Remained stable for 31 months with oral icotinib therapy.


Stained sample of bone metastasis of lung adenocarcinoma, original magnification x400.


Computed tomography (CT) and magnetic resonance imaging scan of spine. . Notes: T8 and T10 pathological fracture with local spinal canal stenosis (A, B).


Computed tomography (CT) and magnetic resonance imaging scan of spine. CT scan after surgery via retroperitoneal approach and radioactive particle implantation into T8 and T10 spine (C, D).


MRI scan of brain (scattered small nodules on the cerebellum and bilateral temporal lobe). . Notes: The lesions remained stable at diagnosis.


MRI scan of brain (scattered small nodules on the cerebellum and bilateral temporal lobe). , 1 month.


MRI scan of brain (scattered small nodules on the cerebellum and bilateral temporal lobe).31 months later R=right side.


A; A white, flat, elevated lesion, 15 mm in size, was identified from the rectum to the dentate line of the anal canal on internal hemorrhoids.


B; NBI showed irregular vascular patterns (dilatation, tortuous running, caliber changes, and different shapes).


C; A chromoendoscopy with indigo-carmine dye showed the edge of the lesion clearly and revealed a lobulated, flat, elevated lesion.


D; The lesion was identified by chromoendoscopy with iodine staining as the stained area, with some unstained parts observed.


E; The ulcer after en bloc resection.


F; The resected specimen.


G; The tumor was composed of well-differentiated SCC in situ. The vertical and horizontal cut ends of the tumor were both negative. In the superficial layer, koilocytosis was recognized.


J An immunohistochemical evaluation showed strong expressions of p53 , Ki-67.


Medical image.


Indicating that the patient was infected with HPV.


Chest radiograph showing multiple, round, variably sized masses scattering in both lungs, compatible with pulmonary metastasis.


(a) Axial MIP image showing multiple masses, scattering in both lungs and surrounding segmental/subsegmental branches of pulmonary arteries, and multiple PAPs.


(b) Coronal 3D Volume Rendered image showing multiple PAPs scattering in both lungs. The two largest ones are located in both lower lobes.


Serial axial chest CT within one month showing aneurysmal dilatation and developing soft tissue masses surrounding the previously seen tumor emboli in the peripheral branches of right pulmonary arteries (arrows).


Serial axial chest CT at eight months prior.


One month prior.


The present study.


Showing gradual dilatation of peripheral branches of right pulmonary arteries, and finally pseudoaneurysms with surrounding soft tissue masses (arrows).


Computed tomography scan of the temporal bone. The tumorous mass is indicated by an arrow.


Pathological finding of the third specimen for her left ovarian cyst (H&E staining; a x40, b x400). A; Grade 1 endometrioid adenocarcinoma was observed.


Pathological finding of the third specimen for her left ovarian cyst (H&E staining; a x40, b x400). B; The transition between the carcinoma and the benign endometriosis was detected.


Pathological finding of the second specimen for her right ovarian cyst (H&E staining; x400). Atypical features were observed, including eosinophilic cytoplasm, large hyperchromatic or pale nuclei with moderate pleomorphism, an increased nuclear to cytoplasmic ratio, cellular crowding and stratification.


Clinical photograph showing two extraoral deep necrotic ulcers on the right side.


Orthopantomograph showing irregular bone destruction from 44 to 48 with floating tooth appearance with 44, 45.


Removed maggots (Case 1).


Well-differentiated squamous cell carcinoma (x10). Section showing connective tissue infiltration by tumor cells and keratin pearls (Case 1).


Extensive necrotic wound with maggots.


Removed maggots (Case 2).


Poorly differentiated squamous cell carcinoma (x10). Section showing tumor epithelial cells infiltrating the stroma (Case 2).


Cracked red lips in our patient (with permission).


T2W MR shows hyperintensities in the left basal ganglia and external capsule (arrow).


Magnetic resonance angiography (MRA) shows occlusion of the left middle cerebral artery (red arrow) that is compatible with arterial ischemic stroke (AIS).


A; Neck CT scan with contrast axial cut, soft tissue window: tumor of the parotid gland.


B; Neck CT scan with contrast axial cut, sof tissue window: enlarged lymph nodes.


Salivary duct carcinoma, micropapillary type. HE. x5.


Contrast MRI brain axial.


Sagittal images. Showing a ring-enhancing lesion in right temporo-parietal region.


FLAIR.


Contrast axial. MR image showing left frontal tumour with inhomogenous post-contrast enhancement with perilesional edema and mass effect.


31-year-old man with known glycogen storage disease Type-1a undergoing surveillance imaging. Dynamic multiphase contrast-enhanced MRI obtained in May 2014. (a) Pre-contrast T1W axial image shows two hepatic lesions in segments 4 (double arrows) and 8 (single arrow).


