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.


Comparison of the adhesive-retained vs. implant-retained epitheses (modified according to [13]).


CT scan showed subcortical hematoma in left parietal area.


CTA showed small intracranial aneurysm above hematoma.


Cytokeratin stain in tumor cells.


HCG stain in tumor cells.


Erected penis with gluteal mass.


cafe-au-lait spots on trunk.


Voiding cystourethrogram showing elongated post urethra.


CT reconstruction showing the mass.


Photograph taken 11/2 years after the surgery.


Extent of tumor in oral cavity.


Coronal computed tomography scan showing the extent of tumor.


Postoperative obturator in situ.


Photomicrograph showing admixture of epithelial and stromal components.


Post-redo-DSAEK slit lamp photography of the left eye prior to and following PTK. Slit lamp photography of the left eye. a Post-redo-DSAEK (1st month) slit lamp photograph demonstrating resolution of corneal oedema and the presence of anterior corneal scar. b Post-PTK slit lamp photograph (1st month) demonstrating clear cornea with absence of scar.


Whole body Gallium-68 prostate-specific membrane antigen positron emission tomography/computed tomography maximum projection image shows uptake in primary prostate lesion and penile metastasis.


Sagittal computer tomography.


Positron emission tomography.


Positron emission tomography/computed tomography.


Maximum projection image , Gallium-68 prostate-specific membrane antigen positron emission tomography/computer tomography showing soft-tissue enhancing lesion in the prostate gland and corpora cavernosa thickening of penis with intense prostate-specific membrane antigen uptake suggesting metastasis.


Brain magnetic resonance imaging (MRI). Contrast-enhanced T1-weighted MRI showing a lesion with mass effect in the right parietal lobe.


Brain magnetic resonance imaging (MRI). The same image using the fluid-attenuated inversion recovery (FLAIR) sequence.


Histologic section of a basal cell carcinoma with perineural invasion (Hematoxylin and Eosin, 10x).


A) Basal cell carcinoma of the right lower eyelid and lateral canthus.


B) The surgical defect after resection of the mass with frozen section control of the margins.


C) The defect was closed using a tarsoconjunctival flap and a full-thickness skin graft.


D) Final appearance after opening the flap and administration of postoperative adjuvant radiation therapy.


Surgical resection of zone II-III leiomyosarcoma. , leiomyosarcoma protruding into right atrium.


Surgical resection of zone II-III leiomyosarcoma. , en-bloc resection of IVC with whole liver.


Surgical resection of zone II-III leiomyosarcoma. , bench resection of tumor, and ,hypothermic perfusion.


Surgical resection of zone II-III leiomyosarcoma. , IVC reconstruction with prosthetic graft.


Surgical resection of zone II-III leiomyosarcoma. , hepatic veins' orifices after leiomyosarcoma resection.


Surgical resection of zone II-III leiomyosarcoma. , re-implanted liver graft.


A coronal computed tomography scan with contrast demonstrating a homogenous mass at the bladder neck. No metastases or lymphadenopathy were present.


A high-power view of the specimen demonstrating pure LELC: A syncytial arrangement of malignant cells and many admixed lymphocytes.


Immunohistochemical staining with leukocyte common antigen highlights the dense lymphocytic infiltrate within the tumor.


Reticular, erythematous lesions involving the maxillary and mandibular gingiva.


Post operative photograph of healed hard palate excisional biopsy.


Intra operative photograph showing a tumour thrombus easily removed from the right IJV (arrow) via a longitudinal venetomy incision.


Clinical manifestations of the perioral area.


The oral mucosa tissue. Infected due to non-O1/non-O139 V. Cholerae.


Minimum spanning tree analysis of NOVC isolates based on multilocus sequence typing data according to sequence type (ST). The number in the circle indicates the ST and the size of the circle corresponds the total number of isolates belonging to that ST. The number of different alleles between STs is indicated on the branches.


Magnetic resonance imaging revealed an epidural collection causing compression of the spinal cord from T5 to T6.


Magnetic resonance imaging demonstrated a moderate- sized, left-sided pleural effusion, and left lingular and lower lobe consolidation.


Magnetic resonance imaging revealed that patchy right perihilar airspace opacities were noted with scattered nodules.


Chest X-ray of metastatic pulmonary meningioma.


Computed tomography chest axial image of metastatic pulmonary meningioma.


Computed tomography chest coronal image of metastatic pulmonary meningioma.


Hematoxylin and eosin stain - Atypical meningioma invading the brain.


Hematoxylin and eosin stain - Metastatic pulmonary meningioma.


Surgical resection of the tumor. Tumor of 35 x 30 x 17 mm.


Photo of the tumor at low magnification (X50). Nodular and well limited tumor composed of sheets of eosinophilic cells with Hematoxylin Eosin and Saffron (HES) stain.


Photo of the tumor at high magnification (X200). Tumor cells are large with an abundant eosinophilic cytoplasm and round regular nuclei with small nucleoli, according with Leydig cells. Hematoxylin Eosin and Saffron (HES) stain.


Photo of the tumor at high magnification (X400). Tumors cells were diffusely stained with antibody to inhibin A(immunoperoxydase). All tumor cells present a diffuse and strong cytoplasmic staining.


Photo of the testicular biopsy at high magnification (X100). Histopathological micrograph with hematoxylin-eosin-green FCF stain. The testicular biopsy consists of tubules with hypospermatogenesis (white arrows) mixed with aplasia (black arrows).


Testicular Steroidogenesis.


H&E stain of the patient's lung adenocarcinoma specimen under 20x magnification.


H&E stain of the patient's bone marrow biopsy consistent with MPN under 40x magnification.


CD20 immunostain of the patient's small bowel biopsy consistent with DLBCL.


H&E stain of the patient's bone marrow biopsy consistent with AML-M5 under 40x magnification.


Patternless sheets of primitive appearing neoplastic cells with hyperchromatic nuclei with neuropil.


Primitive appearing neoplastic cells with hyperchromatic nuclei, scant cytoplasm, and indistinct cell borders.


Tumor cells showing positivity for immunohistochemical stain CD56.


Tumor cells showing focal positivity for immunohistochemical stain glial fibrillary acidic protein.


Patient 2. MR images of the brain on admission. Serial consecutive fat-suppressed fluid-attenuated inversion recovery.


Patient 2. MR images of the brain on admission. Gadolinium-enhanced T1-weighted. Axial images showed an inhomogeneous, irregularly contrast-enhancing mass lesion (arrows) in the right paratrigonal region associated with a marked vasogenic edema, resulting in a mass effect.


Patient 2. MR images of the brain on admission. Also note the sellar and suprasellar macroadenoma (white arrowheads), which is shown better on the gadolinium-enhanced T1-weighted sagittal image (c), and a left frontal meningioma (black arrowhead).


(a) Erythematous to hyperpigmented infiltrated nodules and plaques, showing peau daeorange appearance.


(b) Close up view.


(a) Low power: Dermis shows diffuse infiltration of tumor cells. Lymphoplasmacytic infiltrate around blood vessels.


(b) High power: Dermal tumor cells are present in cords and singles, with pleomorphic round to oval nucleus, high N:C ratio, and vesicular chromatin. Signet ring-like cells are present.


(a) Endoscopic view of gastroesophageal junction: Friable hypertrophic growth, which on biopsy showed features suggestive of poorly differentiated adenocarcinoma.


(b) Endoscopic view of fundus of the stomach.


Endoscopic findings. . Type 2 tumor found in the anal canal.


Abdominal contrast-enhanced CT findings. . A: The mass with enhancement detected at the anal canal (white arrow).


Abdominal contrast-enhanced CT findings. . B: An enlarged left inguinal lymph node (white arrow).


PET findings. . A, b: PET revealed an accumulation of FDG in the anal canal mass and left inguinal lymph nodes (white arrow head) which were detected by CT.


Macroscopic findings. . Type 2 tumor encircling the wall found in the anal canal (white arrow).


Histopathological findings. . A: The tumor nuclei of different sizes and intercellular bridge led to a diagnosis of poorly differentiated squamous cell carcinoma (Hematoxylin-eosin stain, original magnification x200).


Histopathological findings. . B: Tumor cells were positive for p63 (marker of basal cells) (original magnification x200).


Abdominal contrast-enhanced computed CT findings 3 weeks after surgery. . A-c: Few low-density areas with irregular peripheral rim enhancement in the liver.


Abdominal contrast-enhanced computed CT findings 3 weeks after surgery. . D: 3/4th of lumbar spine melted.


Abdominal contrast-enhanced computed CT findings 3 weeks after surgery. . E: Multiple pulmonary nodules detected bilaterally (white arrow).


The liver biopsy findings. . The liver biopsy necrosis similar to the tumor cells (Hematoxylin-eosin stain, original magnification x400).


Abdominal contrast-enhanced CT findings 3 months after surgery Liver and lung metastases rapidly increased in size.


Magnetic resonance imaging showing a left frontal mass lesion measuring 5.0 cm in size, which exhibits ring enhancement on gadolinium-enhanced T1-weighted imaging.


Hyperintensity in the lesion rim and part of the lesion interior on diffusion-weighted imaging.


Panoramic radiograph showing widening of the periodontal ligament space around the right maxillary second premolar (arrow) and second molar (dotted arrow) due to apical periodontitis.


(a and b) Gadolinium-enhanced T1-weighted magnetic resonance imaging (MRI) approximately 4 months after the surgery showing shrinking of the lesion with only a very small area of high signal intensity (arrow) and hydrocephalus secondary to central nervous system infection. Hyperintensity in the lesion disappeared completely on diffusion-weighted MRI (not shown).


Magnetic resonance imaging (MRI) showing two mass lesions of <2 cm in the left frontal and right parietal lobes. Both lesions exhibited ring enhancement on gadolinium-enhanced T1-weighted imaging.


Magnetic resonance imaging (MRI) showing two mass lesions of <2 cm in the left frontal and right parietal lobes. And homogeneous hyperintensity on diffusion-weighted imaging.


Magnetic resonance imaging (MRI) showing two mass lesions of <2 cm in the left frontal and right parietal lobes. , with vasogenic edema surrounding the lesions on fluid-attenuated inversion recovery (FLAIR) imaging.


Magnetic resonance imaging (MRI) showing two mass lesions of <2 cm in the left frontal and right parietal lobes. (d) FLAIR MRI obtained 7 weeks later showing slight enlargement of the mass lesion in the right frontal lobe with worsening vasogenic edema.


Panoramic radiograph showing no apparent abnormalities.


Approximately 4 months after the surgery, the lesions disappeared on diffusion-weighted magnetic resonance imaging (MRI).


The surrounding vasogenic edema partially improved on FLAIR MRI Postoperative gadolinium-enhanced MRI was not performed because the gadolinium-enhanced MRI was refused.


T2-weighted midsagittal magnetic resonance imaging scans revealing a progressive Chiari I malformation in a patient with unilateral sporadic retinoblastoma treated by enucleation of the left eye. Basion-opisthion line is shown to determine the herniation of cerebellar tonsils through the foramen magnum at 4.5-year-old.


T2-weighted midsagittal magnetic resonance imaging scans revealing a progressive Chiari I malformation in a patient with unilateral sporadic retinoblastoma treated by enucleation of the left eye. 5-year-old. Visits.


T2-weighted midsagittal magnetic resonance imaging scans revealing a progressive Chiari I malformation in a patient with unilateral sporadic retinoblastoma treated by enucleation of the left eye. Orbital socket filled with hydroxyapatite is also shown (c).


