Axial. T1-weighted magnetic resonance images of the brain with gadolinium contrast demonstrate the presence of an enhancing mass in the right posterior parietal region.


PET-CT demonstrates a significant activity in the right tonsillar 4.8 cm mass.


PET-CT shows significant improvement in large right palatine tonsil mass post chemo-radiation therapy.


PET CT showing new FDG-avid 4.9 cm cardiac mass in the anterior wall.


Cardiac MRI showing a bulky mass in the right ventricular apex 4.6 cm of right ventricle post chemo-radiation therapy. Moderate-sized pericardial effusion and septal hypertrophy.


Ulceroproliferative growth on left foot.


Left inguinal lymph adenopathy.


In-transit lymph node.


Histopathologic examination shows features of desmoplastic melanoma, both in low and high magnification, with eosin and hematoxylin staining. Last image shows positivity for S100 immunohistochemistry.


CECT thorax, with pulmonary metastases.


Blackish brown proliferative growth on edentulous maxillary arch, and ,palate.


Small blackish macules on the soft palate.


Contrast enhanced computed tomography showing (c) a large infiltrating homogenous mass on right anterior alveolus.


(d) heterogenous enlarged submandibular lymph nodes.


(a and b) Brownish black, irregular growth extending from 13 to 27 on both buccal and lingual aspects involving ridge area.


Contrast enhanced computed tomography showing. A homogeneous mass with the erosion of left alveolar arch.


Extension into the left lateral margin of hard palate.


(a) Well circumscribed ovoid growth on maxillary anterior region.


(b) Contrast enhanced computed tomography showing heterogenous soft tissue mass perforating the anterior hard palate.


(c and d) 18F-fluorodeoxyglucose positron emission tomography-computed tomography scan showing metastatic deposits in lymph nodes (cervical, supraclavicular, mediastinal, and abdominal), liver, lung, and brain. Inset shows multiple deposits in the brain.


Pre-operative MRI of the brain. (A-C) MRI T1-weighted images with contrast demonstrating a heterogeneously enhancing lesion of the pineal gland.


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


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


Pre-operative MRI of the brain. (G-I) MRI T1-weighted images with contrast demonstrating an enhancing lesion of the left cerebellar hemisphere.


Histopathology and immunohistochemical analysis of the pineal lesion. (A) Hematoxylin and eosin stain with nests and singly dispersed cells with a high nuclear to cytoplasm ratio (200x magnification).


Histopathology and immunohistochemical analysis of the pineal lesion. (B) Hematoxylin and eosin stain demonstrating a signet ring-like cell (arrow) (600x magnification).


Histopathology and immunohistochemical analysis of the pineal lesion. (C) Cytokeratin AE1 immunostain demonstrating strong reactivity (100x magnification).


Basic diagnostic workup and treatment flowchart of a solitary pineal lesion.


Our diagnostic workup and treatment plan of the case described herein (ie, suspected pineal region metastasis).


Functional assessment of the knee by the "Stair Climbing Test" over 12 months. . Notes: A 9-step "Stair Climbing Test" assessed monthly by the ability to ascend and descend a flight of stairs, as well as lower extremity strength, power, and balance. The rate of perceived exertion scale (0-10) was used to indicate physical strain, with 10 being the most difficult and 0 being the easiest. C4 - left knee data was not provided as the knee was normal and untreated. . Abbreviations: C1, Case 1; C2, Case 2; C3, Case 3; C4, Case 4.


Functional assessment of the knee by the "Get-Up and Go" test over 12 months. . Notes: A "Get-Up and Go" test was assessed monthly by the subject rising from a chair, walking 3 m, turning around, and returning to the chair to sit down. The rate of perceived exertion scale (0-10) was used to indicate physical strain, with 10 being the most difficult and 0 being the easiest. C4 - left knee data was not provided as the knee was normal and untreated. . Abbreviations: C1, Case 1; C2, Case 2; C3, Case 3; C4, Case 4.


(a) Tumor resection with 20-mm margins.


(b) The inner layer and the eyelid margin were reconstructed with a buccal mucosal graft (dotted line) and a reverse Hughes flap.


(c) A radial forearm flap was harvested.


Contrast-enhanced CT scan performed at the time of diagnosis in December 2009. Presence of a large mass arising from an osteochondroma (arrow) of the left iliac bone (coronal plane, bone window, venous phase).


Contrast-enhanced CT scan performed at the time of diagnosis in December 2009. The primary tumour appears as a poli-lobulated mass extending within the pelvis, characterised by an irregular, peripheral contrast enhancement and scattered calcification islets (circle) (axial plane, abdomen window, arterial phase).


Tru-cut biopsy of the pelvic, primary tumour, performed in December 2009. Histopathological examination (HE x5, inset x10): fibrous tissue with nests of cartilaginous proliferation with hypercellularity and variation in cellular size and shape, in a focally myxoid matrix. Final diagnosis was G2 peripheral conventional chondrosarcoma. Radiologic features were not consistent with the presence of dedifferentiated areas thus supporting the final diagnosis of a conventional chondrosarcoma.


CT scan without contrast of the liver at the time of the first hepatic progression, showing a single metastasis, characterised by pronounced hypodensity and calcification islets (axial plane, abdomen window).


Contrast-enhanced CT scan of the liver and the pelvis (axial plane, abdomen window, venous phase). The progressive hepatic metastasis (black arrow) before.


Contrast-enhanced CT scan of the liver and the pelvis (axial plane, abdomen window, venous phase). After. Chemotherapy with cisplatin/etoposide.


Contrast-enhanced CT scan of the liver and the pelvis (axial plane, abdomen window, venous phase). Then a RECIST response after 4.


Contrast-enhanced CT scan of the liver and the pelvis (axial plane, abdomen window, venous phase). 9. Cycles of gemcitabine.


Contrast-enhanced CT scan of the liver and the pelvis (axial plane, abdomen window, venous phase). Pelvis reports (e-h) appear stable (white arrow: primary tumour; asterisk: urinary bladder).


Axial T2-weighted MRI image showing a solid expansile lesion.


Ultrasonography showing subcutaneous fluid collection in the anterior aspect of the left arm root.


Ovoid hypoechoic nodule, located in the lateral quadrant of the right breast. Category BI:RADS 3.


Computed axial tomography scan view showing secondary haematogenous implant in the pericardial fat.


Computed axial tomography scan view showing secondary haematogenous implant in the right subcutaneous tissue of the breast.


Computed axial tomography analysis after resection of secondary haematogenic implant.


Adenocarcinoma of Meckel's Diverticulum. Extensive gastric epithelial differentiation (arrow) strongly suggests origin in ectopic gastric epithelium.


Sagittal.


Coronal. Results from gadolinium-enhanced T1-weighted magnetic resonance imaging.


Gross total resection of the tumor was confirmed based on the sagital.


Coronal.


Axial results. From the postoperative computed tomography.


Four-month follow-up axial.


Sagittal results. From T1-weighted magnetic resonance imaging revealed a hyperintense sellar mass, which was compatible with an autologous fat graft that was used to prevent nasal fistula.


Findings from T1-weighted gadolinium-enhanced magnetic resonance imaging after 4 months.


18 months.


Tumor was found to involve the retromolar trigon (Left), extending laterally to the buccal mucosa and gingivobuccal sulcus and superiorly to the alveolar process and the hard and soft palates.


A contrast-enhanced CT scan (Axial section) revealed a soft tissue mass in the left RMT, involving the body and ramus of mandible (left side) and the upper alveolus.


Complete closure of the surgical defect with pectoralis major myocutaneous flap six weeks after the surgery.


The changes of Physical examination. (A) Physical examination on admission.


The changes of Physical examination. (B) "EC" chemotherapy.


The changes of Physical examination. (C) "PCb" chemotherapy.


The changes of Physical examination. (D) the administration of anlotinib.


The pathological examination of postoperative. (A) Some lamellar tumor cells, different sized cells, atypia, coarse chromatin, obvious nuclear division, and osteoclast-like cells.


The pathological examination of postoperative. (B) Some tumor cells were tubular, while some were fusiform and atypical, with different sizes and in different stages of nuclear division.


The pathological examination of postoperative. (C) Some cells are necrosis in the center of the tumor.


The pathological examination of postoperative. (D) VIM (+) (4X10).


The pathological examination of postoperative. (E) CD56 (+) (4X10).


The pathological examination of postoperative. (F) ki-67 40% (4X10).


The pathological examination of postoperative. (G) ER (-) (10X10).


The pathological examination of postoperative. (H) PR (-) (10X10).


The patient had a left anterior neck mass, which showed on fine needle aspiration cytology as papillary thyroid carcinoma. Ultrasonography of the neck did not show any other neck nodes.


The MRI scan of the thoracic spinal cord: Sagittal. T1-weighted contrast image.


Sagittal. T2-weighted image.


Axial. T1-weighted contrast image and axial: Showing a solitary mass in the intramedullary spinal cord at D11-12 level. The lesion showed a heterogeneous enhancement following intravenous gadolinium contrast.


The operative picture as seen under operating microscope. Before durotomy.


After durotomy.


The brownish yellow, soft to firm, suckable, vascular, friable tumour.


Cervical computed tomography scan in axial view displaying a right cervical mass of 27.5x17.5 mm. P denotes posterior, L denotes left.


Clinical photograph showing excessive hair growth of eyelashes.


Overview of the patient's course of disease, treatment regimen and genetic analysis.


Astroblastoma - Axial NECT (a) shows a heterogenous mass in the right temporal lobe with calcification (arrow).


Axial FLAIR.


Medical image.


T1W pre-contrast. Images show T1 & T2 prolongation in the right temporal lobe (arrowheads) and right temporal horn. There is dilation of the right temporal horn (arrow).


The T1W post-contrast image (e) shows lesion enhancement and enhancement of cysts (dotted arrow).


There is diffusion restriction (arrow) on DWI.


The coronal gradient T2* image (h) shows a region of susceptibility artifact compatible with calcification.


Astroblastoma Immunohistochemistry - x100, x200, and x400 hematoxylin and eosin (H&E) staining depicting epithelioid cells of the astroblastoma (a-c).


X400 H&E staining demonstrating astroblastoma cells with short cytoplasmic processes arranged in perivascular pseudorosettes (d).


X400 GFAP+ staining (e).


X200 PHH3 positive staining at (f).


CT scan of this patient, showing multiple liver metastases in the liver.


Diffusion weighted MRI of this patient, showing liver metastases in the right lobe and in segment 3.


The first stage of ALPPS. (a,b) Shown are the right hepatic artery (yellow arrow), ligated right portal vein (white arrow), right hepatic duct (blue arrow), right hepatic vein (red arrow) and middle hepatic vein (purple arrow).


Coronal CT scan showing non-specific findings of "mucosal disease" involving the right maxillary, ethmoid, and sphenoid sinuses. An erosion of the lateral wall of right sphenoid is also noted.


A 48-year-old man developed right lower quadrant pain and was taken to the operating theater. A ruptured appendix was associated with widespread mucinous tumor within the peritoneal space. He was treated with 5-fluorouracil plus leucovorin chemotherapy. Seven years after the appendectomy a repeat CT scan shows a 7 cm in diameter cystic mass within the central portion of the spleen.


(A) Axial unenhanced CT image demonstrates a soft tissue mass (arrow) in the upper of the left ureter. On unenhanced CT scan, ureteral mass measures 37 HU.


(B) Axial contrast enhanced CT in the arterial phase reveals heterogeneous enhancement of the lesions. On contrast enhanced CT scan, ureteral mass measures 55 HU.


(C) Axial unenhanced CT image of 7 months after operation.


Microscopic examination confirmed that the ureteral tumour cells were composed of two parts, and each component accounted for half of it (magnification, x100).


Radiation dose distribution for patient 2 with stomach remnant outlined in yellow: axial view.