31-year-old man with known glycogen storage disease Type-1a undergoing surveillance imaging. Dynamic multiphase contrast-enhanced MRI obtained in May 2014. (b) T1W axial image (arterial phase) shows variable heterogeneity foci of both of the lesions and arterial enhancement.


31-year-old man with known glycogen storage disease Type-1a undergoing surveillance imaging. Dynamic multiphase contrast-enhanced MRI obtained in May 2014. (c) T1W axial image (venous phase) shows persistent enhancement of hepatic lesions.


31-year-old man with known glycogen storage disease Type-1a undergoing surveillance imaging. Dynamic multiphase contrast-enhanced MRI obtained in May 2014. (d) T1W axial image (delayed or equilibrium phase) shows subtle washout in both of the lesions; posterior lesion also shows peripheral rim enhancement (double arrows).


31-year-old man with known glycogen storage disease Type-1a undergoing surveillance imaging diagnosed with hepatic adenoma. (a) T1W opposed-phase axial image shows diffuse loss of intensity of hepatic parenchyma (asterisk), which suggests the presence of diffuse hepatic steatosis. Two hepatic lesions in segments 4 and 8 are relatively hyperintense on the background of steatosis and lack microscopic fat.


31-year-old man with known glycogen storage disease Type-1a undergoing surveillance imaging diagnosed with hepatic adenoma. (b) T1W in-phase axial image shows two hepatic lesions in segments 4 (double arrows) and 8 (single arrow).


31-year-old man with known glycogen storage disease Type-1a undergoing surveillance imaging diagnosed with hepatic adenoma. (c) Fat-suppressed T2W axial image demonstrates isointense to slightly increased intensity of the above-described hepatic lesions (see the corresponding arrows), with an eccentric, ill-defined, T2-hyperintense possible scar.


31-year-old man with known glycogen storage disease Type-1a undergoing surveillance imaging. Dynamic multiphase contrast-enhanced MRI obtained in Nov 2014 with gadolinium-EOB-DTPA. (a) Pre-contrast fat-suppressed T1W axial image shows two hepatic lesions in segments 4 (double arrows) and 8 (single arrow). The anterior lesion (single arrow) shows interval decrease in size, whereas the posterior lesion is slightly increased in size compared to MR dated May 2014 [Figure 2.


31-year-old man with known glycogen storage disease Type-1a undergoing surveillance imaging. Dynamic multiphase contrast-enhanced MRI obtained in Nov 2014 with gadolinium-EOB-DTPA. (b) Fat-suppressed T1W axial image (arterial phase) shows arterial enhancement of both hepatic lesions.


31-year-old man with known glycogen storage disease Type-1a undergoing surveillance imaging. Dynamic multiphase contrast-enhanced MRI obtained in Nov 2014 with gadolinium-EOB-DTPA. (c) Fat-suppressed T1W axial image (venous phase) shows persistent enhancement of hepatic lesions; however, the anterior lesion (single arrow) appears fainter.


31-year-old man with known glycogen storage disease Type-1a undergoing surveillance imaging. Dynamic multiphase contrast-enhanced MRI obtained in Nov 2014 with gadolinium-EOB-DTPA. (d) Fat-suppressed T1W axial image (delayed or equilibrium phase) shows remarkable washout in the posterior lesion (double arrows) with well-evident peripheral rim enhancement.


31-year-old man with known glycogen storage disease Type-1a undergoing surveillance imaging. Dynamic multiphase contrast-enhanced MRI obtained in Nov 2014 with gadolinium-EOB-DTPA. (e and f) Fat-suppressed T1W axial image (hepatobiliary phases at 10 and 20 min, respectively) shows peripheral retention of the contrast in the anterior lesion (image f, star), which can be seen with inflammatory adenomas. The posterior lesion gradually becomes hypointense to the liver parenchyma and shows no uptake of contrast.


31-year-old man with known glycogen storage disease Type-1a undergoing surveillance imaging. Index images of two hepatic lesions with an interval of 6 months. (a) Fat-suppressed T1W fat post-contrast image acquired in Nov 2014.


31-year-old man with known glycogen storage disease Type-1a undergoing surveillance imaging. Index images of two hepatic lesions with an interval of 6 months. (b) Fat-suppressed T1W fat post-contrast image obtained in May 2014. The anterior lesion (single arrow) shows interval decrease in size on follow-up imaging, whereas the posterior lesion (double arrows) is slightly increased in size.


Cancer on the trunk with left humerus exposed and gangrenous arm.


Left humerus post-midshaft amputation.


HE staining of the specimen (x200).


Immunohistochemical examination revealed CD10.


Bcl-6 (+) suggested putative germinal center B-cell origin. . Abbreviation: HE, hematoxylin.