Preoperative magnetic resonance imaging (MRI) of the brain postcontrast T1-weighted MRI. Axial view.


Coronal view.


Sagittal view reveals multilobulated complex mass with both cystic and solid components again seen in the suprasellar region measuring 28.7 mm x 34.5 mm x 37.2 mm (AP by TR by CC).


Postoperative magnetic resonance imaging (MRI) of the brain postcontrast T1-weighted MRI. Axial view.


Sagittal view reveals partial resection of the previously seen suprasellar mass with decrease mass effect and trace postsurgical hemorrhage.


3D reconstruction with a catheter in the common hepatic artery (asterisk) and six electrodes placed alongside the metallic Wallstent.


Facial profile showing swelling in the submandibular region.


Coronal CT scan.


Axial CT scan.


Intraoperative photograph.


Excised lobular tumor (8 cm x 5 cm x 4 cm).


A red free fundus photograph of the right eye reveals a mass lesion in the nasal quadrant (arrowheads).


Schematic representation of the fundus appearance of the right eye at presentation. White area denotes attached retina. Light grey area denotes detached retina. Dark area denotes retinal dialysis. Stippled line denotes demarcation line. Shaded area denotes hemorrhagic intraretinal macrocyst.


Ultrasound scan of the right eye at presentation. A well-delineated cystic mass lesion measuring 12.2 mm x 7.4 mm is noted. It has a high surface reflectivity and low-to-moderate internal reflectivity with an irregular echotexture. Retinal detachment is noted inferior to the lesion (arrow).


A late phase fluorescein angiographic image showing blocked fluorescence in the area of the lesion as well as lack of double circulation within the lesion (arrowheads).


Ultrasound scan of the right eye two months after surgery. The retinal 'cyst' is persistent. An echolucent area in the orbit adjacently behind the 'cyst' denotes the scleral buckle (arrow).


Ultrasound scan of the right eye three years after surgery. Acoustically clear vitreous cavity with complete retinal re-attachment and resolution of retinal 'cyst' is noted.


Brain MRI of the patient: axial plane of T1-weighted brain MRI. With.


Without contrast.


(C) Sagittal plane of T1-weighted brain MRI. MRI of the brain shows a low-signal, heterogeneous mass in T2 and T1 in the right frontal lobe area, extending to the right parietal area and with significant midline shift to the left. After contrast injection, a punctuate enhancement was reported.


Hematoxylin, and ,eosin staining, 400x, showing cartilaginous lobules without atypia, mitosis, or necrosis.


Positive IHC staining of S100 marker.


Clinical photograph showing intraoral soft tissue swelling in the left retromolar region bluish in colour with diffuse margins and stretched mucous membrane.


Computed Tomography (CT) scan showing a cystic lesion present medial to the angle of the mandible.


Contrast CT scan showing cystic lesion medial to the angle of the mandible measuring 1.5 cm x 2.6 cm.


Gross examination showing a cystic lesion, roughly oval in shape, creamish brown in color, and nodular surface.


Abdominal and pelvic non-contrast CT revealing a 36 x 31-mm, well-demarcated, ellipsoid and hypodense mass with a CT value of about 27 Hounsfield units (HU) in the external branch of the right adrenal region. Hypodense lesions with a diameter of 15 mm.


Abdominal and pelvic non-contrast CT revealing a 36 x 31-mm, well-demarcated, ellipsoid and hypodense mass with a CT value of about 27 Hounsfield units (HU) in the external branch of the right adrenal region. 39 mm discovered in the upper.


Abdominal and pelvic non-contrast CT revealing a 36 x 31-mm, well-demarcated, ellipsoid and hypodense mass with a CT value of about 27 Hounsfield units (HU) in the external branch of the right adrenal region. Lower. Poles of the right kidney, respectively.


Abdominal and pelvic non-contrast CT revealing a 36 x 31-mm, well-demarcated, ellipsoid and hypodense mass with a CT value of about 27 Hounsfield units (HU) in the external branch of the right adrenal region. Non-contract CT of the chest suggesting lung metastasis: multiple nodules in both lungs, the largest one being located in middle lobe of the right lung (D).


TTE revealing a 23.9 x 13.4-mm, hyperechoic mass with a smooth surface in the left atrium, close to the posterior leaflet of the mitral valve, and moving without extension to the outflow tract during the cardiac cycle; the mass was suspected to be a myxoma (A).


Repeat TTE showing a 27.7 x 16-mm isoechoic mass attached to the posterior leaflet annulus of the mitral valve in the enlarged left atrium (B).


Immunohistochemical staining showing positivity for CAIX, CD10, and Vimentin. (A) CAIX (x200).


Immunohistochemical staining showing positivity for CAIX, CD10, and Vimentin. (B) CD10 (x200).


Immunohistochemical staining showing positivity for CAIX, CD10, and Vimentin. (C) Vimentin (x200).


Immunohistochemical staining showing positivity for CAIX, CD10, and Vimentin. (D) Histological examination of the tumor using Hematoxylin & Eosin stain.


Clinical picture.


Photomicrograph (H&E, x10).


Photomicrograph (D2-40 stain, x10).


Echocardiographic image of myxoma in parasternal long axis view (LV: left ventricle, RV: right ventricle, AORT: aorta).


Echocardiographic image of myxoma on the interatrial septum (Note the mark on the left side of interatrial septum) (LV: left ventricle, RA: right atrium, RV: right ventricle, + : Remnant on the interatrial septum).


Macroscopic image of myxoma (postoperative).


Ultrasound sonography:. A well-capsulated heteroechoic round mass over the tail of epididymis, 4.7 x 3.5 cm in size.


Abundant tortuous vessels adjacent to the paratesticular tumor.


(c) The tumor had a rich blood supply on color Doppler sonography.


A white, grayish, well-circumscribed, solid tumor (4 x 3.5 cm) adherent to atrophic testis and epididymis (arrow: tumor; star: testis).


Typical bland spindle or stellate cells with little or no nuclear polymorphism and variably elongated cytoplasm set in a mucomyxoid stroma. Vascularity was variably composed of delicate to more hyalinized vessels. (hematoxylin, and ,eosin, magnification 200x).


Typical bland spindle or stellate cells with little or no nuclear polymorphism and variably elongated cytoplasm set in a mucomyxoid stroma. Typical cytoplasmic desmin.


Typical bland spindle or stellate cells with little or no nuclear polymorphism and variably elongated cytoplasm set in a mucomyxoid stroma. Smooth muscle actin. Immunopositivity (magnification 200x).


On immunohistochemistry tumor cells show positivity for:. Vimentin (x400).


HMB-45 (x400).


S-100 (x400).


Ki67 <2% (x100).


Computed tomography scan-neoplastic lesion of left parotid gland (arrows).


Post-operative photograph showing. Location of excised tumor.


Patient with post-operative facial palsy.


Initial 9 cm right renal cyst.


Paracolonic cystic lesion (white arrow) along the ascending colon in relation to recurrent right renal mixed epithelial stromal tumor cyst (red arrow).


Mesenteric multiloculated paracolonic mixed epithelial stromal tumor lesion (arrows).


Immunohistochemical stain of stroma is positive for estrogen receptor (x200).


Fusion image in cross section. Image of peritoneal carcinomatosis of the patient.


Fusion image in axial cut. It is found that the mass is well-located behind the tracheabronchial axis.


Maximal intensity projection of our patient. Acquisition of broadcoast images realized 60 min after injection of 252 Megabecquerels of FDG-IBA in a vein of the right wrist. Visualization of the supra-diaphragmatic isolated hypermetabolism.


Sagittal cut, fusion image, 30 mm mass above aortic stock, maximum standardized uptake value of 12.8.


Imaging studies of the left lobe of the liver by. Ultrasound examination.


Computed tomography.


T1-weighted imaging (WI).


T2WI by magnetic resonance imaging.


(A) Pathological result of the biopsy from the lesion of the left lobe of the liver.


(B) Pathological result of the resected rectal cancer.


Schematic overview of the timing and dosing of the BV-DHAP regimen. . Notes: Dosage in cycle 1 was reduced to 75%. Cycle 2 was administered at 100% as indicated. . Abbreviations: BV-DHAP, brentuximab vedotin and cisplatin/cytarabine; d, day; iv, intravenous; po, per os; sc, subcutaneous.


T1-weighted MRI with gadolinium contrast of the metastatic lesion. At presentation, coronal.


T1-weighted MRI with gadolinium contrast of the metastatic lesion. Sagittal. Views showing expanded sella with thick-walled sellar/suprasellar mass with extension into the right sphenoid sinus, dorsum sellae, and clivus.


T1-weighted MRI with gadolinium contrast of the metastatic lesion. At one month after resection, coronal.


T1-weighted MRI with gadolinium contrast of the metastatic lesion. Sagittal. Views showing recurrence and of the enhancing mass centered in the sphenoid sinus with locoregional involvement, new bulging into the right cavernous sinus and involvement of right Dorello's canal.


T1-weighted MRI with gadolinium contrast of the metastatic lesion. At three months after resection, coronal.


T1-weighted MRI with gadolinium contrast of the metastatic lesion. Sagittal. Views showing significant increase in size of the mass. The lesion involved the sphenoid sinus and posterior ethmoid air cells, elevating the sellar floor and displacing the pituitary gland superiorly. The lesion extended to the cavernous sinus and abutted the cavernous carotid arteries, with erosion of the posterior cortex of the clivus, mild retroclival extension with dural involvement, and partial encasement of the basilar artery.


Biopsy of the patient's tumor (H&E 20x10): tumor islands comprised of poorly differentiated squamous cancer cells having intercellular bridges with macronucleoli and hyperchromatic vesicular nuclei. . Abbreviation: H&E, hematoxylin and eosin.


Timeline of the present case. . Abbreviations: bid, twice a day; m, month; PR, partial response; qd, once a day; TEC, docetaxel + epirubicin + cyclophosphamide; TACE, transcatheter arterial chemoembolization; y, years; HER2, human epidermal growth factor receptor 2; SD, stable disease; PD, progression of disease.


Photographs of the primary lesion in the patient's left breast. . Notes: (A) Before VT therapy.


Photographs of the primary lesion in the patient's left breast. (B) After 2 cycles of VT therapy.


Photographs of the primary lesion in the patient's left breast. (C) After 4 cycles of VT therapy. . Abbreviation: VT, vinorelbine + trastuzumab.


Comparison of computed tomography scans before and after 2 cycles of vinorelbine + trastuzumab regimen. . Note:. Left breast lesion before, and ,after treatment, respectively.


Comparison of computed tomography scans before and after 2 cycles of vinorelbine + trastuzumab regimen. Left liver lesions before and after treatment, respectively.


Analysis of the primary left breast and liver lesion tissue. . Notes:. H&E.


Analysis of the primary left breast and liver lesion tissue. H&E.


Analysis of the primary left breast and liver lesion tissue. IHC, HER2 2.


Analysis of the primary left breast and liver lesion tissue. FISH, HER2-; analysis of the primary breast lesion.


Analysis of the primary left breast and liver lesion tissue. IHC, HER2-; analysis of metastatic liver lesion. H&E stained images are depicted at 100x magnification. . Abbreviations: FISH, fluorescence in situ hybridization; HER2, human epidermal growth factor receptor 2; IHC, immunohistochemistry.


Computed tomography (CT) scans of the thorax of the patient. (A) CT scan before the treatment.


Computed tomography (CT) scans of the thorax of the patient. (B) Image of the best response of pembrolizumab therapy.


