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


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


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


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


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


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


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


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


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


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


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


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


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


(a) Abolished microarchitecture and epitheloid granulomas of the sentinel node from the left groin. Hematoxylin and eosin staining (H&E) x50.


(b-d) Micrometastasis (partly single cell spread) in the lymph node. Pictures represent the same section in the lymph node.


18-Fluorodeoxyglucose positron emission tomography (PET) and Computed Tomography (CT) in transverse ,. The transverse image (a) shows multiple active lymph nodes in the mediastinum.


Coronal.


Sagittal. Images.


Histological features of germ-cell tumor (seminoma) with somatic malignant transformation (spindle cell sarcoma) (A) Classic seminoma (upper right corner) associated with spindle cell sarcoma (lower left corner), (H&E 200x).


(B)
in situ germ cell neoplasia (upper right corner) admixed with somatic spindle cell sarcoma (lower left corner), (H&E 200x).


(C) Metastatic spindle cell sarcoma within the spermatic cord (H&E 200x).


(D) The same field of picture C shows high proliferative Ki67 index (DAB 200x).


Principal component analysis of seminoma, mixed germ cell tumors and sarcoma publicly available in The Cancer Genome Atlas project (TCGA) and our primary tumor and relapse in sarcoma.


Magnetic resonance images of the patient's brain in the course of the disease, with brain metastasis in the right temporal lobe (blue arrow). Dates are given in the format DMY. 1. OP, first operation; 2. OP, second operation; RT, radiotherapy.


Illustration of the radiotherapy planning process. A; Contouring of the target volumes. The red curve represents the clinical target volume, and the blue curve the planning target volume.


Illustration of the radiotherapy planning process. B; Isodoses of the final irradiation plan.


Illustration of the radiotherapy planning process. C; Layout of the irradiation fields (volumetric modulated arc technique).


Cone-beam computed tomography view shows large ill-defined radiolucency with ragged borders on anterior part of maxilla.


(a) Microscopic features of tumor. Nest of epithelial cells and some clear cells with abundant cytoplasm.


(b) Microscopic features of tumor. Atypical mitotic figures in tumoral cells (H & E, x400).


Positron emission tomographic-computed tomography view. Note numerous hypermetabolic areas in right maxillary sinus and nasal cavity, lungs, hilar regions, left kidney and left retroperitoneal soft tissue.


Immunohistochemical stain for CD10 showing positive reactivity in tumoural cells.


Clinical view of the patient shows large exophytic mass.


Microscopic features of tumor. (a)sheets of tumoral cells with large clear cytoplasm. (H & E, x100).


Microscopic features of tumor. (b) hemorrhagic background of tumoral cells. (H & E, x400).


Immunohistochemical staining. Positive reactivity for epithelial membrane antigen.


Positron emission tomographic-computed tomography view shows some hyper metabolic areas.


Left: Preoperative abdominal CT. Solid hepatic lesion at segments VI and VII (arrows) and calcified lesion at the tail of the pancreas (circle). Right: Postoperative abdominal CT. Subcapsular hepatic fluid collection without recurrence of the HCC (circle). . Abbreviations: CT, computed tomography; HCC, hepatocellular carcinoma.


Left: Intraoperative photo. Microwave tissue coagulator marking the margins for hepatic segmentectomy. Right: Gross specimen photo. Hepatic segments VI and VII containing the HCC. . Abbreviation: HCC, hepatocellular carcinoma.


A 58-year-old male patient presented with obstructive jaundice due to choledocho-nodal fistula. Endoscopic retrograde cholangiopancreatography with cholangiogram showing dilated upper common bile duct (CBD) and intrahepatic biliary radicles (short arrow) and a rounded lesion compressing the lower CBD (long arrow) consistent with the necrotic lymph node.


A 58-year-old male patient presented with obstructive jaundice due to choledocho-nodal fistula. Endoscopic ultrasonography image showing partially cystic lesion (long arrow) with heterogeneous content around the common bile duct consistent with the necrotic lymph node, surrounding the inserted plastic stent (short arrow).


A 58-year-old male patient presented with obstructive jaundice due to choledocho-nodal fistula. Endoscopic ultrasonography with aspiration from the necrotic lymph node showing the yellow fluid consistent with bile. The bile source was confirmed on laboratory examination.


A 58-year-old male patient presented with obstructive jaundice due to choledocho-nodal fistula. Fluoroscopy/ cholangiogram showing endoscopic ultrasonography needle aspirating the lesion with obvious size reduction (long arrow) in comparison to the size in Figure 1. Note the stent passing through the lesion (short arrow).


Three-dimensional computed tomography image showing an intraosseous odontogenic squamous cell carcinoma of the mandible. At the physical examination, the patient presented a bone consistency with swelling of vestibular region in the left side of the jaw.


Axial computed tomography image of mandibular intraosseous odontogenic squamous cell carcinoma. The lesion affects the body and the ascendant branch of the mandible in the left side.


Orthopantomogram of mandibular intraosseous odontogenic squamous cell carcinoma.


Histopathological image of mandibular intraosseous odontogenic squamous cell carcinoma with H&E stain.


A; Administration of ipilimumab was accompanied by a temporary increase in serum LDH concentrations, followed by a slight but durable decrease over the next months.


B; Serum concentrations of the tumor marker S100 significantly dropped after administration of 4 cycles of ipilimumab, but subsequently started rising again after cessation of therapy, indicating a temporary initial reduction of total tumor burden.


Postcontrast axial MRI showing a large intra-axial space occupying lesion in the left temporal lobe with peripheral enhancement and peritumoral edema.


Postcontrast axial CT scan showing a large recurrent tumor almost occupying the whole posterior part of the left temporal lobe.


Postoperative contrast axial CT showing radical excision of tumor with enhancement along the tentorial leaflet.


Postcontrast axial CT scan showing recurrent tumor in the left posterior temporal lobe extending into the posterior fossa and compressing the brain stem.


A 17-year-old female with H3F3A G34R mutated infiltrative glioma. MRI of the brain with and without contrast at the time of presentation revealed (A) a T2 FLAIR hyperintense focus (arrow) with adjacent T2 FLAIR hyperintense cortical thickening.


A 17-year-old female with H3F3A G34R mutated infiltrative glioma. (B) T1 contrast-enhanced imaging revealed faint peripheral enhancement (arrow).


A 17-year-old female with H3F3A G34R mutated infiltrative glioma. Three-month follow-up imaging revealed (C) increase in the size of the T2 FLAIR hyperintense lesion long arrow with associated cortical thickening short arrow.


A 17-year-old female with H3F3A G34R mutated infiltrative glioma. (D) T1 contrast-enhanced imaging revealed a solid enhancing nodule (arrow).


A 17-year-old female with H3F3A G34R mutated infiltrative glioma. MRI of the spine with and without contrast at the time of presentation was performed. (A) A sagittal T1 pre-contrast image of the lumbar spine shows no evidence of a marrow replacing lesion.


A 17-year-old female with H3F3A G34R mutated infiltrative glioma. MRI of the spine with and without contrast at the time of presentation was performed. (B) Follow-up imaging 3 months later reveals the development of rim-enhancing marrow replacing lesions (arrows) within the lumbar vertebral bodies on this sagittal T1 contrast-enhanced image.


A 17-year-old female with H3F3A G34R mutated infiltrative glioma. MRI of the spine with and without contrast at the time of presentation was performed. (C) Five months later there was a significant increase in the size and number of enhancing marrow replacing lesions (arrows) on this sagittal T1-post contrast fat saturated image.


A 17-year-old female with H3F3A G34R mutated infiltrative glioma. 18F-FDG PET CT fused axial image of the superior bony pelvis reveals a hypermetabolic sclerotic lesion (maximum SUV of >6) within the left iliac bone (arrow).


A 17-year-old female with H3F3A G34R mutated infiltrative glioma. An axial image from a CT of the chest with contrast in soft tissue window (A) reveals a destructive soft tissue lesion involving a lower right rib (arrow).


A 17-year-old female with H3F3A G34R mutated infiltrative glioma. The image in bone window (B) better demonstrates the rib destruction (white arrow) and also shows predominantly blastic lesions within the vertebra (black arrow).


A 17-year-old female with H3F3A G34R mutated infiltrative glioma. A coronal image from a CT of the abdomen and pelvis with contrast in soft tissue window.


A 17-year-old female with H3F3A G34R mutated infiltrative glioma. Bone window. Reveals a destructive lesion of the left iliac bone with large soft tissue component (long arrow), a destructive lesion centered around a right lower rib adjacent to a plural drainage catheter (short arrow), and iliac lymph node metastases (thin arrows).


A. Image of pre surgical MRI of September 09 2013 showing within the posterior medial right temporal and occipital lobes a 3.8 x 5.8 x 4.7 cm. Mass. The mass had peripheral enhancement and effacement of the atrium of the right lateral ventricle, displaced laterally.


B. Post- surgery image of September 21 2013, showing interval right parietal craniotomy with significant debulking of right temporal occipital tumor. There was a large area of restricted diffusion along the margins of the resection cavity in the right occipital lobe. There was expected postoperative enhancement of the margins of the resection cavity and along the operative tract.


C. At one year post- surgical intervention and completion of temozolomide adjuvant treatment, there were evolving intrinsic T1 hyper-intensities along the margins of the resection cavity in the right parietal lobe. There was improvement in the enhancement along the margins of the operative tract and section cavity. No new areas of enhancement, hydrocephalus or midline shift.


D. At thirty months follow up there were post-operative changes with no new enhancing lesions, no hydrocephalus or midline shift. The patient is neurologically functional and with a ECOG PS* of 0. *Eastern Cooperative Group Performance Status.


Key interactions modulated by potential pharmacogenomic agents in glioblastoma. Dashed lines: indirect interactions; Red coloration/t-bar: downregulation; Green coloration/arrow: upregulation; Blue coloration/arrow: dual- directional regulation or binding.


Axial T1 weighted magnetic resonance imaging scan showing a complex multilobulated mass centered within the right cavernous sinus and encasing the cavernous internal carotid artery.


Coronal T1 weighted magnetic resonance imaging scan showing a complex multilobulated mass centered within the right cavernous sinus and encasing the cavernous internal carotid artery.


CT image.


Postoperative pathology of lung adenocarcinoma 11 years ago. The yellow triangle indicates the location of lung adenocarcinoma.


Chest computed tomographic images showing a pulmonary mass in the left upper lobe with pleural effusion at the patient's first visit (a).


This tumor grew rapidly to occupy the entire left upper lobe 1 month after the patient's first visit (b).


Postoperative 18F-fluorodeoxyglucose positron emission tomographic images showing abnormal and diffuse accumulation of 18F-fluorodeoxyglucose in the left pleural cavity.


Which disappeared after five cycles of chemotherapy.


Histopathological findings showing an admixture of spindle-shaped and circular cells, arranged in a storiform pattern (hematoxylin and eosin, x100) (a).


Immunohistochemical staining revealed cells positive for vimentin (x100) (b).


Gallium-68 prostate-specific membrane antigen-positron emission tomography/computed tomography clearly showing tracer uptake in the left testis, in correlation with the pathological findings.


Pelvic magnetic resonance on sagittal view confirming the presence of a 2.2 cm nodule circumscribed to the left epididymis, hypointense in T2 sequence.


Ultrasonography of nodular formation at the upper external quadrant of the right breast.


Ultrasound second look and fine-needle aspirate biopsy of the second lesion.


