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


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


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


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


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


Computed tomography of the chest and breast before treatment.


Computed tomography of the chest and breast before treatment. Computed tomography image of the hepatic mass before biopsy.


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


Pathological results after breast cancer surgery. Haematoxylin-eosin (H&E) staining of biopsy samples (40x) magnification). Immunohistochemical staining results after breast cancer surgery: ER 10.


Pathological results after breast cancer surgery. Haematoxylin-eosin (H&E) staining of biopsy samples (40x) magnification). , PR 20.


Pathological results after breast cancer surgery. Haematoxylin-eosin (H&E) staining of biopsy samples (40x) magnification). , HER-2 2+-3.


Pathological results after breast cancer surgery. Haematoxylin-eosin (H&E) staining of biopsy samples (40x) magnification). , Ki-67 40.


Pathological results of the intracranial space-occupying lesion after the second operation. Haematoxylin-eosin (H&E) staining of biopsy samples (40x) magnification).


Pathological results of the intracranial space-occupying lesion after the second operation. Haematoxylin-eosin (H&E) staining of biopsy samples (40x) magnification). Immunohistochemical staining results of the intracranial space-occupying lesion after the second operation showed GFAP (small part.


Pathological results of the intracranial space-occupying lesion after the second operation. Haematoxylin-eosin (H&E) staining of biopsy samples (40x) magnification). , ki-67 (5%, partial 5-10.


Pathological results of the puncture of the space-occupying liver lesions. Haematoxylin-eosin (H&E) staining of biopsy samples (40x) magnification.


Pathological results of the puncture of the space-occupying liver lesions. Haematoxylin-eosin (H&E) staining of biopsy samples (40x) magnification. Immunohistochemical staining results of the puncture of the space-occupying liver lesions: vimentin.


Pathological results of the puncture of the space-occupying liver lesions. Haematoxylin-eosin (H&E) staining of biopsy samples (40x) magnification. , HMB45.


Pathological results of the puncture of the space-occupying liver lesions. Haematoxylin-eosin (H&E) staining of biopsy samples (40x) magnification. , ki-67 15.


Pathological results of hepatic space-occupying lesions after surgery. Haematoxylin-eosin (H&E) staining of biopsy samples (40x) magnification.


Pathological results of hepatic space-occupying lesions after surgery. Haematoxylin-eosin (H&E) staining of biopsy samples (40x) magnification. Immunohistochemical staining results of hepatic space-occupying lesions after surgery: Melan A.


Pathological results of hepatic space-occupying lesions after surgery. Haematoxylin-eosin (H&E) staining of biopsy samples (40x) magnification. , ki-67 10.


A; Endoscopic image depicting a 3-cm mass in the descending portion of the duodenum that is adjacent to the oral side but does not involve the papilla of Vater. The papilla of Vater is indicated by an arrow.


B; Endoscopic ultrasonography image showing the tumor partially invading the head of the pancreas (arrow).


C; Duodenography showing a protruding lesion in the descending portion of the duodenum (arrow).


D; Computed tomography image showing an ill-defined hypervascular mass (arrow). The tail of the pancreas had been minimally resected during a previous surgery.


E; Magnifying endoscopy depicting a diminished surface pattern of the gastrointestinal epithelium across the entire surface of the tumor.


F; Magnifying endoscopy combined with NBI depicting a diminished capillary network pattern.


A; Macroscopic findings of the resected specimen reveal a polypoid mass in the descending portion of the duodenum that appears ulcerative and friable. The papilla of Vater is indicated by an arrow.


B; Histologic findings show that the surface of the tumor was coated by granulation tissue consisting of inflammatory cells, fibrosis and edematous stroma.


C; Histologic image shows dysplastic clear cells containing glycogen and arranged in an alveolar pattern.


F Immunohistochemical staining demonstrates that the clear cells are positive for vimentin. And CD10.


Negative for CK7.


Confirming the diagnosis of RCC with clear cell histology.


CT scan of the chest with density in bronchus intermedius.


Bronchus intermedius mass.


Bronchus intermedius after endobronchial debulking.


(a) CT scan showing swellings in the lymph nodes (arrows).


(b) Low-density areas in the spleen were also observed (arrows), suggesting metastasis from a malignant tumor of the left ovary.


18FDG avidity was observed in the lymph nodes (arrows).


In the spleen (arrows).


(a) Microscopic findings of the resected ovarian tumor and lymph nodes. Atypical cells with clear cytoplasm grew papillary, tubulocystic, and focally solid pattern (hematoxylin and eosin [HE.


(b) Non-caseating epithelioid granulomas were observed in the pelvic lymph node as well as in the spleen where there were no metastatic lesions (HE).


PSA level over the course of the treatment.


Swelling in the floor of mouth obliterating the lingual vestibule.


Mucosa over swelling adherent to lingual gingiva in the region of 44, 45.


Contrast-enhanced computed tomography axial sections showing enhancing mass lesion in the right sublingual region.


Histopathology photomicrograph.


Excised surgical specimen showing well-encapsulated tumor; superficial mucosa seen excised along with the tumor.


Left precentral gyrus metastatic small cell lung cancer lesion on axial T1-weighted MRI with gadolinium contrast before.


3 months after. Pulsed reduced dose-rate radiotherapy.


Case 1 cancer diagnosis and treatment timeline.


Left precentral motor cortex lesion re-treatment plan with dose-volume histogram. This patient was re-treated with 35 Gy in 100 fractions, over the course of 3 weeks, to her surgical cavity of her left precentral gyrus lesion. Pulsed reduced dose-rate radiotherapy was used with TomoHDA. Planning Station Version 5.1.1.6, and 97% of the target volume received 35 Gy. The colors in the top of the figure correspond to isodose distributions, with orange corresponding to the volume receiving 35Gy (100% dose area). The dose-volume histogram relates radiation dose to tissue volume and includes both the target structure as well as organs at risk.


Comprehensive dose-volume histogram based on a summation of the patient's previous radiation treatments detailed in Figure 2 on the organs at risk along with the pulsed reduced dose-rate radiotherapy targets based on the treatments to the brain, compiled using MIM software (MIM Software Inc. , Cleveland, OH, USA). The colors in the figure correspond to the volumes as shown in the key receiving doses of radiation.


Case 2 cancer diagnosis and treatment timeline.


Glioblastoma multiforme at T11-12 seen on T1-weighted axial magnetic resonance image with gadolinium contrast before.


1 month after. Pulsed reduced dose-rate radiotherapy.


Comprehensive dose-volume histogram based on a summation of the patient's previous radiation treatments detailed in Figure 5 on the organs at risk along with the pulsed reduced dose-rate radiotherapy targets based on the treatments to the brain, compiled using MIM software (MIM Software Inc. , Cleveland, OH, USA). The colors in the figure correspond to the volumes as shown in the key receiving doses of radiation.


Patient 1 preoperatively.


Clinical image of Patient 2 two years postoperatively.


Excised lesion from Patient 1 following first surgery.


Three-year postoperative photograph of Patient 1 showing satisfactory healing.


Preoperative 3D reconstruction CT of patient 2, showed marked expansion of the Left maxilla.


Intraoperative image of Patient 2 prior to tumour excision.


Right groin showing multiple excavating ulcers, left groin shows 'Groove sign of Greenblatt' and multiple tense bullae with erosions over thighs and penile shaft.


Haematoxilin/eosin-stained pancreatic cytology revealed the presence (A) of poorly cohesive, pleomorphic, monucleated or multinucleated large cells (20x).


Positivity (B) for cytokeratins AE-AE2 confirms the diagnosis of anaplastic cell carcinoma (20x).


Peritoneal washing cytology (PWC) with Papanicolaou stain (C) detects cells with malignant features such as nuclear displacement, irregular nuclear membranes, small and eccentric nucleoli (40x).


Patient diagnosed as esthesioneuroblastoma presenting with proptosis and diminished vision in right eye.


Coronal cuts of CECT showing homogeneously enhancing soft tissue involving right side of sinuses and orbit.


Axial cut of CECT of the paranasal sinuses (PNS) showing hyperintense mass involving right side of nose and orbit.


Midsagittal view of a T2-weighted.


A contrast-enhanced T1-weighted. Magnetic resonance imaging (MRI) of the lumbar spine demonstrating an intradural extramedullary spinal lesion (white arrowhead) from L1 to L2 with avid contrast enhancement.


(c) Axial view of a contrast-enhanced T1-weighted MRI of the lumbar spine demonstrating high-grade compression of conus medullaris and cauda equina from an intradural extramedullary lesion (white arrowhead).


Postoperative magnetic resonance imaging, sagittal.


Axial. Views, confirmed complete tumor removal.


Histologic findings of the lesion. (a and b) Show spindle cells, collagen fibers, microcystic changes, and hemosiderin deposits on Hematoxylin Eosin staining (black circle and arrowhead).


Histologic findings of the lesion. (c) Shows a Ki67 <1.


Histologic findings of the lesion. (d) shows uniform S-100 protein immunoreactivity.


Axial section of a contrast-enhanced computed tomography scan of the abdomen and pelvis showing the sigmoid tumor (marked with arrow).


Intraoperative photograph showing the perianal scar at the site of excised fistula and the perianal abscess (marked with arrows).


Photograph of the abdominoperineal resection specimen showing the perianal scar at site of the excised fistula, the perianal abscess and the sigmoid tumor (marked with arrows).


Sections showing moderately differentiated adenocarcinoma of the sigmoid (H& E x 100x).


Anal fistula tract lined by inflammatory granulation tissue (H& E x 40x).


With tiny foci of adenocarcinoma in the fistulous tract along with pools of extracellular mucin (H& E: 40x).


High magnification showing similar tumour in anal fistula tract as in the sigmoid (H& E: 100x).


Sections showing sigmoid adenocarcinoma immunopositive for cytokeratin 20.


While immunonegative for cytokeratin 7.


Perianal adenocarcinoma immunopositive for cytokeratin 20.


(A) Marginal facial asymmetry was observed on the left side of the patient's face.


(B and C) Intraoral images were captured showing a large mass located in the buccal and palatal aspect of the edentulous alveolus of the left maxilla, in the area between the second premolar and the first molar. The mucosal surface was covered with rough hemorrhagic papules, which were pink-red in color.


A panoramic radiograph revealed a dome-shaped radiopaque mass with well-defined margins extending from the left maxilla to the maxillary sinus.


(A) Axial 18F-fluorodeoxyglucose positron emission tomography (FDG-PET)/computed tomography revealed FDG accumulation in the lesion in the left maxilla (maximum standardized uptake value, 12.2).


(B) No other abnormal FDG accumulation was detected elsewhere by FDG-PET.


Histopathological observations. (A) The tumor mass was located in the center of the maxilla and extended to the surface epithelium. The epithelium of the maxillary sinus was not involved.


Histopathological observations. (B) The tumor cells formed atypical squamous epithelium, exhibiting features of squamous cell carcinoma (magnification, x2).


Histopathological observations. (C) The surface of the mass was covered by non-cancerous oral mucosa with ulcers, indicating an intraosseous origin (magnification, x2).


Histopathological examination of the biopsy specimen revealed a poorly differentiated adenocarcinoma with neuroendocrine differentiation. X100).


Immunohistochemical staining for CK. X200).


CK7. X200).


Ki-67. X200).


P63. X200).


Transcription factor-1. X200). . Abbreviation: CK, cytokeratin.


Computerized tomography images of chest indicated that no evidence of recurrence has been detected during the 24-month follow-up. Images in June 2015. Images of vertical window.


Computerized tomography images of chest indicated that no evidence of recurrence has been detected during the 24-month follow-up. Images in June 2015. : images of lung window.