Computed tomography (CT) scans of the thorax of the patient. (C) Image of progression of pembrolizumab therapy and before atezolizumab therapy.


Computed tomography (CT) scans of the thorax of the patient. (D) Image of best response of atezolizumab therapy. CR, complete response; SD, stable disease; PD, progressive disease.


Clinical picture showing a diffuse extraoral swelling of size 4.5 cm x 3.5 cm present on the right side of the face (maxilla).


Intraoral picture showing erythematous growth on the right side of the maxilla extending from 14 to 17.


Radiograph revealing ill-defined radiolucency and significant bone loss on the right side of the maxilla.


Odontogenic epithelium in follicular pattern, few of the follicles showing stellate reticulum-like cells, along with increase in cellular atypia and mitotic activity.


CK19 was found to be positive.


Clinical picture showing the ulcerated growth with bleeding.


CT scan showing the expansile mass involving the maxillary sinus.


Pleomorphic undifferentiated epithelial cells in the form of nests and trabeculae separated by thin fibrous connective tissue septa (H&E, x10).


Photomicrograph showing large cells with pleomorphic nuclei (H & E, x40).


Photomicrograph showing positive reactivity to cytokeratin (x40).


Timeline of the diagnosis and treatment. M1, the mass adjacent to the left hilum; M2, the mass on the basal segment; chemo, chemotherapy; pembr, pembrolizumab; CA-125, carbohydrate antigen 125; CEA, carcino-embryonic antigen; i. V. , intravenously.


Chest X-ray showing an enlargement of the mediastinum.


Computed tomography scan coronal cut revealing a large solid tumoral lesion in the posterior mediastinum.


Computed tomography scan sagittal cut revealing a large solid tumoral lesion in the posterior mediastinum.


Computed tomography scan axial cut revealing a large solid tumoral lesion in the posterior mediastinum.


Computed tomography scan axial cut revealing cutaneous nodules on the abdomenlesion in the posterior mediastinum.


Preoperative facial view.


Preoperative view of the lesion.


Intraoral periapical radiograph.


Orthopantomogram.


Post preliminary therapy.


Post biopsy.


Histopathologic section: Dashed arrow denotes attempted keratin pearl formation, black colored arrow denotes absence of epithelial rete pegs, and red colored arrow denotes altered nuclear/cytoplasmic ratio.


Chest radiograph.


Computed tomography. Thyroid tumor with a diagnosis as a well- differentiated papillary carcinoma, invaded the cervical esophagus and right jugular vein with lymph node metastasis in July 2004.


Computed tomography. Abdominal computed tomography showing an intra-abdominal abscess adjacent to the small intestine.


Macroscopic findings of the resected small intestine indicated a type 2 tumor, which perforated and developed a mesenteric abscess.


PET/CT depicting increased of FDG uptake at the paratracheal site. A PET/CT in 2006. B; PET/CT in 2012.


PET/CT depicting increased of FDG uptake at the intrathoracic esophagus site. A PET/CT in 2006 showed no accumulation of FDG around the middle mediastinum. B; PET/CT in 2012 indicated FDG uptake on the thoracic esophagus and adjacent lymph node.


Endoscopic findings of esophageal stenosis showing a circular occlusion caused by the esophageal tumor.


Computed tomography scan of thoracic esophageal tumor growing in the middle portion of the mediastinum at the time when the patient suffered from severe dysphagia.


CA15-3 and radiological response to treatment with TDM-1. Changes in CA15-3 (U/ml) were recorded in response to treatment (A). The normal range (NR) for CA15-3 is <28 U/ml. Each cycle of TDM-1 treatment is shown along with its cycle number, dose and any dose reduction instituted. Day 0 represents the administration of the first cycle of TDM-1.


CA15-3 and radiological response to treatment with TDM-1. MRCP was performed at baseline.


CA15-3 and radiological response to treatment with TDM-1. After administration of 3 cycles of TDM-1. To monitor radiological response of the metastatic deposit (yellow arrows).


Magnetic resonance imaging findings and pathologic evaluations of our patient. (A) Gross finding, midline lower abdominal wall mass with rectus abdominis muscle (photo during operation).


Magnetic resonance imaging findings and pathologic evaluations of our patient. (B,C) About 9-cm-sized midline lower abdominal wall soft tissue lesion with low signal intensity in T2W1 image on magnetic resonance imaging (arrowed). Sagittal view.


Magnetic resonance imaging findings and pathologic evaluations of our patient. (B,C) About 9-cm-sized midline lower abdominal wall soft tissue lesion with low signal intensity in T2W1 image on magnetic resonance imaging (arrowed). Transverse view.


Magnetic resonance imaging findings and pathologic evaluations of our patient. (D) The tumor was composed of nests of epithelioid cells with necrotic debris and peritumoral hyaline-like material (H&E, x20).


Magnetic resonance imaging findings and pathologic evaluations of our patient. (E) Positive cytoplasmic staining for beta-human chorionic gonadotropin (x100).


Magnetic resonance imaging findings and pathologic evaluations of our patient. (F) Positive cytoplasmic staining for inhibin-alpha (x100).


Magnetic resonance imaging findings and pathologic evaluations of our patient. (G) Positive nuclear staining for p63 (x100).


Pretreatment MRI: Coronal.


Axial.


Sagittal. Postcontrast T1demonstrate a mildly enhancing upper nasal cavity mass with extending through the cribriform plates. Associated abnormal retropharyngeal lymph nodes.


MR images important for the correct differential diagnosis: ADC map (a) demonstrating mild restricted-diffusion, suggesting hypercellularity.


Axial T2 (b) at the level of the nasopharynx demonstrates enlarged retropharyngeal lymph nodes, suggesting either primary lymphoid-disease or typical nodal spread of esthesioneuroblastoma.


Four month post treatment coronal.


Sagittal. Postcontrast T1 MR images, demonstrate decreased size of the lymphoma mass in the nasal cavity, along the cribriform plates, and prepontine cistern.


Hematoxylin and eosin (H&E) staining and immunohistochemical analyses of the resected tumor. (A) The tumor cells arrange in a diffuse pattern(x4). Melan-. Patchy).


Hematoxylin and eosin (H&E) staining and immunohistochemical analyses of the resected tumor. (B) Epithelioid tumor cells are oval or polygonal, with clear or granular eosinophilic cytoplasm. Nucleoli are prominent in the vesicular nuclei. Increased mitotic activity and dysplasia are observed (x20).


Hematoxylin and eosin (H&E) staining and immunohistochemical analyses of the resected tumor. Tumor cells are positive for. HMB-45 (strong, and ,diffuse).


Hematoxylin and eosin (H&E) staining and immunohistochemical analyses of the resected tumor.


Hematoxylin and eosin (H&E) staining and immunohistochemical analyses of the resected tumor.
TFE3 (modest, and ,diffuse).


Hematoxylin and eosin (H&E) staining and immunohistochemical analyses of the resected tumor. Are negative for. SMA.


Original plain computed tomography scan obtained upon presentation demonstrating a mass located in the cerebellum with associated, obstructive hydrocephalus.


Posteroanterior chest radiograph demonstrating pacemaker.


Posteroanterior chest radiograph demonstrating pacemaker. Corresponds with nonmagnetic resonance imaging compatible device whereas. The new, magnetic resonance imaging compatible pacemaker in place.


Demonstrating axial and sagittal pre-and post-operative imaging. All sections are postgadolinium contrast. Representing preresection.


Demonstrating axial and sagittal pre-and post-operative imaging. All sections are postgadolinium contrast. Whereas. Are postresection.


Location of facial malignant tumor and histopathological findings of Merkel cell carcinoma. . Notes: (A) Merkel cell carcinoma was excised from the right preauricular area.


Location of facial malignant tumor and histopathological findings of Merkel cell carcinoma. (B) H&E staining revealed diffuse proliferation of atypical and pleomorphic tumor cells; small, round basophilic cells are arranged in cordlike structures (original magnification x200). Histology of the tumor.


Location of facial malignant tumor and histopathological findings of Merkel cell carcinoma. Immunohistochemical analysis found that the tumor cells were positive for. CK20.


Location of facial malignant tumor and histopathological findings of Merkel cell carcinoma. Syn.


Location of facial malignant tumor and histopathological findings of Merkel cell carcinoma. CgA.


Location of facial malignant tumor and histopathological findings of Merkel cell carcinoma. CD56.


Location of facial malignant tumor and histopathological findings of Merkel cell carcinoma. Ki67 (original magnification x400).


Location of facial malignant tumor and histopathological findings of Merkel cell carcinoma. (H, I) Excisional biopsy revealed Merkel cell carcinoma with negative margins (original magnification: H x40; I x200). . Abbreviations: CT, Computed tomography; PET, positron emission tomography.


Images of the whole-body PET/CT scan 2 weeks post-surgical excision showing a nodule (red arrow) (0.3*0.8 cm) in the post-operative site with maxSUV values of 1.7 (A).


No distant metastases were detected (B, C). . Abbreviations: CT, computed tomography; PET, positron emission tomography.


Computed tomography scan.


Neck demonstrating a mass (red arrow) in relation to the. Cervical lymph node mass (red arrow).


Histology of the resected cervical lymph node biopsy mass. . Notes: (A, B) H&E staining found diffuse proliferation of atypical and pleomorphic cells (original magnification: A x40; B x200).


Histology of the resected cervical lymph node biopsy mass. Immunohistochemical analysis found that the resected mass was positive for. CK20.


Histology of the resected cervical lymph node biopsy mass. Syn.


Histology of the resected cervical lymph node biopsy mass. CgA.


Histology of the resected cervical lymph node biopsy mass. CD56.


Histology of the resected cervical lymph node biopsy mass. Ki67 (original magnification x400).


The various treatments the patient received and the duration of each treatment. . Abbreviations: FDG, 18F-fluorodeoxyglucose; IMRT, intensity modulated radiation therapy; PET-CT, positron emission tomography-computed tomography.


(A) Chest radiography revealied the mediastinal mass on April 23, 2013.


(B) Chest computed tomography (CT) revealed a large anterior mediastinal tumor invading the great vessels on April 23, 2013.


(C) A percutaneous core cutting needle biopsy of the anterior mediastinal tumor was performed under CT guidance.


(D) Chest computed tomography re-examination revealed that the anterior mediastinal tumor was enlarged 1 month after the initial CT scan (May 23, 2013).


(A) Malignant peripheral nerve sheath tumor (MPNST) cells. Malignant spindle cells with marked pleomorphism and fasciculated architecture were observed (hematoxylin and eosin; magnification, x200).


(B) High-powered view of MPNSTs with rhabdomyosarcomatous differentiation. Round cells with eosinophilic cytoplasm were morphologically consistent with rhabdoid differentiation and were identified in a background of classic MPNST (white arrow) (hematoxylin and eosin; magnification, x400).


(C) Positive nuclear immunohistochemical staining with S-100 was noted in MPNST (white arrow) (magnification, x400).


(D) Positive nuclear immunohistochemical staining with myogenin was noted in rhabdomyoblastic cells (white arrow) (magnification, x400).


(E) Positive cytoplasm immunohistochemical staining with desmin was noted in rhabdomyoblastic cells (white arrow) (magnification, x400).


MRI brain demonstrating metastases to brain. Axial.


MRI brain demonstrating metastases to brain. Coronal. Views of the brain demonstrating the presence of brain metastasis.


MRI brain showing leptomeningeal disease. (a) T1 axial MRI with contrast depicting new enhancement along superior cerebellar folia compatible with leptomeningeal disease.