Metastatic lymph node agglomerate.


Local findings. A; Before treatment, multiple satellite skin lesions and skin edema were observed.


Local findings. B; After chemotherapy, satellite skin lesions regressed markedly, but skin edema and pigmentation were still observed.


Local findings. C; After radiotherapy, slight skin pigmentation was still observed, but almost all of the satellite skin lesions had disappeared.


Local findings. D; Ten months after operation, a vertical rectus abdominis muscle flap covered the large skin defect and offered favorable cosmetic outcome.


Ultrasound images. A; Before treatment, marked skin thickening with obscured breast mass was observed.


Ultrasound images. B; After chemotherapy, although skin thickening was still observed, a marked shrinkage of the breast tumor (yellow arrow) was observed.


Ultrasound images. C; Before treatment, enlarged and oval axillary lymph nodes (white arrow) were observed.


Ultrasound images. D; After chemotherapy, markedly regressed lymph nodes (red arrow) were observed.


Pathological findings. A; Marked fibrosis and no viable cancer cells were observed on HE staining of the tumor (x40).


Pathological findings. B; Isolated and atypical cells were observed on cytokeratin AE1 + 3 staining (x100) of the skin near the nipple-areolar complex.


Microscopic findings and immunohistochemistry stains of initial lymph node FNA and subsequent needle-core biopsy. (A) Direct smear of lymph node FNA shows pleomorphic cells with scant sytoplasm and fine chromatin, presence of nucleoli was not detected.


Microscopic findings and immunohistochemistry stains of initial lymph node FNA and subsequent needle-core biopsy. (B) Routine hematoxylin and eosin staining of cell block visualizes numerous small cell populations with high nuclear to cytoplasmic ratio.


Microscopic findings and immunohistochemistry stains of initial lymph node FNA and subsequent needle-core biopsy. (C) Routine hematoxylin and eosin staining of needle-core biopsy shows populations of small pleomorphic cells.


Microscopic findings and immunohistochemistry stains of initial lymph node FNA and subsequent needle-core biopsy. (D) High magnification image of needle-core biopsy displays golden-brown coloration resembling that of melanin.


Microscopic findings and immunohistochemistry stains of initial lymph node FNA and subsequent needle-core biopsy. (E) Positive result for SOX10 staining, a biomarker for melanoma.


Microscopic findings and immunohistochemistry stains of initial lymph node FNA and subsequent needle-core biopsy. (F) Positive results for S100 staining, another biomarker for melanoma.


Image of left chest wall lesion.


CT of the chest and abdomen pre and post treatment with combination nibolumab and ipiliimumab. (A) Intrathoracic lymphadenopathy anf right lower lobe lung nodule.


CT of the chest and abdomen pre and post treatment with combination nibolumab and ipiliimumab. (B) Interval resolution of intrathoracic lymphadenopathy and right lower lung nodule.


CT of the chest and abdomen pre and post treatment with combination nibolumab and ipiliimumab. (C) Numerous hepatic metastasis and retroperitoneal lymphadenopathy with the largest hepatic lesion measuring 3.7 cm.


CT of the chest and abdomen pre and post treatment with combination nibolumab and ipiliimumab. (D) Resolution of retroperitoneal lymphadenopathy and marked interval decrease size of hepatic metastasis with lesion now measuring 1.7 cm.


Pathologic findings of the gastroscopy biopsy. (A and B) The high-medium differentiated adenocarcinoma showed that some glands were well structured with obvious cell atypia; some glands were cribriform with cell atypia (hematoxylin and eosin, original magnification from left to right was x100, x200).


Pathologic findings of the gastroscopy biopsy. (C) Immunohistochemistry of HER2 demonstrated completely negative staining in tumor cells (immunohistochemistry, original magnification x200).


Dynamic change curves of tumor markers in peripheral blood during immunotherapy. (A) The curves of CA-125 (carbohydrate antigen-125) showed that an increase in the related quantity at the beginning of immunotherapy, followed by a gradual decrease. The curves of CA-199 (carbohydrate antigen-199) were similar to . First of all, the gray dashed line represented the normal range in detail. The normal range of tumor markers was below the dashed line. More intuitively, tumor markers had fallen from high to low levels and had remained low, a phenomenon that reflected the effectiveness of combination therapy. In addition, the definition of the normal range is based on our hospital testing methods. Next, if the evaluation of the treatment effect is CR (complete response), the tumor markers are required to continue normally for more than 4 months.


Dynamic change curves of tumor markers in peripheral blood during immunotherapy.


Positron emission tomography-computed tomography demonstrated a hypermetabolic lesion (standardized uptake value, 12.8) in the interspace between the liver and stomach. There was no additional fludeoxyglucose (18F) uptake, which indicated a primary site in other organs.


Intraoperative fast pathological sections revealed that the tumor tissues were composed of nidulant, multi-mitotic cells and necrosis, which was reported as a squamous cell carcinoma. (Hematoxylin and eosin staining; magnification, x100).


Tumor cells were observed in the. Gastric serosa fibrous tissue.


Lamina muscularis.


Submucosa. (Hematoxylin and eosin staining; magnification, x100).


Strong expression of cytokeratin 5/6 observed via immunohistochemical staining. (Hematoxylin and eosin staining; magnification, x200).


Immunohistochemical staining identified p63 positivity in the tumor cells. (Hematoxylin and eosin staining; magnification, x200).


Immunohistochemical staining identified cytokeratin pan positivity in the tumor cells. (Hematoxylin and eosin staining; magnification, x200).


Positive glutathione S-transferase pi immunostaining was observed in the neoplastic cells. (Hematoxylin and eosin staining; magnification, x200).


Ki-67 proliferation index, ~50%. (Hematoxylin and eosin staining; magnification, x200).


CT-scan three years preoperative. The corticalis is
preserved. Within the lesion pseudo-trabeculation is visible.


T1-weighted MRI three years preoperative. Note that the
lesion presents with low signal intensity and no infiltration of the
surrounding tissue.


CT-scan 2 weeks before the operation. There is cortical breakthrough of the tumor. The size of the lesion has slightly increased in
comparison the previous CT-scan.


Intraoperative photograph showing the removed tissue. It
has a beige color and hard as well as soft areas of consistency.


CT-scan 6 months after the operation. No residual tumor is
present.


CT-scan 18 months after the operation. The bone graft is
well integrated in pelvic bone. No discontinuity of the cortical
bone. No recurrence of the tumor is present.


Transesophageal echocardiogram of the mass in the left atrium.


Tridimensional transesophageal echocardiogram of the mass in the left atrium.


Transesophageal echocardiogram of the mass in the right atrium.


Tridimensional transesophageal echocardiogram of the mass in the right atrium.


Transesophageal echocardiogram of the mass both in the right and left atria.


CT scan head.


T1-contrast enhanced MRI showing a left parietooccipital lesion with intraventricular extension. Both solid and cystic components can be appreciated with calcifications on the medial aspect.


(a-c) T1-contrast enhanced MRI head performed 6 months postoperatively suggestive of recurrent disease.


(a) Sagittal section T-2 MRI showing lesion at T5-T7 levels resulting in significant cord compression.


(b) Axial section T-2 MRI (with magnification tool of PACS) showing an intradural extra-medullary mass compressing the spinal cord.


The tumor cells are diffusely positive for GFAP immunostain (x 400).


Quantification of HPC marker-positive cancer cells in the primary tumor, tumor-invaded vessels, and metastatic nodules. In the primary lesion, the percentage of cancer cells that were EpCAM- or NCAM-positive was 5-10% and 10-20%, respectively. In the cancer-invaded blood vessels, both the ratio of the number of vessels invaded by specific HPC marker-positive cancer cells/the total number of vessels invaded by cancer cells and the ratio of the number of specific HPC marker-positive cancer cells in the vessel/the total number of cancer cells in the vessel were much higher than the corresponding ratios in the primary lesion. In the metastatic lesions, the frequency of EpCAM- or NCAM-positive cancer cells differed according to the tumor, and the bigger tumors tended to include HPC marker-positive cancer cells.


Anterior segment photo of the right eye showing conjunctival congestion, mid-dilated pupil, and iris neovascularization.


Ultrasonography showing a mushroom-shaped, elevated, solid lesion with regular internal structure and low to moderate internal reflectivity suggestive of choroidal melanoma.


Histopathology demonstrating choroid tissue infiltration by a tumour arranged in sheets and fascicles with elongated spindle-shaped vesicular nuclei with prominent nucleoli and abundant melanin pigment (hematoxylin and eosin, original magnification 300x).


Facial T2 FLAIR-weighted MRI. Hyperintensity located in the left temporal fossa corresponding to a perineural invasion of the trigeminal nerve (arrow).


Spine MRI. A; Sagittal plane: diffuse leptomeningeal pathological enhancement after gadolinium injection.


Spine MRI. B; Axial plane: abnormal medullary signal enhancement and left paravertebral invasion (arrow).


CSF examination using Cytospin. With May-Grunwald Giemsa staining. A; Many well-differentiated squamous cells are observed.


CSF examination using Cytospin. With May-Grunwald Giemsa staining. B; At higher enhancement (x50), few nuclear abnormalities were identified (arrow).


Chest CT and pelvic MRI before etoposide chemotherapy. Multiple nodules located in both sides of the lung.


Chest CT and pelvic MRI before etoposide chemotherapy. No visible recurrence shown on the pelvic MRI.


Histopathology of lung metastesis. Hematoxylin, and ,eosin staining (magnification: x200).


Histopathology of lung metastesis. Immunohistochemistry for 34betaE12 (magnification: x200).


Histopathology of lung metastesis. Immunohistochemistry for CK5/6 (magnification: x200).


Histopathology of lung metastesis. Immunohistochemistry for PSA (magnification: x200).


Chest CT and pelvic MRI after 5 circles etoposide chemotherapy. 80% decrease in size of measurable lung nodules.


Chest CT and pelvic MRI after 5 circles etoposide chemotherapy. No visible recurrence shown on the pelvic MRI.


CT scan of the lymphangioma (marked by open arrows) in right abdomen area. The mass is reaching the right side of abdomen wall, contacting abdominal aorta, vena cava and right common iliac artery, also ileocolic artery and vein.


A cystic lymph-filled tumor of about 12 cm in diameter on the ileum mesentery. Open arrows indicate lymphangioma, bold arrows indicate the cecum and the ascending colon.


The picture shows the third portion of the duodenum (bold arrow) and the ileocolic and superior mesenteric vessels (open arrows) after the removal of lymphangioma.


The picture shows milk-like fluid (open arrow) coming out of the lymphangioma. The fluid color is similar to milk due to the accumulation of lymphocytes.


Cystic tumor structures with lymphoid aggregates. 40x magnification hematoxylin and eosin.


Lining of tumor structures positive for podoplanin (D2-40). 100x magnification.


Multiple pulmonary nodules. Lesions indicated by arrows were confirmed in adjoining planes in the original CT scan to rule out that they might represent vessels.


(a) Scanned slide of lung biopsy obtained via bronchoscopy, stained with hematoxylin and eosin: Multiple well-defined rounded, strongly basophilic lesions in the lung parenchyma.


(b) Cytoplasmic positivity for chromogranin in part of neoplastic cells indicates neurosecretory character.


Left: 3D PET/CT Ga-68 DOTATATE showing moderate uptake in large pituitary lesion (SUV = 4.4). Right: Scintigraphy after Tc-99 HYNIC-octreotide showing no abnormal uptake in sellar region. The mild radiotracer uptake in the nasopharynx may be considered nonspecific.


