsy specimen by electron probe X-ray microanalysis (EPMA). Significant amounts of aluminum were identified by EPMA as shown by red to yellow colours.


Elemental analysis of the biopsy specimen by electron probe X-ray microanalysis (EPMA). , whereas iron and silica were detected in much lower amounts compared with aluminum.


Axial T2 weighted MR image at the level of the posterior fossa revealing a slightly hyperintense infiltrating lesion adjacent to the right side of the fourth ventricle.


Axial T2 weighted MR image after the conclusion of salvage chemotherapy demonstrating the complete disappearance of the lesion.


The transthoracic echocardiogram showed a mass located between the right atrium and the right ventricle. LV: left ventricle, LA: left atrium, RV: right ventricle, and RA: right atrium.


(A) Sagittal T2-weighted magnetic resonance imaging scan revealing a well-defined high signal intensity mass, 3.1 cm in size, at the anterior aspect of the endocervix, along with multiple uterine myomas less than 9 cm in size.


(B) Macroscopically, the cervix was open at 12 o'clock.


(C) The cells had large, ill-defined cytoplasmic borders, abundant cytoplasm, prominent nucleoli, and syncytial growth patterns (H&E, x200).


(D) Formalin fixed paraffin-embedded tissue used for in situ hybridization for Epstein-Barr virus-encoded early RNAs. The result was negative.


Positron emission tomography - computed tomography imaging. (a) Increased flurodeoxy glucose (FDG) uptake (standardized uptake value [SUV] max 9.5) is noted in the right kidney with regular margins. Increased FDG uptake is also noted in left kidney (SUV max 18.5) with irregular margins. Note is made of 9 mm calculus in left kidney lower calyx with mild hydronephrosis.


Positron emission tomography - computed tomography imaging. (b) Avid FDG uptake is noted in multiple lesions in liver with largest lesion (7.9 cm x 5.9 cm, SUV max 13.8) in left lobe.


Clockwise from top left - cranial to caudal axial MRI imaging highlighting an 8-centimeter pelvic mass.


36-year-old female presented with pain under the left arm and was diagnosed with intermediate-grade DCIS. FDG-PET/CT Maximum Intensity Projection (MIP) image shows only postsurgical changes with no evidence of residual or metastatic disease.


Pelvic computerized tomography revealed a 3.5 cm tumor at the left lateral wall of the bladder (arrow).


Tumor have an epitheloid and sarcomatoid areas (H&E x 200).


Multiple flesh coloured plaques on the : lower trunk thighs.


Vulva.


Histopathology (H&E) shows discohesive nests and sheets of malignant small round blue cells having hyperchromatic to vesicular nuclei, prominent nucleoli and scant to moderate pale eosinophilic cytoplasm.


Axial.


Coronal. Postcontrast computed tomography images demonstrating a fairly well-defined solid tumor with heterogeneous enhancement in the right kidney (arrows). Neither signs of invasion of the hilum vessels nor hydronephrosis was observed.


Axial (a and b) postcontrast computed tomography images of the pelvis showing an enlarged uterus with multiple large leiomyomas (arrows), predominantly in subserosal and intramural locations.


Echo-endoscopic aspect.


Histologic and immunohistochemical (WT-1, cancer antigen-125 and estrogen receptor antibodies) aspect.


Radiation Necrosis. Magnetic resonance images at presentation of a 73-year-old female with a history of trigeminal neuralgia, which was treated previously by TomoTherapy radiosurgery, shows significant mass effect in close proximity to Meckel's cave. Axial T1-weighted image with contrast.


Radiation Necrosis. Magnetic resonance images at presentation of a 73-year-old female with a history of trigeminal neuralgia, which was treated previously by TomoTherapy radiosurgery, shows significant mass effect in close proximity to Meckel's cave. Axial FLAIR.


Radiation Necrosis. Magnetic resonance images at presentation of a 73-year-old female with a history of trigeminal neuralgia, which was treated previously by TomoTherapy radiosurgery, shows significant mass effect in close proximity to Meckel's cave. Coronal T1-weighted image with contrast.


Radiation Necrosis. Magnetic resonance images at presentation of a 73-year-old female with a history of trigeminal neuralgia, which was treated previously by TomoTherapy radiosurgery, shows significant mass effect in close proximity to Meckel's cave. Coronal T2-weighted image. Used with permission from Barrow Neurological Institute.


Postoperative Resection. Postoperative magnetic resonance image showing excellent resection of enhancing portion, pathologically confirmed to be radiation necrosis. Axial T1-weighted image with contrast.


Postoperative Resection. Postoperative magnetic resonance image showing excellent resection of enhancing portion, pathologically confirmed to be radiation necrosis. Axial FLAIR.


Postoperative Resection. Postoperative magnetic resonance image showing excellent resection of enhancing portion, pathologically confirmed to be radiation necrosis. Coronal T1-weighted image with contrast.


Postoperative Resection. Postoperative magnetic resonance image showing excellent resection of enhancing portion, pathologically confirmed to be radiation necrosis. Coronal T2-weighted image. Used with permission from Barrow Neurological Institute.


Computed tomography (CT) scan of the pelvis with intravenous contrast: (a) Axial CT image of the pelvis acquired during the portal venous phase demonstrates irregular thickening of the right anterolateral urinary bladder wall (red arrow) and an enlarged prostate bulging into the bladder base (white arrow).


Sagittal CT images of the inguinal region reveal a heterogeneous, enhancing soft tissue mass in the right inguinal canal, inseparable from the right anterolateral aspect of the urinary bladder wall (red arrow). There is a moderately sized hydrocoele in the right scrotum (yellow arrow).


Histopathological diagnosis of primary squamous cell carcinoma of the urinary bladder (a) Hematoxylin and eosin stain; 400 x magnification indicating well differentiated squamous cells (red arrow).


(b) The Ck-7 stain is positive (yellow arrow).


(c) The P40 stain is also positive in the tumour cells (white arrow). The histopathology confirms the diagnosis of primary squamous cell carcinoma of the urinary bladder.


Pre-operative CT scan of the brain. (A-C) Non-contrast CT imaging demonstrating a heterogeneous mass with cystic features and calcification in pineal region causing obstructive hydrocephalus.


Pre-operative MRI of the brain. (A-C) Post-contrast T1-weighted images demonstrating a heterogeneously enhancing 3.9 x 2.6 x 3.1 cm mixed cystic and solid pineal mass and consequential obstructive hydrocephalus.


Pre-operative MRI of the brain. (D, E) T2-weighted images revealed a hyperintense cystic lesion and hypointense solid lesion with mass effect and compression of the cerebral aqueduct resulting in supratentorial ventricular dilatation and periventricular white matter signal abnormality.


Pre-operative MRI of the brain. (F) FLAIR image demonstrated periventricular transependymal flow of cerebrospinal fluid indicative of acute hydrocephalus.


Post-operative MRI of the brain 12 months following surgery. (A-C) Post-contrast T1-weighted images demonstrating no evidence of residual or recurrent disease.


Post-operative MRI of the brain 12 months following surgery. (D, E) T2-weighted images showing resolution of the ventricular dilatation and flow voids from the internal cerebral veins.


Post-operative MRI of the brain 12 months following surgery. (F) FLAIR image showing minimal hyperintense signal surrounding the surgical resection cavity.


Histopathological analysis of the resected pineal lesion. (A) Hematoxylin and eosin (H&E) stain with nested architecture and sheets of cells (original magnification, 40x).


Histopathological analysis of the resected pineal lesion. (B) H&E stain with sheets of cells with speckled chromatin and indistinct to small nucleoli with multifocal necrosis (original magnification, 200x).


Histopathological analysis of the resected pineal lesion. (C) H&E stain with mitotic figure (original magnification, 400x).


Histopathological analysis of the resected pineal lesion. (D) Strong immunostaining of tumor cells with synaptophysin (original magnification, 100x).


Histopathological analysis of the primary atypical bronchopulmonary carcinoid tumor. (A) Hematoxylin and eosin (H&E) stain with nested architecture and sheets of cells (original magnification, 40x).


Histopathological analysis of the primary atypical bronchopulmonary carcinoid tumor. (B) H&E stain with sheets of cells with speckled chromatin and indistinct to small nucleoli (original magnification, 200x).


18FDG PET/CT performed before lenvatinib administration. Besides the numerous bilateral lung metastases, note the intense uptake by two locally recurrent lesions in the neck and by the cavernous sinus metastasis.


MRI brain scans performed before.


One month after. The administration of lenvatinib. The right cavernous sinus metastasis completely encapsulates a consistent portion of the intracranial tract of the right internal carotid artery.


Ultrasound scan of a locally recurrent neck lesion in right supraclavicular region. (A) Imaging before lenvatinib start.


Ultrasound scan of a locally recurrent neck lesion in right supraclavicular region. (B) Ultrasound scan after 1 month of therapy at 10 mg daily. Tumor vascularization is significantly reduced.


Ultrasound scan of a locally recurrent neck lesion in right supraclavicular region. Progressive tumor reduction after 2.


Ultrasound scan of a locally recurrent neck lesion in right supraclavicular region. 6 months. Of treatment at the same dose.


Timeline of the treatment. PD, progression of the disease; NED, no evidence of the disease.


PET/CT image performed 4 days after vaccination (A, B). The multiple-intensity projection image (A) showing increased 18F-FDG uptake in the left deltoid muscle (black arrow) and in the left axillary region.


PET/CT image performed 4 days after vaccination (A, B). Fused coronal image (B) showing the uptake in the muscle (white arrow) and in the axillary lymph node (yellow arrow).


PET/CT image performed 32 days after vaccination (C, D). Both the muscular uptake and nodal uptake have disappeared. The referred axillary lymph node (red arrow) shows similar morphology but no 18F-FDG accumulation.


Axial thorax computerized tomography showed a macrolobulary mass (white arrow) with irregular border and calcification, invasion to brachio-cephalic vein and pathological size paratracheal, subcarinal, and hilar lymphadenopathy.


(A) Atypical carcinoid. Uniform tumor cells with nested, trabecular and rosette-like growth patterns. Polygonal tumor cells have moderate eosinophilic granular cytoplasm, round to oval nuclei, "salt and pepper" chromatin and inconspicuous nucleoli (H&E staining, x200 magnification) H&E x200.


(B) Immunohistochemical staining with adrenocorticotropic hormone (ACTH) (ACTH staining, x400 magnification) ACTH x400.


(C) Immunohistochemical staining with synaptophysin (Synaptophysin staining, x400 magnification) synaptophysin x400.


NGS confirmed ALK fusion (EML4 exon 13-ALK exon 20, variant allele frequency was 4192).


EGFR 18 exon (c.2156G>C:55241708, p.