MRI brain showing leptomeningeal disease. (b) Abnormal leptomeningeal enhancement along posterior margin of splenium of corpus callosum.


Ultrasonography.


Lateral and posteroanterior view of skull.


Fine needle aspiration cytology.


Cut surface of the gross specimen.


(a) Clinical image showing a tan-red exophytic, lobulated mass of the maxillary anterior facial gingiva.


(b) A separate, similar appearing smaller lesion was identified in the right maxillary vestibule.


Periapical radiograph showing no changes in the quality or quantity of bone and no evidence of odontogenic infections.


(a) Histopathologic image showing tumor cell nests completely effacing the lamina propria, (H&E, x40).


(b) These tumor nests were arranged in lobular aggregates separated by thin fibrous septae, (H&E, x100).


(c) On high power magnification, the cells displayed pink to vacuolated cytoplasm with vesicular nuclei and prominent nucleoli. Significant nuclear pleomorphism was present and the lesion demonstrated brisk mitotic activity, (H&E, x400).


Endoscopic ultrasound image of a linear filling defect inside pancreatic duct.


Endoscopic ultrasound image showing infiltration of ampullary lesion to duodenal wall and terminal common bile duct.


Endoscopic retrograde cholangiopancreatography image of a linear filling defect inside dilated pancreatic duct.


Section showing histological features of malignant melanoma.


Section showing histological features of malignant melanoma (highpower field).


Tumor excised - skin graft cover.


MRI brain. T1 noncontrast.


MRI brain. T1 postcontrast sequences demonstrate a 7.0 cmx5.0 cmx4.9 cm heterogeneously enhancing left frontal mass with T1 shortening at the posterior aspect of the lesion, suggestive of prior hemorrhage.


MRI brain. T1 postcontrast sequences also reveal a dural tail.


MRI brain. T2-weighted sequences demonstrate a partial cerebrospinal fluid cleft around the periphery of the lesion; both findings suggest that the mass is extra- axial in origin.


CT abdomen/pelvis demonstrates a hypodense hepatic lesion (arrow) concerning for metastatic disease.


(a) Histologic sections of the left frontal mass demonstrate a high-grade SFT/HPC. Note the four mitotic figures in the mid-upper right (red arrows). (H & E, 200x).


(b) Nuclei of the neoplastic cells express STAT6, indicating a fusion of the NAB2 and STAT6 genes (Diaminobenzidine, 100x).


(a) Metastatic hemangiopericytoma in liver core biopsy (H & E, 200x).


(b) Expression of STAT6 by the neoplastic cells (Diaminobenzidine, 100x).


Postoperative surveillance MRI brain (T1 postcontrast) demonstrates no evidence of residual or recurrent disease.


Histology of a prolactin-producing pituitary tumor. Tumor with diffuse growth pattern of cells with elongated nuclei and inconspicuous nucleoli and moderate amount of slightly acidophilic cytoplasm [(A):HE 400x.


Histology of a prolactin-producing pituitary tumor. Prolactin expression in neoplastic cells [(B):400x.


Thyroid ultrasonography (A) showed a normal size gland, with heterogeneous texture and pseudonodular areas, without nodular lesions, suggesting thyroiditis. The color flow Doppler signal showed significantly increased vascularity with diffuse homogeneous distribution (thyroid inferno).


There was a markedly hyperfunctioning thyroid in scintigraphy (B), with homogeneous activity distribution and no focal areas suggestive of hyper- or hypoactive nodular formations. The radioactive iodine uptake was 70.2% at the end of 24 h, markedly elevated compared to normal range (10-30.


Panel (C) shows the evolution of thyroid function. After pituitary surgery in 2009 the patient developed secondary hypothyroidism and initiated LT4. She was admitted with primary hyperthyroidism in April 2015 and initiated MMI. During antithyroid drug withdrawal before scintigraphy, FT4 and FT3 re-increased above the reference range. MMI was progressively reduced after 6 months of treatment, but after withdrawal in October 2015, central hypothyroidism recurred and she resumed LT4 since March 2016. Abbreviations: LT4, levothyroxine; MMI, methimazole; FT4, free thyroxine; FT3, free triiodothyronine.


Evolution of serum prolactin levels over time and its relation with medical, surgical, and radiation therapy. *Samples not diluted.


Plane hand radiograph reveals bone erosion in the right thumbs' distal phalanges.


Plane hand radiograph reveals bone erosion in the left thumbs' distal phalanges.


Postoperative view.


Computed tomography scan shows the lesion, located in meta-diaphysial area.


Primary giant cell tumor of bone (Haematoxylin and Eosin).


Histopathological findings of the resected liver. (a) Photograph showing the removed section of the liver. Most of the tumor was successfully treated with transcatheter arterial chemoembolization, except for the small remaining viable hepatocellular carcinoma (HCC) (red zone). These lesions correspond with the computed tomography findings.


Histopathological findings of the resected liver. (b) The viable tumor is a moderately differentiated HCC (hematoxylin and eosin staining).


(a) Computed tomography scan showing multiloculated collections (black arrows) encasing the uterus (white arrow). Bilateral ovaries are seen compressed (yellow arrows).


(b) Pelvic mass showing solid cystic part (black arrow) with focal keratinous areas (white arrow).


(a) Right adnexal mass showing stratified squamous epithelium and abundant keratinous material (H and E, x100). (b) The section from the pelvic mass showing islands of malignant squamous cells (H and E, x100). (c) Focal areas of highly pleomorphic tumor cells. (H and E, x400).


Chest computed tomography shows heterogeneously enhancing infiltrating mass (*) with pleural (white circle) and pericardial (arrows) effusion.


Encasement of the right coronary artery (arrow.


Proliferation of atypical lymphoid cells in H and E, x40 (a), CD20 positivity, x40 (b), and high Ki67 proliferative index, x40 (c).


Total body 18F-fluorodeoxyglucose positron emission tomography (coronal section) shows only cardiac uptake.


Serum IgM level before and after therapies. (A) The serum IgM level was 23.4g/L before R-CHOP regimen and 23.90g/L after 4 cycles of R-CHOP regimen.


Serum IgM level before and after therapies. (B) The serum IgM level was 23.90g/L before R-Vd regimen and 16.10g/L after 2 cycles of R-Vd regimen.


Histopathological sections of the lymph nodes (hematoxylin and eosin staining). Small atypical lymphocytes diffusely or follicle-like distributed and follicle-like structure accounted for 75% of the whole tissue. The absolute number of centroblasts was 0-5 for each high-power field. Original magnification: 50x.


Histopathological sections of the lymph nodes (hematoxylin and eosin staining). Small atypical lymphocytes diffusely or follicle-like distributed and follicle-like structure accounted for 75% of the whole tissue. The absolute number of centroblasts was 0-5 for each high-power field. Original magnification: 100x.


Histopathological sections of the lymph nodes (hematoxylin and eosin staining). Small atypical lymphocytes diffusely or follicle-like distributed and follicle-like structure accounted for 75% of the whole tissue. The absolute number of centroblasts was 0-5 for each high-power field. Original magnification: 200x.


Histopathological sections of the lymph nodes (hematoxylin and eosin staining). Small atypical lymphocytes diffusely or follicle-like distributed and follicle-like structure accounted for 75% of the whole tissue. The absolute number of centroblasts was 0-5 for each high-power field. Original magnification: 400x.


Immunohistochemical staining of the lymph nodes. The tumor cells were positive for. CD20 (original magnification: 400x).


Immunohistochemical staining of the lymph nodes. CD23 (original magnification: 400x).


Immunohistochemical staining of the lymph nodes. CD10 (original magnification: 400x).


Immunohistochemical staining of the lymph nodes. Bcl-2 (original magnification: 400x).


Immunohistochemical staining of the lymph nodes. Ki-67 (with a proliferation index approximately 5-10%; original magnification: 400x). The tumor cells were negative for CD3, CD5, and Cycline-D1 (data not shown).


Magnetic resonance imaging of intracranial lesions. A Parieto-temporal lesion that was irradiated. T1 weighted MRI after application of Gadolinium-containing contras material. B; Presentation of the radiation field that was applied to the lesion.


Magnetic resonance imaging of intracranial lesions. A Parieto-temporal lesion that was irradiated. T1 weighted MRI after application of Gadolinium-containing contras material. C; Progression of irradiated lesion after irradiation and before resection of the lesion.


Chemokine levels over time and detection of anti-vascular endothelial antibodies. A, b Changes in inflammatory chemokine levels that were measured in the serum of the patient by a multiplex bead assay. Chemokines were measured before treatment with nivolumab (time point 1), after 4 weeks (time point 2), after 10 weeks (time point 3), at the diagnosis of the vasculitis/encephalitis (time point 4), and 3 weeks later (time point 5).


Chemokine levels over time and detection of anti-vascular endothelial antibodies. C; Staining of control cerebellum sections with serum from the patient at the time point when the vasculitis/encephalitis was diagnosed.


Chemokine levels over time and detection of anti-vascular endothelial antibodies. D; Staining of cerebellar sections with control serum (left panel) or serum from the patient before PD-1 blockade (right panel).


Histologic examination of the right patellar mass reveals the diffuse infiltration by atypical lymphocytes.


Contrast-enhanced computed tomography images showing the enlargement of the left kidney, renal pelvis, and ureter. And gas accumulation within the renal pelvis, ureter, and bladder The patient's right kidney is absent, and a thickened gastric wall can be observed (arrows).


Gas accumulation within the renal pelvis, ureter, and bladder The patient's right kidney is absent, and a thickened gastric wall can be observed (arrows).


CT scan showing soft tissue mass anterior to sternum.


MRI coronal view showing large pre-sternal mass.


MRI sagittal view- multicystic lesion.


PET CT showing FDG uptake in the mass and neck node.


Resected specimen.


Specimen showing multiple cystic and solid areas.


HPE consistent with papillary thyroid carcinoma. H & E stain.


T1-weighted pituitary magnetic resonance imaging before . (A) Pre-CAPTEM sagittal image shows an increase in the size of the seal tumor (26 mm) with a subacute bleeding component.


After. Treatment with capecitabine and temozolomide. (B) Post-CAPTEM sagittal image shows a decrease of 65% with a total size of 9 mm.


T1-weighted pituitary magnetic resonance imaging before . (C) Pre-CAPTEM pituitary coronal image shows invasion of clivus and protrusion into the sphenoid sinus.


After. Treatment with capecitabine and temozolomide. (D) Post-CAPTEM coronal image shows a decrease in size of the lesion, more prominent at the right level.


T2-weighted pituitary magnetic resonance imaging before . (A) Pre-CAPTEM axial image.


After. Treatment with capecitabine and temozolomide. (B) Post-CAPTEM axial image shows a decrease in size of 65% with prominent cystic degeneration.


T2-weighted pituitary magnetic resonance imaging before . (C) Pre-CAPTEM pituitary coronal image.


After. Treatment with capecitabine and temozolomide. (D) Post-CAPTEM coronal image shows a decrease in lesion.


Initial (Pre- IP therapy) radiological, laparoscopic and pathological picture. . A. MRI image with mucus filled appendix compressing the sigmoid lumen (arrow).


Initial (Pre- IP therapy) radiological, laparoscopic and pathological picture. . B. Omental caking.


Initial (Pre- IP therapy) radiological, laparoscopic and pathological picture. . C. Composite intra-operative picture showing omental mass and mucinous deposits all over abdomen.


Initial (Pre- IP therapy) radiological, laparoscopic and pathological picture. . D. Gross specimen picture of perforated appendix.