MRI after enlargement of the lesion: Solid lobulated lesion with hyperintense components on T1 without gadolinium (hemorrhage).


On T2-weighted.


Heterogeneous enhancement on T1-weighted after gadolinium (c) with extension to both cavernous sinuses and right temporal lobe.


Abdominal CT revealed stenosis at the transition of the descending to sigmoid colon.


The progressive multiple lung shadows were detected with chest CT. Twelve days before admission.


The progressive multiple lung shadows were detected with chest CT. , on the 2nd hospital day.


The progressive multiple lung shadows were detected with chest CT. , 11th day.


The progressive multiple lung shadows were detected with chest CT. And 19th day.


Magnetic resonance imaging showing the left parotid gland mass in the coronal plane.


Node histology (x250) demonstrating necrotic tissue, an abundance of mitotic figures, and the impression of glandular architecture (H&E).


Photograph of the right fundus, with evidence of two uveal metastases.


Chest CT before disease progression.


When disease progression was first confirmed.


1 month after disease progression.


2 weeks after discontinuation of crizotinib.


5 weeks after discontinuation of crizotinib.


PET-CT scan of chest, abdomen, and pelvis. Coronal reformatted image obtained 90 min after IV administration of 14.0 mCi of F18-FDG demonstrating a solitary focus of intense activity noted within the cecum with a maximum standardized uptake value of 9.6 (denoted by the blue arrow). At the time, this was suspicious for a colonic primary tumor.


Abdominal CT image at admission with IV and oral contrast. Multiple contiguous axial images of the abdomen and pelvis were obtained following the administration of intravenous and oral contrast. The appendix is dilated to 1.8 cm with significant periappendiceal stranding and appendiceal wall thickening (blue arrow). Also in the right lower quadrant, either adjacent to or within the wall of the cecum, is a bowel mass measuring 2.3 x 1.9 x 2.3 cm, concerning for a malignancy (demonstrated by the red arrow).


Hematoxylin and eosin (H&E) stain at 40x magnification demonstrating the tumor from the colectomy specimen (green arrow) within the submucosa with an overlying, benign colonic mucosa (red arrow).


Magnetic resonance cholangiopancreatography indicated diffuse dilation of the intrahepatic bile duct and the common hepatic duct. A tumor is seen in the bile duct (arrow).


ERCP directly showed the mass spreading from the cystic duct to the upper-middle bile duct (arrows).


Intraoperative picture after resection of the extrahepatic bile duct including the intrapancreatic bile duct.


Macroscopically, a papillary proliferated tumor is originated from the cystic duct.


A - Note the capsular thickening and ill-formed vascular channels (H & E x
100).


B - Immunohistochemistry with anti-HHV8-LANA1 showing nuclear positivity in
spindle cells and in the endothelial cells lining the vascular channels.


Esophagoscopy showing a polypoidal mass lesion arising at 32 cm from incisors. Black pigmentation is visible at the base.


Contrast enhanced CT scan showing a polypoidal mass in the esophagus with no regional lymphadenopathy and maintained planes with adjacent structures.


Timeline of the case history.


Hisopathological and immunohistochemical examinations. (A) 100 times. Dense eosinophilic cytoplasm, with red staining and large obvious nucleous.


Hisopathological and immunohistochemical examinations. (B) 200 times. Large cell with abundant eosinophilic cytoplasm and a large hyperchromatic nucleus with a prominent nucleolus, obvious nuclear heteromorphism, and visible mitotic strutures.


Hisopathological and immunohistochemical examinations. (C) 400 times.


Hisopathological and immunohistochemical examinations. (D) The positive rate of Ki67 is 70.


Hisopathological and immunohistochemical examinations. (E) TTF-I positive.


Hisopathological and immunohistochemical examinations. (F) CK19 negative.


Hisopathological and immunohistochemical examinations. (G) TG negative.


Hisopathological and immunohistochemical examinations. (H) PCK focal positive.


Hisopathological and immunohistochemical examinations. (I) P53 part positive.


Pathological results of the resected bowel deposit. . Notes: (A) The postoperative gross specimen showed a circumferential lesion located in the small intestine measuring about 2.5x2x1.5 cm and causing the proximal bowel dilation. The cut surface of the tumor is grayish white, solid, and hard.


Pathological results of the resected bowel deposit. (B) Hematoxylin-eosin stained section revealed submucous invasion of cancer cells (original magnification: 100x).


Pathological results of the resected bowel deposit. (C) Hematoxylin-eosin stained section documented neoplastic cells infiltrated muscular layer exhibiting nest-like pattern (original magnification: 200x).


IHC results suggestive of bowel metastasis of BC origin (upper left part: normal intestinal mucosa; lower right part: tumor infiltrating part. ). Notes: (A-C) ER, GCDFP-15, and CA153 were intensively positive for tumor cells (original magnification: 100x).


IHC results suggestive of bowel metastasis of BC origin (upper left part: normal intestinal mucosa; lower right part: tumor infiltrating part.


IHC results suggestive of bowel metastasis of BC origin (upper left part: normal intestinal mucosa; lower right part: tumor infiltrating part. CK7 was partly positive for tumor cells (original magnification: 100x) while. CK20, Villin, and PR were negative for neoplastic cells (original magnification: 100x).


IHC results suggestive of bowel metastasis of BC origin (upper left part: normal intestinal mucosa; lower right part: tumor infiltrating part. (H) Ki-67 expressed in the nuclei of ~10% of tumor cells (original magnification: 100x). . Abbreviations: BC, breast cancer; ER, estrogen receptor; IHC, immunohistochemistry; PR, progesterone receptor.


Selective cranial MRI scan images of skull involvement. . Notes: (A, B) Head MRI of July 2016 revealed multiple bone destruction in left frontal bone, temporal bone, and lateral orbital wall.


Selective cranial MRI scan images of skull involvement. (C, D) In January 2018, the skull metastasis progressed with obvious localized soft tissue lesions.


Pre-operative.


Excised tissue.


Post-operative.


Pre-operative (lateral view).


After excision.


Periodontal dressing.


Histopathologic slide.


Coronal plane magnetic resonance imaging of the face shows a large tumor that fills the left maxillary sinus and invades the nasal cavity, face, and orbit, displacing the left globe.


Pleural fluid smears showing (a) numerous malignant cells arranging singly and in small aggregates (Papanicolaou, x4).


The malignant cells exhibit eccentrically located nuclei with fine chromatin, and ,nucleoli (Papanicolaou, x40).


(Diff-Quick, x20).


Timeline. Abbreviations: 18FDG, 18-fluordeoxyglucose; CT, computed tomography; VATS, video assisted thoracic surgery; 18FDG-PET-CT, 18-fluordeoxyglucose positron emission tomography-computed tomography; EBUS-TBNA, endobronchial ultrasound with transbronchial needle aspiration; MRI, magnetic resonance imaging.


Brain magnestic resonance imaging in March 2014. T1-weighted image after gadolinium of the brain shows a small right frontal enhancing cerebral lesion.


Skin biopsy with presence of fungal hyphae. Periodic Acid Schiff stain on skin biopsy with fungal hyphae stained purple. Two fungal hyphae with dichotomous branching (diagnostic of Aspergillus) are depicted (arrows).


Cerebral biopsy with presence of fungal hyphae. Hematoxylin and eosin stain on cerebral biopsy showing nectrotic tissue with moderate numbers of septate fungal hyphae with parallel walls. Two fungal hyphae with dichotomous branching (diagnostic of Aspergillus) are depicted (arrows).


Axial CT and PET/CT imaging of the proximal tibial lesion. A; Axial CT imaging shows medial cortical destruction and a large soft tissue mass containing areas of fat attenuation (white arrowheads) and ossification (black arrows).


Axial CT and PET/CT imaging of the proximal tibial lesion. B; A coronal fused PET/CT image shows there is marked FDG uptake in the proximal tibial tumour as well as in a lateral distal femoral metastasis (white arrow). No other lipomatous lesion or tumour is present.


Histological analysis of the proximal tibial lesion shows primary pleomorphic liposarcoma of bone. A; The tumor infiltrates cancellous bone and is composed of numerous lipoblasts and large pleomorphic cells, which have vacuolated cytoplasm and atypical nuclei.


Histological analysis of the proximal tibial lesion shows primary pleomorphic liposarcoma of bone. B; Lipoblasts and brown fat-like cells are seen within the tumour.


Histological analysis of the proximal tibial lesion shows primary pleomorphic liposarcoma of bone. Immunohistochemistry shows the tumor cells express FABP4/aP2.


Histological analysis of the proximal tibial lesion shows primary pleomorphic liposarcoma of bone. And UCP1.


Post-resection AP plain radiograph demonstrates a Stanmore prosthesis with integral distal femur and modular proximal tibial component.


CT-scan showing a bilateral heterogeneous mass of about 6 cm in diameter in both adrenal glands.


CT-scan at the end of chemotherapy treatment showing complete response.


Clinical presentation of NEC and SCC. Esophagogastroduodenoscopy and CT findings in NEC (A,B). (A) A large ulcerated mass was found in the esophagogastric junction.


Clinical presentation of NEC and SCC. Esophagogastroduodenoscopy and CT findings in NEC (A,B). (B) CT imaging reveals para-aortic lymph node swelling (yellow arrow).


Clinical presentation of NEC and SCC. Esophagogastroduodenoscopy and CT findings in SCC (C,D). (C) A tiny, red-colored mucosal area in the center of the cicatrized lesion (white arrow).


Clinical presentation of NEC and SCC. Esophagogastroduodenoscopy and CT findings in SCC (C,D). (D) CT imaging shows no distant metastasis after the chemotherapy for NEC.


Clinical presentation of NEC and SCC. (E) Macroscopic findings for the resected specimen. No other regional/distant metastasis can be seen in the resected specimen.


Clinical presentation of NEC and SCC. (F) An ulcerated mass at the esophagogastric junction can be observed in the resected specimen (white arrow). NEC, neuroendocrine carcinoma; SCC, squamous cell carcinoma; CT, computed tomography.


Histological evaluation of NEC and SCC. Hematoxylin and eosin, and immunohistochemical staining of the biopsy (NEC;. E staining.


Histological evaluation of NEC and SCC. Hematoxylin and eosin, and immunohistochemical staining of the biopsy (NEC;. Synaptophysin.


Histological evaluation of NEC and SCC. Hematoxylin and eosin, and immunohistochemical staining of the biopsy (NEC;. CD56.


Histological evaluation of NEC and SCC. Hematoxylin and eosin, and immunohistochemical staining of the biopsy (NEC;. MIB-1.


Histological evaluation of NEC and SCC. Hematoxylin and eosin, and immunohistochemical staining of the biopsy (NEC;. P53. NEC, neuroendocrine carcinoma; SCC, squamous cell carcinoma; H-E, hematoxylin and eosin.


Histological evaluation of NEC and SCC. And surgically resected specimen (SCC.


Histological evaluation of NEC and SCC. And surgically resected specimen (SCC;. Synaptophysin.


Histological evaluation of NEC and SCC. And surgically resected specimen (SCC;. CD56. NEC, neuroendocrine carcinoma; SCC, squamous cell carcinoma; H-E, hematoxylin and eosin.


Histological evaluation of NEC and SCC. And surgically resected specimen (SCC;. P53.