Sagittal view A total dose of 45 Gy was prescribed, shown in color wash to the 70% isodose surface (green), 90% isodose (red).


Patient 3 radiation fields shown in three-dimensional view.


Axial view.


Coronal view. Color washed to the 70% isodose surface (green), 90% isodose (red).


Radiation dose distribution for patient 4 with gastrojejunal anastomosis outlined in red: axial view.


Coronal view A total dose of 45 Gy was prescribed, shown in color wash to the 70% isodose surface (green), 90% isodose (red).


Preoperative magnetic resonance imaging. The intramedullary lesion showing relative hyperintensity on T1-weighted magnetic resonance images.


Preoperative magnetic resonance imaging. And hypointensity on T2-weighted magnetic resonance images accompanying the long-axis syringomyelia.


Preoperative magnetic resonance imaging. The mass lesion showed homogenous contrast enhancement on T1-weighted images (d).


Postoperative magnetic resonance imaging. Magnetic resonance images obtained 1 week after surgery showed no apparent lesion enhancement, with diminution of syringomyelia (a-c).


Postoperative magnetic resonance imaging. Magnetic resonance images obtained 1.5 months after surgery showed local recurrence of the intramedullary tumor (d and e).


MRI and histologic finding of cardiac osteosarcoma and its femoral metastasis. . A. Axial double inversion-recovery T1-weighted image with fat saturation (TR/TE, 960/8.6 msec) showed well-demarcated mass of mildly heterogeneous and high signal intensity without evidence of invasion into surrounding structures.


MRI and histologic finding of cardiac osteosarcoma and its femoral metastasis. B, C. Axial triple inversion-recovery T2-weighted image with fat saturation (TR/TE, 960/100 msec) and four chamber view of cine image (3211/1605 msec) showed heterogeneous signal intensity of mass.


MRI and histologic finding of cardiac osteosarcoma and its femoral metastasis. D. Axial image of delayed contrast-enhanced MRI (TR/TE, 4457/1427 msec) showed heterogeneous enhancement.


MRI and histologic finding of cardiac osteosarcoma and its femoral metastasis. E. Mass measured about 5.0 x 3.7 x 2.3 cm and had focal hemorrhage and necrosis on gross specimen.


MRI and histologic finding of cardiac osteosarcoma and its femoral metastasis. F. Photomicrograph showed atypical spindle cells with abundant collagen material and displayed focal immature osteoid production (Hematoxylin & Eosin stain, x 40).


MRI and histologic finding of cardiac osteosarcoma and its femoral metastasis. G. T1-weighted coronal image (TR/TE, 651/20 msec) showed mass that was isointense to muscle at right femoral neck. Peripheral rim with low signal intensity was seen.


MRI and histologic finding of cardiac osteosarcoma and its femoral metastasis. H. T2-weighted axial image (TR/TE, 4053/100 msec) showed heterogeneously high signal intensity lesion with peripheral hypointense rim at right femoral neck.


MRI and histologic finding of cardiac osteosarcoma and its femoral metastasis. I. Gadolinium-enhanced T1-weighted coronal image with fat suppression (TR/TE, 540/17 msec) was performed and lesion showed heterogeneous enhancement within central portion of non-enhancement.


MRI and histologic finding of cardiac osteosarcoma and its femoral metastasis. J. Atypical spindle cells with abundant collagen material were seen on photomicrograph (Hematoxylin & Eosin stain, x 40).


PET/CT of patient with spleen metastasis from ovarian cancer - case 1.


View of the specimen - case 1'.


PET/CT of patient with spleen metastasis from rectal cancer - case 2.


Intaoperative view of laparoscopic splenectomy - case 2.


Circular genome diagrams of the patient. The outer circle (outside the green circle) represents the structure and scale of the chromosome. The middle circle indicates the somatic variation, in which, its Y-axis represents the allelic fraction (AF) value of each locus. 0 is the minimum and 1 is the maximum. The inner circle represents copy number variation (CNV). Orange color indicates deletion; green color indicates amplification, and blue color indicates neutral.


Loosely dispersed malignant cells with round to oval nuclei, irregular nuclear borders, stippled chromatin pattern, inconspicuous nucleoli, and scant cytoplasm (Papanicolaou, x600).


Malignant cells arranged in clusters with occasional mitotic figures (Papanicolaou, x600).


Malignant cells arranged in single-file pattern with focal nuclear molding (Papanicolaou stain, x600).


Tumor cells with "dot-like" rim pattern of staining with CK20 (x400).


Few tumor cells showing nuclear staining with Merkel cell polyomavirus monoclonal antibody (CM2B4) (x400).


Chest roentgenogram shows bilateral diffuse micronodular opacities.


Histopathology shows malignant glands and papillary structures with psammoma bodies and cells with classic papillary thyroid carcinoma nuclear features (H&E, 400x magnification).


TTF1 immunohistochemistry labels the neoplastic cells (400x magnification).


Computed tomographic scan of abdomen showing pseudomyxoma peritonei with multiple peritoneal masses (arrow) with "scalloping effect. ".


Laparotomy with right oophorectomy, omentectomy, and pseudomyxoma debulking.


Yellow-orange gelatinous material.


Hematoxylin and eosin staining (x20).


Cytokeratin 7 focally positive staining (x10).


Cytokeratin 20 diffusely positive staining (x10).


Abdomen ultrasonography showing a mass with 58 x 30 mm in the left parietocolic groove.


Abdomen ultrasonography showing a ganglion with 32 mm at hepatic hilum.


Change in total lymphocytes (dark blue) and T lymphocytes (purple) during hospitalization. The number of total lymphocytes reached the lowest at 0.12 x 109 cells/L on February 9, 2020. The lower limit of the normal range of total lymphocytes and T lymphocytes is marked in the figure (dashed line).


Sagittal.


Axial. T1 with contrast MRI images demonstrating multiple, 2-3 mm, contrast enhancing nodules within the cauda equina.


CT images before . A 7.0 x 6.0 cm solid tumor apparently located in the left lobe of liver.


CT images before . Luminal narrowing with marked wall thickening involving the ascending colon. Are seen. The colon lesion has become smaller with chemotherapy but the size of the liver lesion has not changed significantly.


After. Chemotherapy. A 7.0 x 6.0 cm solid tumor apparently located in the left lobe of liver.


After. Chemotherapy. Luminal narrowing with marked wall thickening involving the ascending colon. Are seen. The colon lesion has become smaller with chemotherapy but the size of the liver lesion has not changed significantly.


Preoperative MRI and FDG PET/CT scan findings. (A) T1-weighted MRI image showing low intensity.


Preoperative MRI and FDG PET/CT scan findings. (B) T2-weighted MRI image showing heterogeneous high intensity.


Preoperative MRI and FDG PET/CT scan findings. (C, D) FDG PET/CT scan image showing increased tracer accumulation in both the colon (SUVmax = 5.66) and liver (SUVmax = 5.37) lesions.


Pathological findings of the liver lesion. (A) Macroscopically the 7.0 x 6.0 cm tumor is solitary, yellowish, encapsulated, and has a smooth surface.


Pathological findings of the liver lesion. Microscopically.


Pathological findings of the liver lesion. There are proliferating spindle-like tumor cells arranged in a fascicular fashion. Immunohistochemically, the tumor cells ae positive for S-100 protein.


Pathological findings of the liver lesion. (D) The Ki-67 index is about 3.


Leiomyosarcoma arising from the intrapancreatic common bile duct. The tumor infiltrates the full thickness of the common bile duct, extends into its lumen and invades the pancreas. Tumor cell necrosis, high cellularity, many mitotic counts, pleomorphism, and nuclear atypia are present in the neoplasm (H&E, x10).


Leiomyosarcoma arising from the intrapancreatic common bile duct (Desmin, x10).


Leiomyosarcoma arising from the intrapancreatic common bile duct (smooth muscle actin, x20).


T1-weighted magnetic resonance imaging image showing a well-defined hypodense lesion in the left parietal lobe with rim enhancement, disproportionate perilesional edema, and midline shift of 8 mm.


Preoperative view of the lesion.


Intraoral periapical radiograph.


Preoperative orthopantogram.


Chest radiograph with no evidence of secondary malignancy.


Postoperative view Figure.


Postoperative orthopantogram.


Case presentation 1. Clinical presentation.


Case presentation 1. Clinical presentation, detailed view of the suspected lesion.


Case presentation 1. Dermoscopic picture of seborrheic keratosis.


Case presentation 1. Dermoscopic picture of the pigmented BCC.


Case presentation 2. Clinical presentation.


Case presentation 2. Dermoscopic picture of solar lentigo.


Case presentation 2. Dermoscopic picture of seborrheic keratosis.


Case presentation 2. Dermoscopic picture of the lentigo malignant melanoma.


Contrast-enhanced computed tomography scan brain 6 months after radiotherapy-both the lesions disappeared with ventriculo-peritoneal shunt in situ.


Intraoperative image of the mass as it appears under micro-laryngoscopy.


Low-power view of the tumor composed of pleomorphic malignant spindle cells. Note the overlying nonatypical squamous mucosa on the top right aspect of the image (HE, x10).


High-power view of the tumor showing marked nuclear pleomorphism with frequent mitoses (black arrow) (HE, x40).


Initial axial CT at the mid-abdominal level reveals no infiltration of the greater omentum and absence of ascites.


Follow-up axial CT of the abdomen confirms the tumorous infiltration of the greater omentum (known as omental cake, arrow) and ascites (arrowhead), as could be seen on the preceding ultrasound.


Sagittal reformation of the middle abdomen demonstrates the diffuse infiltration extending from the right pleural space (arrow) and abdominal cavity. Infiltration of the greater omentum can be seen with typical confirmation of the omental cake (curved arrow). Additionally, free infradiaphragmatic fluid is depicted (arrowhead).


Aspiration of ascites shows atypical mesothelial cells, originating from the primary tumor in the right pleura, consistent with malignant secondary peritoneal mesothelioma.


Histological analysis (HE staining) shows infiltrating malignant mesothelioma (arrows) within the greater omentum. In combination with the cytological results, secondary peritoneal mesothelioma, originating from the previously diagnosed pleural mesothelioma with infiltration of the abdominal space, was confirmed.


Clinical photograph of I. O lesions.


Orthopantomogram of the patient showing patchy radiolucency with irregular margins in the left anterior region extending as poorly defined radiolucency into the body of mandible region.


H & E stained sections in x5 magnification showing diffuse presence of round cells in deep connective tissue.


H & E stained sections in x10 magnification showing diffuse presence of two different morphologies of cell populations in deep connective tissue.


H & E stained sections in x40 magnification showing diffuse presence of two different morphologies of cell populations in deep connective tissue.


Cytokeratin-high molecular weight negative staining of the tissue cells.


Cytokeratin 7 negative staining of the tissue cells.


P63 mild positivity of tumor tissue cells.


Gross photograph of the globular fleshy polyp.


Gross photograph of the polyp protruding into the endometrial cavity from posterior wall of the uterus.


Immunohistochemical analysis showed neoplastic endometrial stromal cells immunoreactive for CD10 (IHC, x40).


An anterio-posterior X-ray of the hip performed preoperatively shows extraarticular spontaneous fusion of the right hip joint along with deterioration of the articular surface.


A post-operative anterio-posterior X-ray shows placement of a metallic prosthetic joint with proper prosthetic alignment.


An anterio-posterior chest X-ray was unremarkable for any tuberculotic lesions excluding the co-existence of pulmonary tuberculosis.


Cranial computed tomography and magnetic resonance imaging revealed a large cortical-based lesion of approximate size 5.7 cm x 5.3 cm x 4.4 cm in the left frontal lobe, causing a significant midline shift to the left. The lesion is predominantly cystic, with suppression on fluid-attenuated inversion recovery with a peripherally based heterogeneous mural nodule showing contrast enhancement. Computed tomography scan showing tumor.