Post IP chemotherapy. . A. MRI imaging showing resolution of omental mass.


Post IP chemotherapy. . B. No tumor deposits in peritoneum and small bowel.


Post IP chemotherapy. . C. Normal small bowel mesentery.


Histological picture. . A. Appendix with high grade tumor cells after initial appendectomy. Microscopic examination (10x) of Omentum - without tumor cells (after CCRS). Acellular mucin in deposits (10x) with intense Alcian blue staining (after CCRS).


Head and neck magnetic resonance. A. Cross section without contrast.


Head and neck magnetic resonance. B. Cross section with contrast.


Head and neck magnetic resonance. C. Coronal section without contrast.


Head and neck magnetic resonance. D. Coronal section with contrast. Arrow indicates lesion.


Surgical specimen. Total left parotidectomy. Histological findings.


Diffuse black pigmentation of vaginal mucosa.


Follow up of the patient at one year.


Dermatological and histopathological characteristics of pyoderma gangrenosum. Ulcerative lesions showing necrotic base, and ,erythematous-violaceous undermined borders on the right, and ,left breast, respectively.


Dermatological and histopathological characteristics of pyoderma gangrenosum. Skin histology revealing epidermal necrosis, and ,a dermal-hypodermal inflammatory infiltrate mainly consisting of neutrophils (haematoxylin-eosin, original magnification x 100) (in the box, a magnified detail of the inflammatory infiltrate).


Dermatological and histopathological characteristics of pyoderma gangrenosum. Partial healing after therapy with pulsed intravenous methylprednisolone, followed by the combination of prednisone, and ,cyclosporine given orally.


Dermatological and histopathological characteristics of pyoderma gangrenosum. Complete healing with hypertrophic aspects.


Neck ultrasonography performed at 12-month follow-up visit after thyroidectomy. (a) Transversal scan shows two adjacent left paratracheal lesions (arrows).


Neck ultrasonography performed at 12-month follow-up visit after thyroidectomy. These marked hypoechoic areas have ill-defined margins but not microcalcifications; (b) Longitudinal scan depicts the elongated shape of the paratracheal lesion (lateral one) and its parallel orientation to the dermis without deformation of surrounding tissues, unlike true focal masses.


Neck ultrasonography performed at 10-month follow-up visit after the second cycle of intravenous methylprednisolone treatment shows complete regression of the two hypoechoic areas in the thyroid bed.


(A) Chest computed tomography scan shows high density mass in right upper lobe.


(B) Liver magnetic resonance imaging scan shows 1 cm sized nodule in segment 2.


Abdomen computed tomography scans show liver metastasis with pneumoperitoneum.


Small bowel edematous change with fluid collection in distal ileum.


A; Abdominal CT showed that the left renal pelvis was occupied by a staghorn calculus.


B; Percutaneous nephrostomy was performed.


Nephrectomy was performed, and the kidney was divided into two pieces.


Evolution of serum calcium and PTH concentrations.


Picture showing pre-operative left Breast tumor.


Breast MRI. Arrow pointing towards bilobed intra-parenchymal Phyllodes tumor.


Tumor appearance. (Left) Operating field after excision of right, caudate and quadrate lobe of liver; (Right) gross specimen.


Follow-up of right lung disease before and after immunotherapy. (a) Pulmonary right nodule, suggesting contralateral lung disease.


Follow-up of right lung disease before and after immunotherapy. (b) Complete lung response during nivolumab treatment.


Tissue specimen of primary tumor sample and brain metastases. (a) Immunohistochemistry stained with PD-L1 primary antibody (28-8 pharmaDx; Dako) in a pretreated formalinfixed paraffin-embedded tissue of primary lung tumor before treatment, exhibiting strong membrane staining in 100% of tumor cells (20x magnification).


Tissue specimen of primary tumor sample and brain metastases. (b) Cerebellar tissue specimen after complete resection.


Timeline of events since the diagnosis and summary of administered treatments.


Intra-oral picture showing growth with respect to right body mandible.


Histopathology report shows tumor cells arranged in glands suggestive of colonic type of intestinal-type adenocarcinoma.


Computed tomography findings before and after treatment with alectinib. A computed tomography scan before treatment revealed a solitary tumor in left upper lung (A).


Computed tomography findings before and after treatment with alectinib. A computed tomography scan 1 months after commencing treatment with alectinib revealed that dramatic reduction in tumor size.


Computed tomography findings before and after treatment with alectinib. , almost no presence of tumor lesion.


Percutaneous lung biopsy specimen from tumor lesions (A and B, hematoxylin-eosin). Pathology showed a lot of mucus filling the alveolar space.


Pathological examination of tissue specimens from thoracoscopic left lobectomy (A and B, hematoxylin-eosin). Pathology showed a small amount of scattered high-grade atypical glands in the interstitium, and fibrous tissue proliferation, foam cell aggregation, lymphocyte infiltration, multinucleated giant cell reaction, necrotic hemicalcium can be seen in the remaining lung tissue.


Immunohistochemical staining (20-X) revealed Ki61 positivity.


Cytokeratin 7 (CK7) and thyroid transcription factor-1 (TTF-1) positivity.


Changes in CA125 levels after everolimus administration. . Notes: Serum CA125 levels started to decrease after the administration of everolimus and then stabilized. The lowest value was 559 U/mL, in September 2012. Serum CA125 levels started to rise after the discontinuation of everolimus. . Abbreviation: DOD, died of disease.


A; A red-colored, elastic, soft, well-demarcated nodule on the left cheek.


B; The tumor spontaneously regressed 20 days after the biopsy.


Paraffin-embedded tissue samples were deparaffinized and stained with anti-CD8 antibodies.


Anti-granulysin antibodies.


Anti-caspase 3 antibodies The sections were developed with Liquid Permanent Red (original magnification x100).


Summary of the average number of immunoreactive cells in the 5 conventional MCC cases and the present case. Three representative fields of each section were selected from tumor areas with dense dermal lymphoid infiltrates. The number of immunoreactive cells was counted using an ocular grid of 1 cm2 at a magnification of x400. The data are expressed as the means +- SD of the numbers in each area. White bars: conventional MCC; black bars: present case.


Plain radiography of pelvis at the first week of local pain showed flake bone destruction in right femoral trochanter.


Sagittal T1-postgadolinium contrast enhancement magnetic resonance imaging suggestive of two heterogeneously contrast enhancing intra-dural, extramedullary lesions at D11-L2 and S1-S2 spinal levels (arrows).


(a) Microphotograph of H and E section showing highly cellular tumor with focal endothelial proliferation along with small focus of necrosis (arrow) (H and E, x100). (b) Microphotograph of H and E section showing highly cellular tumor with pleomorphic cells and small foci of necrosis (arrow) (H and E, x100).


Ultrasound of neck showing enlarged supraclavicular and cervical and lymph nodes (Left side).


X-ray of the pelvis showing evidence of Looser's zone.


(a-c) Contrast magnetic resonance imaging showing homogenous enhancement of the lesion in L4 body with extension into the spinal canal, pre vertebral and paravertebral region.


(a-c) Sagittal T2, Sagittal T1 and axial T2 weighted magnetic resonance imaging respectively at the end of one month following initial surgery showing increase in the lesion and wide involvement of the L4 body and extension of the lesion into the spinal canal.


Intraoperative image showing friable tissue engulfing the dural sac during revision procedure.


Positron emission tomography computed tomography showing increased fluorodeoxyglucose uptake in the L4 body and in the pre, para vertebral regions and in the spinal canal.


HPE showing epitheloid cells with deeply stained eosinophilic cytoplasm and intercellular deposition of hyalinised collagen.


Immunohistochemistry showing cells positive for Epitheloid Membrane Antigen.


Case one timeline.


Microscopic finding of a carcinoma of neuroendocrine cells in the liver biopsy from case one. Tumor cells exhibit invasive growth with non-distinct cell borders, light-staining or basophilic cytoplasm, large and dark nuclei with an irregular shape, visible pathologic mitosis, and coagulative necrosis. The biopsy section was stained with hematoxylin-eosin and imaged at 400x. The image was adjusted in Photoshop to remove the pink background and increase the contrast, and the original image before adjustment is provided in Additional file 1: Figure S1.


Case two timeline.


Microscopic finding of a carcinoma of neuroendocrine cells in the liver biopsy from case two. Tumor cells are clustered and composed of small cells with little cytoplasm, a high nucleo-cytoplasmic ratio, and dark nuclei with an irregular shape. The biopsy section was stained with hematoxylin-eosin and imaged at 400x. The image was adjusted in Photoshop to remove the pink background and increase the contrast, and the original image before adjustment is provided in Additional file 2: Figure S2.


Findings at presentation. (A) Fundus photograph of right eye. An orange-yellow mass is shown at the inferotemporal side.


Findings at presentation. (B) Fundus photograph of left eye. A yellow-white mass is shown at the superior side.


Findings at presentation. Early frame.


Findings at presentation. Late frame of fluorescein angiogram of left eye. Note hyperfluorescence in the tumor region from the early phase to late phase.


Histopathology of the tumor from a breast biopsy. Foci of oval and spindle-shaped cells are shown in alveolar and palisading arrangement. . Notes: Hematoxylin and eosin staining; scale bar =100 mum.


Findings at 15 months after presentation. Fundus photographs of right eye.


Findings at 15 months after presentation. Left eye. The choroidal tumors are shown. The tumors have apparently enlarged in size compared with size at presentation.


Findings at 15 months after presentation. Early frame.


Findings at 15 months after presentation. Late frame of indocyanine green angiogram of right eye. Choroidal vessels inside the tumor are stained from the early phase, with a mixture of hyperfluorescence and hypofluorescence in the late phase.


Findings after photodynamic therapy of right eye and external radiation therapy of left eye. (A) Fundus photograph of right eye 5 months after photodynamic therapy. The choroidal tumor at the inferior-temporal side has decreased in size compared with size before therapy.


Findings after photodynamic therapy of right eye and external radiation therapy of left eye. (B) Fundus photograph of left eye 5 months after external radiation therapy. The choroidal tumor has decreased in size and the optic disc is visible.


Color fundus photograph of the left eye. (a) At presentation, the left eye shows a subretinal mass approximately of 1.5-disc diameter in size located near superotemporal arcade with surrounding subretinal fluid extending till fovea.


Color fundus photograph of the left eye. (b) At 2-week follow up, the choroidal tuberculoma did not show any significant change in the size.


Color fundus photograph of the left eye. (c) At the last follow-up visit, a regressed and partially scarred tuberculoma is seen.


Fundus fluorescein angiography of the left eye at 10 weeks of presentation. (a) A small area of hypofluorescence overlying the lesion surrounded by hyperfluorescence in the early phase.


Fundus fluorescein angiography of the left eye at 10 weeks of presentation. (b and c) There is progressive staining of lesion in the late phase.


Fundus picture showing a typical orange-yellowish lesion.


B-scan ultrasonogram showing hyper-reflectivity of the lesion persisting even at 60 dB gain.


Neuroradiologic images on preoperatively. Representative axial T1-weighted postgadolinium contrast image.


Neuroradiologic images on preoperatively. And axial T2-weighted FLAIR image.


Follow-up neuroradiologic images. One-month postoperative representative axial T2-weighted FLAIR image.


Follow-up neuroradiologic images. , 2-month postoperative representative axial T2-weighted FLAIR image.


Follow-up neuroradiologic images. , 2-month postoperative representative axial T1-weighted postgadolinium contrast image.