Histological evaluation of NEC and SCC. CK5/6. Scale bars; 50 mum.


Whole-body bone scan reveals increase uptake in T8-T9, left femur, left knee, and left ankle.


The thyroid scintigraphy with technetium-99m showed a large cold nodule in the left lobe of the thyroid gland.


Follicular thyroid carcinoma invasion to the tumor capsule vessels.


Whole-body scan after 150 micg of iodine 131, intake was indicative of extensive bone metastases.


Abdominal CT - coronal reconstruction - showing the mass.


Abdominal cavity after resection.


(A and B) Axial post contrast CT images at the level of brainstem show thickened and enhancing cisternal segment of left oculomotor (white arrow) and bilateral trigeminal nerves (black arrows).


(A and B) PET scan images show absence of uptake elsewhere in the body, ruling out the possibility of metastatic cranial neuropathy.


Low power microscopy (x10) image showing diffuse proliferation of small round lymphoid cells having monotonous appearance with few intermediate to large cells infiltrating neural tissue.


Axial.


Sagittal. CT scans of the whole abdomen included the pelvis with IV contrast injection demonstrated a large heterogenous enhancing mass, 5.3x6.2 cm in size with internal calcification in the urinary bladder.


Coronal. CT scan of the abdomen/pelvis with IV contrast injection, demonstrated a new left cardiophrenic lymph node enlargement.


Thyroid mass with active bleeding.


Raw area following thyroidectomy covered with skin graft.


(A) Sonographic examination of the right axilla revealed an irregularly shaped hypoechoic mass with unclear borders and uneven internal echoes.


Color Doppler ultrasonography. Depicted spot-like blood flow signals around the mass.


Pathology of the low-grade adenosquamous carcinoma. In photomicrography (original magnification x100) scattered small glandular ducts and nests of squamous differentiated cells were evident in the sclerosing stroma. The glands were elongated, with angulated (red arrow), comma shaped (green arrow), or polliwog-shaped (yellow arrow) appearances in a disordered infiltrative pattern. The nests of squamous cells (black arrow) were mostly solid bands, and some of them formed keratocysts, of various sizes. Mitosis was rare. Peripheral lymphocyte proliferation (blue arrow) and multinucleated giant cell responses were evident in the periphery.


Immunohistochemistry staining of the low-grade adenosquamous carcinoma (original magnification x100) revealed positive expression of p63.


Weakly positive expression of estrogen receptor.


Low expression of Ki-67.


No expression of progesterone receptor.


Or human epidermal growth factor receptor 2.


Light microscopy image of malignant melanoma (hematoxylin and eosin stain; magnification, x100).


Light microscopy image of papillary thyroid carcinoma (hematoxylin and eosin stain; magnification, x200).


(a) Gross specimen showing nodular enlargement of thyroid with blackish discoloration of the right lobe.


(b) Microscopic features showing polygonal to spindle cells, in an organoid pattern with clumped chromatin, abundant cytoplasm, and areas of necrosis, focal hemorrhage, copious extracellular brownish black melanin pigment (arrow).


(c) Immunohistochemistry right lobe shows tumor cells with brownish-black pigment showing strong cytoplasmic positivity with HMB45.


(d) Immunohistochemistry left lobe shows tumor cells with brownish-black pigment showing strong cytoplasmic positivity with calcitonin.


Coronal and axial section of fluorine-18 fluorodeoxyglucose positron emission tomography/computed tomography showing intensely hypermetabolic hypo dense intraluminal filling defect right internal jugular vein, external jugular vein, subclavian vein confluencing at the right innominate vein with inferior extension into superior vena cava (arrow) and a small metabolically active pretracheal lymph node (dotted arrow).


Coronal fluorine-18 fluorodeoxyglucose positron emission tomography/computed tomography postradiotherapy showing complete metabolic regression in the intravascular tumor (arrow) with significant reduction in the tumor thrombus load and better contrast passage through the superior vena cava (dotted arrow).


Color Doppler of the neck showing grossly shrunken thrombus in the right internal jugular vein with absent flow (arrow) and normal flow through the left innominate vein (dotted arrow).


Coronal and sagittal contrast computed tomography chest showing hypodense filling defect in the right internal jugular vein reduced in extent with tiny calcifications, suggesting chronic thrombus (arrows), and patent left innominate vein filled with contrast streaking past the thrombus into superior vena cava (dotted arrows).


Fungating mass of approximately 15x15 cm noted at the left heel appreciated via lateral view.


Inferior view.


Foot X-ray in anteroposterior view.


Oblique view. Showing lesion in the lateral posterior calcaneus with surrounding large irregular soft tissue radiopacity/mass. There was no bone resorption that may suggest osteomyelitis.


Photomicrograph of histopathologic specimen at low power reveals infiltration of tumor into deep dermis.


At high power. Shows infiltrating islands of well-differentiated neoplasm and squamous epithelium within dermis.


A 43-year-old man presented with porta hepatis inflammatory myofibroblastic tumor who presented with painless jaundice and pruritis. Axial pre-contrast CT image.


A 43-year-old man presented with porta hepatis inflammatory myofibroblastic tumor who presented with painless jaundice and pruritis. Axial post-contrast CT image in arterial phase.


A 43-year-old man presented with porta hepatis inflammatory myofibroblastic tumor who presented with painless jaundice and pruritis. Axial post-contrast CT image in porto venous phase, and . Axial post-contrast CT image in delayed phase show a heterogeneously enhancing mass at the porta hepatis [black arrow in.


A 43-year-old man presented with porta hepatis inflammatory myofibroblastic tumor who presented with painless jaundice and pruritis.


A 43-year-old man presented with porta hepatis inflammatory myofibroblastic tumor who presented with painless jaundice and pruritis. (e) Sagittal reformatted post-contrast CT image shows the mass compressing the common bile duct with upstream biliary dilatation. No vascular invasion was identified. The pancreas and liver were normal.


A 43-year-old man presented with porta hepatis inflammatory myofibroblastic tumor who presented with painless jaundice and pruritis. MRCP image shows diffuse dilatation of the intrahepatic biliary radicles and proximal common bile duct (CBD) with narrowing noted at the middle third of the CBD.


A 43-year-old man presented with porta hepatis inflammatory myofibroblastic tumor who presented with painless jaundice and pruritis. Axial pre contrast MR image.


A 43-year-old man presented with porta hepatis inflammatory myofibroblastic tumor who presented with painless jaundice and pruritis. Axial post-contrast MR image in the arterial phase.


A 43-year-old man presented with porta hepatis inflammatory myofibroblastic tumor who presented with painless jaundice and pruritis. Axial post-contrast MR image in porto venous phase.


A 43-year-old man presented with porta hepatis inflammatory myofibroblastic tumor who presented with painless jaundice and pruritis. Axial post-contrast MR image in delayed phase show a heterogeneously enhancing mass at the porta hepatis. The mass is of intermediate T1 signal intensity with no fat component. The mass shows mild arterial enhancement with progressive enhancement throughout the delayed phases [thin white arrow.


A 43-year-old man presented with porta hepatis inflammatory myofibroblastic tumor who presented with painless jaundice and pruritis. Axial DWI image.


A 43-year-old man presented with porta hepatis inflammatory myofibroblastic tumor who presented with painless jaundice and pruritis. Corresponding axial ADC image show mild diffusion restriction [bold arrow]. No vascular invasion was identified.


A 43-year-old man presented with porta hepatis inflammatory myofibroblastic tumor who presented with painless jaundice and pruritis. (a) ERCP image after cannulation of the common bile duct (CBD) shows stricture at the middle third of the CBD with subsequent proximal CBD and intrahepatic biliary radicles diffuse.


A 43-year-old man presented with porta hepatis inflammatory myofibroblastic tumor who presented with painless jaundice and pruritis. (b) ERCP image after stent placement.


Chest CT image on initial presentation (10 years before the onset of Budd-Chiari syndrome) showing an anterior mediastinal tumor mass with a low-density area. The pathological diagnosis was invasive thymoma (type B2). She underwent systemic chemotherapy (CAMP therapy) followed by total thymectomy at that time. CT, computed tomography.


Abdominal CT image on the first visit to our hospital showing a large right hepatic mass of irregular density with indistinct borders. Abundant ascites was also detected.


Ulcer involving the left posterior lateral border of the tongue and lingual vestibule.


A; Tumor cells were positive for AFP, which was mainly expressed in the cytoplasm of tumor cells (x70).


B; Tumor cells were positive for CEA, which was mainly expressed in the apical surfaces of tumor cells (x70).


C; CDX2 was expressed strongly in the tumor cell nuclei (x70).


D; CD10 was positive in the luminal surfaces in some tumor cells (x140).


Imaging examination results. (A) The yellow arrows indicate the enlarged right cervical lymph nodes, which were suspicious for metastasis.


Imaging examination results. (B) CT showed an oval mass with low attenuation in the right lobe of the thyroid and a round nodule with discontinuous peripheral annular calcification. (The yellow arrow indicates the tumor; the green arrow indicates the tumor focally broke into the nodule below and caused the interruption of the annular calcification; the red arrow indicates airway deviation caused by tumor compression).


Imaging examination results. (C) The yellow arrow indicates the left lobe of the thyroid gland; the red arrow indicates airway deviation caused by tumor compression; the green arrow indicates a nodule with interruption of the annular calcification. . Abbreviation: CT, computed tomography.


CT showing hypodense mass occupying right thyroid gland, across the isthmus to the left thyroid lobe with a ring calcification feature on right lobe.


Cohesive malignant cells arranged in sheets, nests, cords, islands and trabeculae pattern [4x, hematoxylin and eosin (HE)]. These malignant cells exhibit large, pleomorphic, hyperchromatic to vesicular nuclei with large prominent eosinophilic nucleoli and abundant eosinophilic cytoplasm.


Features of keratin pearls and intercellular bridges. (40x, HE).


T1-weighted imaging after gadolinium administration revealed a tumor with irregular ring-enhancement in the right temporoparietal region. Axial.


Sagittal).


(c) Axial fluid-attenuated inversion recovery imaging revealed the tumor accompanied extensive perifocal edema.


Contrast-enhanced computed tomography revealed multiple hypodense lesions at the head of the pancreas.


Para-aortic lymph nodes enlargement , as indicated the arrows.


(a) Microscope analysis revealed the tumor to be a moderately differenciated tubular adenocarcinoma surrounded by an extracellular matrix (H and E, x200). (b) Immunohistochemical stains showed that the tumor cells were positive for cytokeratin-7 (x200).


An MRI of the brain, T2 W images, axial.


Coronal view Clearly visible in the right portion of the pons is a hyperintense area (white arrows), according to pathologic findings (mucormycosis localisation).


The cerebral parenchyma showed red neurons typically observed in early ischaemic damage (20x original magnification HE staining).


Front picture of the mastectomy.


Left side of the body.


Plaques of the skin.


(a) Computerized Tomography section showing enlarged perigastric lymph nodes.


(b) PET scan showing intense uptake in primary gastric lesion.


Gross appearance of the schwannoma on cut section.


H&E appearance of the tumor. Photomicrographs of the microscopic appearance of the tumors were taken at 100X magnification.


Tumor positively staining for S100.


Cut Section of the uterus showing a polypoidal growth arising from endometrium, 5.0x4.5 cm with areas of hemorrhage. Myometrium is thickened and multiple calcifications are present. Ovaries are multicystic.