Computerized tomography images of chest indicated that no evidence of recurrence has been detected during the 24-month follow-up. Images in March 2017. Images of vertical window.


Computerized tomography images of chest indicated that no evidence of recurrence has been detected during the 24-month follow-up. Images in March 2017. : images of lung window.


MRI of the shoulder joint and elvic showed newly formed bone metastases in the left humeral.


The right iliac.


New pleural effusion.


Cancerous lymphangitis.


With enlarged mediastinal.


Axillary.


Supraclavicular. Lymph nodes on pulmonary CT after third-line treatment.


Enhanced MRI of the abdomen showed enlarged retroperitoneal lymph nodes (G, H).


Spindle cell carcinoma involving the right mandibular ramus has destroyed the posterior border of the ramus, retromolar area and ramus.


H&E-stained section at 10x magnification shows a poorly differentiated ductal carcinoma (left side of field) with areas of chondroid (cartilaginous) differentiation (right side of field).


H&E-stained section at 20x magnification shows malignant neoplastic cells within chondroid matrix material.


Chest radiograph showing left lung upper lobe mass.


(a and b) Preoperative clinical evidence with a smooth external appearance in the right side.


A computed tomography scan shows a non-homogeneously enhancing mass in the right parotid gland.


Partial superficial parotidectomy.


Macroscopic appearance of the resected tumor. Grossly, the lesion was apparently well circumscribed, multilobated and gray-white in appearance; the cut surface revealed many small cysts with hemorrhagic content.


The myoepithelial cells were strongly reactive for p63 (p63 immunostain, original magnification x20).


The myoepithelial cells were strongly reactive for smooth muscle actin (smooth muscle actin immunostain, original magnification x20).


Chest x-ray (October 2011).


Gluteus mass biopsy histopathology examination (December 2011).


Left frontal brain tumor histopathology examination (December 2011).


Staging CT showing bilateral renal masses, pancreatic cysts and multiple lung metastases.


Chest X-ray showing multiple nodular lesions in both lungs.


Computerized tomography of the brain showing a hyperdense lesion (arrow) in the right posterior parietal lobe.


A-d LELCB in this case. A; Microscopic findings at low magnification showed that the tumors had invaded the perivesical soft tissue. H&E stain.


B; Microscopic findings at high magnification showed that tumor cells (arrows) were surrounded by infiltrating lymphocytes (arrowheads). H&E stain.


C; Immunohistochemical staining for cytokeratin (AE1/AE3).


D; Immunohistochemical staining for E-cadherin.


E; EBER-ISH for this case. Tumor cells were negative.


F; Lymphoepithelioma of the pharynx in another patient. EBER-ISH of tissues. Tumor cells (arrows) were positive for EBER-ISH (positive control).


Irregular hypertrophic duodenal mucosal folds suggestive for tumoral infiltration - endoscopic view.


Internal-external percutaneous biliary drainage, left side approach.


(a and b) Baseline PET-CT showing bilateral groin lymphadenopathy with scrotal edema.


(c and d) Post 12 weeks resolution of right groin lymphadenopathy with persistent disease on left side.


(e and f) Showing resolution of lower inguinal lymphadenopathy with persistent scrotal edema-post 12 weeks of therapy.


(A) Struma and PTC x40.


(B) PTC x40.


(C) PTC x400. PTC (arrow) can be seen arising in the background of benign thyroid tissue (1A) (Hematoxylin and Eosin, x40). The carcinoma exhibits the classical papillary architecture (1B) as well as diagnostic cytologic features (Hematoxylin and Eosin, x40). The latter includes cuboidal-to-low columnar cells with overlapping nuclei, nuclear grooves (arrows), and the presence of optically clear chromatin (arrowheads) (1C) (Hematoxylin and Eosin, x400).


Struma x100. Also present are foci of relatively more recognizable thyroid tissue, consistent with a struma ovarii. The colloid-filled acini are lined by a single layer of flat-to-low cuboidal cells just like in the eutopic thyroid. (Hematoxylin and Eosin, x100).


(A): Struma and hair follicles x100. The mature teratoma shows intimate admixture with thyroid tissue, the greatest component of the tumor in this case. Hair follicles (arrows) can be seen amongst small acini filled with colloid (microfollicular pattern) (arrowhead) (Hematoxylin and Eosin, x100).


(B): Bone and hair follicles x200.


(C): Epidermoid x200.


(D) Cartilage x100. Mature teratoma component. The tumor shows foci consistent with a mature teratoma showing derivation from at least two of the three germ layers (ectoderm, mesoderm, and endoderm). The various mature elements include hair follicles (arrows) intermixed with bone (arrowhead) (3A), squamous epithelium (3C), and cartilage (arrow) juxtaposed with adipose tissue (arrowhead) (3D) [Hematoxylin and Eosin, x200 (1A, 1B), x100 (1C).


(A): Carcinoid x100.


(B): Carcinoid x400.


(C): Synaptophysin x400.


(D): Chromogranin x400. An incidental focus of insular carcinoid (0.3 cm) was identified in one of the tumor sections. The carcinoid tumor consists of solid nests made up of uniform cells with centrally-placed nuclei (4A) (Hematoxylin and Eosin, x100) and (4B) (Hematoxylin and Eosin, x400). The tumor is positive for the neuroendocrine immunohistochemical markers synaptophysin (4C) and chromogranin A (4D) (x400), while negative for CK7 (not shown). The Ki-67 proliferation index of the tumor is less than 1%, and no mitotic figures were identified (not shown).


Maximum intensity projection of 18-fluorodeoxyglucose positron emission tomography/computed tomography scan showing abnormal increased tracer uptake in the sinuses, breasts, retrosternal, and sacral region.


Low-power photomicrograph of patient's original glioblastoma showing pseudopalisading necrosis.


Proliferative endothelium . Note: Hematoxylin and eosin stain; x220.


Axial, coronal, and sagittal T1 gadolinium enhanced magnetic resonance images before oncolytic HSV treatment.


At five year follow-up . Abbreviations: 5yr F/U, 5-year follow-up; HSV, herpes simplex virus.


Photomicrograph of hematoxylin and eosin-stained representative tissue from 1998 (post-G207 treatment) resection, demonstrating areas of coagulative necrosis, perivascular inflammation, edema, astrocytosis, and foamy macrophages consistent with treatment effect. . Note: Atypical cells seen could represent inflammation, but tumor is not excluded; x200.


Magnetic resonance imaging L spine. Sagittal slices demonstrates lesion on T2.


Magnetic resonance imaging L spine. , T1.


Magnetic resonance imaging L spine.T1 with contrast.


Magnetic resonance imaging C spine. Sagittal slices demonstrates lesion on T2.


Magnetic resonance imaging C spine. , T1.


Magnetic resonance imaging C spine.T1 with contrast.


Contrasted brain MRI revealed enhanced masses in the occipital and parietal lobes (arrow).


Spindle squamous cell carcinoma prior to excision.


Hematoxylin-eosin stain of section from completely excised skin tumor located on the right gluteal region. Short black arrow: epidermis with hyperplasia. White arrow: poorly differentiated squamous cell carcinoma in upper dermis. Long black arrow: spindle cell carcinoma in dermis.


Hematoxylin-eosin stain of section of lymph node from right inguinal region (x10). Black arrow: lymphatic tissue. Blue arrow: metastatic spindle cell carcinoma. Lower right corner: metastatic spindle cell carcinoma, immunohistochemical positive reaction cytokeratin 14, confirming epithelial origin.


Axial contrast-enhanced 3D-FAST SPIN ECHO spectral presaturation with inversion recovery [left: pre-whole-brain radiotherapy (WBRT); right: 9-month follow-up]: note decrease in intraparenchymal brain metastases and leptomeningeal enhancement pre- vs. Post-WBRT. In addition, note consecutive enlargement of the lateral ventricles on 9-month follow-up scan.


Coronal contrast-enhanced T1-weighted magnetic resonance imaging [left: pre-whole-brain radiotherapy (WBRT); right: 9-month follow-up]: note decrease in leptomeningeal enhancement pre- vs. Post-WBRT. In addition, note enlargement of the lateral ventricles on 9-month follow-up scan.


A 3 x 4 cm, raised, ulcerous, and bleeding tumor, developing in the lower lip and expanding to 1/3 external upper lip.


Final pathology result was squamous cell carcinoma.


Trypsin immunohistochemical stain (400 x ). Peripancreatic lymph node shows strong positivity in trypsin-positive tumor cells, supporting acinar differentiation.


CD8+ cells and caspase 3+ cells in the areas of invasive BD and MCC. Paraffin-embedded tissue samples were deparaffinized and stained with anti-CD8 antibody. For the areas of invasive BD.


CD8+ cells and caspase 3+ cells in the areas of invasive BD and MCC. Paraffin-embedded tissue samples were deparaffinized and stained with anti-CD8 antibody. And MCC The sections were developed with liquid permanent red. Original magnification: x200.


CD8+ cells and caspase 3+ cells in the areas of invasive BD and MCC. And anti-caspase 3 antibody. For the areas of invasive BD.


CD8+ cells and caspase 3+ cells in the areas of invasive BD and MCC. And anti-caspase 3 antibody. And MCC The sections were developed with liquid permanent red. Original magnification: x200.


Foxp3+ Tregs, CD163+ macrophages and CD206+ cells in the areas of invasive BD and MCC. Paraffin-embedded tissue samples were deparaffinized and stained with anti-Foxp3 antibody. For the areas of invasive BD.


Foxp3+ Tregs, CD163+ macrophages and CD206+ cells in the areas of invasive BD and MCC. Paraffin-embedded tissue samples were deparaffinized and stained with anti-Foxp3 antibody. And MCC The sections were developed with liquid permanent red. Original magnification: x200.


Foxp3+ Tregs, CD163+ macrophages and CD206+ cells in the areas of invasive BD and MCC. , anti-CD163 antibody. For the areas of invasive BD.


Foxp3+ Tregs, CD163+ macrophages and CD206+ cells in the areas of invasive BD and MCC. , anti-CD163 antibody. And MCC The sections were developed with liquid permanent red. Original magnification: x200.


Foxp3+ Tregs, CD163+ macrophages and CD206+ cells in the areas of invasive BD and MCC. And anti-CD206 antibody. For the areas of invasive BD.


Foxp3+ Tregs, CD163+ macrophages and CD206+ cells in the areas of invasive BD and MCC. And anti-CD206 antibody. And MCC The sections were developed with liquid permanent red. Original magnification: x200.


X-ray of the pelvis with both hip anteroposterior. Multiple osteolytic lesions in the pelvis and proximal femur showing right side neck of femur fracture.


X-ray of shoulder anteroposterior and lateral view diffuse lesion involving the whole humerus and scapula.


X-ray of knee anteroposterior and lateral view. Both distal femur and proximal tibia showing wide spread diffuse osteolytic lesions.


Sequential head CT examinations in a 55-year-old man with severe traumatic brain injury. At the time of admission (a-c), massive acute subdural hematoma above the right cerebral convexity causing prominent brain shift with subfalcine and transtentorial herniation, the obliteration of basal cisterns, as well as diffuse subarachnoid hemorrhage were seen.


Sequential head CT examinations in a 55-year-old man with severe traumatic brain injury. Immediately after surgery directed at the evacuation of subdural hematoma, right temporal lobectomy, and external decompression (d-f), the "re-appeared" ambient cistern can be clearly visualized, as well as wide area of infarction within the right parietal and occipital lobes caused by compression of the posterior cerebral artery at the time of herniation, and subcutaneous hematoma.