Follow-up neuroradiologic images. , 4-month postoperative representative axial T2-weighted FLAIR image.


Follow-up neuroradiologic images. , 1-year postoperative representative axial T2-weighted FLAIR image with appreciated stable FLAIR signal.


Follow-up neuroradiologic images. , 1-year postoperative representative axial T1-weighted postgadolinium contrast image with no appreciated contrast-enhanced disease.


Pathological slice of undifferentiated pleomorphic sarcoma. Arrows indicate that the tumor cells have obvious nuclear atypia and pathological nuclear mitosis. 20X HE stain.


Pathological slice of undifferentiated pleomorphic sarcoma. Arrows indicate that the tumor cells have obvious nuclear atypia and pathological nuclear mitosis. 40X HE stain.


Skull base MRI in May, 2018 (Before the operation combined with carbon-ion radiotherapy): (A) MR images in transection.


MR images in coronal plane.


MR images in sagittal plane. The cross location denotes the recurring tumor.


Skull base MRI in March, 2019 (After the operation combined with carbon-ion radiotherapy):. MR images in transection.


MR images in sagittal plane. The cross location denotes no recurrent tumor.


Seller MRI scans showed a sellar lesion with suprasellar extension and compression of the optic chiasm. The lesion located in the sellar region presented with an isointense signal on T1-, and ,T2-weighted MRI.


Seller MRI scans showed a sellar lesion with suprasellar extension and compression of the optic chiasm. The mass was uniformly enhanced on MRI after contrast enhancement, and a pituitary adenoma was highly suspected.


Seller MRI scans showed a sellar lesion with suprasellar extension and compression of the optic chiasm. (E-H) The postoperative MRI showed total resection of the lesion.


Intra-operative conditions of the lesion. The dura of sellar floor was invaded by the tumor.


Intra-operative conditions of the lesion. The lesion was soft, mimicking pituitary adenoma in texture (the arrow).


Intra-operative conditions of the lesion. The dura of sphenoid platform was opened.


Intra-operative conditions of the lesion. The lesion was totally resected and the third ventricle was revealed. A, the invaded dura of the sellar floor; b, the cavernous sinus; c, the optic nerve; d, the sphenoid platform; e, the tumor; f, the arachnoid membrane of sphenoid platform; g, the optic chiasm; h, the mamillary body; i, posterior commissure.


CT image with adjusted plane showing a double duct sign.


A dilated common bile duct.


Immunohistochemical staining of the ampullary tumor, with benign tissue on the left border of each image. Positive staining for CK-19.


Immunohistochemical staining of the ampullary tumor, with benign tissue on the left border of each image. , CK-20.


Immunohistochemical staining of the ampullary tumor, with benign tissue on the left border of each image. , MUC-1.


Immunohistochemical staining of the ampullary tumor, with benign tissue on the left border of each image. , MUC-2.


Immunohistochemical staining of the ampullary tumor, with benign tissue on the left border of each image. , CDX-2.


Immunohistochemical staining of the ampullary tumor, with benign tissue on the left border of each image. , DPC-4.


Immunohistochemical stain for CD30 shows diffuse strong immunoreactivity on the cell membrane and in the Golgi region (original magnification x200).


Immunohistochemical stain for CD45 (LCA) shows diffuse membranous staining (original magnification x200).


Immunohistochemical stain for CD4 shows diffuse membranous staining of tumor cells (original magnification x200).


(a and b) Axial contrast enhanced computed tomography images of the liver reveals multiple hypodense well-defined mass lesions in both lobes.


Axial magnetic image of the liver.


Reveals the lesions to be homogeneously hypointense spin-echo (SE) T1-Weighted (W). And SE T2-W with fat suppression shows multiple hyperintense masses in both lobes.


Exophytic erythematous lesion on the tip of the nose with telangiectasia and central ulceration.


(A) Subepidermal infiltration of moderately differentiated squamous cell carcinoma with focal keratinization; the tumor cells showed no epidermotropism. Of note, the overlying epidermis was not dysplastic, as it is often observed in precursor lesions of primary cutaneous SCC. In the superficial dermis prominent dilated lymphatic vessels were found. (hematoxylin and eosin stain - H&E, magnification: 100x).


(B) Immunohistochemical study with CD34 antibody (marker of the endothelial cells) revealed numerous thrombi of neoplastic cells in the lumen of dilated thin-walled vessels. (CD34, 100x).


Thoracic HRCT revealed an infiltrative lesion of the upper part of the left lung cavity with dimensions 54x38mm adjacent to the pulmonary artery trunk, entangling the aorto-pulmonary window with bronchial infiltration into segments 1-3 and the upper left pulmonary vein as well as enlarged lymph nodes.


Infiltration of moderately differentiated squamous cell carcinoma (SCC) of the lung with focal keratinization (inset in top left); features of angioinvasion by tumor cells (arrow). Immunohistochemically the neoplastic cells showed strong expression of p63 and CK5/6, what is typical for squamous cell differentiation in lung tumors (not shown). (H&E, 100x).


The ulceration covered with serous crust including the tip of the nose with the destruction of the right ala of the nose spreading to the upper lip.


Subepidermal accumulation of atypical cells with hyperchromatic nuclei suggesting squamous cell carcinoma (SCC) (arrows) surrounded by subepidermal necrotic cells.


HRCT revealed eight neoplastic infiltrations in both lungs with the biggest one present in the middle field of the left lung with dimensions 17.7x26.0 mm.


Mutiple lesions noted on the vulva of a 45 years old, immunocompromised patient, diagnosed with VIN3/CIS on biopsy.


Healthy vulva, with resolution of all lesions after treatment with Sinecatechins ointment.


Definitive pathology of the thyroid tissue and lymph nodes of the first operation with the microscopy and immunochemistry evaluation:. The nests of neoplastic cells were separated by thick septa of fibrous tissue (haematoxylin, and ,eosin, original magnification, x 100).


Amyloid deposits around the cell nest (haematoxylin, and ,eosin, original magnification, x 200).


Neoplastic cells were strongly immunoreactive for chromogranin A (immunoperoxidase stain for anti-chromogranin A, original magnification, x 100).


Neoplastic cells were strongly immunoreactive for synaptophysin (immunoperoxidase stain for anti- synaptophysin, original magnification, x 100).


Neoplastic cells were strongly immunoreactive for carcinoembryonic antigen (immunoperoxidase stain for anti- carcinoembryonic antigen, original magnification, x 100).


Central lymph node metastasis. (haematoxylin and eosin, original magnification x 200).


Changes in CEA and Ctn of serum levels from the fisrt operation to the last follow-up.


Definitive pathology of lymph nodes of the second operation with the microscopy and immunochemistry evaluation:. Recurrence of lateral cervical lymph nodes (haematoxylin, and ,eosin, original magnification, x 100).


Neoplastic cells were negativity immunoreactive for calcitonin (immunoperoxidase stain for anti-calcitonin, original magnification, x 100).


Right thumb showing worsening cutaneous erythema and roughening of the eponychia.


Biopsy prepared with haematoxylin and eosin stain (20x magnification).


Bilateral mammogram showing a mass with 90/75 mm on the left breast and a right mass behind the nipple with multiple microcalcifications, measuring 40 mm.


FDG-PET-CT:. Coronal section, active areas on the intestinal ansae (max SUV= 9.7).


Axial section, active area on the lower quadrant (max SUV= 9.7).


Brain CT, axial section, brainstem lesion measuring 20 mm (red arrow).


Brain CT, axial section, brainstem lesion measuring 14 mm (red arrow).


Brain CT, axial section, brainstem lesion measuring 23 mm (red arrow).


Brain CT, axial section, no evidence of the brainstem lesion.


Diagnostic imaging. Echocardiography (A, B) showed a hypoechoic mass in the left ventricle and the anterolateral right ventricle.


Diagnostic imaging. Chest CT scan mediastinal window (C, D) with contrast enhancement showed that the heart shadow had increased. A round, soft-tissue mass was observed at the left edge of the Cardiac margin. Multiple lymph node shadows were observed at the left hilum of the lung and mediastinum.


Diagnostic imaging. The chest CT scan lung window (E, F) showed right pleural effusion and bilateral pneumonia.


Right paraventricular mass biopsy (200x). The H&E stain (A, B) showed poorly differentiated carcinoma infiltration in fibrous tissue.


Right paraventricular mass biopsy (200x). The immunohistochemical analysis (C-H) showed EGFR (+), CK (+), P63 (+), Ki67 (40%+), PD-L1 (CPS 80%+), and PD-L1.


68Ga-DOTATOC PET-CT (upper panel), and . 68Ga-DOTATOC PET-CT showed accumulation of radiotracer in left epiglottic region.


18F-FDG PET-CT (lower panel). 18F-FDG PET-CT showed uptake of the radiotracer in the left emilarynx lesion, SUV max 9.3, and in two laterocervical lymph nodes, SUV max 11.4 and 7.


Barium swallow showing irregular narrowing in the distal esophagus (black arrow).


Computed tomography showing thickening wall in the distal esophagus (white arrow) as well as the proximal stomach. Massive ascites was also shown.


Upper endoscopy showing stricture was found in the lower esophagus starting at 35 cm and extending to 40 cm from the incisors with normal mucosa.


Endoscopic ultrasound with a 12 MHz mini-probe showed thickened esophageal wall without normal esophageal wall layer pattern.


Endoscopic ultrasound showing the esophageal wall thickening (white arrow) and EUS-guided fine needle aspiration (white arrow head) was done.


The timeline of patient's treatment history and the response of the tumor lesions. Time line.


The timeline of patient's treatment history and the response of the tumor lesions. The radiographic imaging of pancreatic and metastatic liver lesions.


Adrenal metastasis with a blood filled appearance.


Image 1. Highly pleomorphic malignant epithelial cells of poorly differentiated non-small cell carcinoma. Numerous mitoses and areas of necrosis. H&Ex200. Image 2. TTF-1 positive staining. Neoplastic cells show a moderate to strong nuclear staining with TTF-1 in favour of adenocarcinoma and lung primary. TTF-1 immunoperoxidase x200.


Thoracoscopic approach: esophageal resection below the azygos vein arch.


Thoracoscopic approach: esophago-gastric termino-lateral mechanical anastomosis.


Esophagectomy specimen.


(A) Left adrenal mass - demonstrating initial size on imaging for gastrinomas. Left adrenal mass - 18 months after. - significant increase in size.


Medical image.


H&E stain demonstrating haphazard arrangement of the bland spindle cells and nerve fiber bundles of the MPNST 40 x.


A contrast-enhanced axial CT image shows an enhancing, lobulated mass in the left preauricular region.


Computed tomography scan images of. Whole chest.


Computed tomography scan images of. Enlarged scan of the tumor.


Immunohistological staining with. Hematoxylin, and ,eosin.


Anti-napsin A antibody.


Anti-cytokeratin AE1/AE3 antibody.


Anti-thyroid transcription factor 1 antibody (magnification, x20).


Endoscopic picture of the second part of the duodenum showing a nodular mass with superficial erosion and active bleeding.


Endoscopic picture of the second part of the duodenum showing small nodules with focal erosion.


Normal endoscopic picture of the second part of the duodenum.


The patient had a reddish pigmentation left at the spot similar to this one. She had also received radium treatment for haemangioma at this site on the lower part of her abdomen.


Obliterated anterior sulci.


Orthopantomograph showing marginal mandibular resection.


Joining of two sectional trays for diagnostic impression.


Diagnostic cast.


Metal crowns with patrix parts of attachments.


Try-in of metal framework.