Endometrial stromal cells positive for CD-10 stain (internal control).


CD 10 positvity focally in tumor cels.


Completely excised right adrenal gland with the mass.


Histologic appearance of clear cell renal cell carcinoma on hematoxylin and eosin stain showing polygonal cells with marked clear cytoplasm and medium-sized nuclei with prominent nucleoli arranged in sheets and tiny clusters.


A well-defined nodule (4.0 x 3.8 cm) of HCC in S5 of the liver (case 1). A; Before it ruptured (arrow).


A well-defined nodule (4.0 x 3.8 cm) of HCC in S5 of the liver (case 1). B; After it ruptured and embolized (arrow).


The peritoneal recurrence (5.6 x 5.3 cm) found by a CT scan (case 1).


Photomicrograph of thrombosis of a pelvic vein (Masson's trichrome staining: 200 X).


Macroscopic examination of the thrombosis of the pudendal plexus sample in three different regions of the plexus.


In A, residual papillary structure of epithelium with multilayer cores (EE: 200X, in B higher magnification EE: 1000X), with evidence of moderate nuclear atypia. In C (periodic acid-Schiff stain, 32X) and D (Alcian blue pH 2.5,100X), high amount of mucus tightly fixed to the internal surface of neoformation.


Clinical examination showing his black teeth with enhancing accumulations of plaque calculus. No abnormal protuberance in gingival cheek groove.


The panoramic radiography of the jaw was normal.


The mandibular computerized tomography scan showing destruction in the body of mandibular bone and a mass in the surrounding soft tissue.


Positron emission tomography combined with computed tomography from the cerebellum to the upper thighs showing increased uptake in the mandibular bone body especially in the left mandible. No abnormal uptake in distant sites.


Histopathological examination of the biopsy specimen showing infiltration of carcinoma cells with nest-like distribution. The carcinoma cells, round and oval in shape and most in mitosis, were abundant of cytoplasm [H&E. 40x.


Histopathological examination of the biopsy specimen showing infiltration of carcinoma cells with nest-like distribution. 100x.


The patient's laboratory and treatment diary.


Stable scattered less than 4 mm micronodules, left upper lobe.


Stable perifissural mass in the right middle lobe.


The primitive neuroectodermal tumor with strong immunoreactivity for CD99, vimentin, and CK5 markers.


The primitive neuroectodermal tumor with strong immunoreactivity for CD99.


Computed tomography (CT) scans show (A) prior treatment of the lung tumor.


(B) Cisplatin+cyclophosphamide regimen after chemotherapy.


(C) Pemetrexed combined with cisplatin regimen after chemotherapy.


(D) Intestinal obstruction after pemetrexed combined with cisplatin regimen.


(A) Hematoxylin and eosin (H&E) staining revealed adenocarcinoma (H&E x100).


Immunohistochemical (IHC) analysis revealed that the lung tumor cells were positive for Napsin A.


TTF-1. (H&E x100).


Computed tomography (CT) scan shows (A) postoperative intestinal obstruction and crizotinib before treatment.


(B) Two months after crizotinib treatment.


(C) Disease progression after 7 months of crizotinib treatment.


Schema shows tumor with drivers of ROS1 gene positive by RT-PCR. Purple, brown, and orange represent the sample, positive control, and negative control, respectively. . Abbreviation: RT-PCR, real-time PCR.


50-year-old female patient with invasive lobular breast carcinoma metastasized to the urinary bladder. Contrast-enhanced MRI image of the pelvis with axial reconstruction demonstrating hyper-dense segmental urinary bladder wall thickening involving posterior wall of the bladder.


50-year-old female patient with invasive lobular breast carcinoma metastatic to the urinary bladder. Contrast Enhanced MRI image of the pelvis, sagittal reconstruction demonstrating: thickening of posterior urinary bladder wall.


50-year-old female patient with invasive lobular breast carcinoma metastatic to the urinary bladder. Contrast Enhanced MRI image of the pelvis, axial reconstruction demonstrating: bilateral hydronephrosis.


Thyroid scan showing no uptake in the thyroid gland, but increased uptake in the right ovary.


Mature teratoma adjacent to tumor.


Case 1 - A 22 year-old male patient with chronic back pain. X-ray lumbosacral spine lateral view.


Medical image.


Axial computed tomography scan image showing osteolytic lesion at L3 vertebra. Magnetic resonance imaging T2-weighted axial and sagittal showing hyper intense lesion with multilobulated cavity filled with fluid.


Case 1 -. Postoperative X-ray lumbosacral spine anteroposterior, and ,lateral views showing well placed cement.


Computed tomography scan on followup showing placement of cement.


(A, B) Magnetic resonance imaging scan of abdomen revealed a large well-defined suprarenal mass that measured 12x10x8.3 cm displacing the right kidney inferiorly and inferior the right lobe of liver and close to the porta hepatis, with evidence of cystic changes, fatty component, and calcification.


Histopathology of the recurrent tumor revealed heterogeneous mature elements including. Epidermal cyst lined by mature keratinized squamous epithelium, and ,filled with keratinous debris (H&E, 4x).


Dermoid cyst lined by benign squamous epithelium surrounded by mature fibroadipose tissue with embedded adnexal glands (H&E, 4x).


A, b Control chest CT scans performed 30 days after admission show response to voriconazole.


Computed tomography at the first presentation showing a 5-cm massive pulmonary tumor in the left upper lobe and multiple nodules in both lung fields. Mediastinal window.


Computed tomography at the first presentation showing a 5-cm massive pulmonary tumor in the left upper lobe and multiple nodules in both lung fields. Pulmonary window.


(A) Histological examination of lung biopsy specimens obtained from the left pulmonary mass revealing proliferation of polyhedral and spindle atypical cells.


(B) PD-L1 tumor proportion score was detected by Burning Rock Dx.


Chest CT images obtained after one course of chemotherapy.


Chest CT images obtained after 2 weeks.


6 weeks.


10 weeks. In a patient who received single camrelizumab (PD1 monoclonal antibody) treatment.


The expression of EGFR2 was detected by IHC before.


After. Apatinib treatment. (100x).


Contrast enhanced computed tomography of abdomen of the patient showing a periampullary mass (yellow arrow) with ascites (red arrow) and dilated intrahepatic biliary radicles.


Patient photos. . Notes: (A) Two years ago, normal skin color.


Patient photos. (B) Before treatment.


Patient photos. (C) After treatment.


The patient's chest X-ray. . Notes: (A) Before treatment, nearly normal.


The patient's chest X-ray. (B) After treatment. The arrow represents the minimal enlargement of mediastinal lymph node.


Patient's chest computed tomography (CT). . Notes: (A and C) Before treatment.


Patient's chest computed tomography (CT). (B and D) After treatment. The arrows represent the minimal enlargement of mediastinal lymph node.


Biopsy images. . Notes: (A) EBUS-FNA for mediastinal subcarinal lymph node: cytological appearance of nonkeratinizing squamous cell carcinoma. Sheets of atypical squamous cells with large hyperchromatic nucleus, dense squamoid cytoplasm, and moderate pleomorphism are observed (MGG stain, original magnification x400).


Biopsy images. (B) A cell block section of tumor displaying few small atypical small squamous islands and scattered lymphocytes showing crushing artifact in a fibrinous background (H&E stain, original magnification x400).


Biopsy images. Cell block immunohistochemistry of the tumor: tumor cells display strong nuclear p63.


Biopsy images. Cytoplasmic cytokeratin 5/6. Positivities, which are characteristics for squamous cell carcinoma. . Abbreviations: EBUS-FNA, endobronchial ultrasound-guided transbronchial fine-needle aspiration; MGG, May-Grunwald-Giemsa; H&E, hematoxylin and eosin.


The lesion manifests epidermal acanthosis and papillomatosis with increased deposition of melanin pigment along the epidermal basal layer (H&E stain, original magnification x46). . Abbreviation: H&E, hematoxylin and eosin.


The patient's hands. . Notes: (A) Before treatment, tripe palms.


The patient's hands. (B) After treatment.


Enhanced CT examinations revealed a mass of inhomogeneous shadow located in the left main bronchus close to the carina as shown by the arrows.


Bronchoscopy examination revealed a left main bronchus embolism by a sarcomatoid mass.


T2-weighted magnetic resonance imaging (MRI) showed irregular pancreatic mass measuring 105 mm in the maximum diameter.


(A) Histological findings revealed a pancreatic squamous cell carcinoma (SCC) with abundant eosinophilic cytoplasm and large vesicular nucleus. (HE x 200).


(B) Immunohistochemical staining of PD-L1 expression. Original magnification, x200.


(C) T2-weighted magnetic resonance imaging (MRI) showed the mass decreased to 55 mm in the maximum diameter.


(D) T2-weighted magnetic resonance imaging (MRI) showed the mass measured 16mm after 2 cycles of intra-arterial chemotherapy.


Contrast enhanced computed tomography image of the abdomen: 5.5 cm x 4.4 cm sized well encapsulated inhomogeneous mass (arrow heads) with central areas of necrosis in the upper pole of right kidney.


Microscopic examination of right nephrectomy specimen follicular cells suggesting metastatic deposits from thyroid malignancy or a rare primary renal tumor (thyroid like follicular carcinoma of the kidney) inset: Immunohistochemistry performed showed that the cells were strongly positive for pan-cytokeratin, thyroid transcription factor-1, thyroglobulin (as shown in figure), suggesting metastatic deposits from thyroid malignancy.


Ultrasound of neck revealed bilateral hypoechoic nodules with peripheral rim of egg-shell calcifications (left lobe nodule is shown).


Fluorodeoxyglucose positron emission tomography-computed tomography maximum intensity projection image shows a hypermetabolic lesion in the thyroid and left acetabular region. Transaxial fused 18F-fluorodeoxyglucose positron emission tomography-computed tomography image shows hypermetabolic calcified nodule (black arrow) in the left lobe of thyroid gland with maximum standardized uptake value of 12.6 (arrow) and hypermetabolic lytic lesion in left acetabulum with maximum standardized uptake value of 9.5 (arrow).


Histopathology image of thyroidectomy specimen revealed features consistent with follicular variant of papillary thyroid carcinoma with vascular invasion.


Simulation imaging.


First fraction positioning imaging. (red: GTV, green: gating boundary, yellow: small bowel loops).


Target lesion is not visible and dose distribution is inconsistent (right, 95% isodose level in red colorwash).


Beam on time and total delivery time (primary axis, in min) for each following adapted treatment fraction reported against achieved PTV coverage (secondary axis, in PTV V95%).


Large expansile tumor mass with thinned out cortex in the anterior end of fourth rib noted on computed tomography scan.


Diffuse meningeal enhancement on MRI of the brain - transverse view.


Diffuse meningeal enhancement on MRI of the brain - coronal view.


Patient #1. Thoracic CT scan documenting micronodules in the right and left lungs (lower lobes). Arrows indicate secondary lesions.


Lung wedge resection of patient #2 showing positive staining for PSA. Original magnification x200.


Thoracic CT scan (patient #3) exhibiting bilateral nodes. Arrow indicates lesion in the left lung (apical segment of the lower lobe) and right lung (anterior segment of the lower lobe).


Abdomen-pelvis CT scan showing left renal mass encroaching the left renal vein. . Notes: Metastatic deposits in the liver are also present. The red arrow points to the carcinoma in the left kidney.