G719A, abundance 74.8%); (C) EGFR exon 19 (c2239T>G:55242469, pL747V, abundance 70.05.


Lumbar puncture indicated positive cytology of cerebrospinal fluid (at high magnification 10 * 40).


Axial PET-CT scan. An asymmetric contrast medium enhancement of the right tonsil is visible (arrow). No enhancement of the left tonsil.


Cervical CT showing a 2.8 x 1.7 cm solid poorly defined mass in the superficial lobe of the parotid right gland.


Full body CT (abdominal section) ruling out a renal tumor.


Preoperative photograph of the tumor.


Intra-operative photograph showing the area after modified funcional neck dissection and radical parotidectomy.


Response in patient 1. CT scan shows liver metastasis presentation at basal time.


Response in patient 1. After 5 cycles.


Response in patient 1. After 12 cycles. Of chemotherapy containing Trastuzumab/Pertuzumab. The target lesions are indicated by arrows.


Response in patient 2. RMI shows several metastatic lesions in all vertebra at basal time.


Response in patient 2. After 6 cycles.


Response in patient 2. After 12 cycles. Of chemotherapy containing Trastuzumab/Pertuzumab. Arrows indicate some target lesions.


Axial CT venous phase (January 2016) demonstrated the irregular wall thickening of the subcardial lesser curvature (arrow) referable to the primary gastric neoplasm.


Axial CT venous phase (December 2017) showed no abnormal findings in the L5-S1 foraminal space (a).


Axial CT venous phase.


With coronal.


Sagittal. Reconstructions, showing the slightly hypervascular right-sided S1 nerve root mass.


Axial CT bone window (e) showing initial erosive bone changes on right S1 sacral foramina.


Histopathological examination stained with hematoxylin eosin (f) confirmed a metastasis of gastric adenocarcinoma.


CT scan showing two cystic pancreatic lesions. Left panel (a) shows a 6 mm lesion in uncinate process (arrow).


CT scan showing two cystic pancreatic lesions. Right panel (b) shows a 5 mm lesion in tail of pancreas (arrow), and a dilated main pancreatic duct in the body and tail. CT, computed tomography.


Final histopathologic slides. Histology of specimen (H&E stain): pancreaticobiliary subtype ampullary carcinoma at 10 x on the left.


Final histopathologic slides. And 20 x on the right H&E, hematoxylin and eosin.


Thigh MRI. T1-weighted-axial plane.


T1w with gadolinium-saggital.


T1w with gadolinium-axial.


(c) T2w coronal.


(d) Diffusion sequence.


Medical image.


Vimentin 20X. KI67 40X. Cerebellar tumor: Dedifferentiated tumor metastasis, sarcomatous in appearance with a fusiform pattern, marked nuclear atypia, high mitotic rate, compatible with previous tumor metastasis. In the immunohistochemical study, it only expresses vimentin, with the absence of expression of the S100 protein and also the gliofibrillar protein and liposarcoma markers.


MRI Brain with contrast revealed a mass adjacent to the brainstem at the level of the medulla hypointense on axial T1-weighted sequences.


With heterogeneous enhancement on the post-contrast sequence.


Edema noted on T2 enhancing.


FLAIR. Sequences.


The planning target volume (PTV) consisted of the resection cavity (outlined in orange) plus a 3 mm margin (outlined in red) as identified on the T1 post-contrast sequence (a). 100% of the dose was prescribed to this volume.


A 3-arc volumetric modulated arc therapy technique with 6-MV photons was used to cover the volume with the 100% isodose line (5400 cGy) (in yellow) covering the PTV target (resection cavity + 3 mm margin) (in red) on the planning CT head (b).


Axial T1-weighted post contrast MRI sequence at the level of the brainstem 24 months after resection demonstrated no residual or recurrent gross disease.


Similarity among different lesions based on somatic mutation analysis. (A) Venn diagram illustrating the distributions of genetic mutation in different lesions [left kidney (Tkl) vs right kidney (Tkr) vs neck (Tn).


Similarity among different lesions based on somatic mutation analysis. (B) Venn diagram illustrating the distributions of driver genetic mutation in different lesions [left kidney (Tkl) vs right kidney (Tkr) vs neck (Tn).


Analysis of heterogeneity between different lesions. Two-dimensional analysis of tumor subclonal architecture in right kidney (Tkr), and ,left kidney (Tkl).


Analysis of heterogeneity between different lesions. In neck (Tn) vs.


Analysis of heterogeneity between different lesions. Left kidney (Tkl); and (C) in neck (Tn) vs. Right kidney (Tkr). These subclones were shared between the spatially distinct lesions.


Fish plots constructed by timescape. Colors indicate different clones. Driver genes detected in the clones are shown. Tkl, left kidney tumor; Tkr, right kidney tumor; Tn, neck tumor.


Coronal reformatted CT image showing a large polypoid intra-luminal mass arising in the trachea within 1 cm of the larynx, causing obliteration of 70% of the lumen.


Resected specimen showing a polypoid growth pattern. The tumor was present at 1 cm below the larynx.


Histologic specimen showing adenoid cystic carcinoma mixed with tubular and cribriform pattern (H&E, original magnification x 10).


Physical findings in the patient. Multiple melanotic macules on the fingertips characteristic or Peutz-Jeghers syndrome.


Physical findings in the patient. Melanotic macule on the right cheek.


X-ray cervical spine showed osteolytic destruction of C2 body with subluxation of C1 and C2 complex over C3.


X-ray showing occipito-C1-C3 lateral mass screws fixation with vertex Medtronic system.


(a and b) Histopathological examination showed spindle cells arranged in whorls and fascicles with proliferation of smooth muscle cells surrounding the blood vessels. Spindle cells showed eosinophilic cytoplasm with elongated nuclei with blunt ends.


There is moderate cellularity, minimal atypia, inconspicuous mitosis, and no evidence of necrosis; (c and d) Immunohistochemistry of the tumor cells stained positively for smooth muscle actin, and negative for S-100 protein.


Post operative magnetic resonance imaging at 1 year showed small residual tumor at C2 body.


CT imagine of pulmonary metastasis.


Pulmonary metastasis.


Parathyroid scintigraphy.


Initial computed tomography image. A huge mass was observed in segment 8.


Initial computed tomography image.an additional mass in segment 6.


Initial computed tomography image. Perihepatic leakage of contrast (C) was also seen, compatible with rupture of hepatocellular carcinoma.


Computed tomography image shows multiple extrahepatic metastases spleen.


Left adrenal gland.


Back muscle.


Buttock muscle.


Skin of hepatocellular carcinoma.


Magnetic resonance imaging. Focal strong enhancing mass at left precentral gyrus).


Positron emission tomography image. Focal fludeoxyglucose hot uptake nodule on left parietal lobe) of brain metastasis. Brain metastasis was treated with radiation therapy.


After radiation therapy, tumor had shrunk (C).


Skin lesion on computed tomography image.


Arrow) and excised mass on buttock.


(C) Microscopic finding reveals skin metastasis of hepatocellular carcinoma (H&E: Left upper, x10; Right upper, x20; Left lower, x20; Right lower, x30).


(A) After diagnosis of multiple metastases, a new skin lesion was identified on the right thumb.


(B) Magnetic resonance imaging also shows a pedunculated soft tissue mass.


Remnant metastatic masses are still observed on back muscle.


Buttock.


Coronal view (C) also shows these masses.


Periapical radiographs (before and after extraction) of a 67-year-old woman with subtle vague pain in the right premolar region of the mandible and a paresthesia of the right lower lip and chin revealing an ill-defined radiolucency and alveolar bone demineralization (arrows).


Panoramic radiograph (after extraction) of a 67-year-old woman with subtle vague pain in the right premolar region of the mandible and a paresthesia of the right lower lip and chin showing the ill-defined radiolucent spongeous osteolytic lesion of the right premolar region in the mental foramen area (arrows).


Cone-beam computed tomography cross-sectional 1 mm thick of a 67-year-old woman with subtle vague pain in the right premolar region of the mandible and a paresthesia of the right lower lip and chin showing multiple perforation of the buccal and lingual plate area near the right lower premolar (arrows).


A 67-year-old woman whole body PET scan and high- resolution PET-CT after intravenous injection of 11 mCi of 18F-FDG showing large hyperactive area involving the right mandible.


A 67-year-old woman MRI-3T showing lytic lesion of the right anterior mandibular body measuring 3 cm and abnormal signal involving also the left mandibular side, suspicious for tumoral infiltration.


Coronal PET-MRI scan demonstrating a solitary enhancing lesion in the right renal hilum (arrow).


Pathological specimen of right kidney post-nephrectomy demonstrating a dense hilar mass.


Histopathology from tumour specimen demonstrating a moderately differentiated squamous cell carcinoma with associated fibrosis H&E x 200.


A correlative ultrasonography confirmed the presence of mass with spiculated margins, 1.5 cm x 0.7 cm at the right breast.


(b) Polyacrylamide gel electrophoresis of Reverse transcription polymerase chain reaction (RT-PCR) products. The present case showing a 166 bp band of type2 EWSR1/FLI1 fusion (lane 1).


Pathology of a resected skull tumor. A: Metastatic gastrointestinal stromal tumor in the skull. The tumor consists of atypical spindle cells with high cellularity and infiltrative growth pattern with destruction of normal bone tissue (H&E, x100).


Pathology of a resected skull tumor. B: High power view of the tumor. Mitotic figures (arrows) are frequently noted (H&E, x400).


Pathology of a resected skull tumor. C: Tumor cells are positive for c-kit (c-kit immunostain, x400).


(a) A gadolinium-enhanced T1-weighted magnetic resonance (Gd-T1WI MR) image taken before scheduled surgery revealed the contrasted mass lesion on the left calvarium adjacent to normal brain with subdural invasion.


(b) Head computed tomography (CT) taken on the day of admission revealed right-sided acute subdural hematoma (SDH).


(c) Head CT performed before the urgent surgery revealed acute SDH with midline shift that indicated intratumoral hemorrhage of the calvarial metastasis.


(d) Postoperative head CT showed the resected calvarial tumor and improvement of the midline shift.


(a) Intraoperative findings included subdural tumor progression and SDH adjacent to the tumor.


(b) Low-power magnification of a hematoxylin and eosin-stained section. Tumor (arrow head) invasion to the dura mater (*) and hemorrhage (arrow) were observed.


Serial MRI scans. Timeline of systemic therapies and MRI scan findings, stratified by brain lesion sites. Yellow stars denote treatment by stereotactic radiosurgery at a corresponding time point and lesion.


Histopathologic assessment of the right temporal lobe lesion. A; Hematoxylin and eosin (H&E) stained specimen showing an admixture of tumor cells with astrocytic and spindled morphology (magnification, x20).