Cranial computed tomography and magnetic resonance imaging revealed a large cortical-based lesion of approximate size 5.7 cm x 5.3 cm x 4.4 cm in the left frontal lobe, causing a significant midline shift to the left. The lesion is predominantly cystic, with suppression on fluid-attenuated inversion recovery with a peripherally based heterogeneous mural nodule showing contrast enhancement. Magnetic resonance imaging axial.


Cranial computed tomography and magnetic resonance imaging revealed a large cortical-based lesion of approximate size 5.7 cm x 5.3 cm x 4.4 cm in the left frontal lobe, causing a significant midline shift to the left. The lesion is predominantly cystic, with suppression on fluid-attenuated inversion recovery with a peripherally based heterogeneous mural nodule showing contrast enhancement. Magnetic resonance imaging coronal.


Cranial computed tomography and magnetic resonance imaging revealed a large cortical-based lesion of approximate size 5.7 cm x 5.3 cm x 4.4 cm in the left frontal lobe, causing a significant midline shift to the left. The lesion is predominantly cystic, with suppression on fluid-attenuated inversion recovery with a peripherally based heterogeneous mural nodule showing contrast enhancement. Magnetic resonance imaging sagittal.


Immunohistochemistry: High Ki67 labeling index indicating increased proliferation of tumor cells (immunohistochemistry; x400).


Swelling of the distal phalanx of the right middle finger without prior trauma or infection.


Intraoperative view of a cystic brown tumor with a soft consistency.


Low-grade papillary eccrine adenocarcinoma with intracystic macropapillary contents.


Small and monomorphic nuclei without necrosis.


Pan-cytokeratin positive staining in immunocytochemistry.


High proliferation activity in areas of solid tumor, Ki67 index 20%.


Postoperative view after tumor resection and coverage by full-thickness skin graft.


History chart of ePROs as reported from the patient on her mobile device during treatment with vemurafenib. Blue, well-being; dark red, rash; light red, hand-foot syndrome; yellow, loss of appetite; olive green, nausea; orange, headache; green, cold symptoms; light purple, sensory disturbance; dark purple, gait disorder.


CT scan of the lung showing the lung metastasis in the right lung measuring 24.1 x 22.9 mm before vemurafenib treatment.


19.4 x 13.1 mm 3 months after the initiation of vemurafenib treatment.


Staging CT scans and PET imaging of the primary tumor and metastatic lesion prior to radiation therapy. (A) Coronal section of the initial CT of the abdomen/pelvis with contrast identifying a large soft-tissue mass in the right retroperitoneal space overlying the right psoas muscle with extension into the right hemi-pelvis.


Staging CT scans and PET imaging of the primary tumor and metastatic lesion prior to radiation therapy. (B) Coronal section of a CT of the abdomen/pelvis approximately 2 months after the initial diagnosis demonstrating interval growth of the now inoperable retroperitoneal mass.


Staging CT scans and PET imaging of the primary tumor and metastatic lesion prior to radiation therapy. (C) Coronal PET/CT maximum intensity projection (MIP) performed approximately 3 months after initial diagnosis, demonstrating the large FDG-avid mass in the right retroperitoneal space (blue arrow). FDG-avidity in the inferior aspect of the image in the figure corresponds to physiological uptake in the urinary bladder (yellow arrow).


Staging CT scans and PET imaging of the primary tumor and metastatic lesion prior to radiation therapy. (D) Coronal PET/CT MIP from the same study as in C demonstrating a non-enlarged FDG-avid lymph node in the left supraclavicular nodal station. Blue arrows, primary mass; yellow arrow, physiologic FDG uptake.


Maximum Intensity Projections (MIP) from PET/CT scans performed 1 month before, 1, and 5 months after radiation treatment. (A) PET/CT prior to radiation treatment demonstrating a large primary retroperitoneal mass, lesion superior to the mass at approximately T12 and left supraclavicular mass that were not included in the radiation treatment plan (blue arrows).


Maximum Intensity Projections (MIP) from PET/CT scans performed 1 month before, 1, and 5 months after radiation treatment. (B) PET/CT performed 1.5 months after completing radiation treatment to the primary retroperitoneal mass demonstrating disease progression at sites outside of the radiation treatment field (red arrows).


Maximum Intensity Projections (MIP) from PET/CT scans performed 1 month before, 1, and 5 months after radiation treatment. (C) PET/CT performed 5 months after completing radiation treatment demonstrating regression of disease at non-irradiated sites.


Maximum Intensity Projections (MIP) from PET/CT scans performed 1 month before, 1, and 5 months after radiation treatment. (D) Representative inverted coronal image from the patient's CT simulation for radiation treatment showing radiation dose color wash covering the primary mass. Note that disease superior to the mass adjacent to the right kidney and left supraclavicular region were not included in this plan. Dose range: blue >= 2 CGE, green >= 25 CGE, red >= 50 CGE. Yellow arrows indicate physiologic uptake in the urinary bladder as in Figure 1.


CT scan showing recurrence of the tumor in the vaginal stump (June 2016).


CT scan showing complete remission of the lung lesions (July 2017).


Identification of Clonal Immunoglobulin Heavy Chain Gene Rearrangements in non-denaturing polyacrylamide electrophoresis gels (PAGE). Positions 1 and 8 polyclonal controls, positions 2 -4, 9 - 11 samples, and positions 5 - 8, 12 - 16 clonal controls. Requested sample at positions 3 and 10.


Identification of Clonal Immunoglobulin Heavy Chain Gene Rearrangements in non-denaturing polyacrylamide electrophoresis gels. Positions 1 and 9 polyclonal controls, positions 2 - 4, 10 - 12 samples, positions 5 - 8, 13 - 15 clonal controls. Requested sample at positions 3 and 11. M: PhiX174 / HaeIII digest ladder (New England Biolabs).


Identification of Clonal T Cell Receptor Gamma Chain Gene Rearrangements in non-denaturing polyacrylamide electrophoresis gel (PAGE). Positions 1 and 9 polyclonal controls, positions 2 - 5, 10 - 13 samples, and positions 6 - 8, 14, and 15 clonal controls. Requested sample at positions 5 and 13. M: PhiX174 / HaeIII digest ladder (New England Biolabs).


Contrast enhancement T1-weighted MR imaging showed that the tumor invaded the parapharyngeal space and nasopharynx.


Electronic nasopharyngoscope showed new organization in the nasopharynx.


H&E staining of local canceration of the inverted papilloma (x100).


H&E staining of local canceration of the inverted papilloma (x400).


After three cycles of anlotinib treatment, the August 2019 contrast enhancement T1-weighted MR imaging showed the primary tumor was significantly reduced (A-C).


Multiphase CECT showing right adrenal mass with maximum diameter of 9.9 cm. Unenhanced phase (HU of 45.3) with central areas of necrosis.


Early arterial phase showing bright enhancement of mass (HU-158.2).


Early venous phase (HU-98.6) showing washout as compared to early arterial phase.


15-min delayed phase (HU-61.2) showing washout. CECT: contrast-enhanced computed tomography, HU: Hounsfield unit. Technique: 64-slice multidetector CT system (Brilliance 64, Philips Healthcare, Best, and the Netherlands) with imaging done at baseline, 20 s (early arterial), 1 min (early venous), and 15 min (delayed).


Hematoxylin, and ,eosin staining under light microscopy (x40) showing tumor cells arranged as nests separated by thin vascular septae with central round nucleus, and ,moderate eosinophilic cytoplasm.


On immunohistochemistry, tumor cells showed positivity for TFE suggestive of alveolar soft part sarcoma.


Conformal radiotherapy plan showing the dose distribution where the planning treatment volume is the shaded red contour, and the isodoses are given as a percentage of 60 Gy.


Computed tomography angiogram.


Corresponding digital subtraction angiogram. Images confirming the fairly long irregular fusiform dilatation (indicated by the white arrows).


Awake catheter angiogram/digital subtraction angiogram performed during trial balloon occlusion showing the fusiform aneurysm.


Loss of flow in the middle cerebral artery branch when the balloon microcatheter was deployed even without inflation resulting in profound dysphasia.


Initial magnetic resonance angiogram (left) showing the fusiform aneurysm.


Three-month follow-up magnetic resonance angiogram (right) showing partial thrombosis of the fusiform aneurysm.


Evolution of Case 1-cutaneous metastasis:. Before TDM1 initiation.


After 3 courses of TDM1.


After 45 courses of TDM1.


Evolution of Case 2-cutaneous metastasis:. Before TDM1 initiation.


After 4 courses of TDM1.


9 months after TDM1 discontinuation.


(a,b) Needle biopsy of kidney low and high magnification showing tumor infiltration confined to interstitium.


(c) Immunohistochemistry with CD45 marker study.


CT scans show: before crizotinib therapy.


CT of the chest revealed the recurrence after 2 months of crizotinib . Abbreviation: CT, computed tomography.


Needle biopsy showed a poorly differentiated carcinoma (HE, x200).


FISH analysis of the lung tumor specimen revealed cells with characteristic ALK translocation . Abbreviations: ALK, anaplastic lymphoma kinase; FISH, fluorescence in situ hybridization; HE, hematoxylin and eosin.


CT scans show: after the course of chemoradiotherapy.


CT of the chest revealed the recurrence after the course of chemoradiotherapy.


CT scan of chest after 1 month of icotinib treatment . Abbreviation: CT, computed tomography.


EGFR Exon 19 deletion (E746-A750del) in next-generation sequencing in plasma (the blank region expressed base deletion and at the bottom of bull lines indicated E to A deletion). . Notes: *A guidance function. The dark gray region represents an expanding fold. . Abbreviation: EGFR, epidermal growth factor receptor.


The right axillary skin appearance. Small reddish nodules were noted at the same site as the synchronous cutaneous metastasis.


Computed tomography imaging. Irregular thickening of the right axillary skin was noted.


Histopathological findings of the gastric cancer . A, b Moderately to poorly differentiated adenocarcinoma was observed. Immunohistochemical staining was positive for CK7 and negative for CDX-2 and CK20 (not shown). HE. X100.


The synchronous cutaneous metastasis of the right axillary skin. Resected 6 years ago.


Computed tomography revealed a small lesion on the superior wall of the urinary bladder.


(A): Cystoscopy revealed a solid papillary pedunculated mass with a measuring of 1.0 x 0.5 cm located on the superior posterior wall.


(B): The surrounding urinary wall have several distended vessels.


(A) Histological findings revealed the almina propria and submucosa of the urinary wall without infiltration of the muscularis propria.


(B) A proliferation of vessel walls with distinct borders and spreading between the normal vasculature, well differentiated, and the stroma of the bladder submucosa with intense congestion.


Atypical menigioma. Axial T1-weighted MRI.


Atypical menigioma. Histological examination.


Cystic cavernous angiomas. Axial gadolinium enhanced T1-weighted MRI.


Cystic cavernous angiomas. Axial GRE T2-weighted MRI.


Cystic cavernous angiomas. Histological examination.


Gastrofiberoscopic findings showed abrupt change in a year. Normal gastric mucosal fold at midbody greater curvature side 1 year ago.


Gastrofiberoscopic findings showed abrupt change in a year. Diffuse thickening of the gastric mucosal folds and cent ral ulceration.


Computed tomography shows diffuse gastric wall thickening suggesting Borrmann-4 gastric cancer.


(A) Computed tomography showed dilatation of roux-limb.


(B) Upper Gastrografin gastrointestinal swallowing study showed near complete obstruction of the Roux-limb proximal to the jejunojejunostomy site.


(A) Laparoscopic findings during reoperation revealed whitish multifocal nodules at the left side of the diaphragm.


(B) Histologic finding for peritoneal biopsy revealed signet ring cell type malignant cells infiltrated into muscle tissue.


MRI of Case 1 (suprasellar germinoma). (A and B) representative sagittal and coronal views, respectively, at the time of presentation.


MRI of Case 1 (suprasellar germinoma). Sagittal view after 2 doses of weekly vinblastine showing dramatic tumor response.