Sequential head CT examinations in a 55-year-old man with severe traumatic brain injury. At the time of discharge after cranioplasty and ventriculoperitoneal shunting (g-i), asymmetric hydrocephalus, extensive infarction of the right parietal and occipital lobes, and small epidural CSF collection are evident, as well as absence of the right temporal muscle (arrows), which was resected at the time of decompressive surgery.


Microscopic view of the bone marrow biopsy specimen. Pathologic diagnosis showed hyperplasia of granulocyte series, erythroid series, and megakaryocytes (hematoxylin-eosin x10).


Chest computed tomography reveals. A 3.0 x 2.6 cm2 soft tissue density shadow in the lower lobe parenchyma of the left lung field.


The lower lobe of the left lung resection.


Microscopic view of the lung biopsy specimen. Pathologic diagnosis showed pulmonary adenocarcinoma (hematoxylin-eosin x10).


Pictures of the patient throughout the years.


2000. 2001.


Latest front.


Lateral. Pictures of the patient taken July 2015.


T1 weighted sagittal MRI image of the pituitary post contrast. 2015.


2004. Both showing a small pituitary gland which is pressed against the sellar floor with no internal hypoenhancement post-contrast.


T1 weighted coronal MRI image of the pituitary post contrast. 2015.


Pituitary carcinoma size (mm) over time. Superior to inferior measurement (SI), Anterior to posterior measurement (AP).


Case 1: Interval development of a left renal mass. (A) CT abdomen pelvis from July 2013 demonstrating stable stone burden compared to the original CT from August 2011 (not shown).


Case 1: Interval development of a left renal mass. (B) CT scan in September 2013 following PCNL, revealing a subcapsular hematoma and heterogeneous density in the left renal pelvis concerning for tumor vs blood clot. PCNL, percutaneous nephrolithotomy.


Case 1: CT scan from January 2014 following left nephroureterectomy demonstrating diffuse new hypoattenuating lesions consistent with metastatic disease. There is also peritoneal carcinomatosis, increased lymphadenopathy, and moderate intra-abdominal ascites.


Case 2: Original preoperative CT scan from June 2015. Coronal.


Axial) demonstrating bilateral staghorn calculi and a hyperdensity in the central region of the left kidney (arrows) felt to represent indeterminate, possibly representing hemorrhagic or proteinaceous debris.


Case 2: Flank mass eruption from the skin at the nephrostomy tube site. (A) CT abdomen pelvis performed 1 month following PCNL demonstrating what was felt to be hematoma extending to the skin. Nonspecific para-aortic lymph node enlargement was also noted.


Case 2: Flank mass eruption from the skin at the nephrostomy tube site. (B) One week following CT scan, the patient developed eruption of a mass-like structure from the nephrostomy tube site. Biopsy revealed well-differentiated keratinizing SCC.


Case 2: CT abdomen and pelvis from December 2015. Coronal.


Axial) demonstrating marked progression of metastatic disease, including metastatic lesions of the lung, pleura, pancreatic neck, and innumerable lesions in the subcutaneous tissue.


Epithelioid glioblastoma. (a) Noncontrast head CT shows a large parenchymal hemorrhage centered in the left temporal lobe and significant mass effect on surrounding brain, including left uncal herniation.


Epithelioid glioblastoma. Brain MRI with. T2 FSE.


Epithelioid glioblastoma. T2 FLAIR.


Epithelioid glioblastoma. GRE.


Epithelioid glioblastoma. Pre.


Epithelioid glioblastoma. Post-contrast T1 FSE images demonstrates a lobulated enhancing hemorrhagic mass in the left anterior temporal lobe attached by a stalk to the left insula, moderate surrounding edema, and central vascular flow voids from the left middle cerebral artery. Acute hemorrhage with blood-fluid levels fills mostly a thin-walled cystic space posterior to the mass in the left temporal lobe as well as a smaller region in the left inferior frontal lobe.


Epithelioid glioblastoma. DWI.


Epithelioid glioblastoma. ADC map show a region of reduced diffusion medial to the mass within the left insula, probably infiltrative hypercellular tumor or acute ischemia from the mass.


Diffuse sheets of markedly atypical epithelioid cells with pleomorphic nuclei are noted in a hemorrhagic background. Prominent microvascular proliferation is seen (arrows).


Glial fibrillary acidic protein immunohistochemical stain reveals cytoplasmic positivity in tumor cells.


Clinical appearance of the recurrent squamous cell carcinoma of the left temple with zygomatic bone metastasis.


Clinical appearance of the tumor following surgical debulking and 6 months of lapatinib and nivolumab therapy.


(A) Gross thyroidectomy specimen including the tumor mass in the left lobe (prior to sectioning).


(B) Cut surface of the tumor with solid necrotic areas, cystic degeneration and extensive hemorrhage. The resected infrahyoid muscles are also present (yellow paint).


Microscopical aspect of thyroid angiosarcoma. Vasoformative area of the tumor with large uni- or multinucleated epithelioid tumor cells lining abnormal vascular channels containing papillary fronds.


Microscopical aspect of thyroid angiosarcoma. Or in solid sheets (HE, x200).


Immunohistochemical profile of thyroid angiosarcoma. Strong and diffuse membrane positivity for CD31 in solid areas (IHC, anti-CD31 antibody, x200).


Immunohistochemical profile of thyroid angiosarcoma. Total negativity for CD34 (IHC, anti-CD34 antibody, x200).


Immunohistochemical profile of thyroid angiosarcoma. Total negativity for D2-40 (IHC, anti-D2-40 antibody, x200).


Immunohistochemical profile of thyroid angiosarcoma. Positivity for CKAE1/AE3 in vascular channels (IHC, anti-CK AE1/AE3 antibody, x200).


Computed tomography (CT), chest. Disseminated atypical pulmonary infiltrates (day +145 after alloHSCT).


Computed tomography (CT), chest. Chest CT following antimycotic therapy (day +170).


Computed tomography (CT), chest. Disease progression after three courses of rituximab, and ,two courses R-CHOP (day +228).


Computed tomography (CT), chest. Complete remission (CR) after five courses of brentuximab vedotin and three courses of third-party EBV-specific T-cells.


Histopathology and immunohistochemistry of pulmonary tumor biopsies. AlphaCD20.


Histopathology and immunohistochemistry of pulmonary tumor biopsies. MiB1.


Histopathology and immunohistochemistry of pulmonary tumor biopsies. AlphaLMP1.


Histopathology and immunohistochemistry of pulmonary tumor biopsies. AlphaCD30.


Control abdominal CT showing left adrenal gland metastasis.


Radiological findings observed on initial visit. . Notes: (A) Chest radiograph revealed right pleural effusion.


Radiological findings observed on initial visit. (B) Chest computed tomography revealed a mass in segment 6 of the right lower lobe.


Gadolinium-enhanced MRI of the head on day 48 after the initiation of gefitinib. . Note: Hydrocephalus was detected without intracranial metastases.


Radiological findings before and after VP shunt placement. . Notes: (A) Hydrocephalus on the head CT had worsened compared with the head MRI performed before the initiation of erlotinib. A low-density area was observed in the white matter of the bilateral frontal lobe because of intracranial hypertension 3 months after switching from gefitinib to erlotinib.


Radiological findings before and after VP shunt placement. (B) A head CT after VP shunt placement indicated that the malignant hydrocephalus had improved. . Abbreviations: VP shunt, ventriculoperitoneal shunt; CT, computed tomography.


Gadolinium-enhanced MRI of the head after emergency placement of the VP shunt. . Notes: Gadolinium-enhanced MRI showed diffuse enhancement of the cranial dura mater. No evidence of brain parenchymal metastases was observed. (A) Thickening and enhancement of the dura mater in the optic nerve canal were observed (white arrows).


Gadolinium-enhanced MRI of the head after emergency placement of the VP shunt. . Notes: Gadolinium-enhanced MRI showed diffuse enhancement of the cranial dura mater. No evidence of brain parenchymal metastases was observed. (B) Thickening and enhancement of the dura mater in the auditory nerve canal were observed (white arrows). . Abbreviation: VP shunt, ventriculoperitoneal shunt.


Clinical appearance of lesion.


Periapical radiograph of the right maxillary canine region.


Panoramic radiograph exhibiting radiolucent lesion.


Clinical appearance of lesion after 4 months of initial visit.


Hyperkeratotic and hyperplastic epithelium showing both endophytic and exophytic growth patterns. Rete ridges are narrow whereas superficial epithelial surface is broad. On the other side, normal gingival epithelium is appreciated.


Diffuse swelling (arrow) is seen in the molar region on the right side of the face.


Well-circumscribed, ovoid swelling (arrow) is seen in the midline of the soft palate.


Postero-Anterior view of the skull radiograph shows diffuse opacification of the right maxillary antrum (yellow arrow).


Coronal section, contrast-enhanced computed tomography scan shows a large heterodense destructive soft tissue lesion with intense contrast enhancement on the right maxillary antrum (yellow arrow), crossing the midline and displacing the nasal septum to the left (red arrow) and superiorly into the nasal cavity (blue arrow).


Axial section, contrast-enhanced computed tomography scan shows a large heterodense destructive soft tissue lesion seen in the superior postero-lateral wall of the right nasal cavity, extending into the nasopharynx and adjacent pterygopalatine fossa, right pre-maxillary space causing bowing of the posterior antral wall: The characteristic Holman Miller sign (yellow arrow) with erosion/ destruction of adjacent bones.


Axial section, T1-weighted magnetic resonance image shows a large, well-defined mass (arrow) in the region of the pterygo-maxillary fissure and sphenopalatine foramen on the right side with a heterogenous intensity.


Coronal section, T2-weighted magnetic resonance image demonstrates a large, well-defined hyperintense mass in the right maxillary antrum (red arrow), displacement of the nasal septum (blue arrow) by the heterointense tumor mass to the left side and tiny flow voids are noted within the lesion consistent with hypervascularity (yellow arrows).


Axial section, T2-weighted magnetic resonance image reveals a large, well-defined mass in the region of the pterygo-maxillary fissure and spheno-palatine foramen on the right side with heterogenous intensity. Avid enhancement of the mass (red arrows) and tiny flow voids are noted within the lesion (yellow arrows) consistent with hypervascularity.


Sagittal section, T2-weighted magnetic resonance image shows a large, well-defined tumor mass (arrow) with a heterogenous intensity measuring 6.54 cm x 6.02 cm.


Right external carotid artery angiogram reveals the feeding internal maxillary artery (red arrow) and the hypervascular lesion (yellow arrows).


Fundus photograph of the left eye in case 1 demonstrates multifocal orange-colored choroidal metastases involving the macula.


Scan ultrasound of the lesion in 1A appears acoustically echogenic and associated with retinal detachment, and medium to high internal reflectivity on A-scan;. Scan ultrasound of the lesion in 1C appears as a small acoustically echogenic mass with medium to high internal reflectivity on A-scan.


Fundus photograph of case 2 illustrates a unifocal orange-colored choroidal metastasis.


Scan ultrasound of the lesion in 1C appears as a small acoustically echogenic mass with medium to high internal reflectivity on A-scan.


Fluorescein angiography of the choroidal metastasis in case 1 at 20 seconds.


60 seconds.


5 minutes.


Fluorescein angiography of choroidal metastasis in case 2 at 21 seconds.


63 seconds.


Fluorescein angiography of a typical circumscribed choroidal hemangioma at 17 seconds.


Worm's-eye view.


Profile view.


CT and staining observations. . A. Axial CT after contrast administration in portal phase shows large mass that involved peritoneal surface without visceral organ affected.


CT and staining observations. B. Coronal reformatted CT after contrast administration in portal phase demonstrates inframesocolic and paracolic gutters mass with heterogeneous enhancement and few small foci inside (arrows).