Histopathologic assessment of the right temporal lobe lesion. B; Positive immunostain for GFAP (brown), consistent with glial cells (magnification, x20).


Histopathologic assessment of the right temporal lobe lesion. C; Positive Masson trichrome stain for abundant collagen deposition (blue), a feature of sarcomatous cells (magnification, x20).


Histopathologic assessment of the right temporal lobe lesion. D; H&E stained specimen showing necrosis with viable perivascular tumor cells, more characteristic of tumor necrosis than radiation-associated necrosis (magnification, x10).


Axial CT image shows an intraparenchymal mid-renal hypervascular nodule referred to RCC (arrows).


Axial CT image shows the hypervascular nodule (arrows), centrally located, on the inner margin of the previous ablation area (head of arrow).


Angio-CT Hybrid Suite with the availability of angiography, CT and US.


Retrograde pyelography shows the right positioning of the left ureteral stent in the omolateral collecting system.


Fusion imaging combining real time US with CT images: CT scan shows the hypervascular nodule deeply in the scar of the previous treatment (arrow); the lesion is not clearly visible at US (heads of arrow).


Axial CT image shows the hypo-enhancing ablation zone without enhancing residual tumor (arrow).


Treatment course (Bev, bevacizumab; Iri, irinotecan; PMAb, panitumumab; LN, lymph node; Tissue NGS, tissue next generation sequencing; Guardant360, cell free DNA profiling; Cabo, cabozantinib).


Chest CT image. Before the start of cabozantinib plus panitumumab.


After 42 days of cabozantinib plus panitumumab.


Pre and Post treatment cfDNA profile of. Mutant allele frequency (MAF).


Copy number variation (CNV).


Summary of the treatment course in this case report. Arrows indicate the target lesions in the imaging studies.


(A) Sagittal T1 weighted image demonstrates a 1.8 cm T1 isointense round mass in the lateral subcutaneous soft tissues, plantar to the peroneal tendons.


(B) The lesion is hyperintense on T2 fat suppressed images.


(C) The lesion demonstrates a small area of central contrast enhancement on T1 fat suppressed images (whereas it demonstrated homogenous enhancement on earlier studies). A smaller lesion is partially seen posterior to the dominant lesion.


(A) Sagittal T1 weighted image obtained 6 months following the patient's SBRT treatment demonstrates interval decrease in the size of the dominant mass to 1.1 cm.


(B) It remains hyperintense on T2FS images.


(C) It also demonstrates homogeneous enhancement on T1 fat suppressed post contrast images.


(A) Sagittal T1 weighted image obtained ~2 years following the patient's SBRT treatment demonstrates interval development of an enlarging T1 isointense nodule within the subcutaneous soft tissues dorsal to the fourth-metatarsal diaphysis.


(B) It is hyperintense on T2 fat suppressed images.


(C) Similar to previously identified masses, it demonstrates contrast enhancement on T1 fat suppressed post contrast imaging.


Ultrasonography showed a 19 x 16 mm heterogeneous solid nodule.


Doppler ultrasonography revealed a hypervascular nodule. At the anterior neck.


Ultrasonography showed 23 x 14 mm (right lobe).


15 x 8 mm (left lobe). Smooth isoechoic thyroid nodules including cystic degeneration.


Contrast-enhanced computed tomography of the neck. Axial image.


Sagittal image) showed a 20 x 10 x 17 mm homogeneous contrast-enhanced tumor inferior to the hyoid bone (white arrow). The vascular structure in front of the tumor is the anterior jugular vein (yellow arrows).


18F-FDG PET/CT showed high accumulation in the anterior middle neck tumor, with a SUVmax of 12.8. Maximum Intensity Projection image.


Axial PET/CT fusion image [white arrow.


C Immunohistochemistry showing a positive CDX2 expression in the metastasis. (arrows) and a positive GATA3 expression only in the urothelium.


Arrows).


C; No signs of tumor infiltration to the outer layers of the ureter (arrows show margins of the tumor growing intramucosal) can be seen.


Anteroposterior.


Lateral radiographs of the left arm showing erosion of the posterolateral cortex of the distal humerus (yellow arrows).


T2-weighted : coronal.


Sagittal.


Axial MRI confirming a heterogeneously enhancing intramuscular mass involving the triceps (yellow arrows), measuring 3 cm x 4 cm x 4.5 cm associated with cortical erosion of posterolateral humerus and partial tumoural encasement of the radial nerve (red arrow).


Chest radiography showing ill-defined infiltrates in the right upper lobe (red arrow).


Routine histologic section of tumour revealing malignant epithelial cells disposed in nests, and ,exhibiting ill-formed glandular lumen.


Plump epithelial cells with moderate cytoplasm seen on high-power view exhibiting nuclear atypia (black arrow), anisocytosis and prominence of nucleoli.


Axial MRI view. A heterogeneously enhanced lesion may be appreciated in the pineal region. An artifact generated by a ventriculoperitoneal shunt catheter is noticed. No leptomeningeal enhancement is observed.


Histopathologic view. Cells of several shapes may be seen arranged in a lobular manner. They exhibit an eosinophilic cytoplasm with intervening epithelial and intracellular mucin containing cells. Thin-walled vessels surrounded by a fibrous framework may be appreciated.


Drugs used for pain control during the stay in hospice in the patient presented. . Note: Blue line stands for fentanyl SC pump, morphine rescue doses are mapped out as green pointers, and bupivacaine paravertebral block is marked pink. . Abbreviations: IV, intravenous; PVB, paravertebral block; SC, subcutaneous; VRS, verbal rating scale; h, hours.


Doses of fentanyl in SC constant infusion and bupivacaine boluses administered paravertebrally to the patient. . Notes: Blue line stands for fentanyl SC pump, bupivacaine PVB boluses are marked pink, and bupivacaine PVB constant infusion is marked orange. Bupivacaine PVB rescue bolus is marked white with a purple frame. . Abbreviations: PVB, paravertebral block; SC, subcutaneous; h, hours.


Total bupivacaine serum levels following its administration in boluses and in constant paravertebral infusion (ng. ML-1) in the presented case. . Notes: Red line shows bupivacaine serum concentrations, bupivacaine PVB constant infusion is marked orange, and pink "syringes" stand for bupivacaine PVB boluses. Bupivacaine PVB rescue bolus is marked white with a purple frame. . Abbreviations: PVB, paravertebral block; VRS, verbal rating scale; h, hours.


Computed tomography of the brain showing subarachnoid chemorrhage with a central low density (a).


No substantial sellar enlargement is observed with a sagittal reconstructed view (b).


Brain computed tomography angiography showing the absence of a ruptured aneurysm (c).


Computed tomography obtained 7 days postoperatively showing extensive cerebral infarction due to vasospasm (d).


Magnetic resonance imaging showing an intrasellar mass which is depicted as low-intensity on a nonenhanced T1-weighted image (a).


With gadolinium, the mass exhibits strong enhancement. Sagittal view.


Axial view).


On a T2-weighted image, the mass is depicted as heterogeneous high intensity, and a dense subarachnoid clot was also observed in the prepontine cistern (d).


Axial.


Coronal. T1-weighted magnetic resonance imaging showing contrast-enhancing dural-based lesion with parenchymal invasion along the right frontal lobe (arrow).


Axial ,. Along the falx cerebri.


Coronal. Right temporal lobe.


Sagittal. T1-weighted magnetic resonance imaging showing contrast-enhancing dural-based lesions through the frontal sinus, and . Right sphenoid wing. (arrows).


Sagittal. T1-weighted magnetic resonance imaging showing a contrast-enhancing sinonasal mass with intracranial extension through the cribriform plate into the anterior cranial fossa, maxillary, and sphenoid sinuses.


Sagittal T1-weighted magnetic resonance imaging showing contrast-enhancing dural-based lesions posterior to C2 vertebral body.


Posterior to T9-T10 disc space.


Along the posterolateral dura at the L3-L4 level. (arrows).


Pre-operative clinical photograph of the 41-year old man with a synovial sarcoma in the right medial elbow region.


Pre-operative magnetic resonance image, showing the axial T2WI.


Coronal Gd-DTPA-enhanced T1WI.


Intraoperative photographs showing the frozen autograft technique. The tumor was excised en bloc with a wide (2 cm) margin (a).


Intraoperative photographs showing the frozen autograft technique. All soft tissue and the tumor were dissected from the bone, with exception of the articular capsule and the tendon of triceps brachii with its insertion (b).


Intraoperative photographs showing the frozen autograft technique. The bone specimen was treated in liquid nitrogen (c).


Intraoperative photographs showing the frozen autograft technique. The frozen autograft was fixed in situ with plates (d).


Follow-up radiograph and photograph obtained 2 years after the surgery. Anterior-posterior.


Follow-up radiograph and photograph obtained 2 years after the surgery. Lateral. Radiographs showing bony union of the osteotomy site, with no evidence of osteoarthritic changes at the elbow joint.


Follow-up radiograph and photograph obtained 2 years after the surgery. Clinical photograph showing functional results in extension.


Follow-up radiograph and photograph obtained 2 years after the surgery. And flexion.


Pre-operative clinical photograph of the 73-year old woman, with a fibrosarcoma on the left lateral aspect of her elbow.


Pre-operative magnetic resonance image, showing the coronal Gd-DTPA-enhanced T1WI.


Intraoperative photographs showing the reconstruction, combining the frozen autograft technique with a free anterolateral thigh (ALT) flap. The tumor was excised en bloc with a wide (2 cm) margin (a).


Intraoperative photographs showing the reconstruction, combining the frozen autograft technique with a free anterolateral thigh (ALT) flap. The resected specimen was treated in liquid nitrogen (b). The frozen autograft was fixed in situ with plates and a headless compression screw.


Intraoperative photographs showing the reconstruction, combining the frozen autograft technique with a free anterolateral thigh (ALT) flap. Repair of the tendon of the triceps brachii and the radial articular capsule were repaired (c).


Intraoperative photographs showing the reconstruction, combining the frozen autograft technique with a free anterolateral thigh (ALT) flap. The appropriately sized ALT (27 x 18 cm) flap was harvested and the soft tissue defect reconstructed (d).


Follow-up radiograph and photograph obtained 12 months after surgery. Anterior-posterior.


Follow-up radiograph and photograph obtained 12 months after surgery. Lateral. Radiographs showing bony union of the osteotomy site, with no evidence of osteoarthritic changes at the elbow joint.


Follow-up radiograph and photograph obtained 12 months after surgery. Clinical photograph showing functional results in extension.


Follow-up radiograph and photograph obtained 12 months after surgery. And flexion.


Case 3.


H&E image, showing mixed metaplastic squamous carcinoma and pleomorphic invasive lobular carcinoma.


PD-L1 by the Ventana PD-L1 SP263 assay Lesions at baseline.