MRI of Case 1 (suprasellar germinoma). Sagittal view after completion of vinblastine monotherapy and prior to definitive radiotherapy showing further tumor response.


MRI of Case 4 with germinoma relapse of an intracranial malignant non-germinomatous germ cell tumor (NGGCT). Representative sagittal views at. Original diagnosis of the NGGCT.


MRI of Case 4 with germinoma relapse of an intracranial malignant non-germinomatous germ cell tumor (NGGCT). Following completion of treatment with chemotherapy, and ,radiotherapy.


MRI of Case 4 with germinoma relapse of an intracranial malignant non-germinomatous germ cell tumor (NGGCT). At the time of relapse with germinoma, with nodular enhancing cyst-like lesions posterior and inferior to the corpus callosum and involving the septum pellucidum. White arrows indicate the radiological abnormality.


Bone metastases and PSA responses after receiving maintenance long-term multiple cycles docetaxel chemotherapy in patient 1. (B) The curve of PSA changes and chemotherapy cycles in patient 1. The patient received maintenance docetaxel chemotherapy for a total of 33 cycles. During the treatment, the PSA level of the patient was monitored regularly.


PSA response after receiving long-term multiple cycles docetaxel administration in patient 3. The patients received maintenance docetaxel chemotherapy for a total of 35 cycles. The PSA level of the patient was monitored regularly after docetaxel therapy. At the time of writing, the patient was still being treated with docetaxel.


Right hand: Note gross swelling in the first web space and clubbing of the nails.


A 4.0x4.5 cm, hard, round, protuberant tumor was found on the right palm.


The tumor cells had eccentric nuclei and round and deeply eosinophilic cytoplasms with inclusion bodies, displaying a rhabdoid appearance.


Immunohistochemically the tumor cell were positive for S100 and EMA.


(a) Preoperative plain film showing an expansile osteolytic lesion in the left second metacarpal bone.


(b) Immediate postoperative plain film revealing a bone defect with a hyperdense mass.


(c) Three-year postoperative plain film showing consolidation and remodeling of the bone lesion without fracture.


(a) Illustration of left second metacarpal bone showing metastatic adenocarcinoma composed of infiltrating nests of pleomorphic polygonal cells with focal glandular formation and intracytoplasmic vacuoles.


(b) Tumor cells of the metastatic lesion (metacarpal bone) are immunoreactive for thyroid transcription factor-1 with nuclear staining.


(c) Tumor cells of the metastatic lesion (metacarpal bone) are immunoreactive for cytokeratin 7 with cytoplasmic staining.


(d) Histologically, the left lower lung shows features of adenocarcinoma similar to the metastatic lesion.


Brain MRI at baseline (02.05.13.


After 1 month of treatment with bevacizumab plus vinorelbine at the end of posterior fossa irradiation (05.06.13.


After 11.5 months of treatment with bevacizumab plus vinorelbine (15.04.14.


Principal component analysis (PCA) of the tFL case compared to FL and DLBCL samples. A principal component (PC) analysis on GEP from 7 FL, 41 DLBCL samples and the patient's primary and relapse tumors was performed. All probe sets for all samples were included in the PC analysis. A; The two diagnostic entities, FL and DLBCL, segregated into distinct clusters in the PC analysis, with the primary and relapse tumor samples located at the edges of the FL and DLBCL groups, respectively.


The contents of the cerebellum cyst were old brownish hematoma-like liquid.


Partially nodular lesions were inside the cyst. Arrow).


Preoperative magnetic resonance imaging (MRI) of cerebellar metastasis lesion. T1WI MRI with contrast.


Fluid-attenuated inversion recovery).


T1WI magnetic resonance imaging with contrast. 1 postoperative day.


1 month after operation).


Computed tomography, hemorrhage from the cerebellar metastasis recurrent lesion. Left.


Right).


The MRI scan showing.


Lobulated mass at frontal region which. Enhanced homogenously after contrast administration.


The mass extends to the frontal base viewed by coronal plane.


Shows various intensity on T2 imaging.


(a) Recurrence of mass on the previous surgery site with marked enhancement on T1 imaging.


(b) Contralateral cavernous sinus showing new mass that was not seen on previous images.


Gray-scale ultrasound images (a, b) show hypoechoic areas (yellow arrowhead), with intra-lesional vascularization on color flow Doppler examination, near the dorsal surface of the both corpora cavernosa.


CT images through the. Lung.


Liver demonstrate multiple metastatic lesions.


Positron emission tomography/computerized tomography sagittal scan showing a big hypermetabolic uterine mass (yellow arrow) with maximum standardized uptake value 16.2 g/ml bw.


Proximal left main coronary artery 99% occlusion in Case 1.


Left main coronary artery 99% occlusion in Case 2.


A) Arterial phase CT scan. Multiple cysts (arrow) which replace pancreatic parenchyma.


B) Magnetic resonance imaging, T1 weighted sequence, without contrast demonstrates hypointense focal images and others of different sizes which are hyperintense (arrows).


C) The T2 weighted sequence shows hyperintense cystic focal images and others which are heterogeneously hyper and hypointense consistent with the image descriptions in B (arrow).


D) Cholangioresonance shows dilatation of the bile duct with a blockage in the intrapancreatic bile duct and the disappearance of the Wirsung duct by replacement of the pancreatic parenchyma by the tumour.


Endoscopic Ultrasound (EUS). A) Hypoechoic heterogeneous mass, with irregular borders, located in the head of the pancreas.


Endoscopic Ultrasound (EUS). B) Observe the distal end of the biopsy needle entering the tumour (yellow arrow).


Biopsy of soft tissue lesions. . Notes:. ALK staining, original magnification: x200.


Biopsy of soft tissue lesions. CD30 staining, original magnification: x200. . Abbreviations: ALK, anaplastic lymphoma kinase; CD, cluster of differentiation.


Macroscopic feature of the partial penectomy showing a large exophytic mass with an irregular surface.


Macroscopic cross-section of the partial penectomy showing a gray, white and congestive tissue. Scale bar = 70mm.


During crizotinib treatment multilocular cysts appear in both kidneys.


By continuing the crizotinib treatment the confluent cystic formations extend from the kidneys to the diaphragm, to perirenal spaces, to the left iliopsoas muscle; two hepatic cysts appear.


The cysts decreased in size and number by switching therapy to alectinib.


Preoperative T1 imaging (MRI) shows enhancing mass in the craniocervical junction (Ant cistern of brain stem) with compressive effect on ant medulla.


Microscopic findings for the biopsied specimen before the chemotherapy regimen was chosen. T cell/histiocyte-rich large B cell lymphoma.


Picture of the local injection site.


PET/CT imaging after CAR-T cell infusion. The lesion is significantly smaller than before. The position indicated by the arrow is the location of the lesion.


Coronal MRI STIR images of the pelvis showing infiltrative marrow metastasis.


CT scan of the chest showing a small tumour mass in the right lower lobe.


A; H&E stain showing a non-small cell carcinoma.


B; Dual stains showing a positive cytokeratin 7 stain.


C; Dual stain showing positive TFF-1 staining.


CT findings.


Pouchogram performed three weeks following surgery.


(a) Magnetic resonance imaging scan of the brain showing the initial left temporal mass prior to surgery.


(b) Magnetic resonance imaging scan of the brain showing tumor recurrence 5 months after initial surgery.


(c) Computed tomography scan of the brain showing tumor recurrence 6 months after diagnosis and after two separate tumor resections.


Computed tomography scan of the abdomen showing ascites with diffuse peritoneal enhancement with diffuse omental thickening and stranding.


Appearance of multiple vertebral lesions compared to PET-CT in February 2011 , indicating disease progression.


PET-CT in August 2011. Shows ~35-40% increase in the size of the LRF mass.


Positron emission tomography/computed tomography image showing metabolically active hypo dense area encircling the superior vena cava right atrial junction.


Positron emission tomography/computed tomography revealing hyper metabolic nodule in the sub cutaneous planes of right thigh.


Histopathology of right testis showing microscopically shaved entrapped somniferous tubules in sheets of large monomorphic dyscohesive cells showing vesicular pleomorphic nuclei, clumped chromatin, small nucleoli, and minimal amount of cytoplasm suggesting primary testicular diffuse large B cell lymphoma.


Abdominal MRI. A. Expansive formation on the right lateral body wall of the gallbladder, with 1.7 x 1.3 cm, showing pronounced early and persistent contrast enhancement and promoting exophytic bulging of the underlying outer vesicular margin, which shows irregular contours (Red circle).


Abdominal MRI. B. T2-weighted hypointense expansive formation in the right lateral body wall of the gallbladder (black circle) and T2-weighted slightly hyperintense nodular formation in the body portion of the pancreas (White circle).


T1-weighted hypointense nodular formation in the body portion of the pancreas with 1.5 x 1.2 cm (circle).


Metastatic renal cell carcinoma as a well-circumscribed polypoid mass in the gallbladder body (circle).


A; A chest film revealed a large soft tissue density in the right upper lobe of the lung.


B; A subsequent chest computed tomography disclosed a large space-occupying lesion in the right upper lobe of the lung encasing the superior vena cava and the right pulmonary artery.


Suspicious lesion in the left adrenal area. A; In November 2011, computed tomography disclosed a small, ill-defined tumor (1.8 x 1.4 cm) in the left adrenal area.


Suspicious lesion in the left adrenal area. B; In May 2012, a remarkable enlargement of the previously suspected left adrenal tumor was noted (3.3 x 2.5 cm).


Immunohistochemical stain was positive both for TTF-1 and CD-56. A; Lung TTF-1 (x400).


Immunohistochemical stain was positive both for TTF-1 and CD-56. B; Stomach TTF-1 (x400).


Immunohistochemical stain was positive both for TTF-1 and CD-56. C; Lung CD-56 (x100).


Immunohistochemical stain was positive both for TTF-1 and CD-56. D; Stomach CD-56 (x400).


MRI of the tumor. Pre GKRS MRI, October 2014. Tumor volume 4.43 cm3.


MRI of the tumor. (b) Stereotactic (Treatment) MRI, Feb. 2015. Tumor volume 5.15 cm3.


MRI of the tumor. (c) Post GKRS MRI at 12 months, Feb 2016. Tumor volume 3.87 cm3.


MRI of the tumor. (d) Post GKRS MRI at 20 months, Nov 2016. Tumor volume 1.69 cm3.


Physical and ultrasonography findings. A; Physical examination during the patient's visit revealed an elevated lesion with blue purpura around the nipple in the right breast.


Physical and ultrasonography findings. B; We performed breast ultrasound and detected a well-defined 19.6 x 16.4 x 10.7 mm hypoechoic tumor in the left subareolar area.


Physical and ultrasonography findings. C; Blood flow rich.


Macro- and microscopic diagnosis of the resected specimen. A; A dark-red tumor sized 18.0 x 12.0 mm was found in a specimen from the nipple.


Macro- and microscopic diagnosis of the resected specimen. B; The pathological diagnosis of the specimen revealed short spindle-shaped tumor cells with strong nuclear pleomorphism and a significant interstitial fibrosis (x200). Immunohistochemistry was performed, and the tumor cells were found to be vimentin positive and AE1/AE3, cytokeratin (CK) 7, CK20, gross cystic disease fluid protein, estrogen receptor, progesterone receptor and human epidermal growth factor receptor 2 negative; expression of Ki-67 was high.


Macro- and microscopic diagnosis of the resected specimen. C; Immunohistochemistry using D2-40 (x200) and CD31 antibodies showed irregular luminal proliferation at the anastomosis.


Postoperative imaging.


Physical examination demonstrated mammary asymmetry.


The outer quadrants and the periareolar region had inflammatory signs.


She had supraclavicular lymph nodes.


Case 1. Latest positron emission tomography scan showing complete metabolic resolution of the disease.