CT demonstrating a large abdominal wall abscess containing air. There was no apparent connection between the abdominal wall abscess and the abdominal cavity, although the wall of the ascending colon adjacent to the abscess was thickened.


Colonoscopy revealing an ulcerated irregular tumor in the cecum.


CT performed 39 days after the initial surgery demonstrating a mass that had originated from the ascending colon and had invaded the abdominal wall.


Resected specimen. En bloc resection was carried out for carcinoma of the cecum with abdominal wall invasion (black arrow).


Immunohistochemical study using D2-40, revealing invasion of carcinoma cells into the lymphatic channels of the skin.


CT demonstrating an enlarged lymph node of 3 cm in diameter in the right axillary region (white arrow).


Histological examination of the enlarged right axillary lymph node, proving the presence of metastatic adenocarcinoma.


Dermatologic findings. (A-C) Initial inspection revealed generalized rash with blistering which was more severe in load-bearing areas (yellow asterisk), such as the hip, back, and posterior aspect of the arms.


Dermatologic findings. (D) Peripheral examination showed severe rash in the hands and feet with associated swelling.


Dermatologic findings. (E) Treatment with intravenous immunoglobulin gradually improved his rash.


Photomicrograph shows plump to spindle tumor cells with moderate cytoplasm with round to oval nuclei arranged in fascicles around entrapped normal endometrial gland (x400, hematoxylin andeosin); inset: Immunohistochemical stain for desmin is strongly positive (x100).


Sagittal.


Coronal. Post-gadolinium brain magnetic resonance imaging showing intense dural enhancement of cerebral convexities and tentorium.


(E) Axial T2-weighted brain magnetic resonance imaging that shows abnormal signal changes within right cerebellar hemisphere.


(F) Post-contrast axial brain MRI shows abnormal parenchymal enhancement.


Tumour with uniform population of neoplastic cells with fine granular chromatin pattern and inconspicuous small nucleoli (H&E, 200x).


Tumour cells showing diffuse positivity for synaptophysin (SYN, 100x).


Radiographs of a patient who presented with multiple foot abscesses, showing osteopenic bones without erosive changes.


Color fundus photograph showing optic disc pallor and foveal atrophic changes in a bull's eye configuration in both eyes.


MRI scan of the orbit showing no evidence of active neuritis or infiltration of the optic nerves.


Fundus fluorescein angiography showing window defects with mottled hyperfluorescence in the parafoveal region in both eyes.


Tooth enamel base and gingiva involved by an undifferentiated carcinoma (H&E stain, x40).


Subcutaneous nodules in the left anterior abdominal wall (arrow).


Surgical specimens after resection of subcutaneous nodule.


Abdominal computed tomography showed a subcutaneous nodule in the left anterior wall (arrow).


Histology of the subcutaneous nodule showed that the tumor cells were spindled (H&E staining, x400).


CD117, DOG1 and CD34 immunohistochemistry is positive in the subcutaneous metastasis, respectively.


Hematoxylin and eosin-stained section revealing small cell cervical carcinoma with hyperchromatic nuclei and scant cytoplasm (magnification, x100).


Pretreatment biopsy. Histological aspect of lung adenocarcinoma (HE staining).


Pretreatment biopsy. Intense cytoplasmic ALK protein expression on immunohistochemistry. HE, hematoxylin-eosin; ALK, anaplastic lymphoma kinase.


CT abdomen. Huge right suprarenal mass measuring 16.5 x 6.5 x 8.7 cm.


CT abdomen. Right adrenal mass with break down areas and calcifications.


Posteroanterior radiograph.


Lateral radiograph confirming lytic destruction of the distal femur bone.


CT shows the extent of bone destruction.


MRI shows the extent of the metastatic lesion. . Abbreviations: CT, computed tomography; MRI, magnetic resonance imaging.


T2-weighted basal sagittal pituitary MRI performed at diagnosis. The red arrow indicates the sellar mass.


Imaging performed 3 months after surgery. (A,B) Pituitary MRI, T2-weighted basal sagittal and coronal sequences.


Imaging performed 3 months after surgery. (C,D) Pituitary MRI, T1- weighted post-gadolinium sagittal and coronal sequences.


Imaging performed 3 months after surgery. (E) Whole body fluorine-18-fluorodeoxyglucose positron emission tomography/computed tomography (18F-FDG PET/CT) showing pathological uptake in sellar region. Red arrows indicate the sellar lesion.


Thyroid CT scans pre.


After 6 months. Of neoadjuvant sorafenib therapy.


CT scan of 20 cm large left adrenocortical carcinoma (*) with segment 8 liver metastasis ( ). The segment 7 tumor is not shown on this reconstruction (A).