Abdomen-pelvis CT scan showing metastasis in left lung base. . Notes: The red arrow points to a mass in the left lung- which is the metastasis from the kidney.


Computerized tomography scans before and after immunotherapy in Case #1 Initial CT scan showing large left sided renal mass in April of 2019.


Compared to CT scan in March of 2020. Showing substantially decreased mass.


Representative pathologic images from Case #1 Hematoxylin and eosin (H&E) stained slides at low-power.


High-power. Magnification showing extensive hyalinized fibrosis with scattered chronic inflammation and hemosiderin laden macrophages in the area of tumor regression.


The fibrosis extends into the adjacent fibroadipose tissue (C).


Chronic tubulointerstitial nephritis and globally sclerosed glomeruli are present in the adjacent residual benign renal parenchyma (D).


Computerized tomography scans before and after immunotherapy in Case #2 Initial CT scan in July of 2018 showing large right renal mass.


Pulmonary metastases.


Compared to CT scan in December of 2019 showing substantially decreased mass.


Resolution of pulmonary metastases.


Representative pathologic images from Case #2 H&E stained slides at low-power.


High-power. Magnification showing a massive infiltration of chronic inflammatory cells and foamy macrophages in the area of tumor regression.


Areas of tumor regression also showed necrotizing granulomatous inflammation (C).


Chronic tubulointerstitial nephritis, globally sclerosed glomeruli, and hemosiderin laden macrophages are present in the adjacent residual benign renal parenchyma (D).


MR imagings show a lobulated soft tissue mass from T3 to T5 which extended to the epidural space. There are destructive changes around adjacent bony structures by this mass. T2 weighted image.


MR imagings show a lobulated soft tissue mass from T3 to T5 which extended to the epidural space. . T1 weighted image.


MR imagings show a lobulated soft tissue mass from T3 to T5 which extended to the epidural space. . Gd-enhanced image).


A : Gross finding. The resected specimen shows lobulated grayish-white cartilaginous mass with myxoid and cystic change.


B : Microscopic finding. The tumor shows bimorphic pattern consisting of low grade chondrosarcoma (on the right) juxataposed of high-grade spindle cell sarcoma (on the left) (hematoxylin eosin stain, x200).


(A) CT scan of the neck with contrast. Calcification in the left infrahyoid carotid space possibly calcified lymph nodes.


(B) Neck ultrasound. Nodes with calcifications in the left parajugular region (level 3).


Biopsy pathology and IHC examination. (A) Thoracoscopic photography. Multiple nodular lesions were found in right pleural cavity under thoracoscopy.


Biopsy pathology and IHC examination. (B) Histopathological examination (H&E). The pleural tissue showed neoplasia, large nuclei, deep staining, and strong heterogeneity, which was similar to sarcoma.


Biopsy pathology and IHC examination. (C) IHC, DAB staining. It showed positive CK67 staining in tumor tissue.


Biopsy pathology and IHC examination. (D) IHC, DAB staining. It showed strong positive EML4-ALK staining in tumor tissue. . Abbreviation: IHC, immunohistochemistry.


This T1-weighted axial magnetic resonance imaging scan with gadolinium contrast shows a homogeneously enhancing lesion involving the posterior corpus callosum and internal capsule crossing midline. A biopsy with varioguide showed WHO grade IV glioblastoma multiforme.


This T2-weighted sagittal magnetic resonance imaging scan demonstrates prominent vessels in the anterior cervical spinal cord.


Injection of the left subclavian artery demonstrates a large venous varix at the C5-C6 levels within the region of the left neuroforamina. The venous drainage is into the anterior spinal vein.


An ultraflow microcatheter was used to catheterize a branch of the left thyrocervical artery. Hand injection angiography shows the feeder and venous varices that were seen on the prior angiogram, which were then embolized with 0.3 mL of Onyx-34.


In the delayed phase minimal venous drainage into the varices is present, filled from tiny collaterals too small to individually catheterize.


Photographs 4 months after treatment showed red depigmented fundus in both eyes.


A; Macroscopic appearance of the parotid tumor resected.


B; In the low-power view, the nodule was comprised of hyaline tissue with nests of tumor cells.


C; As cellular contents, high-grade carcinoma with a cribriform growth pattern and comedo-like necrosis (dotted line) and slit-like tubular epithelium with myoepithelium (arrows) were identified.


D; Histological diagnosis of resected lymph nodes was SDC with comedo-like necrosis.


A; A thoracic CT scan revealed multiple bilateral pulmonary metastases (arrows).


B; After 4 cycles of chemotherapy with paclitaxel and trastuzumab, a CR of all pulmonary metastatic lesions was observed.


Initial histology and CT findings. . Notes: (A) Microphotograph of adenocarcinoma, acinopapillary subtype. H&E staining, magnification x40.


Initial histology and CT findings. (B) Axial CT in lung window with solitary nodule in left upper lobe (arrow).


Initial histology and CT findings. (C) Axial CT of abdomen shows solitary liver metastasis (arrow) close to ablation zone in eighth segment.


Initial histology and CT findings. (D) Follow-up CT revealed multiple liver metastases (arrowheads).


Subsequent CT findings. . Notes: (A) Follow-up CT after 2 months' treatment shows only two small liver metastases (arrowheads).


Subsequent CT findings. (B and C) Follow-up CTs of abdomen and thorax from March 2009 show no metastases.


Subsequent CT findings. (D) Follow-up CT of abdomen from 2012 without liver metastases.


Subsequent CT findings. (E and F) Follow-up CTs of thorax from 2010 and 2012 show no lung metastases.


CT finding of disease progression on erlotinib treatment. . Notes: (A) Enlarged lymph nodes of the liver hilum - about 5 cm in diameter (arrows).


CT finding of disease progression on erlotinib treatment. (B) Follow-up after six cycles of gemcitabine-cisplatin chemotherapy; nearly complete response (arrows).


CT finding of disease progression on erlotinib treatment. (C) Contrast-enhanced axial CT of abdomen shows small hypodenze node in the liver hilim is unchanged compared with previous CT; nearly complete response (arrows).


Follow-up single photon emission computed tomography/computed tomography imaging with indium-111-labeled octreotide demonstrates progression of metastatic disease, with two octreotide avid metastatic tumor deposits in the (contralateral) right kidney, which developed 2 years subsequently. An octreotide avid pulmonary metastasis is noted in the left lung.


Proliferating trichilemmal tumor on the nose of a man.


Wall of the intradermal cystic structure, covered by stratified pavimentary epithelium, partly with and partly without the formation of a granular layer, and with larger cells (HE, x40).


Detail of the solid portion of the neoplasia, composed of large cells with eosinophilic cytoplasma, prominent nucleoli, and atypical cells to a moderate degree (HE, x400).


Aspect immediately after total surgical removal.


Lateral cervical spine radiography showing lytic lesion in C6 (arrow).


Cervical computed tomography (CT) (bone window) showing vertebral body and left pedicle lytic lesion.


Cervical CT (soft tissue window) showing the tumoral mass with heterogeneous contrast enhancement.


Parietal nodular lesion that shows contrast enhancement, consistent with metastasis.


Photomicrography of the fine needle aspiration cytology showing the presence of non-differentiated malignancy (H&E, 400X).


(A) Chest computed tomography revealed a lobulated soft tissue (2.7x2.3 cm, arrow) with an irregular hollow shadow in the posterior segment of the upper left lung lobe.


(B) Mediastinal and perihilar lymph node metastases were noted (arrow).


(A) Three-dimensional reconstruction of computed tomography image revealed that the right upper humeral bone metastasis was combined with a pathological bone fracture (arrow).


(B) Gastroscopy revealed an ulcer (arrow) of approximately 2x2 cm located in posterior wall of gastric corpus.


(C) A rough uplift (arrow) of 1.5x2.0 cm was observed in the junction of duodenal bulb and descending part.


(D) Endoscopic ultrasound-guided fine needle aspirate was performed on mediastinal lymph nodes (arrow).


Histologic sections. Myometrium infiltration by tumor cells.


Histologic sections. Vascular invasion.


Histologic sections. Inhibin marking.


Histologic sections. HPL marking.


Humphrey visual field test results for patient's left.


Right. Eyes, confirming a dense bitemporal visual loss.


Pathological fracture of the left proximal humerus.


Suspicious left lung nodule.


Clinical photograph of the patient.


Intraoral clinical photograph.


Photomicrograph of specimen at x4 objective.


Photomicrograph of the specimen at x100 objective.


Case report timeline.


Gross features of the exenterated orbital contents: Cut surface shows ill-defined, whitish and firm tumour. It is attached to the sclera without infiltration into eyeball. It infiltrates the upper eyelid. The tumour is extending to the surgical margins.


Macroscopic appearance of the resected tumor. The tumor was solid and grayish with smooth margins.


A mucosal ulcer lesion in the left retromolar trigone region.


Clinical view of squamous cell carcinoma on the right side of the hard palate invading the maxilla.


Surgical procedure. A; Maxillectomy on the right side.


Surgical procedure. B; Immediate reconstruction using a temporalis muscle flap.


(a) Right mandibular body swelling.


(b) Intraoral view of the lesion.


Occlusal view showing moth-eaten cortex.


Orthopantomogram showing the right body rarefaction.


(a) Right kidney lesion.


(b) Contrast-enhanced computed tomography showing the right kidney lesion.


Vertebral body lesion.


Histopathology of the mandibualr lesion showing clear cells.


Computer tomography image of metastatic lesions in the liver (a, b).


Esophagogastroduodenoscopy image of a bleeding gastric ulcer (see arrow).


Histologic evaluation of the hepatic biopsy.


Chest X-ray shows left lung infiltration.


Spiral computed tomography scan shows left lung opacity and lesion.


A, B) Sections from lung tumor show nests of bland looking cells separated by delicate fibrovascular cores with high mitotic counts (Hematoxylin and Eosin x250, x400).


The images of CT and cystoscopy in a patient with ALK-positive ALCL involving the urinary bladder. . Notes:. Enhanced CT scan showing an exophytic broad-based nodular lesion (white arrow) on the left bladder wall.


The images of CT and cystoscopy in a patient with ALK-positive ALCL involving the urinary bladder. Cystoscopy revealing an irregularly shaped nodule with congestive and hemorrhagic appearance (black arrow). . Abbreviations: CT, computed tomography; ALK, anaplastic lymphoma kinase; ALCL, anaplastic large-cell lymphoma.


H&E and IHC staining in the urinary bladder sample of ALK-positive ALCL. . Notes:. Diffuse infiltration of tumor cells in the lamina propria of bladder (200x, H&E).


H&E and IHC staining in the urinary bladder sample of ALK-positive ALCL. Tumor cells with pleomorphic nuclei, prominent nucleoli, and ,brisk mitotic activity (400x, H&E).


H&E and IHC staining in the urinary bladder sample of ALK-positive ALCL. Strong immunoreactivity of CD30 with membrane staining pattern in neoplastic cells (400x, IHC).


H&E and IHC staining in the urinary bladder sample of ALK-positive ALCL. A diffuse cytoplasmic, and ,nuclear staining for ALK protein (400x, IHC).


H&E and IHC staining in the urinary bladder sample of ALK-positive ALCL. Negative expression of AE1/AE3 in tumor cells (200x, IHC).


H&E and IHC staining in the urinary bladder sample of ALK-positive ALCL. Tumor cells exhibiting negative expression for synaptophysin (200x, IHC). . Abbreviations: H&E, hematoxylin-eosin; IHC, immunohistochemical; ALK, anaplastic lymphoma kinase; ALCL, anaplastic large-cell lymphoma.