Case 2. Magnetic resonance image of the pituitary gland showing a mass lesion infiltrating the pituitary stalk.


Case 3. Magnetic resonance image of the pituitary gland before chemotherapy.


Case 3. Magnetic resonance image of the pituitary gland after chemotherapy showing an empty sella.


Case 4. Magnetic resonance image of the pituitary gland showing a pituitary stalk lesion.


Clinical picture showing extensive intra-abdominal mass.


Nests of tumor cells surrounded by desmoplastic stroma, hematoxylin and eosin stain 10x (H&E stain).


Brain MRIs of the patient revealed the size of BM lesion and PTBE. Comparing with the brain MRI before, the maximum vertical diameter of BM demonstrated slight shrunk (17x22 to 14x18 mm).


Brain MRIs of the patient revealed the size of BM lesion and PTBE. (15x17 to 12x9 mm). While peritumoral brain edema shrunk significantly.


Histological examination consistent with metastatic urothelial carcinoma. A; Solid nests of carcinoma cells are present in a desmoplastic stroma. The neoplastic cells do not show any morphological differentiation (HE, 100x total magnification).


Histological examination consistent with metastatic urothelial carcinoma. C By immunohistochemistry, the carcinoma cells are positive for GATA3. And uroplakin III.


Histological examination consistent with metastatic urothelial carcinoma. , demonstrating an urothelial origin of carcinoma.


Timeline of the clinical course.


A exophytic lesion with measuring 8 cm by 4 cm at the right of the buccal mucosa. The surface of lesion is verrucous.


A verrucous carcinoma with parakeratin and the wide and elongated rete ridges that appear to push into the underlying connective tissue.


A verrucous area extended from the right buccal mucosa into the alveolar ridge, which tender to palpation. The tissue proximal to the lesion is erythematous and atrophic in appearance with indurations.


A early squamous cell carcinoma with some cell degeneration, keratin pearls, nests and cords of malignant epithelial cells with wide cytoplasm, round or oval nuclei, with prominent nucleoli and mitotic figures.


A crater like ulcer on the right lateral border of the tongue that extending into dorsal surface of the tongue.


An ulcero-proliferative lesion in the left mandibular ridge area.


A crater like ulcer on the left vermilion border of lip.


Pretreatment 2.5 cm contrast-enhancing mass in the right lower lobe (A).


Volumetric modulated arc therapy plan with the planning target volume (B).


Dose distribution with isodose lines, from 100% to 30% (C).


Complete tumor response 2 months after treatment (D).


Tumor in the lateral part of the left temporal lobe and the cerebellum in magnetic resonance imaging (MRI) scans.


Necrotic area of the lung surrounded by atypical lymphoid cells.


Necrotic area of the lung surrounded by atypical lymphoid cells . . 20x.


Dense lymphocytic infiltration of the wall of the blood vessel. . 40x).


Positive immunostaining for CD20 ,. . 20x.


CD30. . 20x.


EBV/LMP1. Corresponding to grade 1 lymphomatoid granulomatosis (magnification A-10x. . 20x.


Dense infiltration of the brain composed of Reed-Sternberg cells, small lymphocytes, and macrophages. Corresponding to the classical Hodgkin lymphoma of the central nervous system, mixed cellularity (MCcHL).


Dense infiltration of the brain composed of Reed-Sternberg cells, small lymphocytes, and macrophages. Corresponding to the classical Hodgkin lymphoma of the central nervous system, mixed cellularity (MCcHL), and . . 40x.


Positive immunostaining for CD30 ,. . 20x).


CD20. . 20x).


EBV/LMP1. In Reed-Sternberg cells (objective magnification A-10x. . 20x).


CT findings: 5x4 cm right adrenal mass and 10x8.4x7.4 cm left adrenal mass with minimal surrounding inflammation.


Pathology report high-power view - positive for neoplastic lymphoma cells. High volume of lymphocytes showing high nuclear-cytoplasmic ratios (arrow).


Pathology report: Large B-cell lymphoma non-germinal center type. Neoplastic cells show diffuse reactivity for CD20 and for CD43. Background T cells are reactive for CD3. No reactivity for pan-cytokeratin, CD56, S-100 protein, chromogranin, synaptophysin, or TTF-1.


The changes of the levels of cytokines and CD123-CAR gene DNA, and the changes of the proportion of anti-CD123-CAR T-cells. (A) The serum levels of cytokines reached higher peaks 42 days after anti-CD123-CAR T-cell infusion or 14 days after radiotherapy.


The changes of the levels of cytokines and CD123-CAR gene DNA, and the changes of the proportion of anti-CD123-CAR T-cells. (B) The proportion of anti-CD123-CAR T-cells reached higher peaks 42 days after CAR-T cell infusion or 14 days after radiotherapy.


The changes of the levels of cytokines and CD123-CAR gene DNA, and the changes of the proportion of anti-CD123-CAR T-cells. (C) The trend of the CD123-CAR gene DNA level is the same as that of the anti-CD123-CAR T-cell proportion. . Abbreviation: DNA, deoxyribonucleic acid.


(A) Timeline of clinical course with dates of dietary treatments, magnetic resonance imaging (MRI), magnetic resonance spectroscopy (MRS), and hyperbaric oxygen therapy (HBOT).


(B) Glucose/ketone index indicates the ratio of circulating glucose to urinary ketones at all eight clinical assessments during the 15 months period from February 2016 to April 2017.


(A) Comparison between tumor metabolism over 20 months. Choline indicates cell membrane turnover and reflects tumorigenesis. N-acetylaspartate (NAA) is a marker for neuronal integrity that decreases with brain malignancy and radio necrosis. Creatine is a marker for cellular energy that decreases significantly with malignancy and radio necrosis. Hunter angle (blue arrow) reflects the choline/NAA ratio.


(B) Comparison between tumor size and midline shift (red line) over 20 months.


Analysis of a CSF-470 VAC-SITE tissue. Dense clusters of CD11c+ cells were observed at the VAC-SITE, most of them also expressing PD-L1. Original magnifications = : 20X. Scale bars:. =200 mum.


Analysis of a CSF-470 VAC-SITE tissue. Dense clusters of CD11c+ cells were observed at the VAC-SITE, most of them also expressing PD-L1. : 100X. = 100 mum.


Analysis of a CSF-470 VAC-SITE tissue. Abundant CD68+ macrophages were also present in the area. Original magnifications = : 20X. Scale bars:. =200 mum.


Analysis of a CSF-470 VAC-SITE tissue. (E-G) CD8+ lymphocytes were mainly PD1- and many of them were proliferating (Ki67+). Original magnifications = : 20X. Scale bars:. =200 mum.


Analysis of a CSF-470 VAC-SITE tissue. (H,I) Numerous LMGC were observed by HE staining (arrows). : 100X. = 100 mum.


Analysis of a CSF-470 VAC-SITE tissue. (H,I) Numerous LMGC were observed by HE staining (arrows). : 1000X. = 20 mum.


Analysis of a CSF-470 VAC-SITE tissue. (J,K) The VAC-SITE was surrounded by numerous lymphatic and blood vessels (arrows). Original magnifications = : 20X. Scale bars:. =200 mum.


Analysis of C-MTS tissue. In the area of tumor regression (upper part of the biopsy), CD8.


Analysis of C-MTS tissue. And PD-1.


Analysis of C-MTS tissue. T lymphocytes were mainly present, while FOXP3+ Treg were scarce.


Analysis of C-MTS tissue. ; these lymphocytes were proliferating as determined by Ki-67+ staining.


Analysis of C-MTS tissue. Also, CD68+ macrophages.


Analysis of C-MTS tissue. CD11c Ag-presenting cells. Were mainly concentrated in this area.


Analysis of C-MTS tissue. In the lower part of the biopsy, MART-1.


Analysis of C-MTS tissue. PD-L1.


Analysis of C-MTS tissue. HLA class I +
 viable tumor cells were observed. Original magnification = 20X. Scale bars = 200 mum.


Metastatic spread of pheochromocytoma in abdominal CT.


Metastatic spread of pheochromocytoma in right liver lobe, right kidney, and right hemidiaphragm in abdominal MRI.


Abdominal CT scan after extensive surgery.


Timeline of the patient.


Gene check analysis showed that the patient had an EGFR exon20 insertion (p. D770-N771insGT) mutation.


Contrast-enhanced CT scan shows heterogeneous enhancement of the giant cystic lesion. The plain CT scan.


Contrast-enhanced CT scan shows heterogeneous enhancement of the giant cystic lesion. The arterial phase of CT.


Contrast-enhanced CT scan shows heterogeneous enhancement of the giant cystic lesion. The portal venous phase of CT.


Contrast-enhanced CT scan shows heterogeneous enhancement of the giant cystic lesion. CT scan in the sagittal plane. Arrows indicate the hepatic lesion.


Microscopically, the lesion is composed of anastomosing lymphatic spaces lined by attenuated endothelial-like cells with mature differentiation and containing homogeneous pink fluid.


Initial computed tomography (CT) scan showing the germ cell tumor in the coronal plane.


Axial planes.


CT angiography showing pulmonary artery embolization in the axial plane (d).


Computed tomography scan showing the germ cell tumor in the coronal plane.


As well as positron emission tomography-computed tomography showing the germ cell tumor in the coronal plane.


In the axial plane.


The axial plane , after 4 cycles of systemic chemotherapy in June 2020.


Pathologic and immunohistochemical assessment of response. (A), Excision specimen of recurrent tumor one year prior to ILI.


Pathologic and immunohistochemical assessment of response. (B), Tibial biopsy one month after ILI showing no viable tumor.


Pathologic and immunohistochemical assessment of response. (C), Absence of PD-L1 expression post-ILI and PD-1 inhibition.


Pathologic and immunohistochemical assessment of response. (D), Brisk CD4+ T cell infiltration in tibial biopsy one month after ILI.


Pathologic and immunohistochemical assessment of response. (E), Brisk CD8+ T cell infiltration in tibial biopsy one month after ILI.


Pathologic and immunohistochemical assessment of response. (F), Brisk CD163+ macrophage infiltration in tibial biopsy one month after ILI. Images are presented at 20x magnification.


Fine-needle aspiration cytology smear demonstrating a monomorphic population of cells with eosinophilic cytoplasm arranged in papillary groups (Papanicolaou, x40).


Fine-needle aspiration cytology smear demonstrating lesional cells with round nuclei, prominent nucleoli and foamy cytoplasm (Papanicolaou, x60, inset, x100).


Lesion manifested as a mass in hard palate.


Brain MST (12.04.17): In the left parietal region, there is a solid lesion that replaces the bone marrow, measuring approximately 5.2 cm x 2 cm, infiltrating the dura mater, subcutaneous cellular tissue and adjacent skin.


Photo of 04.07.17, with evidence of injury at the parietal level with the destruction of the cranial shell exposing the meninges.


Photo of 09.08.17, 10 days after radiotherapy treatment. Borders of ulcers in reepithelialisation, no bleeding.


Axial T2-weighted MR images (a, c) show numerous abscesses in the liver (arrows) and pylephlebitis in the intrahepatic branches of the main portal vein (arrowheads).


Axial diffusion-weighted MR images (b, d) show high signal intensity in the abscesses (arrows) and pylephlebitis (arrowheads) due to restricted water diffusion.


(a) Follow-up axial contrast-enhanced T1-weighted MR image shows resolution of liver abscesses and improvement of pylephlebitis with a stricture in the portal branch of the right anterior liver segment (arrowhead), causing inhomogeneous enhancement of the hepatic parenchyma (arrows).


(b) No FDG uptake was seen on 18F-FDG PET/CT.


Computed tomography image of the inflammatory myofibroblastic tumor, invading the left atrium. White thick arrow: left atrial wall invaded by the tumor; black thin line: left ventricular wall; area surrounded by the black thick line: inflammatory myofibroblastic tumor with the lower lobe.