CT and staining observations. C. Hematoxylin and eosin stain (20 x) shows glomus body consisting of uniform small, rounded cells with centrally placed round and pleomorphic nuclei. These cells are located around vessels.


CT and staining observations. D. Smooth muscle actin immunostain demonstrating strong cytoplasmic positivity.


Computed tomography scan. Computed tomography scans showed an enlarged retroperitoneal lymph node of the posterior inferior vena cava.


Computed tomography scan. And rapidly enlarged lymph node after chemotherapy.


Histological examination of biopsy. (A) pleomorphism with bizarre multinucleated tumor cells and high frequency mitosis (hematoxylin and eosin, x100).


Histological examination of biopsy. (B) Tumor cells showed strong reactivity for desmin (desmin, x200).


(A, B) The common axial position and oblique lateral position of the left breast with molybdenum targeting showing breast-occupying lesions. BI-RADS was used for classification into three categories.


(C) The surgical specimen was breast tissue with spinal skin and nipple (15 cm x 11 cm x 6.5 cm). The size of the spinal skin sample was 11 cm x 6.5 cm, and a nodule with a size of 8 cm x 6 cm x 5.5 cm was found under the nipple with multiple cuts. The nodules and surrounding mammary glands were clear. The nodules were gray and grayish yellow. Some areas showed cystic changes, some were solid and lobulated, and some were dark red, suggestive of necrosis.


Microphotographs showing the histopathological features of the tumor. (A) The tumor had loose and dense cell areas (H&E; 40x). The first arrow points to dense cell areas, and the second arrow points to loose cell areas.


Microphotographs showing the histopathological features of the tumor. (B) PT area (H&E; 40x).


Microphotographs showing the histopathological features of the tumor. (C) Fibroadenoma area around the malignant PT (H&E; 40x).


Microphotographs showing the histopathological features of the tumor. (D) Residual ductal epithelium (H&E; 200x).


Microphotographs showing the histopathological features of the tumor. (E) Mucinous background (H&E; 100x).


Microphotographs showing the histopathological features of the tumor. (F) Vascular rich area (H&E; 100x).


Microphotographs showing the histopathological features of the tumor. (G) Adipocytes (H&E; 400x).


Microphotographs showing the histopathological features of the tumor. (H) Odd megakaryocytes (H&E; 200x).


Microphotographs showing the histopathological features of the tumor. (I) Rosette-like cells (H&E; 100x).


(A) A few tumor cells were AE1/3 positive (original magnification: 200x).


(B) Tumor cells were diffusely positive for vimentin (original magnification: 200x).


Tumor cells were negative for E-cadherin.


S-100. (original magnification: 200x).


Tumor cells were diffusely, strongly positive for p16.


MDM2. (original magnification: 200x).


(H) Immunohistochemical staining for Ki-67 showed a labeling index of greater than 90% (original magnification: 100x).


(I) The FISH test results showed that MDM2 was not amplified.


A follow-up PET-CT revealed the uptake of FDG only at the gallbladder (SUVmax 7.1).


Contrast abdominal CT showed an early enhanced mass in the gallbladder (arrow) and the enhancement persisted on the equilibrium phase, suggesting gallbladder cancer. (a) Early phase.


Contrast abdominal CT showed an early enhanced mass in the gallbladder (arrow) and the enhancement persisted on the equilibrium phase, suggesting gallbladder cancer. (b) Equilibrium phase.


MRI demonstrated that the gallbladder tumor (arrow) showed low signal intensity on T1-weighted images and slightly high on T2-weighted images. (a) T1-weighted images.


MRI demonstrated that the gallbladder tumor (arrow) showed low signal intensity on T1-weighted images and slightly high on T2-weighted images. (b) T2-weighted images.


The gallbladder tumor was macroscopically soft and whitish measured 7.5 cm x 5 cm in size.


Immunohistochemical examination revealed that the gallbladder tumor was not similar to the original nasal melanoma. HMB-45 staining was far less positive in the gallbladder tumor than in the nasal tumor. (a) Gallbladder tumor, HE staining.


Immunohistochemical examination revealed that the gallbladder tumor was not similar to the original nasal melanoma. HMB-45 staining was far less positive in the gallbladder tumor than in the nasal tumor. (b) Gallbladder tumor, HMB-45 staining.


Immunohistochemical examination revealed that the gallbladder tumor was not similar to the original nasal melanoma. HMB-45 staining was far less positive in the gallbladder tumor than in the nasal tumor. (c) Nasal tumor, HE staining.


Immunohistochemical examination revealed that the gallbladder tumor was not similar to the original nasal melanoma. HMB-45 staining was far less positive in the gallbladder tumor than in the nasal tumor. (d) Nasal tumor, HMB-45 staining (200x).


X-ray imaging showing fluid in pleural space, loss of pulmonary lobes volume and reticular opacification.


High-resolution computed tomography (HRCT): fluid in pleural cavity.


Interlobular septal thickening, mediastinal nodes enlargement.


The haematoxylin and eosin staining shows multiple emboli of atypical epithelial cells (A, B). Magnification of 0.5x.


The haematoxylin and eosin staining shows multiple emboli of atypical epithelial cells (A, B). , 20x.


The cells have a characteristic signet - ring shape with a central, optically clear droplet of cytoplasmic mucin and eccentrically displaced nucleus (C). , 40x.


Immunophenotyping of tumour cells: positivity for cytokeratin 7.


Cytokeratin 20.


Negativity for TTF1.


The biopsy was positive for mucin (D). Magnification of 10x.


The haematoxylin and eosin staining of signet ring cell gastric adenocarcinoma. Magnification of 20x.


Transverse ultrasound image of the right breast demonstrating retroareolar glandular tissue consistent with gynecomastia. No suspicious masses were identified in the right breast.


Photograph showing ulceroproliferative lesion over left gluteal region with chronic discharging sinus over right gluteal region.


(A) Computed tomography showed an occupying lesion involving the right atrium and the right ventricle.


(B) Echocardiography revealed a mass in the right atrium with moderate pericardial effusion.


Histological findings and immunohistochemical staining of the cardiac lesion. (A) The neoplastic cells proliferated diffusely in the pattern of nests and sheets with scattered deposition of pigment (x100).


Histological findings and immunohistochemical staining of the cardiac lesion. (B) Fibrous separation was notable (x100).


Histological findings and immunohistochemical staining of the cardiac lesion. (C) Focal areas with remarkable cellular dyscohesion imparted a vague pseudopapillary pattern (x100).


Histological findings and immunohistochemical staining of the cardiac lesion. (D) The tumor cells were small to medium in size with fine chromatin and predominantly pale eosinophilic cytoplasm. The nuclei were typically round to oval with somewhat irregular contours and contained small nucleoli. Cytoplasmic clearing was also observed. The mitotic figures were easily found (x400).


Histological findings and immunohistochemical staining of the cardiac lesion. The tumor cells were strongly and diffusely positive for. S100.


Histological findings and immunohistochemical staining of the cardiac lesion. SOX10 (x100).


Histological findings and immunohistochemical staining of the cardiac lesion. Moderately positive for Syn.


Histological findings and immunohistochemical staining of the cardiac lesion. Negative for HMB45.


Molecular characteristics of the lesion. (A) The rearrangement of EWSR1 (arrows) was found in about 50% of tumor cells by fluorescence in situ hybridization using EWSR1 break-apart probe.


Molecular characteristics of the lesion. (B)
EWSR1-AFTF1 dichromatic fusion probe also proved the tumor carrying the EWSR1 rearrangement (arrows).


Molecular characteristics of the lesion. (C) Whole-transcriptome sequencing analysis confirmed that the fusion involved exon 8 of EWSR1 and exon 4 of ATF1.


CT scan of the thorax showing a well-circumscribed lesion with homogenous fat attenuation in the upper lobe of the right lung.


Intraoperative photograph showing pleural lipoma being excised.


CT scan of chest. Red arrow indicates lung metastasis. PET scan and CT chest, abdomen and pelvis were only positive for the isolated lung metastasis.


T2-weighted magnetic resonance image showing multiple lesions in the right lobe of the liver.


Macroscopic view of resected specimen (opened), containing multiple soft pale-brown well-circumscribed lesions.


Microscopic view of one of the liver lesions stained with hematoxylin and eosin. X10.


X40) showing uniform small hepatocytes arranged in sheets and a moderate degree of macrovesicular steatosis. No cytological atypia is present and the lesions are unencapsulated and contain no portal tracts.


Positron emission tomography-computed tomography on a routine follow-up showing a nodule in the right lobe of thyroid.


A prevascular node.


Axial slice of the planning computed tomography cuts showing adequate coverage of tumor bed.


Pretracheal node in superior mediastinum.


Photomicrograph of immunohistochemistry showing positive for AFP (x400).


Image of the dilated fundus of the right eye shows an elevated amelanotic yellow-creamy lesion located in the posterior pole (greater diameter of 4 disc diameter [DD]) with focal round pigmented lesion of 1 DD located superotemporally to the optic nerve. There is also a more peripheral amelanotic lesion extending from 6 to 9 o'clock clockwise inferotemporally.


Macular optical coherence tomography (OCT) examination shows the elevated choroidal lesion (*) associated with exudative changes (subretinal fluid [#] and intraretinal cysts [^]).


An ultrasound of the right eye shows diffuse choroidal thickening (*). There is also a small elevated lesion (#) (<2 mm) located at the macula.


The choroid biopsy shows a dense lymphoplasmacytic infiltrate composed of a majority of small lymphocytes with a slightly irregular nucleus, occasional blasts, and a minor component of cells with plasmacytic features, for example, eccentric nuclei and perinuclear halo.


Right lobe of the thyroid, showing a small solid nodule, markedly hypoechoic, of 6/7.5/7mm, with a thin hypoechoic halo, "taller than wide" (ACR-TIRADS 5).


The same nodule in the right lobe of the thyroid, showing increased vascular flow on colour Doppler sonography.


The left lobe of the thyroid with a large solid nodule, occupying the entire lobe, measuring 27.7/42.6/26.6 mm. The nodule has ill-defined margins, microcalcifications and no halo, mild peripheral and no internal blood flow.


Left laterocervical lymphadenopathy appearing as a round, hypoechoic, inhomogeneous mass, with mild internal vascularity and loss of hilar architecture.


Ultrasound.


Pathological aspects. Of anaplastic thyroid carcinoma in the left thyroid lobe, with hypercellularity, discohesive tumor cells, marked pleomorphism and multinucleated giant cells, (HE, x200).


MRI abdomen pelvis, T2 axial image, important pelvic cavity invasion with vesicular like lesions, englobing the uterus, the left iliac region with involvement of the posterior fascia of the left rectus abdominis muscle. .


Pathologic findings of growing teratoma (right bottom) in contact with the striated muscle of the rectus abdominis muscle (HES x50).


Adult sacral meningocele with yellowish slough over it.


(a, b) Magnetic resonance imaging of the spine (T1, T2 sagittal view) showing sacral meningocele.


Operative photograph showing the swelling being excised.


Visual examination of the anus: a solid mass of a thumb tip size with an uneven indented surface located mainly in the left side of the anus was observed.


Cross sectional imaging studies with computed tomography of the neck. Prior to PD-L1 administration.


After a 40% decrease in calcitonin, showing stable thyroid bed recurrence.


The tumor cells showing large nuclei with dark staining. . Notes: The chromatin was thick, and the nucleoli were obvious. Pathological mitosis was observed with less cytoplasm. The tumor cells showed infiltrating growth in lumps, nests, and glandular tubules. H&E x100 magnification.


CT on March 15, 2017, shows the enlarged inguinal lymph nodes (red arrows) and enlarged lymph nodes around the iliac vessels (blue arrows). . Abbreviation: CT, computed tomography.