PD-L1 by the Ventana PD-L1 SP263 assay. Initially appeared worsened at 4 weeks.


PD-L1 by the Ventana PD-L1 SP263 assay , then demonstrated a complete clinical response by week 14.


Video capsule endoscopy revealed mucosal erosion.


With blood clot at jejunum. (at about 60 cm distal to the ligament of Treitz).


Gastroendoscopy revealed mucosal erosions.


By clipping due to chronic bleeding.


On jejunum and performed bleeding control. By clipping due to chronic bleeding.


Macroscopically,. The mucosal surface was showed multifocal erosion.


Some bright yellow-white multiple submucosal lesions are observed in specimen (resected jejunum).


(A) Histologically, numerous dilated lymphatics are identified in submucosa in hematoxylin and eosin staining (x40).


(B) The lymphatics are positive for D2-40 in immunohistochemical staining (x100).


(C) Hematoxylin and eosin staining (x100).


Progressive recurrent pelvic disease resulting in hydronephrosis.


Reduction in lesion size after starting nivolumab.


Complete resolution of all lesions after 6th dose of nivolumab.


Extraoral photograph showing the lesion.


Intraoral aspect showing extensive mass involving the maxillary alveolar mucosa.


Computed tomography scan showing extensive infiltrative lesion with displacement of adjacent structures.


Skull base to mid-thigh positron emission tomography-computed tomography, following intravenous injection of 18-fluoro-2-deoxyglucose. Multifocal hypermetabolic foci consistent with a metastatic malignancy with largest mass located in the thorax. (For improved resolution with enlargement of all images, please refer to the digital/online version of the article).


Ulceroproliferative mass on the right posterior alveolus measuring 4 cm x 3 cm.


Incisional biopsy specimen from multiple sites of the lesion.


(a) Sheets of spindle-shaped cells admixed with haphazardly arranged polygonal cells. X100), (b) Polygonal, and ,spindle cells showing pleomorphism, high mitotic activity, and . Atypia. X400).


Neoplastic spindle-shaped cells showing positivity for pan-cytokeratin (x100).


Neoplastic spindle-shaped cells showing positivity for pan-cytokeratin (x400).


Clinical images of Case 2. (A1) Brain MRI with contrast showed suspicious reinforcement in the epencephalon and some ischemic areas in the frontal, parietal, and occipital lobes before EGFR-TKI therapy; (A2) Brain MRI showed multiple ischemic foci and lacunar infarction, encephalatrophy, and demyelination in white matter after EGFR-TKI therapy; (B) Chest CT with contrast of patient 2 showed partial response in chest lesions after EGFR-TKI treatment.


Clinical images of Case 5. (A1) Brain MRI showed multiple nodules in the brain, and metastatic tumor was considered; (A2) Brain MRI showed more ischemic foci and lacunar infarction in the bilateral frontal and parietal lobes and demyelination after 3 months of EGFR-TKI therapy; (A3) Brain MRI showed shrinking metastatic tumor in the brain, more and more ischemic foci and lacunar infarction in the bilateral frontal and parietal lobes, and demyelination after 6 months of EGFR-TKI therapy; (B) Chest CT with contrast of patient 5 showed the gradual disappearance of pulmonary nodules after EGFR-TKI treatment.


Timeline of different treatments and disease status.


MRI baseline of brain metastases. (A) Axial T2-weighted fluid-attenuated inversion recovery (FLAIR) shows circular high signal (black arrow) of the left anterior border of cerebellum.


MRI baseline of brain metastases. (B) Axial T2-weighted FLAIR shows patchy edema of bilateral frontal and left occipital lobes (white arrows) and right frontal lobes signals such as nodules (black arrow).


MRI baseline of brain metastases. (C) Axial gadolinium-enhanced T1-weighted MRI shows cerebellar left front ring mass with peripheral rim enhancement surrounding a low-signal-intensity area of central necrosis (white arrow).


MRI baseline of brain metastases. (D) Axial gadolinium-enhanced T1-weighted MRI shows bilateral frontal lobe and left occipital small ring enhancement (white arrows).


PET-CT showed recurrence and metastases of ovarian cancer. Increased 18F-FDG uptake was shown in brain.


PET-CT showed recurrence and metastases of ovarian cancer. , right para-aortic lymph nodes.


PET-CT showed recurrence and metastases of ovarian cancer.lesser sac.


Head MRI after niraparib maintenance therapy. (A) after three months of niraparib.


Head MRI after niraparib maintenance therapy. (B) After six months of niraparib.


Head MRI after niraparib maintenance therapy. (C) After nine months of niraparib. Axial T2-weighted FLAIR shows reduction of small spot high signal of the left anterior border of cerebellum (black arrow), Axial gadolinium-enhanced T1-weighted MRI shows vanish of cerebellar left front tiny dot enhancement (white arrow) and of the right frontal lobe tiny dot enhancement.


Computed tomography scan of case 3. . Note: An irregular mass with a clear border, uneven density, and heterogeneous enhancement is visible.


Pathological results from an atypical thymic carcinoid. . Notes: A section of the mass from case 3 was observed under a light microscope (Olympus BX51; Olympus Corporation, Tokyo, Japan) after hematoxylin-eosin staining. Original magnification x100.


Immunohistochemistry results from an atypical thymic carcinoid. . Notes: Immunohistochemistry analysis of a tumor sample from case 3 demonstrating positive detection of CD56, CAM5.2, CgA, CK, and Syn (A-E, respectively).


Immunohistochemistry results from an atypical thymic carcinoid. The staining index for Ki-67 (F) was between 5% and 20%. Magnification x100.


Right posterior auricular swelling with a healed curvilinear scar (thin arrow) over the scalp; Note another irregular healed scar at the right parieto-occipital region (thick arrow).


CT scan shows soft tissue mass with uninvolved mastoid bone.


Mastoid bone shaved for a better surgical clearance.


One year postoperative image showing healed scar.


Imaging for Case 1. . Notes: Pre-treatment. Fused axial PET/CT images of the patient's left-sided primary breast lymphoma Pre-treatment imaging revealed mildly FDG-avid left breast changes at the site of biopsy-confirmed DLBCL.


Imaging for Case 1. . Notes: Pre-treatment. And gastrointestinal stromal tumor of the pancreatic head Pre-treatment imaging revealed a 5.0 x 6.0 cm duodenal/pancreatic head mass with significant FDG avidity.


Imaging for Case 1. And post-treatment. Fused axial PET/CT images of the patient's left-sided primary breast lymphoma , with resolution of these findings after six cycles of R-CHOP chemotherapy.


Imaging for Case 1. And post-treatment. And gastrointestinal stromal tumor of the pancreatic head ; this decreased in size to 4.6 x 5.2 cm after 10 months of imatinib, with continued FDG avidity, suggesting persistent disease despite partial response . Abbreviations: DLBCL, diffuse large B cell lymphoma; FDG, fluorodeoxyglucose; PET, positron emission tomography; R-CHOP, rituximab/cyclophosphamide/doxorubicin/vincristine/prednisolone.


Case 1 GIST surgical resection pathology findings. . Notes: (A) Gastrointestinal stromal tumor involving the wall of the duodenum (arrowhead). The neoplastic cells showed epithelioid morphology with focal areas of spindle cell morphology. Mitotic figures were few (<5 per 50 high-power fields).


Case 1 GIST surgical resection pathology findings. (H&E stain; 100x original magnification) (B) DOG1 immunohistochemistry showed diffuse positive staining.


Case 1 GIST surgical resection pathology findings. (C) Bcl-2 immunohistochemistry showed diffuse positive staining. (Immunohistochemistry with hematoxylin counterstain; 100x original magnification).


Case 2 GIST surgical resection pathology findings. . Notes: (A) GIST comprised of neoplastic cells with spindle cell morphology exhibiting a herringbone growth pattern. Mitotic figures were few (<5 per 50 high-power fields).


Case 2 GIST surgical resection pathology findings. (H&E stain; 100x original magnification) (B) CD117 immunohistochemistry showed diffuse positive staining. (Immunohistochemistry with hematoxylin counterstain; 100x original magnification). . Abbreviation: GIST, gastrointestinal stromal tumor.


The patient showing left eye proptosis with inferior displacement of the globe.


(a) MRI, coronal view of a heterogeneous intermediate signal (white arrow) of the left superior orbital mass, infiltrating the superior rectus muscle.


(b) The transverse view of the same heterogeneous mass (black arrow) displacing the globe anteriorly (proptosis).


Mature adipocytes (black arrow) intermingled with zones of atypical stromal cells (white arrow) (200x, H & E stain).


MRI findings: sagittal T1-weighted.


T1 post contrast. Weighted sagittal images of a dorsal intramedullary GBM from Th9-L1. Note then large conus medullaris in a prominently widened spinal canal. Diffuse, inhomogeneous tumor enhancement and reactive cord edema were seen on the enhanced MR (c).


Abdominal computerized tomography shows a solid mass located in the right iliac fossa.


Cut surface of the tumor shows greyish white tissue, cystic areas and a central fibrous core.


Radiation-associated angiosarcoma of the breast. A; Case 1 (H&E stain). Low-grade angiosarcoma surrounding an area of perineural invasion with small variable endothelial cells of mild atypia and hyperchromasia.


Radiation-associated angiosarcoma of the breast. B; Case 2 (H&E stain). Vascular spaces are lined by enlarged and hyperchromatic endothelial cells. Specimen is absent of necrotic or mitotic cells, which is consistent with low-grade angiosarcoma.


Contrast-enhanced CT-scan with detection of multiple hypodense pancreatic lesions.


Histologic features of the core-needle biopsy. The lesion was constituted of malignant smooth muscle fascicles, as demonstrated by the immunohistochemistry for smooth muscle actin (SMA) and pool cytokeratin (CK, which is shown to have a positive control on the normal lung parenchyma left).


A series of PET/CT scans (Maximum Intensity Projections) in the first patient showing:. Signs of peritoneal carcinomatosis in the subdiaphragmatic space infiltrating the large omentum, and ,associated with ascites, in addition to supradiaphragmatic laterocervical, and ,mediastinal lymphadenopathies.


Persisting multiple peritoneal implant lesions at the time of treatment initiation.


A significant improvement of the previously described peritoneal lesions with an overall regression of their metabolic activity.


(A) Diagnosis: histological image of hematoxylin and eosin. Section (scale bar: 50 microm) shows small tumor cells with a round-oval nucleus and poor cytoplasm that are very densely arranged in a diffuse pattern of growth.


Post-debulking surgery restaging:. Post-debulking clinical presentation with a purplish lesion (approximately 1.5 x 1.5 cm) situated near the right preauricular region close to the surgical scar.


(C) Face and neck CT scan (axial projection) showing residual disease in the right preauricular region. CT, computed tomography.