(a and b) Magnetic resonance imaging (MRI) in axial and coronal gadolinium showing a solid cystic paramedian mass effect lesion with nodular and wall contrast enhancement.


(c) MRI with axial flair sequence which an important frontal and parietal brain edema.


(d and e) Postoperative axial and coronal gadolinium MRI showing complete tumor resection.


(f) Abdomen MRI with multiple liver hypointense metastatic lesions.


Case (1): FDG PET/CT showing intramedullary and extramedullary involvement: MIP image.


Sagittal CT.


Sagittal fused.


Transaxial CT.


Transaxial fused. Images showing multiple intramedullary lesions in bilateral humerus and femur (red arrowheads), multiple newly developed FDG-avid subcutaneous nodules in the right upper chest wall (green arrowhead) and right lower renal pole lesion (blue arrowhead).


Case (3): FDG PET/CT showing extramedullary involvement: maximum intensity projection (MIP) image.


Coronal CT.


Coronal fused.


Transaxial fused images. Showing multiple enlarged left axillary and supracalvicular lymph nodes (red arrowheads), left humeral head and neck lesion (green arrowhead), intramuscular involvements (blue arrowheads), FDG-avid peripancreatic lymph node (yellow arrowhead) and paracardiac lymph node (orange arrowhead).


Case (3): Lymph node biopsy showed diffuse sheets of PCs with many plasmablasts, scattered anaplastic forms and significantly increased mitotic figures (H & E 20x) (A).


The neoplastic PCs are positive for CD138 immunostain.


57-year-old man presenting with dyspnea and black-colored sputum diagnosed with endobronchial metastasis from melanoma. Posteroanterior chest radiograph demonstrates complete collapse of left lung, pathologic fracture of left sixth rib (arrow), and destructive mass (arrowhead) involving the right posterior fifth rib.


57-year-old man presenting with dyspnea and black-colored sputum diagnosed with endobronchial metastasis from melanoma. Contrast-enhanced axial CT image through the lower chest demonstrates heterogeneous enhancement of the left lower lobe mass (arrow).


57-year-old man presenting with dyspnea and black-colored sputum diagnosed with endobronchial metastasis from melanoma. Microscopic findings: Staining of endobronchial biopsy specimen with hematoxylin and eosin shows pigment-laden cells, indicative of metastatic melanoma (x400).


Right ankle joint swelling.


Right posterior cervical lymph node.


Clinical photograph of the breast tumor with ulceration, skin nodule, and retraction of the nipple with extensive peau d'orange appearance.


CT head from referring hospital. Left sided subdural collection causing midline shift, effacement of the ipsilateral ventricle, sulci and guri. Small collection is evident on the right side as well.


CTV-SR (blue), CTV-HR (orange), and GTV (red) on the simulation CT. . Notes:. The CT layer of the upper edge of CTV-SR; combined CTV-SR included PS and LLN-. LLN-. And M; CTV-HR included M around GTV. LLN-. And M; CTV-HR included M around GTV. . Abbreviations: CT, computed tomography; CTV-HR, high-risk clinical target volume; CTV-SR, standard risk clinical target volume; GTV, gross tumor volume; LLN-A, anterior lateral lymph nodes; LLN-P, lateral lymph nodes; M, mesorectum; PS, presacral space.


CTV-SR (blue), CTV-HR (orange), and GTV (red) on the simulation CT. The CT layer of the upper edge (rectosigmoid) of GTV, combined CTV-SR included PS.


CTV-SR (blue), CTV-HR (orange), and GTV (red) on the simulation CT. The CT layers of mid-low.


CTV-SR (blue), CTV-HR (orange), and GTV (red) on the simulation CT. Low. Pelvic, combined CTV-SR included PS, posterior LLN-P.


CTV-SR (blue), CTV-HR (orange), and GTV (red) on the simulation CT. The CT layers of the lower edge of CTV-HR.


CTV-SR (blue), CTV-HR (orange), and GTV (red) on the simulation CT. CTV-SR ; CTV-SR and CTV-HR included M.


(A) The initial cervical biopsy (100x magnification) demonstrated extensive mitotic activity, high-grade nuclei with hyperchromasia and nuclear molding, scant cytoplasm, and ill-defined cell borders, all characteristic of small-cell carcinoma.


(B) The carcinoma was diffusely positive for chromogranin (100x magnification) and synaptophysin (not pictured).


(C) Positron Emission Tomography/Computed Tomography (PET/CT) scan at the time of diagnosis that showed evidence of cervical disease, multiple hepatic metastases, and right adrenal gland metastasis.


(A) PET/CT scan after completing chemoradiation therapy showed no evidence of disease.


(B) At the time of diagnosis of recurrent disease, brain MRI and CT scan of the abdomen confirming brain metastasis and multiple hepatic metastatic disease.


Computed tomography (CT) scans after different therapies. . Notes:. Before any treatment.


Computed tomography (CT) scans after different therapies. 1 day before icotinib treatment.


Computed tomography (CT) scans after different therapies. CT of the chest showing a slight increase in tumor volume after 1 month of icotinib.


Computed tomography (CT) scans after different therapies. Before afatinib treatment.


Computed tomography (CT) scans after different therapies. CT of the chest showing stable disease after 1 month of afatinib.


Immunohistochemistry (IHC) of biopsy specimen. . Notes: (A) A high-power magnification of the tumor specimen shows squamous carcinoma (200x).


Immunohistochemistry (IHC) of biopsy specimen. IHC analysis revealed that the lung tumor cells were positive for CK5/6.


Immunohistochemistry (IHC) of biopsy specimen. P40.


Immunohistochemistry (IHC) of biopsy specimen. P63 ; 200x.


Molecular analysis of gene detection. . Notes: (A) Tissue biopsy showed a deletion mutation in EGFR exon 19 by amplification refractory mutation system PCR.


Molecular analysis of gene detection. (B) The Integrative Genomics Viewer snapshot of HER2 S310Y by next-generation sequencing.


(a) Intraoperative ultrasound clearly showing suspected tumor progression along Glisson 5. However, it has not reached the root of Glisson 5.


(b) An enlarged retroperitoneal LN is observed.


(c) Surgical field after anatomical liver S4 and S5 sub-segmentectomy.


(d) On histopathological examination, viable adenocarcinoma cells are detected in all the liver metastatic lesions.


(e) Viable adenocarcinoma cells are detected in the resected retropancreatic LN.


(f) Immunohistological staining using D2-40 antibody showing cancer cells in the lymphatic duct of Glisson 5.


(a) Intraoperative ultrasound clearly showing suspected tumor progression along Glisson 6. However, it has not reached the root of Glisson 6.


(b) An enlarged LN is observed at the hepatoduodenal ligament (yellow arrow).


(c) Surgical field after dissection of the hepatoduodenal area.


(d) On histopathological examination, viable adenocarcinoma cells are seen in all the liver metastatic lesions.


(e) Viable adenocarcinoma cells detected in the resected hepatoduodenal LN.


(f) Immunohistological staining using D2-40 antibody shows cancer cells in the lymphatic duct of Glisson 6.


Histologic features of Mammary Analog Secretory Carcinoma of Thyroid (a).


The origin of this unusual tumor is unknown but may be from incidental intrathyroidal salivary gland rests as seen in this normal thyroid (not from the patient reported) (b). The thyroid tumor in the case described is an infiltrative tumor composed of solid sheets and nests of epithelial cells in a fibrous stroma.


The surrounding thyroid exhibits chronic lymphocytic thyroiditis (c).


The solid sheets were punctuated by small cribriform areas and microcysts with pseudopapillae and a few true papillae with fibrovascular cores (d).


The homogeneous tumor cells had abundant cytoplasm and monotonous round nuclei with clear nucleoplasm and conspicuous large nucleoli but no indentations or inclusions (e).


There was extrathyroidal extension into surrounding skeletal muscle (f). In one area of the tumor there was a small 0.2 cm focus of classical papillary microcarcinoma.


Immunohistochemical features of Mammary Analog Secretory Carcinoma of Thyroid (a).


The tumor cells exhibit diffuse positivity for monoclonal PAX-8 that is much weaker than in the surrounding thyroid (b).


There is very focal positivity for TTF-1 (clone: SPT24); some of the stained cells might be entrapped follicular epithelial cells (c).


The tumor cells are completely negative for thyroglobulin (d).


The tumor exhibits strong diffuse positivity for cytokeratin 19 (e).


Staining for CEA with a polyclonal antiserum yields diffuse reactivity, however a monoclonal CEA antibody resulted in a completely negative stain (f).


Tumor cells are positive for gross cystic disease fluid protein-15 (g).


Scattered tumor cells express p63 (h).


Dendritic type cells that are strongly positive for S100 protein are distributed throughout the tumor (i).


Beta-catenin staining is intact at the cell membrane and there is no nuclear translocation (j). Positivity for E-cadherin is retained at the cell borders.


The rare PDK1-ALK and STRN-ALK fusion was identified in the same tumor tissue by next-generation sequencing (NGS). (A) sequencing reads of PDK1 and ALK by the Integrative Genomics Viewer.


The rare PDK1-ALK and STRN-ALK fusion was identified in the same tumor tissue by next-generation sequencing (NGS). (B) sequencing reads of STRN and ALK by the Integrative Genomics Viewer.


Whole-body nuclear magnetic resonance without contrast: images consistent with hepatic metastasis of segment V measuring 29 mm.


Multiple fungating, coalesced ulcerative growths with phimosis.


Pseudoepitheliomatous hyperplasia and vacuolated macrophages (x100).


Complete resolution 3 weeks post treatment.


CT showing reduction in metastatic LNs after radiotherapy. (a,b) Paraaortic LNs.


CT showing reduction in metastatic LNs after radiotherapy. (c) Right renal hilum LN. The upper row shows LNs at 16 months after surgery (before radiotherapy); the lower row shows LNs at 18 months after surgery (after radiotherapy). The red line outlines the circumference of target lesions.


Clinical treatment course.


Ct-scan showing the invaginated tract containing a 24 mm mass.


H&E, 100x magnification: Ileal submucosal spindle cell proliferation.


H&E, 200x: hypercellular proliferation composed of spindle cells with nuclear atypia and intermingled moderate amount of inflammatory cells.


MDM2, 20x: immunohistochemistry against MDM2-antibody shows diffuse and intense nuclear reaction.


Histological findings of the non-small cell lung cancer and renal cell carcinoma. (A) Lung: sheets or islands of large polygonal malignant cells with pink cytoplasm and distinct cell borders consistent with squamous cell carcinoma are observed (H&E staining, x200).


Histological findings of the non-small cell lung cancer and renal cell carcinoma. (B) Kidney: biopsy specimen of the renal mass showed alveolar growth of large polygonal cells with clear cytoplasm, uniform round nuclei, and inconspicuous nucleoli (H&E staining, x200). Neoplastic cells have clear cytoplasm and are arranged in nests with intervening blood vessels, consistent with clear cell carcinoma.


Computed tomography findings of the renal cell carcinoma (RCC). (A) A lobulating contoured RCC mass measuring 5x4 cm located in the left kidney is observed at the time of pazopanib initiation.


Computed tomography findings of the renal cell carcinoma (RCC). (B) After 8 months of pazopanib treatment, the response of the RCC is considered to be stable disease (5.5x4.8 cm).


Computed tomography findings of the squamous cell lung cancer. (A) A mass measuring 7x3 cm is observed in the left lower lobe of the lung at the time of pazopanib initiation.


Computed tomography findings of the squamous cell lung cancer. (B) The mass decreases in size to approximately 3.5x1.5 cm after 8 months of pazopanib treatment. The squamous cell cancer shows an unexpected partial response to pazopanib.


Axial.


Sagittal magnetic resonance imaging (MRI) scan demonstrating the absence of primary site tumor recurrence and the evidence of previous surgical resection.