Chest CT scan indicates a large lesion with dimensions of 3.6 cm x 6.3 cm (red and white vertical arrows) located within the basal segment of the lower lobe and extending out of the thoracic cavity, partially complicated with osteolytic destruction (red and white horizontal arrows). . Note: Lung window.


Chest CT scan indicates a large lesion with dimensions of 3.6 cm x 6.3 cm (red and white vertical arrows) located within the basal segment of the lower lobe and extending out of the thoracic cavity, partially complicated with osteolytic destruction (red and white horizontal arrows). Mediastinum window,. . Abbreviation: CT, computed tomography.


Chest CT scan indicates a larger lesion with dimensions of 2.7 cm x 1.8 cm (red and white vertical arrows) located within the basal segment of the lower lobe and extending out of the thoracic cavity, partially complicated with worse osteolytic destruction (red and white horizontal arrows). . Note: Lung window.


Chest CT scan indicates a larger lesion with dimensions of 2.7 cm x 1.8 cm (red and white vertical arrows) located within the basal segment of the lower lobe and extending out of the thoracic cavity, partially complicated with worse osteolytic destruction (red and white horizontal arrows). Mediastinum window,. . Abbreviation: CT, computed tomography.


Chest CT scan indicates a larger lesion with dimensions of 2.7 cm x 1.8 cm (red and white vertical arrows) located within the basal segment of the lower lobe and partially extending out of the thoracic cavity, complicated with improved osteolytic destruction (red and white horizontal arrows). . Note: Lung window.


Chest CT scan indicates a larger lesion with dimensions of 2.7 cm x 1.8 cm (red and white vertical arrows) located within the basal segment of the lower lobe and partially extending out of the thoracic cavity, complicated with improved osteolytic destruction (red and white horizontal arrows). Mediastinum window,. . Abbreviation: CT, computed tomography.


Brain magnetic resonance imaging before the first surgery, showing a suprasellar mass lesion with enhanced solid and multiseptated cystic components. A : Axial.


Brain magnetic resonance imaging before the first surgery, showing a suprasellar mass lesion with enhanced solid and multiseptated cystic components. B : Coronal.


Brain magnetic resonance imaging before the first surgery, showing a suprasellar mass lesion with enhanced solid and multiseptated cystic components. C : Sagittal.


The first biopsy showing a typical adamantinomatous craniopharyngioma.


Post-operative magnetic resonance imaging scan obtained 6 months after the first surgery, showing a small residual enhancing mass along the right anterior margin of the floor of the third ventricle. A : Axial.


Post-operative magnetic resonance imaging scan obtained 6 months after the first surgery, showing a small residual enhancing mass along the right anterior margin of the floor of the third ventricle. B : Coronal.


Post-operative magnetic resonance imaging scan obtained 6 months after the first surgery, showing a small residual enhancing mass along the right anterior margin of the floor of the third ventricle. C : Sagittal.


Follow-up brain magnetic resonance imaging 2 years after the first surgery, showing recurrence of multiseptated huge cystic mass in the suprasellar, third, and lateral ventricles. A : Axial.


Follow-up brain magnetic resonance imaging 2 years after the first surgery, showing recurrence of multiseptated huge cystic mass in the suprasellar, third, and lateral ventricles. B : Coronal.


Follow-up brain magnetic resonance imaging 2 years after the first surgery, showing recurrence of multiseptated huge cystic mass in the suprasellar, third, and lateral ventricles. C : Sagittal.


Histopathologic findings of a specimen obtained during the second surgery. Typical adamantinomatous craniopharyngioma that is highly cellular and presents with a spindled pattern (A, B; hematoxylin-eosin).


Histopathologic findings of a specimen obtained during the second surgery. The immunological tests showing overexpression of p53.


Histopathologic findings of a specimen obtained during the second surgery. And Ki67.


Histopathologic findings of a specimen obtained during the second surgery.positive results for pancytokeratin.


Histopathologic findings of a specimen obtained during the second surgery. And vimentin.


Brain magnetic resonance imaging after the second surgery showing total resection of the recurrent mass. A : Axial.


Brain magnetic resonance imaging after the second surgery showing total resection of the recurrent mass. B : Coronal.


Brain magnetic resonance imaging after the second surgery showing total resection of the recurrent mass. C : Sagittal.


High-resolution computer tomography imaging showing a large lung lesion in the left parahilar side.


Surgical sample of lingula inflammatory myofibroblastic tumor in 3-year-old child.


A; Right retroauricular zone before chemotherapy.


B; Right retroauricular zone after chemotherapy.


Images of PET-CT for the patient. . Notes: (A) Whole-body FDG fusion PET-CT showed numerous masses in the body.


Images of PET-CT for the patient. (B and C) PET-CT showed bilateral breast masses. . Abbreviations: FDG, fluorodeoxyglucose; PET-CT, positron emission tomography-computed tomography.


Images of hematoxylin-eosin staining and immunohistochemistry of breast masses. . Notes: (A) Hematoxylin-eosin staining of the breast masses showed a poorly differentiated adenocarcinoma. Magnification, 100x).


Images of hematoxylin-eosin staining and immunohistochemistry of breast masses. (B) Immunohistochemistry of tumor cells was negative for Napsin A. Magnification, 200x).


Images of hematoxylin-eosin staining and immunohistochemistry of breast masses. Immunostaining revealed positivity for tumor for. TTF-1, and . Magnification, 200x).


Images of hematoxylin-eosin staining and immunohistochemistry of breast masses. ALK. Magnification, 100x).


CT scan and MRI before and after 3 months treatment with crizotinib. . Notes: (A-D) CT scan and MRI showed masses in the lungs, lymph nodes in the mediastinum, liver, and brain before treatment with crizotinib.


CT scan and MRI before and after 3 months treatment with crizotinib. (E-H) CT and MRI showed a significant response after 3 months treatment with crizotinib. . Abbreviations: CT, computed tomography; MRI, magnetic resonance imaging.


Diffuse swelling over right massetric region with loss of overlying skin creases, scar of incision along lower border of mandible suggestive of incision and drainage done 6 days back.


Orthopantamogram shows the presence of ill-defined radiolucency extending from sigmoid notch up to the lower border of mandible.


Chest X-ray (postero-anterior view) demonstrates nodular opacity at the level of 5th and 6th rib with hilar prominence.


This image is a coronal slice of contrast enhanced computed tomography scan showing heterogenous mass in the right middle lobe with tracheal deviation and adjacent lymphangitis carcinomatosis.


Three dimensional reconstruction demonstrating destruction of buccal cortex over the right side ramus of the mandible.


Coronal slices of computer tomographic scan showing perforation of buccal and lingual cortices with inhomogeneous mass extending into surrounding soft-tissue.


Axial slices of computer tomographic scan showing perforation of buccal and lingual cortices with inhomogeneous mass extending into surrounding soft-tissue.


An extensive erosive erythema with a red, easy-to-bleed nodule on the scrotum (a).


Atypical cells mainly proliferated in the dermis forming solid pattern nests (b).


Paraffin-embedded tissue samples from the right shoulder were deparaffinized and stained with anti-RANKL antibody (c).


T1-weighted MRI before the treatment (a).


Physical examination revealed that all primary tumors had disappeared (b).


T1-weighted MRI after the treatment (c).


Ultrasonography images of primary squamous cell carcinoma of the thyroid. (A) Longitudinal gray-scale sonography revealed a solid marked hypoechoic thyroid nodule in the inferior part of the left lobe.


Ultrasonography images of primary squamous cell carcinoma of the thyroid. (B) Color Doppler flow imaging showed a poor blood flow signal inside this nodule.


Ultrasonography images of primary squamous cell carcinoma of the thyroid. (C) Contrast-enhanced ultrasound image showed a persistent low peak enhancement of the nodule at 37 s.


Ultrasonography images of primary squamous cell carcinoma of the thyroid. (D) Time-intensity curves displayed the wash-in time of 10 s, TTP of 37 s, peak signal intensity of 24.5%, and wash-out time of 70 s for the thyroid tumor.


(A) A positron emission tomography-computed tomography scan showed increased 18F-fluorodeoxyglucose metabolism in the left neck mass.


(B) Preoperative fine-needle aspiration cytology of the mass demonstrated a few sheets of malignant-looking tumor cells with giant deep stained nuclei (hematoxylin and eosin, magnification x 400).


Hematoxylin and eosin staining of primary squamous cell carcinoma of the thyroid:. Magnification x 8.


Magnification x 20.


Magnification x 100.


Magnification x 400.


Immunohistochemical staining of primary squamous cell carcinoma of the thyroid (magnification x 200). Immunohistochemical staining for. CK19.


Immunohistochemical staining of primary squamous cell carcinoma of the thyroid (magnification x 200). CK5/6.


Immunohistochemical staining of primary squamous cell carcinoma of the thyroid (magnification x 200). EMA.


Immunohistochemical staining of primary squamous cell carcinoma of the thyroid (magnification x 200). P40, all of which were deeply stained (positive).


Immunohistochemical staining of primary squamous cell carcinoma of the thyroid (magnification x 200). Immunohistochemical staining for. P63.


Immunohistochemical staining of primary squamous cell carcinoma of the thyroid (magnification x 200). Ki 67.


Immunohistochemical staining of primary squamous cell carcinoma of the thyroid (magnification x 200). TG.


Immunohistochemical staining of primary squamous cell carcinoma of the thyroid (magnification x 200). TTF-1, and p63 was deeply stain (positive); Ki67 proliferation index was 30%; TG and TTF-1 did not stain (negative).


Magnetic resonance imaging of the spine showing vertebral metastases (yellow arrow) on parasagittal.


Sagittal. Views.


Genomic profile of the 5q22.2 chromosomal region showing the breakage in APC gene.


Representative axial cut images of the abdominopelvic CT scan with oral, rectal and intravenous contrast. (a):. The prostate gland is enlarged and converted to a heterogenous mass 6.8 x 5.2 x 5.4 cm in size and a volume of 99.3 cc with intravesical extension and cannot be separated from a rectal mass (blue arrows).


Representative axial cut images of the abdominopelvic CT scan with oral, rectal and intravenous contrast. (b): Confluent, matted, markedly enlarged retroperitoneal lymph nodes (red arrows) and dilated urinary collecting systems and ureters (green arrows).


Representative images from the colonoscopy. (a): Circumferential rectal mass approximately 70% obstructing with noted inflamed nodular and friable mucosa.


Representative images from the colonoscopy. (b): Normal colonic mucosa beyond the mass with noted colonic polyps shown in blue arrows.


Representative images from the colonoscopy. (c): Circumferential rectal mass with noted scope dilated colonic lumen. Multiple biopsies were taken.


Rectal mass, biopsy. (a): Haematoxylin and eosin (H & E) stain, 200x magnification.


Rectal mass, biopsy. (b and c): H & E stain, 400x magnification.


- Cranial MRI showing the retroocular metastatic lesion.


An ulcerated lesion. At the proximal and middle thirds, respectively.


- Photomicrography of the esophagus showing ulcerated lesions (arrows) with inflammatory infiltrate (arrowhead) involving the submucosa and muscular layers (HE, 40X).


A - Gross view of the retroocular mass involving the orbit muscles.


B - Photomicrography of the retroocular mass showing neoplastic cells with the same pattern as the esophageal lesion (HE, 400X).