CT on May 18, 2017, shows the enlarged inguinal lymph nodes (red arrows) and enlarged lymph nodes around the iliac vessels (blue arrows). . Abbreviation: CT, computed tomography.


CT on August 1, 2017, shows the enlarged inguinal lymph nodes (red arrows) and enlarged lymph nodes around the iliac vessels (blue arrows). . Abbreviation: CT, computed tomography.


Infiltration of cancer tissue in the dermis of the skin. . Note: H&E x100 magnification.


ER of the cancer cell nuclei (100% strong positive); envision method x100 magnification.


PR of the cancer cell nuclei (100% strong positive); envision method x100 magnification.


HER-2 negative; envision method x100 magnification.


Ki67 of the cancer cell nuclei (40%, strong positive); envision method x100 magnification.


Syn of the cancer cell cytoplasm (diffuse positive); envision method x200 magnification.


CgA of the cancer cell cytoplasm (diffuse positive); envision method x200 magnification.


GCDFP15 of the cancer cell cytoplasm (diffuse positive); envision method x200 magnification.


Adenocarcinoma which is tubular, moderately differentiated, infiltrating into the deep muscle layer. A; H&E, magnification x40.


Adenocarcinoma which is tubular, moderately differentiated, infiltrating into the deep muscle layer. B; H&E, magnification x100.


Chest computed tomography and histopathological findings of the primary lung tumor. . Note:. Chest computed tomography revealed a nodule in the upper-left lung.


Chest computed tomography and histopathological findings of the primary lung tumor. A diagnosis of pathological lung adenocarcinoma was considered (H&E stain).


Pulmonary CT and MRI screening findings of the lung tumor and brain metastasis (A and B). . Note:. Pulmonary CT indicated multiple metastases in lung.


Pulmonary CT and MRI screening findings of the lung tumor and brain metastasis (A and B). MRI screening showed multiple metastases in brain metastasis. . Abbreviations: CT, computed tomography; MRI, magnetic resonance imaging.


Next-generation sequencing and ALK immunohistochemistry findings of the primary lung-tumor-tissue samples. . Notes: (A) A new fusion form of ALK rearrangement involving inversion of the NCOA1 gene (exons 1-12) and the ALK gene (exons 20-29) was identified.


Next-generation sequencing and ALK immunohistochemistry findings of the primary lung-tumor-tissue samples. (B) Heterozygous genetic polymorphisms were discovered: CDAK27Q, ERCC1N118N, DPYDI543V, MTHFRA222V, and GSTP1I105V. A homozygous deletion polymorphism was discovered in the GSTT1 and TYMS genes (-6 bp/-6 bp).


Next-generation sequencing and ALK immunohistochemistry findings of the primary lung-tumor-tissue samples. (C) Immunohistochemistry results indicated ALK rearrangement was positive. Magnification x200.


Evolution at follow-up of the patient's lung tumor . . Notes:. Baseline chest CT (October 2016) showed multiple metastatic nodules in the right lung before crizotinib treatment.


Evolution at follow-up of the patient's lung tumor . Multiple metastatic nodules in the right lung decreased significantly, and ,the brain-lesion metastases were stable in several follow-up visits on chest CT.


Evolution at follow-up of the patient's lung tumor . Chest CT examination indicated multiple metastatic nodules having almost disappeared (April 2018).


Brain metastasis. During crizotinib treatment. Intracranial metastasis before crizotinib treatment on MRI (September 2016).


Brain metastasis. During crizotinib treatment. Lesions of intracranial metastasis had remained stable in several follow-up visits during crizotinib treatment.


Brain metastasis. During crizotinib treatment. MRI indicated lesions of intracranial metastasis had remained stable (May 2018). . Abbreviations: CT, computed tomography; MRI, magnetic resonance imaging.


Computed tomography (CT) images showed lobulated soft tissue density mass (9.0 x 13.6 cm) suggesting left ovarian cancer. (a) axial image.


Computed tomography (CT) images showed lobulated soft tissue density mass (9.0 x 13.6 cm) suggesting left ovarian cancer. (b) coronal image.


Coronal image with non-contrast chest CT scan shows a focal non-calcified plaque on the left hemidiaphragm.


Right lateral border of tongue showing the soft tissue growth.


Retraction of tongue and localization of lesion.


Tongue after excision of the lesion.


Closure of the wound.


Excised lesion in toto.


Photomicrograph (10x).


Pelvic magnetic resonance imaging showed that a 3.1x2.6 cm2 nodule (blue arrows) had invaded the rectum. . Notes:. T1 weighted image with sagittal view.


Pelvic magnetic resonance imaging showed that a 3.1x2.6 cm2 nodule (blue arrows) had invaded the rectum. T2 weighted image with sagittal view.


Pelvic magnetic resonance imaging showed that a 3.1x2.6 cm2 nodule (blue arrows) had invaded the rectum. T1 weighted image with axial view.


Pelvic magnetic resonance imaging showed that a 3.1x2.6 cm2 nodule (blue arrows) had invaded the rectum. T2 weighted image with axial view.


Transanal specimen extraction via laparoscopic rectectomy without an abdominal incision. . Notes:. The tumor was located at the right front wall of the middle rectum.


Transanal specimen extraction via laparoscopic rectectomy without an abdominal incision. Naked intestines at 3 cm from the distal margin of the tumor.


Transanal specimen extraction via laparoscopic rectectomy without an abdominal incision. Naked intestines at 3 cm from the proximal margin of the tumor.


Transanal specimen extraction via laparoscopic rectectomy without an abdominal incision. The distal rectum was dissected circularly.


Transanal specimen extraction via laparoscopic rectectomy without an abdominal incision. The transected bowel was pulled out via the anus.


Transanal specimen extraction via laparoscopic rectectomy without an abdominal incision. The distal circular stapling device anvil was fixed extracorporeally.


Transanal specimen extraction via laparoscopic rectectomy without an abdominal incision. The colon was then repositioned into the abdomen.


Transanal specimen extraction via laparoscopic rectectomy without an abdominal incision. The rectal stump was closed.


Transanal specimen extraction via laparoscopic rectectomy without an abdominal incision. An endtoend circular anastomosis was performed.


Macroscopic observation of rectal neoplasm. . Notes: (A) Rectal serous membrane.


Macroscopic observation of rectal neoplasm. (B) Rectal mucosal membrane.


Microscopic observation and immunochemistry of rectal neoplasm. . Notes:. Microphotography shows poorly differentiated cells of adenocarcinoma arranged in nests, with vessel invasion (HematoxylinEosin Gx100).


Microscopic observation and immunochemistry of rectal neoplasm. The immunochemistry showed that cells were WT1(3.


Microscopic observation and immunochemistry of rectal neoplasm. The immunochemistry showed that cells were PAX2(3.


Microscopic observation and immunochemistry of rectal neoplasm. The immunochemistry showed that cells were CDX2.


Total body scintigraphy eight days after 5550 MBq. 131I treatment. Intense and multifocal laesions in the liver (*) and abdomen (**).


Follicular carcinoma in a struma ovarii.


Papillary thyroid carcinoma in thyroid gland.


Total body scintigraphy eight days after 5550 MBq. 131I treatment. Two small spots in the region of the former thyroid are visible, probably remnant (*). In the pelvic region, there is pathological uptake visible just left of the bladder (**). This could be residual tumor activity.


Tumour biopsy showing poorly differentiated cells with scarce cytoplasm and vesicular nuclei with inconspicuous nucleoli. High mitotic index and apoptotic figures were present. Immunohistochemical reactions were positive for cytokeratin 8 and 20 and neuroendocrine markers (chromogranin, synaptophysin and CD56/NCAM); TTF-1 was not expressed (H&E stain, 40x).


Before first electrochemotherapy: voluminous bluish lesion of the chin.


Reduction of 80% of the volume to the initial lesion after 2 treatments.


Follow up after four electrochemotherapy applications and 16 months.


CT-guided percutaneous lung biopsy in a 56-year-old woman. The nodular lesion was close to a surgical clip (A, white arrow).


CT-guided percutaneous lung biopsy in a 56-year-old woman. Probe placement during cryoablation with subsequent iceball formation (B, C, arrow).


Same patient as Figure 1. One month CT follow-up showing nodular evolution of the lesion with no misplacement of the surgical clips (A, B).


Same patient as Figure 1. Six month CT follow-up showing shrinkage and cavitation of the nodule (C, D).


CT scan image of a 38-year-old female patient affected by lung metastasis from a carcinoma of the pancreatic tail showing a nodule in the dorsal segment of the right superior lobe, close to the surgical clips positioned during the previous surgical interventions (A).


3 months follow-up CT scan showing dimensional reduction of the nodule (B).


Colonoscopic examination reveals an ulcerating tumor in the rectosigmoid junction.


Computed tomography scan showing the large pelvic mass.


Rectosigmoid junction tumor and pelvic mass.


The pelvic mass was resected robotically and led out in endobag.


Intracorporeal colorectal anastomosis with circular stapler.


Initial abdominal computed tomography (CT) scan sagittal.


Axial. Views demonstrating dilated stomach, proximal and mid small bowel segments, with a transition point at the jejunal area in the left lower quadrant, consistent with mechanical small bowel obstruction.


(a-d) Immunohistochemical analysis of malignant lymphoma infiltrating mucosa and submucosa of small Intestine. The Ki-67 showed a markedly increased proliferative index, with 90% of lymphocytes staining positive.


(a) Positron emission tomography (PET)/CT scan from her skull to mid-thigh, which indicated no hypermetabolic lesions suggestive of active malignancy in the skull base or neck.


(b and c) Brain magnetic resonance imaging (MRI) demonstrated a single ill-defined, irregular, right fronto-parietal enhancing lesion surrounded by vasogenic edema, with associated mass effect and midline shift.


(a, b) Post-operative MRI demonstrated the resection of the right frontoparietal mass with small air fluid level and residual blood product seen at the tumor bed.


Histopathologic evaluation of the lesion biopsy confirmed the diagnosis of metastatic EATL involving the brain.


CT head showing enlarged right frontal scalp mass. Axial view non-contrast.


CT head showing enlarged right frontal scalp mass. Axial view with contrast.


CT head showing enlarged right frontal scalp mass. Coronal view with contrast.


MRI showing scalp mass, vasogenic edema, and midline shift. Axial view T1 no contrast.


MRI showing scalp mass, vasogenic edema, and midline shift. Axial view T1 with contrast.


Nuclear medicine bone scan with 99mTc-hydroxymethylene diphosphonate (HMDP) and SPECT showed multiple areas of uptake concerning for malignancy. Uptake shown in right posterior iliac bone.


Histopathologic staining showing monotonous infiltrate composed of small cells with irregular nuclei, condensed chromatin, and inconspicuous nucleoli.


Chest x-ray showing homogeneous hypotransparency in the medial third of the left lung field.


CT cut through the lower abdomen in a 70-year-old woman. Percutaneous biopsy revealed malignant mesothelioma. The tumor mass occurred within the Spigelian Hernia Belt and appeared to be expanding laterally.


Positron emission tomography/computed tomography image of the fibrous (benign) pulmonary meningioma.


Contrast-enhanced computed tomography image of the fibrous (benign) pulmonary meningioma.


Positron emission tomography/computed tomography image of the malignant pulmonary meningioma.


Contrast-enhanced computed tomography image of malignant pulmonary meningioma.


Cervical CT image. . Note: Cervical CT showed several inhomogeneous nodules (indicated by the arrows) near the cervical vessels. . Abbreviation: CT, computed tomography.