Resected pelvic node metastasis. Histopathological findings of the left obturator node detected by 11C-choline PET/CT revealed invasion by prostate cancer cells.


A. Magnetic resonance imaging showing a voluminous tumor on the left side of the pelvis and a retroperitoneal liposarcoma was suspected. Arrow head indicates a well-differentiated component.


B. A computed tomography of the abdomen indicating that the tumor might be invading the descending colon. Arrow head indicates sigmoid colon invasion.


C. Surgical specimen with in-block resection of DDLS and a sigmoid colon. DDLS appears to be 15 x 10 x 7.5 cm in size. Arrows indicate a resected sigmoid colon.


D. The histopathological diagnosis was dedifferentiated liposarcoma (DDLS). Scale bar = 200 mum.


Coronal. Cross sections before biopsy (2008).


T1-weighted magnetic resonance imaging, axial.


T1-weighted magnetic resonance imaging (October 2010) before second resection (November 2010). Coronal.


T1-weighted magnetic resonance imaging (October 2010) before second resection (November 2010). Axial.


T1-weighted magnetic resonance imaging (October 2010) before second resection (November 2010). Sagittal. Cross sections: tumor regrowth.


FDG-PET showing the pulmonary lesion in the upper lobe.


Transaxial low dose CT image, with midly increased metabolism.


Transaxial PET image, fused transaxial section and maximum intensity projection image.


Intraoral photograph showing the nodular and variegated appearance of the tumor.


Tumor bed after complete excision of the tumor mass.


Abdominal CT -. (axial view) showing a 4.7 x 3.0cm soft-tissue density mass anterior to the left kidney, adjacent to the tail of the pancreas, and ,the previous colonic anastomosis at the splenic flexure.


(axial view) showing the rapid expanding tumor, 12.7 x 8.6cm, adherent to the nearby structures.


(coronal view) showing the rapid expanding tumor, 12.7 x 8.6cm, adherent to the nearby structures.


Computed tomography brain showing soft tissue view. An enhancing lesion measuring 7 cm x 7 cm.


Computed tomography brain showing bone view bony erosion by the underlying lesion.


Thorax-abdominal-pelvic computed tomography showing retroperitoneal mass with intraspinal extension.


Axial CT with intravenous and gastrointestinal contrast. A large homogeneous retroperitoneal mass encases the superior mesenteric artery (arrow), displaces the stomach (St) and insinuates into the hepatic hilum. L = Liver; K = kidney; C = colon.


Spinal magnetic resonance imaging. (a) T2-weighted sagittal sequences showing the intramedullary lesion at T8-T9 level (yellow arrow), with solid (hypointense) and cystic (hyperintense) components. The cranial syringomyelia is evident (red arrow).


Spinal magnetic resonance imaging. (b) T2-weighted axial sequences demonstrating that the tumor is mainly located on the left spinal cord.


Spinal magnetic resonance imaging. T1-weighted sagittal.


Spinal magnetic resonance imaging. Axial. After gadolinium administration sequences showing the dishomogeneous contrast enhancement of the lesion.


H & E-stained histological preparation. Tumoural lesion with unorganised, diffuse growth, where normal glandular architecture is lost, and nuclear atypia is present.


Abdominopelvic CT with oral and intravenous contrast in the elimination phase, coronal sections.


AP cervical radiograph taken in 2010 (Left) AP cervical radiograph demonstrating missing left C6 pedicle and articular pillar taken in 2014 (Right).


Axial CT demonstrating destructive mass C6 left vertebral body and transverse process.


Lytic lesion in right 1st thoracic rib.


CT-PET abnormal 18-FDG uptake on right ventricle thickening 3 months (SUV 4.9, DS 4).


18 months (SUV 5 - DS 4). After ASCT.


(D) Short tau inversion recovery (STIR) T2 black blood image in short axis on the cardiac base.


(E) Steady-state free precession (SSFP) balance image with T2/T1 weighting in short axis on the cardiac base.


Cardiac MRI images of June 2019 (from D to F) show the persistence of the right ventricle anterior wall thickening (14x56 mm). (F) IR TSET1 image for evaluation of myocardial late enhancement in short axis on the cardiac base.


Clinical presentation of the tumor.


Intraoperative view of the deep aspect of the tumor invading the clavicle bone.


Intraoperative view of the harvesting of two fasciocutaneous flaps.


The wound closed by layers at the end of the surgical procedure.


Dermal infiltration by neoplastic proliferation with pushing margins.


This neoplastic proliferation has a solid, trabecular and pseudoglandular growth pattern.


With focal areas of comedonecrosis and extensive areas of coagulative necrosis and hemorragia.


The tumor cells are large with abundant eosinophilic cytoplasm and nuclei with finely dispersed chromatin and prominent nucleoli, there are many atypical mitotic figures Hematoxylin-eosin stain.


Punch biopsy came back positive for moderately differentiated adenocarcinoma composed by cells with abundant cytoplasm, nuclei with dispersed chromatin and prominent nucleoli. Hematoxylin-eosin stain.


Patient 1. PET/CT in 12/12 (left, prior to vemurafenib) showed innumerable intensely FDG avid lymph nodes and soft tissue deposits scattered throughout the body which developed during her course of ipilimumab by 2 cycles.


Patient 1. PET/CT in 2/13 (right, after starting vemurafenib and completion of the ipilimumab course) showed the previously described intensely FDG avid metastases had entirely resolved. The vemurafenib was weaned and completely stopped by 12/13. She has remained in complete remission to date off all therapy.


Vitiligo of right arm in Patient 1. The photo shows patchy depigmentation of skin after the patient was treated with vemurafenib but this process had actually started after completion of high dose IL-2.


Patient 2. PET/CT on 3/13 (left, prior to vemurafenib) showed intensely FDG avid lymph nodes and soft tissue deposits post ipilimumab.


Patient 2. PET/CT on 6/13 (right, after vemurafenib) showed the previously described intensely FDG avid lymph nodes and nodules had entirely resolved. The vemurafenib was gradually weaned and stopped by 3/14. She has remained in complete remission to date off therapy.


Patient 3. PET/CT in August 2013 (left, prior to BRAF inhibitor therapy) showed intensely FDG avid lymph nodes post ipilimumab which were biopsy confirmed metastatic melanoma.


Patient 3. PET/CT in November 2013(right, after trametinib) showed the previously described intensely FDG avid lymph nodes and nodules had entirely resolved. The skin nodules on his scalp also resolved. The trametinib was gradually weaned and stopped by 5/14. He has remained in complete remission to date off therapy.


Enhanced CT scan of case 2 demonstrated a right renal tumor. The tumor was diagnosed as RCC by the radiologist who is the attending doctor and belongs to the Japan Radiological Society. RCC, renal cell carcinoma.


Clinical response to long-term immunotherapy and the effect of surgery. (A) Schematics showing the time line of patient's diagnosis, treatment and response.


Clinical response to long-term immunotherapy and the effect of surgery. (B) Computed tomography scans and Magnetic resonance imaging showing clinical response to immunotherapy and the effect of surgery.


Clinical response to long-term immunotherapy and the effect of surgery. (C) The result of PD-L1 staining before immunotherapy.


Clinical response to long-term immunotherapy and the effect of surgery. (D) PET-CT scan before Lung tumor resection. TC, paclitaxel+carboplatin; Pembro, pembrolizumab.


Mesenchymal tumor epitheloid shape with increased cellularity, arranged in solid and alveolar fashion and infiltrative to surrounding soft tissue. (HE, x40).


Epitheloid cells, small to moderate in size, eosinophilic cytoplasm, with caudated appearance mimicking rhadomyoblast. Round to oval nuclei, some spindle nuclei are found with irregular chromatin, and prominent nucleoli. (HE, x400).


Strong diffuse positive stained with vimentin, x400.


Negative stained with myogenin, x400.


Positively stained with CD34 in blood vessel cells membrane, negatively stained in tumor cells, x400.


46-year-old female with history of neurofibromatosis Type 1 presented with left breast mass diagnosed as metaplastic breast carcinoma. Mediolateral. Oblique.


46-year-old female with history of neurofibromatosis Type 1 presented with left breast mass diagnosed as metaplastic breast carcinoma. Craniocaudal views of left breast mammogram demonstrate a large, relatively circumscribed mass (arrows) adjacent to a dot-shaped radiopaque skin marker to indicate the palpable area in the central left breast. It measured approximately 10 x 10 x 9 cm. Circular-shaped radiopaque skin markers were placed to indicate the skin lesions (neurofibromas) which are consistent with patient's known neurofibromatosis.


46-year-old female with history of neurofibromatosis Type 1 presented with left breast mass diagnosed as metaplastic breast carcinoma. Targeted breast ultrasound on the palpable area in the central left breast demonstrates a large heterogeneous mass with central necrosis (solid arrow) and peripheral irregular solid components (dashed arrow) with Doppler flow.


46-year-old female with history of neurofibromatosis Type 1 presented with left breast mass diagnosed as metaplastic breast carcinoma. Ultrasound of the left axilla showed an enlarged axillary lymph node (arrow) with eccentric thickened cortex.


46-year-old female with history of neurofibromatosis Type 1 presented with left breast mass diagnosed as metaplastic breast carcinoma. Microscopic examination of the core biopsy (hematoxylin and eosin stain, x200) reveals solid sheets of neoplastic cells with squamous differentiation (arrows), diagnostic of metaplastic breast carcinoma with keratinizing squamous histology.


46-year-old female with history of neurofibromatosis Type 1 presented with left breast mass diagnosed as metaplastic breast carcinoma. Breast MRI with. Subtraction post-contrast images demonstrate a large mass (long arrows) in the central left breast with low T1.


46-year-old female with history of neurofibromatosis Type 1 presented with left breast mass diagnosed as metaplastic breast carcinoma. T1-weighted, , high T2.


46-year-old female with history of neurofibromatosis Type 1 presented with left breast mass diagnosed as metaplastic breast carcinoma. Short tau inversion recovery (STIR), and rim-like enhancement.


46-year-old female with history of neurofibromatosis Type 1 presented with left breast mass diagnosed as metaplastic breast carcinoma. Short tau inversion recovery (STIR), and Small enhancing nodules (neurofibromas) (short arrows) are also noted at the skin of the left breast, consistent with patient's known neurofibromatosis (d).


Examination of specific markers expression of ganglioneuroblastoma (case 1). A) Hematoxylin and eosin staining of the tumor sample (HE; 200x).


Examination of specific markers expression of ganglioneuroblastoma (case 1). B) NB84 expression in the tumor (immunohistochemistry NB84; 400x).


Examination of specific markers expression of ganglioneuroblastoma (case 1). C) Protein S100 immunoreactivity on the cells of the tumor (in this case ganglioneuroblastoma, S100; 400x).