(a) Sagittal T1WI magnetic resonance imaging (MRI) scans showing diffuse involvement of the vertebral bodies and posterior laminae exhibiting heterogeneous hyperintensity.


(b) Sagittal T2WI MRI scan: evidence of D6-D8 laminectomy with partial lesion resection.


Coronal CT scan, demonstrating cystic lesion over the left side of the neck.


Multiplanar (coronal, sagittal and axial) and MIP images on CT and PET/CT (upper row) and on PET (lower row) demonstrating a subtle enlarged left thyroid lobe from a heterogenous enhancing lesion seen on CT. The lesion corresponds with high 18F-FDG intensity uptake.


Axial CT scan of the neck at the level of hyoid bone demonstrating ill-defined low attenuation rounded lesions with thick wall in the anterior neck.


Axial CT scan of the neck demonstrating multiple cervical lymph nodes, with normal-looking thyroid gland.


Hematoxylin-eosin (HE) staining for pathological diagnosis in. Right.


Left pulmonary lesions showing lung adenocarcinoma.


Molecular analysis of gene detection. The integrative genomics viewer snapshot of EGFR N771delinsKG (c.2312_2313insGGG) by next-generation sequencing (NGS).


Computed tomography (CT) scans at different time. (A) Baseline imaging (before treatment) of right and left pulmonary lesions, respectively.


Computed tomography (CT) scans at different time. After. 1 month (July 28, 2019).


Computed tomography (CT) scans at different time. 4 months (November 6, 2019) of treatment, the mass in the left pulmonary lesion reduced significantly and the right pulmonary lesion decreased slightly, compared with that of baseline imaging.


Facial swelling on right side of face leading to slight facial asymmetry.


Enlargement of the posterior maxilla caused by the lesion.


Panoramic radiograph showing a large well-defined homogenous radiopaque mass distal to tooth 16 and coronal to 17 with radiolucent margin.


Photograph after reflection of flap showing the lesion and extreme buccal as well as superior displacement of tooth 17.


Mesial.


Buccal view of tooth 17 showing root dilacerations.


Excised specimen showing a well-circumscribed tumor that shelled out in in one piece.


Radiograph of specimen showing mixture of radiopacity and radiolucency in the central region.


(a) Photomicrograph showing trabeculae of woven bone in a background made up of dense mature collagen fibers. X4),. (b) High-power view showing woven bone rimmed by plump osteoblasts. X40).


Tongue depressed with wooden spatula revealing soft tissue mass extending from the nasopharynx and involving uvula.


Nasopharyngeal mass completely obstructing the. Right posterior choana.


Left posterior choana.


(a) Hematoxylin and eosin staining revealed atypical lymphoid cells of medium size with a round to oval shape with vesicular nuclei and irregular nuclear membrane, magnification = 400 x.


(b) The atypical lymphoid cells were positive for CD20 (brown) immunohistochemical stain, magnification = 40 x. A similar positivity pattern was seen for CD79a, CD5, and cyclin D1 (images not shown).


(c) The atypical lymphocytes were negative for CD3 immunohistochemical stain, magnification = 40 x. A similar negativity pattern for CD10 and CD23 was seen (images not shown).


(d) Ki-67 staining (brown) revealed a proliferative index of 20-30%, magnification = 40 x.


Medical image.


Initial T2W MRI showing multiple cystic lesions along with predominant enhancing lesions in the corpus callosum (2009). Initial contrast enhanced T1 weighted MR showing corpus callosul Glioma along with coexistent Neurocysticercosis (2009).


CEMRI showing heterogeneously enhancing lesion in the corpus callosum with multiple healed lesions of neurocysticercosis (2011).


Photomicrograph showing high grade astrocytic tumor with areas of necrosis, hemorrhage and vascular proliferation.


Preoperative MRI dated 1 month before surgery. (a) Axial T1WI MRI showing extensive amorphic heterogeneous mass invading both lateral ventricles with a commitment of midline.


Preoperative MRI dated 1 month before surgery. (b) Axial T1WI Gd MRI demonstrates the same lesion with ring and internal enhancement.


Preoperative MRI dated 1 month before surgery. (c) Coronal T1WI Gd MRI showing better the internal enhancement and commitment of both lateral ventricles.


Preoperative MRI dated 1 month before surgery. (d) Axial T2WI MRI exhibiting heterogeneous intratumoral signal and irregular-margin enhancement. Note hypointense signal surrounding the lesion suggesting extensive vasogenic edema.


Preoperative MRI dated 1 month before surgery. (e) Axial DWI shows nonimpaired diffusion.


Preoperative MRI dated 1 month before surgery. (f) ADC Map demonstrating high signal.


Immediate postoperative Control MRI. (a-c) T1WI Gd MRI exhibiting residual mass on the left ventricle atrium.


Immediate postoperative Control MRI. (d-f) T2WI MRI demonstrating residual mass on the left ventricle atrium. The inclusion criteria in our first systematic review were case series studies with at least ten patients containing GS with molecular profile study (IDH1/2, ATRX, tp53, TERT, 1p19q, or Ki-67). Cases series without any molecular profile were excluded from the study.


Postoperative MRI one month after surgery. (a-c) Axial T1WI Gd MRI showing notorious residual lesion growth.


A-C. Coronal CT reconstruction in early venous phase after i. V. Contrast application, depicting primary tumor and vascular extent.


Ultrasound images in Doppler mode highlighting hepatoatrial transition. As well as atrial dilation and movement of the sacciforme intravascular tumor extension over the tricuspid valve into the right cardiac ventricle All depicted images represent the initial diagnosis.


A. Intravascular tumor extensions along centimeter scale: * subhepatic VCI; ** intrahepatic VCI; *** intracardiac.


B. Dissected kidney along centimeter scale.


Contrast-enhanced CT of the kidneys in patient K. The left kidney examined prior to the second surgery is indicated.


Pathomorphological examination of the mass excised from the right kidney of patient K. Type I papillary RCC. Hematoxylin-eosin staining, magnification x100.


Sanger sequencing of part of MET exon 16 in patient K. The c.3328G>A (p. V1110I) mutation is indicated by the letter R.


Schematic diagram showing treatment record of the patient.


The genetic heterogeneity of liver metastatic tumors. (A) A phylogenic tree showing the genomic similarity of the liver metastatic tumors and the primary intestinal adenoma.


The genetic heterogeneity of liver metastatic tumors. (B) Heatmap showing the frequencies and types of mutations of all mutated genes detected by targeted sequencing. T1-T15 were hepatic tumors and PB was the peripheral blood sample obtained in July 2020.


Ultrasonographic and radiographic findings. (a) A relatively well-demarcated, lobulated, hypoechoic mass with mild heterogeneous echogenicity is noted, showing a focal, ill-defined border, suggesting the possibility of malignancy.


Ultrasonographic and radiographic findings. (b) Positron emission tomography-computed tomography revealing focal fluorodeoxyglucose uptake in the same lesion.


MRI, nine weeks prior to the therapy, revealing the metastatic mass in the liver with an impending IVC compression (IVC diameter: 18.4 x 8.1 mm).


CT scan, Twelve months after last PRRT cycle with significant decompression of the vein (IVC diameter: 30.9 x 19.9 mm).


68gallium DOTATOC PET/CT; : Seven weeks prior to the therapy, revealing intense tracer uptake in the liver lesion (SUV max: 60.78).


Twelve months after last PRRT cycle with significant decreased tracer uptake (SUV max: 8.62).


Preoperative biopsy of pelvic lesion. . Notes: The melanoma had a diffuse growth pattern. The cells of the tumor consisted of spindle-shaped and epithelioid cells with melanin granules scattering around the nucleus in the cytoplasm (hematoxylin and eosin, x200, x400). Immunohistochemicalstains showed positivity for HMB45, Melan-1 antibodies (x200). . Abbreviation: HMB45, human melanoma black 45.


Histopathological examination of the primary leptomeningeal glioblastoma. A; Prominent tumor cell infiltrate in the subarachnoid space and reactive astrogliosis in the brain parenchyma. X20. Hematoxylin and eosin.


Histopathological examination of the primary leptomeningeal glioblastoma. B; The astrocytic tumor cells are positive for glial fibrillary acid protein.


Histopathological examination of the primary leptomeningeal glioblastoma. X40. C; Nearly all tumor cells are positive for the oncoprotein p53.


Histopathological examination of the primary leptomeningeal glioblastoma. X10. D; The p53-positive tumor cells are spreading through the Virchow-Robin spaces throughout the brain. X40.


MRI of the nasal cavity and paranasal sinuses. (A) Contrast-enhanced MRI shows a huge tumor located in the nasal cavity and paranasal sinuses eroded not only the adjacent bone but also bilateral frontal lobes.


MRI of the nasal cavity and paranasal sinuses. (B) Contrast-enhanced MRI shows the tumor was almost completely disappeared 1 month after radiotherapy and chemotherapy. . Abbreviation: MRI, magnetic resonance imaging.


Histopathology of LCNEC. (A) H&E staining: tumor cells in the subepithelial stroma showed nest infiltration. The cells are large in volume, rich in cytoplasm and vacuolated or eosinophilic and have a large nucleoplasmic ratio. The nucleus is round or elliptical, the chromatin is deeply stained, and the granules are coarse and granular, and the obvious eosinophilic nucleoli can be seen (400xmagnification).


Histopathology of LCNEC. Immunohistological staining showing tumor positivity for CD56.


Histopathology of LCNEC. , CgA.


Histopathology of LCNEC. , CKpan.


Histopathology of LCNEC. , Ki-67.


Histopathology of LCNEC. And Syn . Abbreviation: LCNEC, large-cell neuroendocrine carcinoma.


CT abdomen at initial work-up that shows a hypo-attenuated mass in the region of the uncinate process contacting 50% of the superior mesenteric vein, and approximately 25% of the superior mesenteric artery (see arrow) as well as contacting the left renal vein.


CT abdomen at restaging following neoadjuvant chemo-radiation therapy showed a 3.3 cm x 3.1 cm mass, decreased from initial size with involvement of the SMA (see arrow) and SMV improved.


Surgical field at the time of pylorus-preserving pancreaticoduodenectomy in region of the uncinate margin at the superior mesenteric vein (thin arrow), superior mesenteric artery, and inferior vena cava were intraoperative low-kV radiation therapy was administered in retroperitoneal space (thick arrow).


(A) 1 year post-operative scan showing SMA (see arrow) is clear of disease.


(B) 7 year post-operative scan showing renal vein at IVC (see arrow) widely patient and without disease.


Postoperative MRI: To the right, white arrows showing involvement of
inferior and occipital gyrus, with black arrows showing relative
preservation of the right fusiform gyrus. To the left the black arrows
show involvement of inferior and medial occipital gyrus and
fusiform.


Renal CT scan revealed a 40 mm staghorn stone (arrow) in the right renal pelvis. Soft tissue mass measured 45mm is seen surrounding the mentioned staghorn stone.


On gross examination of radical nephrectomy specimen, the right kidney was enlarged in size, measured 25x14x13cm, and a staghorn stone (arrow) was found in cut sections.


Microscopic examination of the hematoxylin and eosin-stained tissue revealed a well-differentiated SCC (arrow).


Chest CT findings before and after corticotherapy. (A): Patchy ground-glass opacity, mainly in the right lung.


Chest CT findings before and after corticotherapy. (B): Significant improvement after 3 weeks with prednisone.


(A): Brain MRI demonstrating right occipitotemporal lesion measuring 1.8 cm x 1.4 cm.


(B): Two months after rechallenge of osimertinib and reduction of the lesion, measuring 0.8 cm x 0.5 cm.


Showing resected IMT with part of stomach.


Showing histopathological findings of IMT.


Hematoxylin-eosin-stained (10*20) biopsy specimens obtained by broncho berscopy. The tumor cells are large with highly atypical nuclei, and the histology and immunohistochemical findings suggest adenocarcinoma. Immunohistochemical results: TTF-1(+), CK7(+), P63(-), P40(-), NapsinA(+).