Hematoxylin and eosin staining of the thymoma. . Notes: (A) Tumor cells were arranged in a nodular pattern. The infiltrated stroma contained large numbers of lymphocytes with formation of lymphoid follicles. Scale bar is 800 mum. (Original magnification x100.


Hematoxylin and eosin staining of the thymoma. ) (B) Epithelial tumor cells were oval shaped with occasionally atypia or mitotic activity. Scale bar is 300 mum. (Original magnification x200.


Hematoxylin and eosin staining of the thymoma. ) (C) Eosinophilic granulocytes infiltrated the tumor nodules and the surrounding stroma. Scale bar is 300 mum. (Original magnification x200.


Hematoxylin and eosin staining of the thymoma. ) (D) High magnification showed the infiltrated eosinophilic granulocytes and the proliferating LCs. Nuclear grooves (indicated by the arrow) could be observed in some LCs. Scale bar is 100 mum. (Original magnification x100. ). Abbreviation: LCs, Langerhans cells.


Immunohistochemical staining of the thymoma. . Notes: Proliferation of epithelial tumor cells were stained by CK (pan).


Immunohistochemical staining of the thymoma. , CK5/6.


Immunohistochemical staining of the thymoma.P63.


Immunohistochemical staining of the thymoma. Proliferated LCs were positive for CD1a.


Immunohistochemical staining of the thymoma. And S100.


Immunohistochemical staining of the thymoma. Mature B lymphocytes were positive for Pax-5 (F). Scale bar is 800 mum. (Original magnification x100. ). Abbreviation: LCs, Langerhans cells.


A 15-year-old Caucasian male with a pigmented iris lesion. The iris lesion was small at presentation.


A 15-year-old Caucasian male with a pigmented iris lesion. And showed growth over 2 years.


A 15-year-old Caucasian male with a pigmented iris lesion. Visible on gonioscopy.


A 15-year-old Caucasian male with a pigmented iris lesion. And anterior segment optical coherence tomography.


A 15-year-old Caucasian male with a pigmented iris lesion. The lesion was excised by partial lamellar scleral flap and sector iridectomy.


A 15-year-old Caucasian male with a pigmented iris lesion. Later tumor recurrence in the anterior chamber angle with elevated intraocular pressure necessitated Iodine125 plaque radiotherapy.


Laryngoscopy image showing a tender mass in the left tonsil (arrow).


Oropharyngeal magnetic resonance images obtained before.


After. Treatment. The images depict a complete regression of the left tonsillar mass after 1 month of chemotherapy (arrows).


Positron emission tomography scans obtained before.


After. Chemotherapy reveal decreases in hypermetabolism in the primary lesion and metastases (arrows).


Pathological findings of hematoxylin and eosin-stained tumor sections. . Notes: (A) The tumor formed scattered irregular nests (magnification: 200x).


Pathological findings of hematoxylin and eosin-stained tumor sections. (B) The tumor comprised cells with crowded nuclei and scant cytoplasm (400x).


The tumor cells exhibited positive immunoreactivity for. CD56.


Synaptophysin (magnification: 200x).


18F-fluoride positron emission tomography/computed tomography bone scan - abnormalities found in the brain parenchyma.


68Ga DOTANOC positron emission tomography/computed tomography - abnormal uptake in brain parenchyma.


The Papanicolaou stain cytology smear slide shows numerous papillary groups of epithelioid cells in a background of lymphoid cells (x100).


The Papanicolaou stain cytology smear slide shows that the epithelioid cells were relatively uniform. The cells had a high nuclear-to-cytoplasmic ratio. The nuclei were predominantly oval and exhibited fine nuclear chromatin. Quite prominent nuclear grooves and irregular nuclear membrane were also noted (x400).


The Papanicolaou stain cytology smear slide shows several psammoma bodies associated with tumor cells (x400).


The tumor cells are immunoreactive with estrogen receptor (x200).


The tumor cells are immunoreactive (nuclear staining) with WT-1 (x200).


Tumor regression after HT. . Notes: (A) CT image acquired in the axial plane reveals infiltrating tumors in bilateral breasts, cutaneous metastasis, and axillary lymphadenopathy before HT.


Tumor regression after HT. (B) CT scan 4 months after completion of HT reveals marked tumor regression. . Abbreviations: CT, computed tomography; HT, helical tomotherapy.


Cutaneous metastases regression after HT. . Notes: (A) Bilateral breast tumors with infiltrating cutaneous metastases in the chest and abdominal walls before HT.


Cutaneous metastases regression after HT. (B) Four months later, the skin was intact, with tumor regression in the chest and abdominal walls. . Abbreviation: HT, helical tomotherapy.


(a) Pre-operative magnetic resonance imaging (MRI) with gadolinium. T1-weighted coronal section showing a large enhancing sellar lesion with suprasellar extension, impinging the chiasm and abutting both cavernous sinuses.


(b) T1-weighted sagittal section with gadolinium showing a mixed solid-cystic component of the tumor.


The chiasm is dislocated upwards (c) T2-weighted coronal scan showing a mixed solid-cystic components of the lesion.


(a and b) CT scan performed after sudden clinical deterioration showed no clear intra- or extr-axial bleeding or fluid collection. No ischemia could be detected.


(c) The lesion of the sella had eroded the skull base.


(a and b) Intra-operative pictures, right fronto-temporal craniotomy: The brain was swelling, with evident pus in the sulci and on the brain surface.


Intra-operative picture: Inside the sellar lesion, more pus was found and drained.


(a) Haematoxilin-eosin stained section of the adenoma at 4x magnification showing neoplastic cells admixed with a robust inflammatory infiltrate with neutrophils.


(b) The same section at 10x magnification.


(c) Synaptophysin positive immunostained section(4x).


An ulcerated metastatic nodule on the chest region is observed. . Note: Other metastatic lesions over the chest and reconstructed breast are also present.


Microphotograph of immunoperoxidase staining of a metastatic cutaneous lesion of the patient. . Notes: Neoplastic cells in the dermis show a strong reaction with anti-mucin 1 monoclonal antibody (HMFG1 monoclonal antibody) with a mixed pattern.


Breast cancer cutaneous metastasis. . Notes: Tumoral malignant cell nests passing through the epidermis are observed. Mucin 1 expression is found at the epidermal borders and at the tumor cells. The pattern of expression is cytoplasmic.


A well-defined erythematous plaque.


Gross examination of the tumor showing a mass with attached ileal segment and its cut surface (scale bar = 9 cm).


Pre-operative physical examination and ultrasound examination. (A) Three subcutaneous palpable nodules at the right anterior neck and the right supraclavicular. Three nodules are annotated with black, red, and blue arrows, respectively, and corresponding the nodules indicated by the arrow in (A).


Pre-operative physical examination and ultrasound examination. The neck ultrasound showed two hypoechoic nodules with a size of about 9*7*9 mm.


Pre-operative physical examination and ultrasound examination. 5*3*7 mm. Subcutaneously at the right anterior neck.


Pre-operative physical examination and ultrasound examination. A hypoechoic nodule with a size of about 8*4*6 mm (H) was observed at the right supraclavicular.


Pre-operative computed tomography findings. The neck enhanced computed tomography scans were observed. A general image of the neck.


Pre-operative computed tomography findings. Features of three nodules. The three nodules are annotated with black, red, and blue arrows, respectively, and corresponding nodules indicated by the arrow in Figure 1A.


During surgery and post-operative image features. (A) The thyroid was incised, and the cervical fascia exposed intraoperatively.


During surgery and post-operative image features. (B) The specimen was resected during surgery, and the arrows indicate the three palpable nodes.


During surgery and post-operative image features. (C) Three removed nodules were presented individually, with a maximum size of 8*8 mm. Three nodules are annotated with black, red, and blue arrows, respectively, and corresponding nodules indicated by the arrow in Figure 1A.


During surgery and post-operative image features. (D,E) Postoperative histopathology revealed subcutaneous nodules of the neck as metastatic carcinoma of follicular variant of papillary thyroid carcinoma. OM, omohyoid muscles; STM, sternothyroid muscle; SHM, sternohyoid muscle.


CT scan showing a cranial bone tumor which has infiltrated the surrounding tissue as an extra bone mass (arrows).


A CT scan showing a lung metastatic lesion (arrow) before the introduction of pazopanib. B; CT scan showing a decreased lung metastatic lesion (arrow) on Day 12 after the initiation of pazopanib.


FISH on the surgical specimen post resection with probes for X chromosome centromere (red) and the Y chromosome heterochromatic region (green) (Abbott Molecular, Downers Grove, IL) showing only X chromosome signals consistent with female donor origin of the urothelial cancer.


CT contrast (delayed phase) showing infiltrative mass in the lower pole of the left kidney with lower enhancement compared to normal surrounding renal tissue. Left para-aortic lymph node involvement can be seen.


CT image showing several non-calcified lung nodules and widened mediastinum due to metastasis to mediastinal lymph nodes (pink arrow).


Chest X-ray showing several non-calcified lung nodules and widened mediastinum due to metastasis to mediastinal lymph nodes.


Response of the tumor metastases to treatment. (A) Photograph taken before treatment: The skin on the left chest wall was diffused with nodules and ulcerated skin on the surface, accompanied by redness and swelling.


Response of the tumor metastases to treatment. (B) Photograph taken after 8 days of treatment: The redness and hard nodules of the skin had obviously subsided.


Response of the tumor metastases to treatment. (C-E) The skin lesions shrank quickly.


Response of the tumor metastases to treatment. (F) The ulcer on the chest wall continued to progress after she chose to reduce the dose of pyrotinib.


Response of the tumor metastases to treatment. (G) The skin lesions shrank rapidly after she resumed the standard dose of pyrotinib.


Response of the tumor metastases to treatment. (H) H&E staining image of tumor samples taken from the chest wall of the patient in case 3.


Response of the tumor metastases to treatment. (I) Very strong immunohistochemical staining (IHC 3+) of HER2 was observed in the tumor samples taken from the left chest wall of the patient in case 3.


Partial response to capecitabine combined with trastuzumab and pyrotinib treatment. (A) Photograph taken before treatment: The skin on the left chest wall was diffused with erosion and exuding hard nodules, and the skin around the edge of the lesion was red and swollen.


Partial response to capecitabine combined with trastuzumab and pyrotinib treatment. (B) Photograph taken on the 4th day during the 1st cycle of treatment: The exudation had completely disappeared, the erosional area had healed, and the redness and swelling of the skin had obviously subsided.


Partial response to capecitabine combined with trastuzumab and pyrotinib treatment. (C) The skin on the left chest wall had completely healed.


Partial response to capecitabine combined with trastuzumab and pyrotinib treatment. (D) Chest CT scans before treatment.


Partial response to capecitabine combined with trastuzumab and pyrotinib treatment. (E) CT scans taken on September 15, 2020 showed that the liver lesions had shrunk significantly.


Partial response to capecitabine combined with trastuzumab and pyrotinib treatment. (F) CT scans showed that the liver lesions had been further reduced.


Partial response to capecitabine combined with trastuzumab and pyrotinib treatment. (G) H&E staining image of tumor samples taken from the liver of the patient in case 5.


Partial response to capecitabine combined with trastuzumab and pyrotinib treatment. (H) Very strong immunohistochemical staining (IHC 3+) of HER2 was observed in the tumor samples taken from the liver of the patient in case 5.


Partial response to capecitabine combined with trastuzumab and pyrotinib treatment. (I) H&E staining image of tumor samples taken from the left chest wall of the patient in case 5.


Partial response to capecitabine combined with trastuzumab and pyrotinib treatment. (J) Very strong immunohistochemical staining (IHC 3+) of HER2 was observed in the tumor samples taken from the left chest wall of the patient in case 5.


Abdominal CT axial plane: A - Initial examination on admission.