Examination of specific markers expression of ganglioneuroblastoma (case 1). D) CD56 also called neural cell adhesion molecule (NCAM) immunoreactivity on the ganglioneuroblastoma cells (CD56; 200x).


Examination of specific markers expression of ganglioneuroblastoma (case 1). E) Positive expression of neuron specific enolase in the tumor sample (NSE) (NSE; 200x).


Examination of specific markers expression of ganglioneuroblastoma (case 1). F) PGP9.5 expression in the tumor sample (PGP9.5; 200x).


CT of the abdomen - heterogeneous tumor with calcifications (70 x 70 x 100 mm) localized in retroperitoneal left space near left kidney (case 2).


Recurrent laryngeal nerve dissection. Black arrow, left recurrent laryngeal nerve; LT, left thyroid lobe (Retracted); ITA, inferior thyroid artery.


Two months postoperative appearance of the lip following the TOETVA.


Neck lymph node (LN) shows metastatic extremely well differentiated papillary thyroid carcinoma (EWD-PTC) E stain, x12.5.


Inset x400) with focal positivity of CK19. X400) in the first metastatic lesion.


The left thyroid shows follicular variant papillary thyroid carcinoma (FVPTC) without capsular (arrow) invasion E stain, x40.


Loss of CD56. X40) in second episode.


The LN also shows metastatic EWD-PTC E stain, x12.5.


Inset x400) with focal positivity of CK19. X400).


Neck lymph node (LN) shows metastatic extremely well differentiated papillary thyroid carcinoma (EWD-PTC) E stain, x12.5, and . The left thyroid shows follicular variant papillary thyroid carcinoma (FVPTC) without capsular (arrow) invasion E stain, x40, and . The LN also shows metastatic EWD-PTC E stain, x12.5, and . CD56. X400) in the second metastatic lesion. The skull lesion shows metastatic FVPTC E stain, x100.


The skull lesion shows metastatic FVPTC E stain, x100.


CD56. X400).


Changes in maximum body temperature and blood cell count after the onset of fever.


Representative images of the chest CT comparing between January 19, 2020 (A1, A2), and January 27, 2020 (B1, B2). The later CT images show multifocal opacities and consolidations in different lobes of the lungs.


GCT was observed strongly positive with S-100 (x100).


While a diffuse and full-layered positive staining with Ki-67 is present on epithelium of atypical squamous islands (red arrow), a limited staining is present on basal-parabasal layers of non-neoplastic epithelium (black arrow) (Ki-67, x200).


While a diffuse and strong positive staining with p63 is present on atypical squamous islands (red arrow), a limited staining is present on basal-parabasal layers of non-neoplastic epithelium (black arrow) (p63, x200).


Cervical enhanced CT 1 month after first 125I seed implantation.


Magnetic resonance imaging revealing a solitary mass lesion in the intraparenchymal region near the ventricular trigone. The mass of high intensity appears on both T2-weighted images (WI) and diffusion-WI.


Magnetic resonance imaging revealing a solitary mass lesion in the intraparenchymal region near the ventricular trigone.that of low intensity on T1-WI.


Magnetic resonance imaging revealing a solitary mass lesion in the intraparenchymal region near the ventricular trigone. Axial, sagittal, and coronal views on T1-WI with gadolinium demonstrate homogenous enhancement of the mass lesion.


Magnetic resonance imaging revealing a solitary mass lesion in the intraparenchymal region near the ventricular trigone. And . The left thalamus and the parietal lobe near the lesion have atrophic changes.


Navigation-guided endoscopic biopsy performed for the differential diagnosis. (a) A transparent sheath of diameter of 10 mm (Neuroport ; Olympus Corp. ) with a removable inner tube, inserted into the front of the target lesion via the burr hole under the control of the navigation system.


Navigation-guided endoscopic biopsy performed for the differential diagnosis. (b) Endoscopic view using rigid endoscope (EndoArm) shows the tumor tissue (arrow heads) near the ventricle wall (arrow).


Histopathology of liver biopsy. (A) Metastatic prostate adenocarcinoma displaying significant nuclear enlargement and pleomorphism, prominent nucleoli, mitotic figures, and comedo-type central necrosis in this representative field. Note the absence in neuroendocrine features and the surrounding benign hepatocytes [H&E stain, 40x magnification.


Histopathology of liver biopsy. (B) Diffuse nuclear positivity with NKX3.1 in tumor cells [NKX3.1 stain, 40x magnification.


Histopathology of liver biopsy. (C) Diffuse cytoplasmic positivity with PSA in tumor cells.


Histopathology of liver biopsy. (D) No cytoplasmic staining with chromogranin in tumor cells [chromogranin, 40x magnification.


Trends of treatment, prostate serum antigen, and tumor size across patient's treatment course. *Right inferior lobe lesion and. segment 7 lesion.


Histopathology of second liver biopsy. (A) Metastatic prostate adenocarcinoma displaying similar features to the previous sample, including significant nuclear enlargement and pleomorphism, prominent nucleoli, mitotic figures, and single-cell necrosis in this representative field. Again, note the absence of neuroendocrine features [H&E stain, 40x magnification.


Histopathology of second liver biopsy. (B) Diffuse nuclear positivity with NKX3.1 in tumor cells [NKX3.1 stain, 40x magnification.


Histopathology of second liver biopsy. (C) Diffuse cytoplasmic positivity with PSA in tumor cells.


Histopathology of second liver biopsy. (D) No cytoplasmic staining with chromogranin in tumor cells [chromogranin, 40x magnification.


44-year-old woman with 4-month history of lumbar pain diagnosed with perivascular epithelioid cell tumor. (a) Sagittal sonographic image of the left hypochondrium depicts the presence of a large heterogenous left perirenal mass. The lesion has cystic parts (asterisk) and solid, heterogeneous components (long arrow). The mass is in close proximity to the ipsilateral kidney (arrowhead).


44-year-old woman with 4-month history of lumbar pain diagnosed with perivascular epithelioid cell tumor. (b) Sagittal power Doppler image of the left perirenal mass reveals vascularity of the solid parts (arrowheads).


44-year-old woman with 4-month history of lumbar pain diagnosed with perivascular epithelioid cell tumor. (a) Transverse noncontrast computed tomography image demonstrates inhomogeneous solid parts of the lesion (arrow). The mean computed tomography density of the solid components is 35 HU on unenhanced images, similar to that of normal renal parenchyma.


44-year-old woman with 4-month history of lumbar pain diagnosed with perivascular epithelioid cell tumor. Coronal reformations during. The portal phase.


44-year-old woman with 4-month history of lumbar pain diagnosed with perivascular epithelioid cell tumor. The excretory phase depict sharply demarcated left perinephric mass (arrow), partly cystic and solid, in close proximity to the renal capsule. The solid parts of the tumor enhance intensely and heterogeneously, with a mean portal phase attenuation of 100 HU. The left renal parenchyma is intact. Prominent vessels are seen in the left perirenal space adjacent to the lesion (long arrow).


PET/CT scan showing diffuse uptake over peritoneal space (SUVmax from 5.6 to 6.4).


PET/CT scan. (A) A 1.8-cm lesion with moderate uptake over right lower buccal/gingival area with an avid metastatic lesion over spine.


PET/CT scan. (B and C) Lymph node metastases over right neck.


Metastatic squamous cell carcinoma over peritoneum (hematoxylin and eosin stain). (A) Neoplastic cells bearing high nucleus/cytoplasm ratio, pleomorphic nuclei and occasional nucleoli forming focal squamoid nests (x200).


Metastatic squamous cell carcinoma over peritoneum (hematoxylin and eosin stain). (B) Acantholytic change similar to that seen in buccal carcinoma specimen, resulting in glandular pattern with some detached or apoptotic tumour cells in the lumen-like structure (x400).


Metastatic squamous cell carcinoma over peritoneum. Negative immunohistochemical staining for. CK7.


Metastatic squamous cell carcinoma over peritoneum. CK20.


Metastatic squamous cell carcinoma over peritoneum. TTF-1.


Metastatic squamous cell carcinoma over peritoneum. (D) Negative histochemical staining for mucicarmine.


Negative immunohistochemical staining for. TNFalpha, and . CD24 in. Primary buccal squamous cell carcinoma.


Negative immunohistochemical staining for. TNFalpha, and . Metastatic squamous cell carcinoma over peritoneum.


CD24 in. Primary buccal squamous cell carcinoma.


Metastatic squamous cell carcinoma over peritoneum.


Mammography.


Mammography. Cranio-caudal. Medio-lateral view: Showing a large densely calcified lobulated mass measuring 5 x 3 cm with irregular margins in the upper outer quadrant of the left breast.


Computed tomography scan axial view showing the 5 x 3 cm multi lobulated densely calcified extra skeletal mass with a normal lung parenchyma.


Technetium 99-methylene diphosphonate bone scintigraphy showing an intense uptake in the left breast corresponding to the primary tumor.


(a and b) Mastectomy specimen showing the tumor excised with wide margins.


Positron emission tomography-computed tomography chest image demonstrates a localized mass in right posterior mediastinal/ paraspinal region with maximum standardized uptake value of 6.6.


Field's stained smear shows cohesive group of cells on a myxoid background (MGG, x2.5). This smear pattern correlates with groups of tumor cells surrounded by fibrous septa on histology. High power view of vacuolated cells somewhat resembling physalipherous cells, but differentiated from them by pleomorphic large nuclei and prominent nucleoli (inset).


Loosely cohesive epithelioid cells with eccentric nuclei, prominent nucleoli, and ample cytoplasm resembling adenocarcinoma. Note the cell showing vacuolated cytoplasm with magenta droplet (arrow) (myxoid background, x63). Mucicarmine stains were negative to faintly positive.


Clusters of epithelioid cells with abundant, poorly defined cytoplasm, mildly pleomorphic nuclei with irregular nuclear membranes (grooves and notches), prominent eosinophilic nucleoli, and chromatin condensation. Rare signet-ring like cells are seen. The myxoid stroma is less obvious in the Papanicolaou (Pap)-stained smear (Pap, x63).


Immunohistochemical results. Tumor cells are positive for calretinin, WT-1, and D2-40, and negative for high molecular weight keratin and thyroid transcription factor-1 supporting mesothelial origin. Mucicarmine stain is negative excluding adenocarcinoma.


The MRI of the brain and the pituitary. (A,C) No significant expansion of the sella, irregular cystic-solid mixed mass in the hypothalamus region, solid part presented iso-signal, the boundaries between the lesion and pituitary stalk, pituitary are not clear, the optic chiasm was compressed.


The MRI of the brain and the pituitary. (B,D) The solid part of the lesion was significantly enhanced, no enhancement in cystic part, no abnormal signal in the brain parenchyma and paranasal sinus.