Hematoxylin-eosin-stained (10x20) surgical specimens obtained by transurethral electric resection of bladder lesions. The tumor cells are large with highly atypical nuclei and the histology and immunohistochemical findings suggest invasive urothelial carcinoma. Immunohistochemical results: CK7(+), CK20(-), Ki-67(about ~30%+), P53(Scattered+), P63(+), GATA3(+), 34BE12(+), PSA(-).


Multiple skin nodules over the pubic area with excoriation of the penile skin.


(A) Enhanced computed tomography (CT) image demonstrating a large mass replacing the lower part of the right kidney (star); the mass had invaded the perirenal space and Gerota's fascia (arrow).


(B) Enhanced CT image of the upper abdomen reveals a thrombus in the renal vein and inferior vena cava (arrow).


(A) Histological examination of the kidney demonstrates that the tumor mass had infiltrated the cortex and medulla (original magnification, x40).


(B) Small, round tumor cells with scanty cytoplasm and round nuclei (original magnification, x400).


(C) Neoplastic cells infiltrating blood vessels (original magnification, x400).


(D) Similar neoplastic cells in the tumor thrombus (original magnification x400). Staining, hematoxylin and eosin.


Immunohistochemical staining reveals that the tumor cells were positive for. Cluster of differentiation 99.


Friend leukemia integration 1.


Integrase interactor-1 (original magnification, x400).


Fluorescence in situ hybridization analysis using a Vysis LSI EWSR1 Dual Color, Break Apart Rearrangement probe for 22q12 demonstrates the green and red probe breaking apart, confirming the Ewing's sarcoma breakpoint region 1 translocation.


Clinical image of the breasts revealing a large left breast mass.


(A) Mammogram (medial-lateral oblique view) of the left breast demonstrating a large central breast mass.


(B) Ultrasound with color doppler of the solid, vascular portion of the left breast mass.


(C) MR image of the left breast mass demonstrates the large cystic portion and one of the enhancing solid portions of the complex mass.


H&E 40 x 5 - high magnification view of core biopsy sample demonstrates apocrine atypia.


H&E 10 x 3 - low magnification view of mastectomy sample demonstrates papilloma.


Hypervascular pancreatic body mass with intraluminal enhancement within portal vein consistent with tumor thrombus (arrow).


CgA and PP levels before, during, and after treatment course. CgA, chromogranin A; PP, pancreatic polypeptide.


(A) Original pancreatic mass with synaptophysin staining, 20x magnification.


(B) Original pancreatic mass with HE staining, 40x magnification.


(C) Recurrent gastric mass with HE staining, 40x magnification. HE, hematoxylin and eosin.


Radiological images of the proximal right tibia. Radiograph.


Radiological images of the proximal right tibia. CT. Showed osteolytic bony destruction.


Radiological images of the proximal right tibia. SPECT (E) images were negative for metastatic lesions.


CT of the chest. (A) Local recurrence but without pulmonary metastasis.


CT of the chest. (B) Multiple pulmonary metastases were found and denosumab initiated.


CT of the chest. (C) 4 months after denosumab therapy.


CT of the chest. (D) 3 months after denosumab and apatinib therapy.


CT of the chest. (E) 15 months after denosumab and apatinib therapy.


CT of the chest. (F) 33 months after denosumab and apatinib therapy.


Pathological features of the local lesions. (A) High-magnification observation of numerous multinucleated giant cells (Hematoxylin and eosin stain, 200x).


Pathological features of the local lesions. (B) High-magnification observation of local recurrence but without sarcomatous change (Hematoxylin and eosin stain, 200x).


Pathological features of the local lesions. (C) Presence of multinucleated giant cells indicates a recurrence of GCTB (Immunohistochemical staining, 100x).


Pathological features of the local lesions. (D) Expression of VEGFR-2 as assessed by immunohistochemistry (Immunohistochemical staining, 100x).


Radiological images of the proximal right tibia. Radiograph , postoperative films following the curettage, and ,packing with cement.


Radiological images of the proximal right tibia. CT. Bone window) showed a circumferential lucency around the bone cement and local cortical bone destruction.


Radiological images of the proximal right tibia. MRI (F, T1-weight) showed a soft tissue mass.


A growth on the right lateral border of the tongue.


Periodic acid-Schiff positive mucinous material present in ductal lumens (PAS, 40x).


(A) Neck computed tomography (CT), axial plan, 4*2,5*3,5 cm size retrosternal mass, trachea pushed right side (arrow).


(B) neck magnetic resonance imaging (MRI) coronal plan, contrast +, multilobular mass extending to the upper mediastinum (arrow).


Image of surgical excision specimen, nearly 6x4x3 cm and multilobular.


(200X magnification). (A) HER-2 immunostain showing overexpression of HER-2 with intense circumferential staining of the tumor cells.


(200X magnification). (B) Hematoxylin and Eosin stained section showing malignant glands infiltrating adipose tissue.


Picture shows gross appearance of the patient with arrow indicating enlarged lymph node. Inset shows penile metastatic nodule.


Photomicrograph shows histology of penile metastatic nodule. Inset showing positivity for prostate-specific antigen on immunohistochemical staining.


Abdominal imaging demonstrates a low-density mass involving the rectosigmoid colon. . The rounded thick-walled structure measures approximately 4 cm (
arrow). There is some adjacent inflammation in the presacral space as well as prominent lymph nodes. Given the radiological findings the differential diagnosis includes transmural abscess versus inflammatory carcinoma of the sigmoid colon.


Case report timeline. . Presented according to CARE guidelines.


Bilateral diagnostic mammogram with. MLO.


CC views demonstrates new spiculated masses throughout both breasts (arrows) which were all initially suspicious for carcinoma.


Comparison mammogram. MLO.


CC views 1 year prior shows only normal scattered fibroglandular breast tissue with no abnormal masses present.


Gray-scale sonograhic image of the right breast demonstrates an irregular hypoechoic mass with angular margins (arrow). Similar masses were present in the bilateral breasts at nearly every clock position by ultrasound. This mass was biopsy proven to be sarcoidosis.


Gray-scale sonographic image of the left breast at the 6:00 o'clock position at the site of known lobular carcinoma also demonstrates an irregular hypoechoic mass (arrow).


Axial MRI T1WI post contrast fat saturation subtracted images of the bilateral breasts.


Breast sarcoidosis presents as multiple patchy bilateral areas of non-mass enhancement (arrows). Known left breast lobular carcinoma at 6:00 o'clock position (arrow) with susceptibility artifact from biopsy clip is indistinguishable from the surrounding sarcoid lesions.


Axial.


Sagittal. Sections of T1-enhanced MRI showing a large extraaxial enhancing mass in the left hemioccipital space of the cranium.


A photomicrograph showing small dark-stained cells with scanty cytoplasm arranged in nests fenestrated by round or oval spaces (the cribriform pattern) and perinerineural invasion (arrow) hematoxylin and eosin (x100).


A photomicrograph showing immunoreactivity with CD-117 (x100).


Clinical picture showing an exophytic growth.


Lesion on the right thumb shown in December of 2016 prior to surgical treatment.


Initial patient presentation to the plastic surgery clinic in August of 2017 post initial surgery demonstrating the recurrence of the lesion on the dorsum of the right thumb interphalageal joint.


(a,b) Images taken two weeks apart showing aggressive re-occurrence of the lesion after the second surgery in April of 2018.


(a,b) Images taken after the third surgery in 2018 showing final functional ability.


Mediastinal windows of computed tomography (A and B) confirm the previously noted bilateral pleural thickening, calcification. There is associated left lobe Pleural effusion and atelectasis.


Right lung branch pulmonary embolism, mainly involved pulmonary artery (arrow).


Mediastinal windows of computed tomography (A and B) revealed pleural effusion on the left side.


PET-CT suggests thickening and calcification of the pleura on both sides, increased FDG metabolism, more pronounced on the left.


Ultrasound guided biopsy specimen from tumor lesions. Fibroblast-like spindle cells arranged in bundles or chaotically, the tumor cells had obvious atypia, mitotic figures, and coagulative necrosis. ((A and B), hematoxylin-eosin).


Immunohistochemical staining (20 X) revealed WT-1 positivity.


GATA-3 positivity.


CK (pan) positivity.


SBRT plan for treatment of recurrent disease in the transplanted liver.


CT scan 1 year after SBRT showing complete remission of the treated lesion.


Gallium-68 prostate-specific membrane antigen positron-emission tomography computed tomography maximum intensity projection.


Fused coronal.


Fused axial. Images. Images showed prostate-specific membrane antigen-avid lesions in the prostate and right testis.


A correlative ultrasonography of the scrotum showing a hypoechoic lesion in the right testis (d).


Fused axial. Images. Images showing a prostate-specific membrane antigen-avid lesion in the left testis.


A correlative ultrasonography of the scrotum showing a hypoechoic lesion in the left testis (d).


A 1.5 cm diameter nodule on left half of upper lip before excison.


FNAC: aggregates, acini and single scattered benign epithelial cells along with myoepithelial cells and chondromyxoid stromal fragments (Giemsa stain, x40). . Abbreviations: FNAC, fine needle aspiration cytology.


(A) FNAC smear showing sheet of myoepithelial cells with basophilic dense cytoplasm and central to eccentric, round to oval nuclei with bland chromatin (Giemsa stain, x200).


(B) Cluster of epithelial cells with scattered myoepithelial cells in a chondromyxoid background (Giemsa stain, x200). . Abbreviations: FNAC, fine needle aspiration cytology.


H&E. x40. Cellular proliferation with weak nuclear pleomorphism.


H&E. x20. Osseous infiltration by the neoplasm.


Prolactin serum behavior 04/1994 to 12/2006.


A: Preoperative magnetic resonance imaging (MRI) - axial section (tra tse t1). The hypointense tumor represents a mass of 47.5x43x34.6 mm that infiltrates the caudal meatus acusticus externus and the parotid gland, attaining up to the sternocleidomastoid and nuchal muscles (rT4N1M0).


B: Preoperative MRI - axial section (tra tse t1 with contrast agent). The tumor is characterized by inhomogeneous cysteiform contrast agent uptake.


C: Preoperative MRI - coronal section (tse t1).


A: Follow-up imaging - axial computerized tomography (CT) section. Red asterisk indicating the partially resected right mastoid process.


B: Follow-up imaging - coronal CT section. Red asterisk indicating the partially resected right mastoid process.


A: Adhesive retained interim epithesis. Note the preauricular actinic keratosis and scarification after removal (Figure b).


B: Lateral view of the right auricular region prior to definitive epithetic treatment. The regional soft tissue is characterized by radioderm, stenosis of the external porus acusticus, residual concha, and voluminous myocutaneous flap.


Preoperative cone beam computerized tomography (CBCT) imaging. A: Axial section. Black asterisk indicating planned cranial implant positions.


Preoperative cone beam computerized tomography (CBCT) imaging. B: Axial section. Black asterisk indicating planned caudal implant position.


Preoperative cone beam computerized tomography (CBCT) imaging. C: Coronal section. Black asterisk indicating planned first cranial implant position.


Preoperative cone beam computerized tomography (CBCT) imaging. D: Coronal section. Black asterisk indicating planned second cranial implant position, red plus marking the external meatus acusticus, and red diamond showing the cochlea.


Preoperative cone beam computerized tomography (CBCT) imaging. E: Coronal section. Black asterisk indicating planned caudal implant position.


A; Preoperative clinical view of the auricular region.


B: Intraoperative view of surgical access route. Blue dots marking the intended implant positions.


C: Intraoperative view of the prepared caudal implant bed. Fresh bleeding demonstrating vital bone of the residual mastoid process.


D: Intraoperative view of inserted implants parallel to each other.


E: Intraoperative view after removal of the insertion pins and fixation of cover screws owing to closed healing.


Treatment course synopsis.