Intraoral view of final mandibular Prosthesis.


Post-treatment intra-oral frontal view.


Representative images from skull mass revealing anaplastic meningioma.


Magnetic resonance imaging head showing recurrent anaplastic meningioma.


(A) An X-ray image of the thorax. The X-ray image revealed that the right clavicle was absent, the anterior extremities of the right ribs were destructed and pleural effusion was observed on the right side of the thorax.


(B) Histological changes of the right cervical ribs. Three pieces of tissue were removed from the right cervical ribs. One was a sample of non-uniform tissue with a size of 0.8x0.4x0.2 cm, while the others were two pieces of grain-like gray tissue. Proliferation of fat and fibrous connective and vascular tissue were observed under an optical microscope. Parts of vessels distended and shunted together to form a construction similar to a sinus. Hyperplastic capillaries aggregated together with monolayer flat endothelium cells coating the wall of the lumen. Proliferative collagen, a few elastic fibers and smooth muscles were observed with Masson's stain.


Patient A: preoperative, axial T1 postcontrast weighted magnetic resonance (MRI) imaging showing enhancing disease.


Postoperative, axial T1 postcontrast weighted MRI imaging showing enhancing, residual disease.


Radiation therapy (RT) planning using volumetric arc therapy (VMAT) resulted in excellent coverage of the planning target volume (PTV) (red) by the 100% isodose line (yellow) corresponding to 5940 cGy.


Follow up gallium-68 dotatate positron emission tomography (PET) after more than 6 years showing hypermetabolic, recurrent disease in the left tentorial leaflet and physiologic uptake in the pituitary.


Patient B: preoperative, axial T1 postcontrast weighted MRI imaging showing enhancing disease.


Postoperative PET showing hypermetabolic, residual disease.


RT planning using VMAT resulted in excellent coverage of the 6000 cGy (red) and 5400 cGy (blue) PTVs by the 100% (yellow) and 90% (green) isodose lines, respectively.


Biallelic inactivation of BAP1 by differing mechanisms. Aligned sequence data from Patient A show the pathogenic BAP1 variant is heterozygous in the germline (top track) and tumor (bottom track).


Biallelic inactivation of BAP1 by differing mechanisms. ; the second hit is a somatic frameshift mutation.


Biallelic inactivation of BAP1 by differing mechanisms. In contrast, aligned sequence data from Patient B.


Biallelic inactivation of BAP1 by differing mechanisms. Show the germline variant approaching homozygosity in the tumor VarScan tumor allele frequency plot for heterozygous germline variants on chromosome 3 of Patient B indicates chromosome-level LOH across chromosome 3.


A mass emanating from the supraglottic part of larynx without erosion or haemorrhage and a lesion of the true right vocal cold presenting as leukoplakia.


Low-power view of the mass shows two neoplastic populations (sarcomatoid and epithelial component) and the overlying dysplastic epithelium (H&E, X40).


(A) Low-power view demonstrates the neoplastic populations to intermingle (H&E, X100).


(B) Low-power view shows the sarcomatoid component and the overlying epithelium (H&E, X100).


Diffuse immunoreactivity of squamous cell carcinoma and the overlying epithelium for cytokeratin AE1/AE3 and focal/weak immunoreactivity of the sarcomatoid component (Immunoperoxidase with haematoxylin counterstain, X100).


Small supraglottic mass just above the anterior commissure two months after initial treatment was excised with CO2 laser and proved to be a recurrence of histiocytoma. The patient remained disease-free nine months after the second look cordectomy.


Low magnification image showing the tumor infiltrating the renal parenchyma (H&E, 40x); high magnification showing cytologic details of the tumor cells (H&E 200x).


Epithelial cells with an organoid and trabecular pattern with positive immunohystochemical staining for chromogranin A.


Negative for thyroglobulin.


Epithelial cells with an organoid and trabecular pattern with positive immunohystochemical staining for calcitonin (A-B).


(bottom) CT shows a large mass that occupies the entire true pelvis. The rectum is markedly compressed. An arrow marks a separate sarcoma nodule at the dome of the bladder.


(top) CT shows a multilobulated mass greater on the left than the right. It is immediately adjacent to pelvic peritoneum on the right and covers the rectosigmoid junction on the left. It pushes the uterus superiorly.


Gross features show a tumour with lobulated surface partially covered by fat tissue measuring 9 cm x 8 cm x 4 cm.


(A) Histopathologic picture showing an encapsulated tumour of myelolipoma composed of mature fat cells mixed with hematopoietic elements (x4 magnification).


(B) High power view of the trilineage hematopoietic element with megakaryocytes (x40 magnification).


(C) Low power view of lipomatous tumour component with attenuated adrenal cortex at the periphery (arrow) (x4 magnification).


(D) Tumour with adjacent adrenal cortex (*) (x20 magnification).


Lower abdominal computed tomography scan, showing local disease regression within the left inguinal area, with infiltration of the left bladder wall.


Endoscopic findings: colonoscopy revealing large tumor-like protruding mass near the cecum.


Pathological images from biopsy specimen. . A. H&E staining of biopsy specimen. (x100).


Pathological images from biopsy specimen. . B. Cyclin D1 expression in majority of nuclei. (x100).


Computed tomography, portal venous phase: tumor of about 5cm in diameter filling out the right pyelon and showing slow contrast enhancement.


A; Typical fascicles of mitotically active spindle-shaped cells of monophasic synovial sarcoma.


B; Tumor cells invading into a blood vessel lumen.


FISH-testing revealing SYT gene rearrangement: some cells show a normal signal with yellow fusion signals (orange arrow), reflecting nonrearranged alleles. The majority of cells, however, show a pathological signal pattern with separated orange and green signals (green arrows) indicative of a rearrangement.


(A) Pelvic MRI obtained prior to the androgen-ablation therapy demon strating the presence of an invasive prostatic tumor and numerous large metastatic LN lesions.


(B) Pelvic MRI following the androgen-ablation therapy demonstrating a locally advanced prostatic tumor, which projected into the bladder and had reduced LN swelling.


(C) Pelvic MRI following the combination treatment involving EBRT and intra-arterial infusion chemotherapy demonstrating that the prostatic tumor had markedly diminished. LN, lymph node; EBRT, external-beam radiotherapy.


(A) Transrectal biopsy produced a diagnosis of poorly differentiated adenocarcinoma with small cell NE carcinoma. HE staining produced an initial diagnosis of Gleason pattern 5b poorly differentiated adenocarcinoma (magnification, x100).


(B) PSA staining revealed that PSA-positive and -negative cells were intermixed in the biopsy sample (magnification, x100). HE, hematoxylin and eosin; NE, neuroendocrine; PSA, prostate-specific antigen.


(A) Transurethral biopsy produced a diagnosis of small cell NE carcinoma. HE staining revealed that these carcinoma cells had similar morphological features to the transrectal biopsy tissue carcinoma cells (magnification, x100).


(B) None of the tumor cells were positively stained for PSA (magnification, x100). NE, neuroendocrine; HE, hematoxylin and eosin; PSA, prostate-specific antigen.


MEST in a 46-year-old man with a history of intermittent gross hematuria. Axial CT scan (A-C) showed a complex but predominantly solid right renal mass, herniating into the renal pelvis. The well-defined mass demonstrated marked delayed contrast enhancement.


MEST in a 46-year-old man with a history of intermittent gross hematuria. (D) Photomicrograph (original magnification, x100; hematoxylin-eosin stain) showed that the tumor was composed mainly of proliferating spindle cells, with dilating epithelial tubular cells scattered amidst the spindle cells.


Brain magnetic resonance image showing leptomeningeal/periventricular enhancement, but no mass lesion.


Actively dividing primary effusion lymphoma cells (DQ stain; original magnification x600).


Cytospin showing LNA-1 (human herpesvirus-8) positive tumor cells (immunocytochemistry; x400).


Flow cytometric analysis showing that large lymphocytes (red), 2.1% of the total population, were (a) CD20 negative, CD19 dim positive, and (b) CD38 positive (blue: B-cells, grey: Other lymphoid cells including T-cells and NK-cells).


Day 1 post the 22nd RT session. Day 1 AQ serum therapy. Pain score =7. ARD grade 3.


A 54-year-old female with a history of metastatic urinary bladder carcinoma presented with shortness of breath and hypoxemia. (a) Axial chest computed tomography set to soft tissue windows demonstrates bilateral pleural effusions (asterisks) with compressive atelectasis.


A 54-year-old female with a history of metastatic urinary bladder carcinoma presented with shortness of breath and hypoxemia. (b) Cytology from the right pleural effusion demonstrates tumor cells with enlarged nuclei, increased nuclear to cytoplasmic ratio, and irregular nuclear membrane.


A 54-year-old female with a history of metastatic urinary bladder carcinoma presented with shortness of breath and hypoxemia. (c) Immunohistochemistry demonstrates positive staining for GATA-3 and CK903 and negative staining for calretinin and D2-40, a pattern consistent with metastatic urothelial carcinoma.


A 79-year-old female with urinary bladder carcinoma diagnosed and resected 7 months previously presented with shortness of breath and focal right-sided wheezing. (a) Chest radiograph (anterior-posterior projection) showing volume loss in the right hemithorax with rightward tracheal deviation and silhouetting of the right heart border and right diaphragm, suggestive of right lower and right middle lobe collapse.


A 79-year-old female with urinary bladder carcinoma diagnosed and resected 7 months previously presented with shortness of breath and focal right-sided wheezing. (b) Axial chest computed tomography set to lung windows showing endobronchial disease occluding the bronchus intermedius (arrow). The patient underwent bronchoscopy with endobronchial tumor debulking; pathology was indicative of high-grade high-grade metastatic urothelial carcinoma.


A 47-year-old man with morbid obesity presented for transurethral resection of a bladder mass. Preoperative hypoxemia prompted computed tomography angiography of the chest, which demonstrates multiple filling defects, including in the anterior segmental artery of the left upper lobe (arrow). Treatment with anticoagulation was started and the patient underwent surgical removal of the bladder tumor, which revealed urothelial carcinoma with sarcomatoid features. His postoperative course was complicated by persistent hypoxemia and progression of disease, and the patient ultimately expired. Autopsy findings demonstrated intravascular tumor thrombi identical on microscopic examination to the previously diagnosed tumor.


Chest computed tomography scan image show the right lower lobe nodule of the lung.


Photomicrography of the biopsied specimen (mammary tissue). A - Well-differentiated carcinoma infiltrating the mammary parenchyma (HE, 100X).


Photomicrography of the biopsied specimen (mammary tissue). B - In detail: note the cellular pattern arrangement and the scarcity of mitotic figures (HE, 400X).


Photomicrography of the biopsied specimen (mammary tissue). Immunohistochemical preliminary workup. A - Negative for the nuclear estrogenic receptor (200X).


Photomicrography of the biopsied specimen (mammary tissue). Immunohistochemical preliminary workup. B - Negative for the nuclear progesterone receptor (400X).


Photomicrography of the biopsied specimen (mammary tissue). Immunohistochemical preliminary workup. C - Negative for cEBR (HER2) (400X).


Photomicrography of the biopsied specimen (mammary tissue). Immunohistochemical preliminary workup. D - Proliferative index below 5% (Ki67) (400X).


Photomicrography of the biopsied specimen (mammary tissue). Complementary immunohistochemical workup. A - Chromogranin positive.


Photomicrography of the biopsied specimen (mammary tissue). Complementary immunohistochemical workup. B - Calcitonin positive.