The image of pathology. Palisaded columnar epithelium cells, stellate reticular cells, and keratinized tissues are dominant, and glial hyperplasia zone is adjacent to the nerve tissue, compatible with adamantinomatous craniopharyngioma (X 200).


The neck CT scan showed multiple metastatic cervical lymph nodes located in the right III, IV, V, and VI regions, with no clear boundary with the right common carotid artery at the second local regional relapse (A and B).


After induction chemotherapy and definitive reirradiation with synchronized weekly chemotherapy, the patient experienced complete remission (C). . Abbreviation: CT, computed tomography.


The process of tumor change and ulcer formation during the application of apatinib, after the third local regional recurrence. . Notes: In January 2018, the patient experienced a third recurrence in the right region of the neck (A).


The process of tumor change and ulcer formation during the application of apatinib, after the third local regional recurrence. The tumor progressed aggressively during a 2-month period before the initiation of apatinib (B).


The process of tumor change and ulcer formation during the application of apatinib, after the third local regional recurrence. The tumor shrank significantly after 7 days of 250 mg apatinib daily (C).


The process of tumor change and ulcer formation during the application of apatinib, after the third local regional recurrence. The 20-day use of apatinib contributed to complete remission, but deep ulcers formed owing to tumor regression (D).


The process of tumor change and ulcer formation during the application of apatinib, after the third local regional recurrence. After a 2-week suspension of apatinib, the tumor regrew (E).


The process of tumor change and ulcer formation during the application of apatinib, after the third local regional recurrence. The tumor disappeared after a 3-week reapplication of apatinib, but large ulcers with local infection occurred (F).


The CT scan conducted on May 17, 2018, revealed obvious tissue defects in the right lower neck and anterior cervical region, with no clear boundaries with the right carotid artery and vein. . Abbreviation: CT, computed tomography.


CT Imaging.


18F]FDG-PET-CT , Venous sampling V.


Hepatica.


Intraoperative localization.


Resected lymph node.


Histological result at time of diagnosis recurrence , White arrow marks the lymph node metastases in the hilus of the liver.


Non-enhanced abdominal MRI showed that there was an occupying mass in the right lobe of liver, the boundary of tumor was unclear.


Enhanced abdominal MRI indicated mild heterogeneous enhancement of solid components around the tumor, and ,the size of the tumor was ~2.7 x 2.8 x 3 cm.


A second non-enhanced abdominal MRI showed that the mass in the right lobe of liver grew larger, and ,the size was ~3 x 3.5 x 3.5 cm.


A second enhanced abdominal MRI showed the low density of the cyst was seen in the tumor, which was considered to be accompanied by hemorrhage.


56-year-old woman had suffered from abdominal fullness for three months. . (A) Axial contrast-enhanced abdominopelvic CT scan shows a uniform well-enhanced peritoneum (black arrow), and bilateral dilated convoluted fallopian tubes with intense mucosal enhancement (white arrow) representing bilateral salpingitis; these findings combined with dirty fat strandings identify infection.


56-year-old woman had suffered from abdominal fullness for three months. . (B) Axial contrast-enhanced CT scan shows the nodules of the omentum (black arrow) and loculated ascites (white arrow).


56-year-old woman had suffered from abdominal fullness for three months. . (C) Coronal contrast-enhanced CT scan demonstrates the disproportionate left ovarian mass (arrow) with loculated ascites, in contrast to the usual findings of ovarian cancer.


Photograph of histological specimen. (A) Hematoxylin and eosin stain shows the caseous necrosis (long arrow) and Langhans giant cell (short arrow) confirming tuberculosis peritonitis.


Photograph of histological specimen. (B) Acid-fast stain shows the tubercle bacilli (red circle).


Abdominal and pelvis computed tomography scans. . Notes: (A) Gallbladder (GB) distention and retropancreatic and periaortic images suggestive of lymphadenopathies (star).


Abdominal and pelvis computed tomography scans. (B) Choledochal dilation (arrow).


Abdominal and pelvis computed tomography scans. (C) Bilateral hydronefrosis (stars).


Abdominal and pelvis computed tomography scans. (D) A solid mass of the cervix suggesting a primary cancer (star), and a cystic formation with hypodense content matching with distended uterine cavity. Bladder (Bl) imaging.


Laparoscopic image of implants in the Douglas pouch.


Laparoscopic image of multiple peritoneal implants in the Douglas pouch.


Laparoscopic image of multiple peritoneal implants at the level of the omentum.


Surgical piece of the omentum.


(a) Maximum intensity projection image - increased fluorodeoxyglucose avidity in the midline of the neck.


(b) Fused axial image - markedly increased metabolic activity in left-sided mass lesion (large single arrow). Another large solid-cystic mass lesion arising from the right lobe of the thyroid gland with mildly increased fluorodeoxyglucose uptake (small double arrow).


(c) Axial computed tomography scan of the neck - left-sided mass lesion is not separable from the isthmus of the thyroid, thyroid cartilage, and obstructing the supraglottic larynx.


(d) Small soft-tissue parenchymal nodules in the lingular segment of the left lung with minimally increased metabolic activity.


Axial section of follow-up positron emission tomography/computed tomography scan shows the partial regression of the metabolically active thyroid mass. The benign lesion in the right lobe of thyroid remains unchanged.


Surgical specimen verifies the presence of both a glottic and an endoluminal tracheal tumour. Intermediate tissue shows no macroscopic signs of malignancy.


Contrast enhanced computerized tomography suggestive of irregular circumferential moderately enhancing thickening of urinary bladder.


Preoperative findings. . (A) Computed tomography reveals a low density mass in the pancreatic tail (allow).


Preoperative findings. . (B) Positron emission tomography shows a hypermetabolic mass in the pancreatic tail.


Contrast-enhanced MDCT shows. A suspicious giant pelvic AVF (arrows).


Confirmed by Color Doppler.


DSA shows branches of the left hypogastric artery sustaining the AVF.


Embolized also using Squid (arrow).


Diagnostic phlebography via trans-femoral of the right gonadal vein shows (a) multiple thrombi (arrows).


Amplatzer plug placement (arrows) via trans-jugular to occlude the right gonadal vein (b) to simultaneously reduce AVF-outflow and avoid pulmonary embolism.


Contrast-enhanced MDCT after 24 h confirms (c) the correct placement of the plug (arrows).


After the second arterial embolization performed 6 months later, the final aortography shows the complete AVF occlusion.


MRI abdomen coronal and transverse images depicting renal lesion in middle and lower pole of the left kidney.


Haematoxylin and eosin staining of the tissue. . (
A) Small round blue tumour cells arranged in sheets and nests infiltrating the adjacent stroma. Numerous hemosiderin laden macrophages are seen at the interface. No viable renal parenchyma is preserved, which is entirely replaced by dense fibrosis.


Haematoxylin and eosin staining of the tissue. Haematoxylin and eosin stain, x40; (
B) Tumour cell morphology at higher magnification with high nuclear cytoplasmic ratio, inconspicuous cytoplasm and occasional mitoses.


Haematoxylin and eosin staining of the tissue. Haematoxylin and eosin stain, x400; (
C) Tumour with adjacent bluish immature myxoid connective tissue. Haematoxylin and eosin stain, x400.


Follow-up contrast enhanced CT scan at 12 months showing no evidence of recurrence.


Magnetic resonance imaging T1 GE 3D axial sequence without intravenous contrast, immediately after virus infusion. The intraparenchymal injection of gadolinium before infusing the virus with the MEMS cannula (this cannula has two independent channels) is pushed out from the tumor as the virus is infused from a second channel.


Diffuse midline glioma showing strong nuclear H3K27M mutant protein (immunohistochemistry, X200).


Bisected kidney showing a well-defined mass with extensive necrosis (bold arrow) and a small focus of viable tumor. The adjacent kidney involved diffusely by prostatic carcinoma metastasis appears grossly firm and whitish (thin arrow). Also seen here is a firm whitish irregular deposit (asterix) adjacent to the hilar region. The same kidney also shows a simple cyst (arrow head).


Microscopic and immunohistochemical examination revealed areas with diffuse interstitial infiltration by prostatic adenocarcinoma. Hematoxylin, and ,eosin, original magnification, x40), which was CK7 negative (a inset, indirect immunoperoxidase).


Separate foci of conventional clear cell renal carcinoma. Hematoxylin and eosin, original magnification, x100).


The prostatic adenocarcinoma was negative for CD10 immunomarker. Indirect immunoperoxidase) in contrast to the renal carcinoma.


Which was CD10 positive. Indirect immunoperoxidase).


Microscopic findings of the resected appendix showed tumour cells infiltration into the muscularis propriae, with two distinct components identified (H&E, 40x).


First component: nests of tumour cells exhibiting uniform, round nuclei with salt and pepper chromatin (arrow head). Second component: goblet cells displaying univacuolated cytoplasm and peripherally compressed nuclei (arrow) (H&E, 200x).


Immunohistochemical findings revealed both components are positive for synaptophysin (A).


However, only the goblet cells are positive for CK20 (B) (400x).


Pedigree and MSH2 c.2656 G > T (p. Glu886*) carriers of the Pakistani cancer family 326. Circles are females, squares are males, and a diagonal slash indicates a deceased individual. Symbols with filled left upper quadrant: unilateral breast cancer. Symbols with filled upper half: bilateral breast cancer. Symbols with filled left lower quadrant: ovarian cancer. Symbols with filled right lower quadrant: cancer other than breast/ovarian cancer, the name of which is mentioned. Identification numbers of individuals are shown below the symbols. The index patient is indicated by an arrow. ALL, acute lymphoid leukemia; BC, breast cancer; OC, ovarian cancer. The numbers following these abbreviations indicate age at cancer diagnosis. M+, mutation positive. [M+], obligatory mutation carrier. M-, mutation negative.


A mass at the ascending colon demonstrated on CT scan of abdomen and pelvis. The arrow showed a circumferential thickening of a segment of ascending colon due to colonic mass.


Microscopic finding of the colon tumor. Biopsy by colonoscopy showed poorly differentiated squamous cell carcinoma with dense cytoplasm, irregular nuclear contours, moderate pleomorphism and prominent nucleoli (hematoxylin and eosin stain, x40). Additional immunohistochemical study and comparison to prior tumor histology indicated metastatic rather than a primary colorectal carcinoma.


Giant nevus encompassing the lower abdomen, genital area, and upper thighs.


Giant nevus involving the middle and lower back, gluteal region, and upper thighs. Numerous smaller satellite nevi are also observed on the neck, upper back, and upper limbs.


Postoperative immunological pathology findings confirmed the lesion to be non-small cell lung cancer (adenocarcinoma). (A) Hematoxylin and eosin staining.