Axial view of CT scans of the neck showing regression of the primary lesion and metastatic lymph node. Before treatment, there was a 7.6 x 4.2 cm mass in the thyroid.


Axial view of CT scans of the neck showing regression of the primary lesion and metastatic lymph node. Before treatment, there was a 1.3 x 1.1 cm left lateral neck metastatic lymph node (arrow).


Axial view of CT scans of the neck showing regression of the primary lesion and metastatic lymph node. Thirty weeks after treatment, the mass shrank to 6.1 x 3.0 cm, demonstrating a 19.7% decrease in the longest diameter of the lesion.


Axial view of CT scans of the neck showing regression of the primary lesion and metastatic lymph node. Thirty weeks after treatment, the metastatic lymph node was 0.9 x 0.7 cm in size (arrow).


Pathological findings of ultrasound-guided core-needle puncture tissue. (A) Hematoxylin and eosin staining (x200).


Pathological findings of ultrasound-guided core-needle puncture tissue. The tumor cells lack conventional papillary thyroid carcinoma nuclei and nested or papillary growth pattern, (B) Immunohistochemical staining for VEGFR-2 (x200). Brown color indicates the presence of VEGFR-2, which is observed not only in blood vessels (arrows) but also in the cytoplasm of the cancer cells.


18F-Fluorodeoxyglucose PET/CT showing a thyroid mass with SUVmax of 17.8 and a metastatic lymph node in the left neck with SUVmax of 8.6. Non-specific inflammation of the small mediastinal lymph nodes, physiological uptake in the heart, liver, and spleen, and radioactive excretion through the intestine and kidneys were verified. Maximum intensity projection of PET.


18F-Fluorodeoxyglucose PET/CT showing a thyroid mass with SUVmax of 17.8 and a metastatic lymph node in the left neck with SUVmax of 8.6. Non-specific inflammation of the small mediastinal lymph nodes, physiological uptake in the heart, liver, and spleen, and radioactive excretion through the intestine and kidneys were verified. Fusion of PET/CT image of the thyroid lesion.


18F-Fluorodeoxyglucose PET/CT showing a thyroid mass with SUVmax of 17.8 and a metastatic lymph node in the left neck with SUVmax of 8.6. Non-specific inflammation of the small mediastinal lymph nodes, physiological uptake in the heart, liver, and spleen, and radioactive excretion through the intestine and kidneys were verified. Fusion of PET/CT image of the nodal metastasis.


Photographs of the patient's left neck demonstrating obvious shrinkage of the thyroid mass. Photograph before treatment, showing a large left-sided neck mass.


Photographs of the patient's left neck demonstrating obvious shrinkage of the thyroid mass. Four weeks after the treatment, the mass shrank notably.


Photographs of the patient's left neck demonstrating obvious shrinkage of the thyroid mass. Thirty weeks after the treatment, the mass seemed to shrink a bit more.


CT image before the start of gemcitabine therapy. CT revealed a tumor located at the cervix of the gallbladder (arrowheads) also involving the common and right hepatic arteries, and enlargement of the No. 12 lymph node.


MRI at the time of the tumor relapse. MRI showed relapse of the tumor at the hilar porta hepatis. The lymph node metastasis invaded the celiac artery and common hepatic artery.


Serial changes of the serum levels of carbohydrate antigen 19-9 and CEA during the treatment course. CA19-9 = Carbohydrate antigen 19-9; G = gemcitabine.


Clinical presentation upon day of surgery.


CT head showing subcutaneous extra cranial cystic lesion with no intracranial connections.


A. H&E section H&E section (2x) : Low power of the cyst lined by malignant squamous epithelium.


B. H&E section H&E section (10x) High power of cyst lining with foci of stromal invasion. (highlighted by red arrow) by islands of malignant squamous epithelium.


Patient's presentation on follow up after 2nd surgery.


T2-weighted magnetic resonance images show.


Axial and
 sagittal views of a 92-year-old patient (Case #1). A tumor mass
(arrows) affected the (left panel) cervix uteri, corpus uteri, and
(right panel) parametrium, and (left panel) a
swollen lymph node (arrowhead) was present in the pelvic cavity.


MRI showed an ill defined area involving bilateral corpora cavernosa with probable extension to the corpus spongiosum as well.


Smear showing scattered round to oval malignant cells showing moderate nuclear pleomorphism (May Grunwald Giemsa stain).


MRI showed evidence of well defined heterogenous soft tissue mass of size 5 x 2.8 x 2 cm seen in left crura of the penis near its base.


PET scan showed intensely FDG avid (SUV maximum 17.6) heterogeneously enhancing soft tissue mass seen in the proximal two third of the shaft of the penis extending to left crura.


Intensely FDG avid well defined nodules of variable sizes in bilateral lung fields.


MLH1 protein expression in squamous cell carcinoma by IHC.


Partial loss of MSH2 protein expression in squamous cell carcinoma by IHC.


Partial loss of MSH6 protein expression in squamous cell carcinoma by IHC.


PMS2 protein expression in squamous cell carcinoma by IHC.


MRI of postoperative right renal percutaneous nephrostomy. (A) The axial T2-weighted MR images showing right renal atrophy, empyema in the right upper ureter with increased thickness and signal intensity in the perinephric fat and Gerota's fascia; there is a water balloon of nephrostomy tube (red head of arrow).


MRI of postoperative right renal percutaneous nephrostomy. (B and C) MRI showed no abnormal diffusion restriction in the right kidney.


Grossly, the tumor appeared as exophytic, cauliflower-shaped like mass in the right renal pelvis (3.5x2.5x2.0 cm3) (red arrow); at the ureteropelvic junction, there was another tumor with invasive growth that caused an obstruction of ureter (black arrow).


Pathological features of the carcinoma of upper ureter:. H&E showing urothelial squamous metaplasia.


Positive immunostaining in tumor cells with CK5/6.


Intense positive immunostaining for CK-HMW (+) in tumor cells.


Positive immunostaining in tumor cells with CK8/18.


Positive immunostaining in tumor cells with CK7.


Positive immunostaining in tumor cells with Vim (focal.


Tumor cell proliferation rate as determined by Ki-67 immunostaining showed 60% of positive cells.


Head and neck computed tomography. . Notes:. Sagittal image showing intracranial dural lesion of size 2.6 cm x 2.3 cm at the top of splenium of corpus callosum.


Head and neck computed tomography. Axial image showing a large left occipital bone mass of size 5.7 cm x 1.9 cm with intracranial extension, and para-sagittal dural-based lesion was thought to be a meningioma.


Magnetic resonance imaging (T2-weighted axial image) showing diffuse dural mass and another large lesion in the left occipitoparietal bone with intracranial extradural, intraosseous, and subgaleal soft tissue components.


Histopathology of para-sagittal dural lesion showing follicular pattern with numerous colloid-filled follicles with characteristic nuclear features of papillary carcinoma (enlarged and elongated nuclei and nuclear grooves).


Immunohistochemical staining showing (a), Intense cytoplasmic immunopositivity for vimentin (Vimentin x400); (b), Cytoplasmic immunoreactivity for Melan-A (Melan-A x 400); (c): Focal cytoplasmic immunoreactivity for HMB-45 (HMB-45 x400); (d), Immunonegative for S-100 protein (S-100, x400).


Pleural biopsy histological images showing. H&E stain.


20xP63 stain (highlighting epithelial cell nuclei).


20xAE1/AE3 stain (highlighting epithelial cell cytoplasm).


20xCD45 stain (highlighting lymphoid cells).


CT chest (coronal and axial views, bulk of tumor circled in red) showing total tumor volumes at diagnosis, 8, 12, 25, and 29 months post-diagnosis.


Magnetic resonance imaging images (a,b) Pre-treatment T1-weighted gadolinium-enhanced MRI (axial and coronal images).


(a) Preoperative three-dimensional computed tomography.


(b) Postoperative three-dimensional computed tomography. The occipital bone has been removed, and the foramen magnum has been opened.


Magnetic resonance imaging images (a,b) T1-weighted gadolinium-enhanced MRI (axial and coronal images) after 2 weeks. Diffuse enhancement of the meninges has improved markedly.


(c,d) T1-weighted gadolinium-enhanced MRI (axial and sagittal images) after 2 months. Diffuse enhancement of the meninges has almost disappeared.


Computed tomography image of invaginated ileal segment.


Macroscopic appearance of invaginated ileal loop.


Stromal tumor that caused invagination.


(A) Magnetic resonance post-contrast (gadolinium enhanced) axial MRI performed 6 months before surgery show low peripheral enhancement.


(B) Axial MR T2 WI, performed 1 month before surgery, show slightly hyperintense lesions visible in the red circle referable to colangiocarcinoma recurrence, located at the hepatic hilum, quickly grow in size.


(A) The probes are positioned intraoperatively under ultrasound.


(B) Contrast computer tomography scan performed after 10 days from the surgery revealing complete ipodensity of the treated area indicating full necrosis of the neoplasia induced by electrochemotherapy with bleomycine.


Contrast computed tomography scan performed with contrast 6 months after surgery.


Magnetic resonance scan performed with gadolinium contrast T1 WI 10 months after surgery show in both that the electrochemotherapy-treated neoplasia resulted permanently ipodense indicating the necrosis of the lesion.


T1 Weighted magnetic resonance imaging showing large cervical mass.


T1 Weighted magnetic resonance imaging showing invasion of the posterior wall of the bladder by the tumor growth.


T2 Weighted magnetic resonance imaging showing multiple lesions in the femur suggestive of metastasis.


Intraoral anterior palatal swelling.


Atypical parathyroid neoplasm (patient 1). 10x magnification, the tumor grows as multiple nodules with fibrous bands.


Atypical parathyroid neoplasm (patient 1). 100x magnification, the tumor cells are arranged in sheets or glands.


Electrocardiography on the first day of consultation showed complete heart block.


Echocardiography showed the presence of a mass in the right atrium and septal leaflet of tricuspid (yellow arrow). . Hyperechoic areas were found in the annulus of tricuspid, lateral wall of right atrium and right ventricle, and interventricular septum (red arrows).


Pericardial effusion was found in. Anterior, posterior.


Inferior.


Base.


Left-lateral of the heart.


Chest X-ray on the 14
th day of treatment showed left parahilar ground glass appearance with suspicion of lung metastasis and pleural effusion. . Pericardial fluid pigtail was already inserted for drainage of pericardial effusion.


MRI showing fetus with extensive neck lymphangioma.


Patient with extensive right neck lymphangioma that crossing midline.


Postnatal MRI showing multilobulated multiseptated extensive neck lymphangioma.


Excised tumour bulk.


Intraoperative fluoroscopy utilizing MIS retractor (a) K-wire targeting involved disc level (b) Serial dilators were docked onto the facet complex (c) A tubular dilator was used, which was angled rostral (d) and caudal (e) to access the extent of tumor.


Preoperative. Sagittal.


Axial T1.


Sagittal.


Axial T2 MRIs reveal diffuse lumbar metastatic disease, L1 vertebral expansivity causing near complete canal occlusion, and left-sided L1 and L2 foraminal impingement from an epidural mass.


Postoperative T1-weighted. Sagittal.


Axial.


T2-weighted. Sagittal.


Axial MRI reveal interval surgery at L1-L2 resulting in decompression of the spinal canal.


A; An immunohistochemical staining of the balloon cell component with Fontana-Masson stain was negative.