Note large mass involving the abdominal aorta; B - CT scan performed 7 months after the first examination and under treatment with corticosteroid. Note the expressive reduction of the periaortic mass.


A; Mammograms showed a well-defined, round, and lobulated mass in the upper outer quadrant of the right breast.


B; Ultrasound examination demonstrated 3.0-cm sized heterogeneous, hypoechoic, irregular-margined masses of the right breast.


C; Microscopic findings of the mastectomy specimen were compatible with the diagnosis of metastatic small cell carcinoma. H&E stain. X400.


D; By immunohistochemical (IHC) staining, the tumor cells were strongly positive for synaptophysin and chromogranin. IHC stain. X400.


Initial slit-lamp examination of the left eye. Diffuse disseminated pigmentation in the conjunctiva can be seen around the cornea.


Rapid histopathological analysis of initial biopsy. There was no excess melanocyte proliferation in the epithelial layers. Thus, it was diagnosed as primary acquired melanosis (PAM) with reactive lymphoid hyperplasia and without atypia. Low magnification.


Rapid histopathological analysis of initial biopsy. There was no excess melanocyte proliferation in the epithelial layers. . High magnification).


Seven years after excisional biopsy. No change was observed on the pigmentation in the conjunctiva.


Fourteen years after the excisional biopsy. Black tumor expanding from the fornix and disseminated pigments at bulbar and palpebral conjunctiva can be seen.


Histopathological specimen of the conjunctival tumor (H&E staining). Tumor was a conjunctival malignant melanoma.


Medical image.


Ulceroproliferative growth in right mandibular retromolar trigone. Proliferative growth in mandibular anterior region.


Orthopantomograph showing slight erosion of underlying bone in lesional area. Orthopantomograph showing erosion of the underlying bone in anterior mandibular region.


Stained section showing top to bottom dysplastic features in overlying epithelium (H&E x 10).


Stained section showing nests, cords and gland-like lobules of closely packed basaloid cells with prominent comedo necrosis surrounded by fibrous stroma (H&E, x4).


Showing islands surrounded at periphery by pleomorphic hyperchromatic basaloid cells showing palisaded nuclear arrangement with attempt at gland formation (H&E x 40).


(A) Timeline of patient disease progression and treatment interventions.


Sagittal.


Axial. Contrast-enhanced T1-weighted images of the lumbosacral spine were obtained on patient presentation in 2018. The 1.2 x 1.3 x 2.3 cm enhancing intradural extramedullary mass posterior to L3 is indicated by white arrows.


(F) Copy number variation plot demonstrating chromosomal derangements present in the lesion.


Pathologic findings: the glial neoplasm Original magnifications:. 100x.


Identified in the resection specimen was GFAP-positive. And had vascular proliferation (*). . 200x.


Spinal cord from the autopsy showed the spinal dura mater to be expanded by the subarachnoid neoplasm.


That surrounded the spinal cord but did not infiltrate it on cross-sections grossly.


Or microscopically . 20x.


(A-C) Three-dimensional (3D) reconstruction images revealed that the tumor invaded into the right internal jugular vein and the right side of the thyroid cartilage and hyoid bone. However, the tumor did not adhere to the right common carotid artery.


(D and E) Tumor was found to invade the right internal jugular vein during surgery. The vein was removed, while the right common carotid artery was protected.


(A-C) Tumor was found to extend deep into the upper mediastinum by CAD and 3D visualization. However, the tumor boundary was found to be distinct.


(D and E) Using the imaging data for guidance, the entire tumor was excised successfully through a neck incision.


The patient's CT images. . Notes: (A, B) Chest CT images showed a soft mass in the right upper lobe measuring 35x30x25 mm in size.


The patient's CT images. (C, D) Lower abdominal enhanced CT showed a soft mass at the distal end of the ureter with uneven continuous enhancement.


The patient's CT images. (E) Intravenous urography showed that left pelvis, renal pelvis, and ureter were not developed. . Abbreviation: CT, computed tomography.


Comparative clinical photograph of the patient. At the time of presentation.


Comparative clinical photograph of the patient. , after preoperative radiotherapy.


Comparative clinical photograph of the patient. , after surgery.


Comparative clinical photograph of the patient.after postoperative radiotherapy.


Computed tomography scan of head and neck sagittal.


Bone window (b) shows erosion of the posterior arch of atlas and occipital bone.


Axial.


Coronal. View showing moderately enhancing soft tissue lesion in the nape of neck, extending from skull base to thyroid gland level.


Photomicroscopy of the excised tumor showing vascular neoplasm consisted of sheets and groups of spindle and oval shaped cells (pericytes) in between thin wall blood vessels in some areas with stag horn pattern low power.


High power view).


Immunohistochemistry demonstrating CD34.


Vimentin. Positive tumor cells.


Computed tomography scan done at 2 month, sagittal.


Axial. View demonstrating near total decompression of the craniovertebral junction with minimal residual tumor.


Slit-lamp examination; nasal limbal gelatinous mass with inferior corneal infiltration.


A) One month later, the lesion had decreased.


B) At the third month, CIN had disappeared.


A) Slit-lamp examination: a gelatinous temporal conjunctival mass (7x10 mm) with dilated superficial vessels without corneal involvement is exposed.


B) Abduction limitation in right eye.


Anatomopathological study: moderately differentiated squamous cell carcinoma was confirmed; tumour cells present in corion.


Tumor progression involving ocular globe tissues and soft periorbital structures.


Preexcision photograph of child.


Postexcision photograph of child.


Clinical features of the intraoral OFMT. A painless nodule in the anterior region of buccal mucosa with approximately 2 years of duration.


Clinical features of the intraoral OFMT. A well-circumscribed submucosal nodule with a smooth surface and normochromic in the anterior region of buccal mucosa measuring 1.3 cm in maximum diameter.


Papanicolaou-stained smears showing atypical epithelioid cells with abundant dense cytoplasm and orangeophilia.


Cell block showing cohesive cells with squamous features and atypical nuclei.


Postoperative follow-up demonstrating successful vascularised composite allotransplantation to bilateral arms.


MRI showing region of avascular necrosis of humeral head (**refers to location in depiction). Coronal.


MRI showing region of avascular necrosis of humeral head (**refers to location in depiction). Axial.


Axial view CT scan of the abdomen showing a metastatic lesion in the head of the pancreas.


Thyroid ultrasound showing a nodule in the left lobe of the thyroid gland.


CT scan showing multiple metastatic lesions in the pancreas post Whipple procedure.


First preoperative MRI shows a cystic plexus papilloma in the left parietal region. An enhanced ring can be visualized after gadolinium. Histological diagnosis revealed a CPP grade I WHO.


Post operative CT scan showed the partial removal of the extra ventricular cystic lesion.


A new MRI, after 7 months, showed a new cystic lesion in the cerebellar vermis with an eccentric nodule, in the temporal lobe and a recurrent multiloculated lesion in the left parietal region. Histological diagnosis was CPC grade III WHO.


Computed tomography (CT) scan of the head and neck revealing a mass in the right parotid region. (A) Seven months previously: The mass is ~4x2.5 cm and is accompanied by a slightly osteolytic destruction of the right mandibular branch.


Computed tomography (CT) scan of the head and neck revealing a mass in the right parotid region. (B) At present: The enlarged mass is ~12.5 cm and is accompanied by serious osteolytic destruction of the right mandibular branch.


Sagittal.


Coronal computed tomography (CT) scan demonstrating the mass of the left kidney.


Computed tomography (CT) scan of the pelvic cavity revealing a mass in the right iliac area. (A) Seven months previously: The mass is ~3 cm and is accompanied with a slightly osteolytic destruction of the right iliac bone.


Computed tomography (CT) scan of the pelvic cavity revealing a mass in the right iliac area. (B) At present: The enlarged mass is ~13.5 cm and is accompanied with a serious osteolytic destruction of the right iliac bone.


Histological analysis revealed a typical morphology of a middle-grade (grade 2) clear-cell renal cell carcinoma, which confirmed the patient's tumor to be a primary neoplasm. Hematoxylin and esosin (H&E); magnification, x1,000.


Computed tomography imaging of neurofibroma in mediastinum and axilla.


Positron emission tomography/computed tomography imaging of neurofibroma in mediastinum and axilla.


(A) A transverse computed tomography scan of the patient's chest on admission showing a large left-sided diaphragmatic hernia with bowel loops herniating into the left side of the chest, causing a mediastinal shift and resulting in small-bowel obstruction.


(B) Axial CT of the abdomen showed intraperitoneal mesenteric folds. . Abbreviation: CT, computed tomography.


Preoperative barium enema shows dilated intestinal segments detected above the line of the diaphragm. The mediastinum is shifted to the right side.


MRI (T1-weighted with gadoliunium) at presentation in April 2008.


MRI (T1-weighted with gadolinium) at detection of seeded metastasis September 2009.


CT scan appearance. . Notes: (A and B) Chest computed tomography on hospital admission showed irregular mass in the lingual segment of upper lobe of left lung (arrows).


CT scan appearance. (C and D) Abdomen CT scan demonstrated multiple masses occupying gastrointestinal cavity, spleen, and left adrenal gland (arrows). . Abbreviation: CT, computed tomography.


Findings from endoscopy. . Notes: (A) Bronchoscopy demonstrated a tumor mass in the left lingual bronchus (arrow).


Findings from endoscopy. (B) The tumor projected into the left main bronchus on the second admission (arrow).


Findings from endoscopy. (C) Gastroscopy demonstrated multiple submucosal masses in the fundus of the stomach (arrows).


Findings from endoscopy. (D) Multiple lesions were also seen in the duodenum (arrows).


Microscopic appearances. . Notes: (A) Tumor cells of lung, adjacent to small vessels, were mostly oval to spindle with abundant pale cytoplasm and distinct cell borders and the tumor showed focal necrosis with inflammatory exudate (H&E stain, 200x).


Microscopic appearances. (B) The metastatic tumor in gastric antrum reveals similar morphology (H&E stain, 200x).


Microscopic appearances. (C) Marked nuclei and prominent nucleoli in present with mitotic activity (H&E stain, 400x).


Microscopic appearances. (D-F) Immunohistochemistry: tumor cells of lung showed strong immunoreactivity for smooth muscle actin and vimentin, and it was partially positive for CD99 (200x). . Abbreviation: H&E, hematoxylin and eosin.


FLAIR images A. D) and after administration of IV acyclovir (ACV d).


T1 post-gadolinium images. Of the patient at increasing days post-admission (P. Double arrows in (B,D,F) demonstrate decreasing left frontal sulcal effacement and increasing size of the left frontal enhancing lesion.


FLAIR images Arrows in A, C, and E demonstrate decreasing FLAIR signal in the left frontal white matter from day 1 to day 17 of acyclovir administration.


FLAIR images.


FLAIR images. T1 post-gadolinium images. Of the patient at increasing days post-admission (P. Double arrows in (B,D,F) demonstrate decreasing left frontal sulcal effacement and increasing size of the left frontal enhancing lesion.


T1 post-gadolinium images. Of the patient at increasing days post-admission (P. Increasing FLAIR signal and increasing size of the enhancing lesion on T1 post-gadolinium of the left frontal lobe are again noted on post-admission day 45 and post-acyclovir day 17 (G,H).


Increasing FLAIR signal and increasing size of the enhancing lesion on T1 post-gadolinium of the left frontal lobe are again noted on post-admission day 45 and post-acyclovir day 17 (G,H).


A; The PET/CT image shows an increase in FDG uptake in the mediastinum (black arrow) and the cervical metastatic lymph node (white arrow).


B; The chest CT shows the mediastinal tumor infiltration of the large vessels and the trachea.