Postoperative immunological pathology findings confirmed the lesion to be non-small cell lung cancer (adenocarcinoma). Immunological images showing the lesion to be. Thyroid transcription factor 1-positive.


Postoperative immunological pathology findings confirmed the lesion to be non-small cell lung cancer (adenocarcinoma). Cytokeratin (CK) 88-positive.


Postoperative immunological pathology findings confirmed the lesion to be non-small cell lung cancer (adenocarcinoma). CK-positive. All images: Magnification, x200.


(A and B) PET-CT scan showed an abnormal mass at the level of T9 and the left upper lobe of the lung.


Twenty-four months after treatment, PET-CT scan showed inactivation of the neoplasm in the left upper lobe, and ,T9 vertebra, and . A decrease in the left upper lobe mass in the short axis. PET-CT, positron emission tomography-computed tomography.


Twenty-four months after treatment, PET-CT scan showed inactivation of the neoplasm in the left upper lobe, and ,T9 vertebra.


The pre-operative view shows a smooth, ovoid swelling on the lingual aspect of the mandible extending from mesial of 41 to 47.


Cross-sectional mandibular occlusal radiograph shows cortical expansion with hazy radiopacity on the lingual surface of mandible extending from 41 to 47 region.


CT scan before radiotherapy: local recurrence of melanoma, 36.80 x 26.78 mm in size, in the nasal cavity (A).


MRI at 2 months after IMRT treatment: regression of the tumor (B).


PET-CT image: metastasis at the scapula before.


After. Combination therapy.


MRI follow up. (A) March 2018: FLAIR sequences showed a left temporo-parieto-occipital and a right temporal hyperintensity (A1, A2, A3); no gadolinium enhancement (A4, A5).


MRI follow up. (B) April 2018: FLAIR sequences showed an extension of the white matter (WM) hyperintensity (B1, B2, B3); gradient-echo sequences showed microbleeds (B4, B5).


MRI follow up. (C) June 2018: FLAIR sequences showed a reduction of the WM alterations (C1, C2, C3); susceptibility-weighted imaging (SWI) sequences confirmed microbleeds (C4, C5).


MRI follow up. (D) February 2019: FLAIR sequences showed a further reduction of the WM alterations (D1, D2, D3); SWI sequences corroborated microbleeds (D4, D5).


Axial view of CT scan with contrast showing delayed nephrogram and hydronephrosis of both collecting systems (see arrows) on the right kidney.


Sagittal view of CT scan with contrast showing a hydronephrotic bifid ureter (red line indicating boundary between two ureteral segments) with enhancement at bifurcation (see arrow).


Retrograde pyelogram showing bifurcation at the proximal ureter (yellow arrow) with reduced flow through the more proximal ureteral segments (lower pole:green arrow, upper pole:red arrow) indicating partial obstruction.


CT scan with extensive retroperitoneal adenopathy.


Gallium-68 dotatate PET/CT scan demonstrating avidity in the left ventricular myocardium.


First EKG (11/12/18).


Second EKG (4/14/19).


High magnification SS-OCT images at the parafoveal area of the right.


Left. Eyes at the initial visit. In both the area where the SRD appeared and in the adjacent area, SS-OCT detected a high reflection of the photoreceptor outer segment while the interdigitation zone was indistinguishable (between the arrowheads). SS-OCT also detected thickening (maximum diameter 75 mum) of the photoreceptor outer segment. The reflection of the retinal pigment epithelium line appeared to be brighter with slightly poorer margins.


Autofluorescence at the initial visit. The right and left eye exhibited no abnormal hyperfluorescence in the macular area.


FDG-PET before treatment revealed increased uptake in the mediastinal lesion and right supraclavicular lymph node.


Spinal MRI examination revealed a circular mass in the spinal canal of T12-L2 with unclear boundaries. Signaling within the tumor was not uniform, with hypointensity on T1-weighted images (T1WI).


Spinal MRI examination revealed a circular mass in the spinal canal of T12-L2 with unclear boundaries. Speckled hyperintensity on T2-weighted images (T2WI).


(a) The nerve roots were carefully separated from the tumor under a microscope and the tumor was completely excised.


(b) There was no residual tumor in the spinal canal.


(c) The fish-shaped round mass obtained by gross total resection.


(d) Pedicle screws and connecting rods were used to reconstruct the area.


Postoperative pathology of the tumor tissue revealed undifferentiated small round blue cells with hematoxylin and eosin staining: x40.


Lateral profile of the patient showing the tumor mass below the ear lobe.


Ultrasonography of the left parotid gland showing a hypoechoic area suggestive of pleomorphic adenoma.


Tumor mass was removed without damaging the capsule.


Excised specimen (1.3 cm in size).


Histopathologic picture showing features of pleomorphic adenoma.


Eighth month postoperative followup pic.


Transanal local excision of the tumor.


Rectal gastrointestinal stromal tumors specimen.


Microscopic features, H&E x10. . Notes: Tumor composed of spindle or polygonal cells with eosinophilic cytoplasm, parts of which are arranged like woven, vortex or in intersecting bundles.


Microscopic features, H&E x40. . Notes: Tumor composed of spindle or polygonal cells with eosinophilic cytoplasm, parts of which are arranged like woven, vortex or in intersecting bundles.


Immunohistochemical stain positive for C-KIT (x40).


Immunohistochemical stain positive for CD34 (x10).


Immunohistochemical stain negative for smooth muscle actin (x10).


Hepatocellular carcinoma composed of cells exhibited an eosinophilic cytoplasm, and ,enlarged, and ,round nuclei (haematoxylin & eosin.


Stain 200).


The tumour cells were positive for alpha-fetoprotein (AFP) (AFP stain 100).


The tumour cells were positive for Arginase l (Arginase l stain 100).


The tumour cells were positive for CK8/18 (CK8/18 stain 100).


The tumour cells were positive for Glypican 3 (Glypican 3 stain 100). The tumour cells were positive for CD34 (CD34 stain 100).


The chart shows the general trend of serum AFP at different stages of the treatment. . Abbreviations: XELOX, Oxaliplatin and Capecitabine, X: Capecitabine; S, Sorafenib; L, Lenvatinib.


CT of the lungs demonstrates diffuse ground-glass attenuation, bilateral effusions, and scattered pulmonary nodules. The yellow arrows show prominent interlobular septal thickening.


Poorly differentiated invasive duct carcinoma of the left breast; H&E, 20x.


Metastasis of well differentiated invasive carcinoma in the axillar lymph node; H&E, 20x.


Metastasis of poorly differentiated carcinoma into the fimbrial part of left Fallopian tube; H&E, 5x and 40x.


Contrast-enhanced abdominal computed tomography reveals a right adrenal mass. Axial.


Contrast-enhanced abdominal computed tomography reveals a right adrenal mass. Coronal. Images of a well-defined, heterogeneously enhancing mass measuring 18x11x18 cm between the liver and right kidney.


Gross appearance of the resected adrenal tumor. The mass was large, solitary, and circumscribed tumor (21x15.3x12 cm). The cut section is yellowish-tan in color, with a variegated appearance. Many areas of necrosis and hemorrhage are visible.


Immunohistochemical staining of the tumor. The Ki-67 index of the tumor cells is 20% (x400).


Postsalvage chemotherapy biopsy.


Gadolinium-enhanced magnetic resonance images (a, axial b, coronal) reveal a ring-shaped enhancement in the left parietal lobe and peritumoral cerebral edema associated with a cystic lesion.


Resected tumor: thin cyst wall is well stained of pyoctanin blue (arrow) and fibrin glue is in the tumoral cavity (arrow head).


PTEN status in PT#1 and PT#2. Sections are from PT#1 and PT#2 and stained for anti-PTEN as labeled. Primary (PT#1 and PT#2sk) and metastatic (PT#2 v and PT#2br) melanomas are illustrated. Loss of PTEN reactivity was observed in melanoma cells from all samples except PT#2sk; internal positive control are represented by vessel. Sections were counterstained with hematoxylin and imaged at 100x magnification. Sequencing data illustrate the PTEN sequencing analysis (Igv screenshot of amplicon that cover exon 2 of PTEN) by Illumina MiSeq in P#T1 and PT#2 samples. A; PTEN substitution is observed in samples PT#2ov and PT#2br. Sk, skin; ov, ovary; br, brain.


Initial clinical manifestation of the patient. A red nodule located in the left upper side of left breast and several palpable lymph nodes in the homolateral axillary fossa region. Diagnostic ultrasound demonstrates hypoechoic mass and suspicious left axillary lymph nodes at initial presentation (pre-biopsy).


Tissue pathological confirmation of the primary mass. Ultrasound-guided core needle biopsy, hematoxylin-eosin (HE) morphological diagnosis and immunohistochemistry examination routinely.


Reassessment of the primary tumor after neoadjuvant chemotherapy. Skin red nodule disappeared after 6 cycles of TAC neoadjuvant chemotherapy. Surgical pathology revealed a similar subtype of breast cancer with core needle biopsy before neoadjuvant chemotherapy, though ER, PR and Ki67 staining intensity was not completely consistent, which didn't change the subtype of breast cancer.


Cranial computerized tomography (CT). CT revealed the brain metastatic lesion and brain midline shift. There is a slightly high density nodule in the left parietal lobe, and the surrounding is the low density edema before operation, and patchy opacity left there after operation.


Surgical pathology of the brain metastatic lesion. Hematoxylin-eosin (HE) morphologically identified breast cancer metastasis in brain, and immunohistochemistry examination reassessment of the metastatic lesion showed ER+70% mild, PR+70% mild, HER2++, Ki67+ 30%, fluorescence in situ hybridization confirmed HER2 overexpression.


Endometrial aspiration: histopathological examination (HPE), endometrial glands in the secretory phase (arrow) with neoplastic cells suggestive of low-grade endometrial stromal sarcoma.


HPE (high power) showing uniform oval or spindle-shaped cells.


Tumor (arrow) almost perforating right side of the myometrium.


Section from the fallopian tube showing neoplastic cells in dilated lymphatic spaces.


Papillary tumor of the pineal region. (1) The vascular axes of neoplastic papillae often harbor multiple capillaries. Neoplastic cells detached from the papillary vascularized core, leading to an apparent clear perivascular space. (2) Cytokeratin AE1-AE3 is diffusely expressed in the epithelial-like neoplastic cells and predominates in perivascular areas.


Medical image.


T1 contrast showing homogenously hypointense lesion with minimal patchy enhancement in cerebellum. T2 fluid attenuated inversion recovery showing homogenously hypertintense lesion in cerebellum.


Dissection of the left-sided posterior cervical triangle, after reflection of both the platysma and sternocleidomastoid muscles, revealed a Virchow node (VN) in the region of the lesser supraclavicular fossa.