A; Spot image taken during fluoroscopic esophagogram. A long stricture segment (11 cm) is noted in the mid to distal esophagus with associated mucosal irregularity (arrows). S = Stomach.


B; Endoscopic visualization in the middle third of the esophagus demonstrating very friable, erythematous and hyperemic mucosa with a stricture noted 25 cm from the incisors (between the two arrows).


Endoscopic images showing the target lesion that is grasped and pulled into the cap by the grasping forceps.


The over-the-scope clip (OTSC) completely closing the full-thickness resection site.


The rectal full-wall resection specimen.


The serosal surface macroscopically visible on the specimen.


Two over-the-scope clips (OTSC) completely closing the full-thickness resection site.


T1 magnetic resonance imaging of the brain, axial post-contrast sequences, showing right external capsule lesion before stereotactic radiosurgery.


3 months following stereotactic radiosurgery.


After treatment with bevacizumab.


Planning magnetic resonance images for stereotactic radiosurgery to a lung-primary brain metastasis. The panel on the left depicts the tumor prescribed a 20 Gy dose to the 45% isodose line with a gradient index of 2.91. The right panel additionally shows the 10 Gy and 5 Gy lines.


Chest radiography showed a cardiothoracic ratio of 66 % with cardiac enlargement and bilateral pleural effusions, which were greater on the right. Lung lesions were not clearly visible.


Contrast-enhanced chest computed tomography scan confirmed the ultrasound findings and showed mass effect on the superior vena cava, which was significantly narrowed. The inside of the tumor could not be clearly visualized on contrast-enhanced imaging; neither fatty nor calcified components were observed.


Microscopic examination of hematoxylin and eosin-stained slides of the tumor specimen showed no pattern or any specific tissue architecture at low magnification (A), indicating an undifferentiated malignant tumor.


In addition, highly deformed nuclei were found on high magnification (B).


Immunostaining was positive for vimentin (C).


Positron-emitting computed tomography of heart taken on August 11, 2008. (A) It shows higher fluorodeoxyglucose uptake of right ventricle comparing the left.


Positron-emitting computed tomography of heart taken on August 11, 2008. (B) The hyper-metabolic lesion due to right ventricular mass.


Transthoracic echocardiography taken on August 12, 2008. The mass arising from right ventricle was observed with the abnormal septal bouncing motion probably due to right ventricular pressure overload by mass effect. Heterogenous mass size of 2.52x2.54x3.25 cm observed.


CT findings. A; Coronal contrast-enhanced CT in the arterial phase showing a recurrent hepatocellular carcinoma (arrow) and mucosal irregularity under the cardia, suggesting gastric carcinoma (arrowhead).


CT findings. B; Multiple lung metastases (arrows) are depicted.


Pathological examination of the intracranial tumor. A; Macroscopic findings of the resected tumor.


Pathological examination of the intracranial tumor. B; HE staining of the tumor, x20.


A 34-year-old female patient with a swelling on the left side of the face.


Intraoral view of 34-year-old female shows lingually tilted tooth 35 and periodontal pocket in relation to teeth 37 and 38.


The orthopantamograph of 34-year-old female view revealed a well-defined radiopaque mass in relation to left lower border of mandible.


CT with 3D reconstruction view of 34-year-old female revealed a well-defined radio-dense area attached to the left medial aspect of lower border of mandible.


CT view revealed a well-defined radio-dense area attached to the left medial aspect of lower border of mandible of 34-year-old female.


Computed tomography scan thorax showing growth in trachea lumen.


Postradiotherapy (4 months) regression of growth in computed tomography scan thorax.


Image of pelvic tumor and metastasis. (A) Para-aortic lymph nodes and pelvic tumor.


Image of pelvic tumor and metastasis. (B) Supraclavicular lymph nodes.


Image of pelvic tumor and metastasis. (C) Sub-diaphragmatic seeding.


Image of pelvic tumor and metastasis. (D) Lung metastasis.


Pathological findings of ovarian adrenocortical carcinoma. (A) A piece of tissue measuring 23 x 17 x 10 cm in size.


Pathological findings of ovarian adrenocortical carcinoma. (B) Sections of the huge ovary and uterine body tumor showing solid sheets and nests of tumor cells with monotonous morphology with large, centrally located nuclei and abundant cytoplasm. Focal tumor necrosis is present. Lymphovascular invasion is prominent.


Pathological findings of ovarian adrenocortical carcinoma. (C) Biopsy sample of the peritoneum cavity.


Pathological findings of ovarian adrenocortical carcinoma. (D) Lymph node metastasis: Lesion cells are arranged in thick trabeculae and in organoid pattern. They contain eosinophilic cytoplasm and small dark nuclei. High prevalence of mitotic figures is seen.


Sagittal view on T2-weighted magnetic resonance imaging at. Two.


Four months after completing treatment for hypopharyngeal carcinoma. A well-defined tumour in the pituitary fossa was revealed in subsequent imaging (arrow).


Gross appearance of the surgical specimen. Grossly, the tumour appeared brown and soft.


Microscopically, the tumour contained small round tumour cells in a solid sheet pattern, with focal tumour necrosis (H&E; magnification, x200).


Tumour cells revealed a high nucleo-cytoplasmic ratio, hyper-chromatic nuclei, occasional nucleoli and frequent mitoses (H&E; magnification, x400).


By immunohistochemistry, the tumour cells were diffusely weak to moderately positive for cytokeratin , diffusely positive for cluster of differentiation (CD)117 (magnification, x100).


Focally positive for CD56 (magnification, x200).


Negative for cytokeratin (CK)7, CK20, chromogranin, synaptophysin, CK5/6, p63, S-100 and CD99 (magnification, x200).


(a) Juxtapapillary retinal hemangioblastoma with adjacent lipid exudation.


Note minimal lipid exudation in the papillomacular bundle region.


Foveal contour is normal before photodynamic theraphy (PDT). OCT performed 1 day after PDT shows retinal edema.


Subretinal fluid under the foveola. Three weeks after PDT there is complete reabsorption of intraretinal and subretinal fluid. There are a few focal intraretinal optically dense juxtafoveal deposits consistent with ophthalmoscopically visible lipid exudates.


Partially pigmented retinal astrocytoma (needle biopsy proven) with lipid exudation at the superior, inferior, and ,nasal margins extending into the fovea.


Forming a foveal star.


OCT before PDT reveals moderate intraretinal cystoid edema at the fovea.


Three days after PDT there is increased subretinal fluid. Four months later, there is complete reabsorption of intraretinal and subretinal fluid leaving retinal atrophy.


Medical image.


Color fundus photograph showing small amelanotic choroidal melanoma with documented growth.


OCT shows normal fovea before PDT. Eleven days after PDT.


Neurosensory retinal detachment extending under the fovea is evident. Three months after PDT, subretinal fluid has completely disappeared and foveal contour has returned to normal.


The radiographs of the proband before and during the treatment. The pelvic MRI.


The radiographs of the proband before and during the treatment. Chest CT. Scan of the proband before and after the systematic treatment.


DNA sequencing (with white blood cells) showed a germline MET exon 14 skipping mutation.


Cardiac MRI from Case 1: T2 maps (top row) demonstrate patchy focal areas of myocardial edema in the anterior wall and inferior wall (black arrows). Late gadolinium enhancement (LGE) images (bottom row) demonstrate patchy focal areas of scar (yellow arrows). These findings are consistent with myocarditis.


Electrocardiogram for Case 1. Taken on the final hospital day in the setting of clinical decline and three hours prior to final cardiac arrest. Junctional tachycardia, abnormal R-wave progression, prolonged QTc (532 msec).


Presenting Electrocardiogram for Case 2. Complete atrioventricular block with wide QRS complex.


Electrocardiogram from Patient 3. Taken in the setting of chest pain, dizziness and dyspnea. Prolonged QTc 519 msec (baseline 437 msec).


The first brain magnetic resonance imaging performed for the patient revealed an extradural posterior fossa mass lesion that was hypointense in T1 ,hyperintense in T2.


Increased signal intensity in diffusion-weighted imaging.


Decreased signal intensity in apparent diffusion coefficient map.


Suggested the diagnosis of an epidermoid tumor.


Two months after previous surgery, brain computed tomography scan revealed a large heterogenous dense mass in the left occipital part of the scalp.


Associated with destruction of the occipital bone.


Brain magnetic resonance imaging showed a heterogenous lesion including cystic and solid components in the left side of posterior fossa.


Resected gallbladder mass.


Liver mass (arrows) with resection of affected segments.


Pelvic CT scan showing asolid tumor with adiameter of 30.88mm in the cervix.


The H&E staining of the cervical squamous cell carcinoma, right ovarian serous borderline tumors with intraductal carcinoma, right fallopian tube adenocarcinoma. (A) Cervical squamous cell carcinoma. The atypicality was obvious, the proportion of cytoplasm was increased, part of the nucleus was deeply stained, the chromatin was irregular, the nuclear membrane was gathered and the nuclear membrane was wrinkled (H&E, x100).


The H&E staining of the cervical squamous cell carcinoma, right ovarian serous borderline tumors with intraductal carcinoma, right fallopian tube adenocarcinoma. (B) Right ovarian serous borderline tumors with intraductal carcinoma. The tumorous epithelial cells are arranged in layers to form acomplex branch of papillary and mesh-like structures, which protrude from the surface of the cystic cavity. The proliferating tumor cells form cell buds and fall off, and are free of the cystic cavity. The nucleus is heterotypic, and the cell nucleus is deeply stained with visible nucleoli (H&E, x100).


The H&E staining of the cervical squamous cell carcinoma, right ovarian serous borderline tumors with intraductal carcinoma, right fallopian tube adenocarcinoma. (C) Right fallopian tube adenocarcinoma. The cancer cells are flaky, complex and irregularly arranged, the papillary structure is reduced or disappeared, the cancer cells are closely arranged, the nuclear atypia is obvious, the staining is deep, the nuclear fission is increased and pathological nuclear division is seen (H&E, x100). Scale bar: 20 microm.


The timeline of diagnosis and treatment for the patient.


Laparoscopic features: intraoperative . Notes: (A) Panoramic view of intact uterus before the ESS enucleation.


Laparoscopic features: intraoperative (B) Panoramic view of ESS during enucleation.


Laparoscopic features: intraoperative (C) Panoramic view of uterus after ESS enucleation.


6 months after surgery (D-E) Panoramic view of disease-free pelvis and uterus.


6 months after surgery (F) Cromosalpingoscopy with direct visualization of bilateral transtubal methylene spillage. . Abbreviation: ESS, endometrial stromal sarcoma.


Microscopic appearance with the appropriate pathological specimen description. . Notes: (A) The tumor showed an admixture of neoplastic cells arranged in cords and trabeculae with an island of lipidized cells.


Microscopic appearance with the appropriate pathological specimen description. These vacuolated cells were positive for inhibin.


Microscopic appearance with the appropriate pathological specimen description. Whereas the others. Were strongly immunoreactive for SMA.


Microscopic appearance with the appropriate pathological specimen description. In both components, MNF116 was widely positive (D). (Original magnification 10x). . Abbreviation: SMA, smooth muscle actin.


Timeline of diagnosis and treatment.


Spine MRI before and after 7 months of metronomic chemotherapy. MRI evidence of disseminated leptomeningeal tumor in pre-treatment T1-weighted gadolinium enhanced sagittal view.


Spine MRI before and after 7 months of metronomic chemotherapy. Disappeared after 7 months of metronomic chemotherapy.


Magnetic resonance (MR) images in sagittal T2.


T1 coronal.