C; The histopathological finding shows anaplastic carcinoma. Hematoxylin and eosin staining. X60.


CT shows severe tracheal stenosis as a result of tumor invasion.


A; A rapid, prominent reduction of the mediastinal tumor led to the dead space in the mediastinum. The air within the mediastinal tumor represents the dead space caused by tumor necrosis after lenvatinib administration (arrow).


B; Abdominal CT shows progression of the liver metastases.


Cells with low N/C ratio and indistinct cell borders, tending to form acini at places, pale foamy background (MGG, x50).


Variable number of single cells, clusters of poorly cohesive large cells, low N/C ratio, bland chromatin, abundant pale cytoplasm with vacuoles, relatively indistinct cell borders, large nucleoli, intranuclear cytoplasmic inclusions and vacuolated background (MGG, x400).


Primary laparoscopy feature of the tumor in a 24 year old patient, December 2012, Rasoul-e-Akram hospital, Tehran, Iran.


Pathologic feature of the tumor in a 24 year old patient, December 2012, Rasoul-e-Akram hospital, Tehran, Iran.


Extraoral picture revealing facial asymmetry on the left side.


Intraoral picture revealing restricted mouth opening.


(a and b) Orthopantomograph and computed tomography scan revealing radiolucency at the left ramus region.


Excision of the tumor.


Representative histologic image of patient's Merkel cell carcinoma with hematoxylin and eosin staining.


PET-imaging demonstrating metastatic dissemination of Merkel cell carcinoma. (A) whole body positronic imaging showing bilateral pelvic and retroperitoneal SUV avidity consistent with metastatic disease.


PET-imaging demonstrating metastatic dissemination of Merkel cell carcinoma. (B) representative fused PET CT-scan axial imaging showing SUV avid retroperitoneal adenopathy.


Isolated left pelvic nodal progression on pembrolizumab. PET-scan showing SUV avid progression involving the left inguinal and left external iliac regions.


Computed tomography (transverse plane) revealing 2.8 x 1.7 cm mass in patient's left lateral neck.


Computed tomography (coronal plane) of the patient's left lateral neck mass.


Combined CT/PET capture of fluorodeoxyglucose (FDG) uptake in left lateral neck mass.


(A) Low-power view showing a submucosal tumor with relatively clear boundaries (hematoxylin and eosin, H&E, 2x magnification).


(B) High-power view of the tumor showing a syncytial cytoplasmic appearance and abundant intratumoral immune infiltration (H&E. 10x and 40x magnification).


Immunohistochemistry and ISH. The tumor was diffusely positive for CK5/6 [, 4x magnification.


Immunohistochemistry and ISH.negative for CK20 [, 4x magnification.


Immunohistochemistry and ISH. [, 4x magnification.


Immunohistochemistry and ISH. Immunostaining for p16 was diffusely positive, and
in situ hybridization (ISH) for Epstein-Barr virus-encoded small RNA was negative [, 4x magnification.


Immunohistochemistry and ISH. Strong PD-L1 positivity, and . , 20x magnification.


Immunohistochemistry and ISH. Abundant CD8+ T cell infiltration were observed. , 20x magnification.


CT images of an SFT in the spermatic cord:. Unenhanced CT scan.


Enhanced CT scan (the mass density is enhanced slightly).


Coronal section of the enhanced CT scan. SFT, solitary fibrous tumor; CT, computed tomography.


Immunohistochemical detection of tumor marker expression, showing. Hematoxylin-eosin staining.


Partial CD34.


CD99+. Magnification, x100.


A; A 10 x 7-mm, blue-black nodule with an irregular border, which was accompanied by 1-2-mm guttate macular satellite lesions, was observed on the left forearm.


B; Dermoscopic examination revealed a homogeneous, blue-white structure in the absence of any other dermoscopic structures.


A; In the main papule, there were hyperpigmented, spindle-shaped melanocytes infiltrating among the collagen bundles. No features suggestive of malignancy were seen, such as cytological atypia, atypical mitoses or necrosis. HE. Original magnification x40.


B; Periappendageal and perivascular concentrations of the nevus cells were observed in the main lesion. HE. Original magnification x100.


C; Perivascular concentration of the nevus cells was observed in the satellite lesions as well. HE. Original magnification x100.


(A) Clinical image of the 8-cm scalp tumor.


Sagittal.


Coronal gadolinium-enhanced T1- weighted magnetic resonance imaging depicting a biconvex mass with extracranial and intracranial invasion, compressing bilateral brain tissue.


(D) A sagittal computed tomography (CT) image showing an osteoblastic lesion.


(E) Angiographic tumor staining of the left middle meningeal artery. At the 6-month follow-up , sagittal.


Coronal CT.


3D reconstruction image. Illustrated normal skull contour with a solid fusion of the graft to the skull.


Intraoperative images (A) Following reflecting the galea showing a well-demarcated extracranial tumor.


(B) After removal of the extracranial tumor showing the osteoblastic tumor-bearing bone.


(C) The intracranial tumor was removed with the preservation of the superior sagittal sinus.


(D) Duraplasty with tensor fascia lata.


Medical image.


Ex vivo cryotherapy was done with the autologous bone graft by soaking it in liquid nitrogen for 20 min , thawing it in room air for 10 min and soaking it in povidone-iodine solution for 15 min.


The nitrogen-treated graft.


Was fixed back in situ with plates and screws.


Summary of the ex vivo cryotherapy.


Pre-operative pelvic MRI. (A) Before first surgery in our hospital, contrast-enhanced pelvic MRI in sagittal view showed a 6.8 cm * 5.2 cm * 7.3 cm mass located at presacral space (white arrow).


Pre-operative pelvic MRI. (B) Before second surgery in our hospital, contrast-enhanced pelvic MRI in sagittal view showed a 3.2 cm * 7.2 cm * 5.8 cm mass located at presacral space (black arrow).


Pre-operative pelvic MRI. (C) One year after final surgery, enhanced pelvic MRI showed no signs of recurrence (the yellow dotted circle indicated the location of the previous mass).


Histological features of the resected tumors. Representative pathological photos of the third surgery: (A) original magnification x 100 and insert x 400.


Histological features of the resected tumors. Representative photos of the latest surgery: (B) original magnification x 100 and insert x 400.


Dr. Jagdeesh KS.


X-ray of the kidney and urinary bladder shows calcific specks (arrow) in the left hemipelvis with Double J stent on the right side.


Transverse ultrasound of the pelvis reveals a polypoidal mass in the urinary bladder with calcific specks (arrow).


Transverse ultrasound of the pelvis shows a polypoidal mass in the urinary bladder with vascularity (arrow) on color Doppler.


Plain computed tomography of the pelvis shows polypoidal mass within the urinary bladder with dense foci of calcification on the left side (arrow).


Contrast-enhanced computed tomography of the pelvis shows a heterogenously enhancing polypoidal mass involving the bilateral lateral and posterior walls.


- Complete opacification of the right hemithorax. Note obliteration of ipsilateral main bronchus and foci of perihilar alveolar opacity on the left lung.


- Axial computed tomography (CT) of the chest - mediastinal window - showing voluminous hypodense collection with discrete pleural thickening and enhancement associated with retraction of the apex of the right hemithorax.


Axial CT of the chest - pulmonary window. A and B - Fissure thickening with micronodules. Septal thickening and ground glass opacities associated with septal thickening ("crazy paving") in the left upper lobe.


Gross examination of right lung showing pleural thickening, adherence to diaphragm, and ,pneumonia-like pattern.


Photomicrography of tumor cells filling alveolar spaces (air dissemination) (H&E 200x).


Photomicrography of tumor lymphatic dissemination, note fluid edema in bronchiolar lumen (right bottom) (H&E 200x).


Photomicrography of segmental bronchus invaded and obliterated by tumor (H&E original magnification 12.5x).


Photomicrographs. Acinar pattern with columnar cells (H&E 400x).


Photomicrographs. Solid pattern with mucin vacuoles (H&E 400x).


Photomicrographs. Signet-ring cells (H&E 400x).


Photomicrographs. Sheet-like pattern of poorly cohesive cells with eosinophilic cytoplasm (H&E 400x).


Photomicrographs. Large eosinophilic cells in focal trabecular pattern (H&E 400x).


Photomicrographs. Clear cells (H&E 400x).


Photomicrographs. Eosinophilic globules (H&E 400x).


Photomicrographs. Large nuclear pseudoinclusion (arrow) (H&E 400x).


Photomicrographs. Immunohistochemistry for keratin 7 (H&E 400x).


Photomicrographs. Focal nuclear TTF-1 immunostaining (H&E 400x).


Photomicrographs. Focal keratinization (H&E 400x).


Photomicrographs. Focal immunostaining for keratin 5/6 (H&E 400x).


Photomicrographs. Immunohistochemistry for CEA with diffuse staining (H&E 100x).


Photomicrographs. Multifocal immunostaining for AFP (H&E 400x).


Photomicrographs. Diffuse Hep-par (H&E 400x).


Photomicrographs. Cytoplasmatic granular TTF-1 staining (H&E 400x).


CT scan showing right upper lobe mass.


(A) Adenocarcinoma of the prostate Gleason score 3 + 3 = 6, grade group 1 (ISUP/WHO, 2016).


(B) Higher magnification of Figure 1A.


(A, B) Axial CT scan demonstrating a hypodense nodular lesion with barely defined contours located on the abdominal wall near the upper port site (arrow).


(C) CT scan demonstrates a heterogeneous mass adjacent to the pancreatic tail (arrow).


(A) Adenocarcinoma of acinar pattern infiltrating conjunctive tissue, compatible with metastatic adenocarcinoma.


(B)
Figure 3A amplified.


CT of abdomen and pelvis shows obstructive mass in sigmoid colon.


CT of chest shows patchy ground glass opacities in right upper lung, peripheral field.


Hematoxylin-eosin staining of colon tumor shows moderately differentiated malignant cells invading the seroma.


Pretreatment radiological imaging. . Notes: (A) Coronal view of enhanced CT. Opacification of the left maxillary sinus, ethmoid sinus, and sphenoid sinus is revealed.


Pretreatment radiological imaging. (B) Axial view of enhanced CT. The posterolateral wall of the maxillary sinus is invaded and destroyed.


Pretreatment radiological imaging. (C) Coronal view of T2-weighted imaging. The tumor expands from the maxillary sinus to the common nasal meatus. The ethmoid sinus and nasofrontal duct are filled with secondary sinusitis.


Pretreatment radiological imaging. (D) Axial view of Gd enhanced T1-weighted imaging. The tumor extends posterior-laterally, invading the medial and lateral pterygoid muscles. . Abbreviation: CT, computed tomography.


(A and B) Hematoxylin-eosin stain revealed spindle cells and small round cells with ovoid hyperchromatic nuclei arranged in cellular sheets.


(A and B) Hematoxylin-eosin stain revealed spindle cells and small round cells with ovoid hyperchromatic nuclei arranged in cellular sheets. (Original magnification A: x100, B: x400.


Immunohistochemically, the tumor cells were diffusely reactive for TLE1.


Magnetic resonance imaging after three courses of ifosfamide and pirarubicin. . Notes: No residual tumor can be identified. (A) Coronal view of Gd-enhanced T1-weighted imaging.


Magnetic resonance imaging after three courses of ifosfamide and pirarubicin. . Notes: No residual tumor can be identified. (B) Axial view of T2-weighted imaging.


Intraoperative image from eyebrow incision and orbital craniotomy.


Preoperative.


Postoperative images demonstrating resection of lateral orbital lesion.


A microscopic picture (X100) showing malignant well differentiated squamous components in the upper half of the image that infiltrate the thyroid tissue which is shown below.


Preoperative sagittal.