CT scan of 20 cm large left adrenocortical carcinoma (*) with segment 8 liver metastasis ( ). Necrosis on CT after liver TAE ) and embolization of the previously bleeding primary tumor (**) (B).


CT scan of 20 cm large left adrenocortical carcinoma (*) with segment 8 liver metastasis ( ). Abscess from the necrotic tumor reaching the thigh (+) (C).


CT scan of 20 cm large left adrenocortical carcinoma (*) with segment 8 liver metastasis ( ). Drains in the abscess (arrows); the descending part is already resolved (D, E).


Embolization of the S8 tumor through the right replaced hepatic artery was achieved with 0.1mm PVA particles (A).


Embolization of the primary tumor through the left inferior phrenic artery was performed by 0.2mm PVA particles (B). CT, celiac trunk; SA, splenic artery; CHA, common hepatic artery; GDA, gastroduodenal artery; *, dominant suprarenal artery from left inferior phrenic artery.


Presence of chorioretinal lesions in the tapetal fundus OD noted on initial presentation. Images represent central view.


Presence of chorioretinal lesions in the tapetal fundus OD noted on initial presentation. And a view angled to highlight the largest chorioretinal lesion Multifocal pink lesions are noted throughout the tapetal fundus arising from the termination of retinal vessels representing metastatic spread of the hemangiopericytoma. Images obtained with the RetCam Shuttle.


(A): Metastatic spindle cell sarcoma. Subgross photograph. Note the carpet of neoplastic cells in the choroid (arrow) and in the ciliary body (*). Hematoxylin and eosin (H&E).


(B): Tumor in the choroid. Higher magnification of the neoplastic cells near the arrow in Fig. 2A. Cells infiltrate the tapetum (*) and surround choroidal vessels (arrow). (H&E) (Bar = 100 mum).


(C): Tumor in the scleral vessels. Higher magnification of the square in Fig. 2A. Cells surround and infiltrate scleral vessels (arrow). (H&E). (Bar = 100 mum).


Immunohistochemical staining of both the original right flank/limb hemangiopericytoma and the left eye metastasis. Both tissues show positive staining for vimentin and alpha-smooth muscle actin (SMA).


Image of right tapetal fundus two weeks after initial presentation. The presence of numerous large pink/red colored lesions throughout tapetal fundus present near retinal vessel terminations showing significant progression of chorioretinal lesions. Perilesional retinal elevations are seen around each foci of metastasis and appear as halos of reduced reflectivity. Image obtained with the RetCam Shuttle.


T1-weighted image (WI) (a) shows the 4-cm tumor in the left cerebellum with hypointense signal.


T2WI (b) shows the tumor with hyperintense signal.


Axial.


Coronal. Images showed the tumor after application of contrast enhancement.


Postsurgical contrast T1-weighted magnetic resonance-images show complete resection of the tumor. (non-contrast T1-weighted image [WI.


Postsurgical contrast T1-weighted magnetic resonance-images show complete resection of the tumor. T2WI.


Postsurgical contrast T1-weighted magnetic resonance-images show complete resection of the tumor. Contrast T1WI.


Postsurgical contrast T1-weighted magnetic resonance-images show complete resection of the tumor. Diffusion- WI.


Magnetic resonance imaging (MRI) with contrast enhancement of brain metastasis. (A, B) July 2011, before radiotherapy on brain.


Magnetic resonance imaging (MRI) with contrast enhancement of brain metastasis. (C, D) September 2011, after radiotherapy on the brain.


Magnetic resonance imaging (MRI) with contrast enhancement of brain metastasis. (A-D) April 2016, after GK radiotherapy on the brain, new intracranial lesions have been observed.


Hematoxylin-Eosin (HE) staining and immunohistochemistry of the OCCC. (A) HE staining determined it was an ovarian cancer; Magnification: 200X.


Hematoxylin-Eosin (HE) staining and immunohistochemistry of the OCCC. (B) Positive of Napsin A determined it was an OCCC. Magnification: 200X.


Hematoxylin-Eosin (HE) staining and immunohistochemistry of the OCCC. (C) The patient's tumor had positive expression of PD-L1 (tumor proportion score of 10%). Magnification: 100X.


Abdomen CT shows low density fluid collection (open arrow) in abdominal and pelvic cavity with an enhancing thickening of the peritoneum (solid arrow).


May 2015, baseline mammography. . Note:. Craniocaudal.


May 2015, baseline mammography. Mediolateral oblique projections.


September 2015, mammography after neoadjuvant therapy. . Note:. Craniocaudal.


September 2015, mammography after neoadjuvant therapy. Mediolateral oblique projections.


Enhanced abdominal CT findings. A; At baseline. Huge hypoenhanced tumors showed mainly in peripheral areas of the liver (segments 2 and 3).


Enhanced abdominal CT findings. B; About 3 years later. The liver tumors have gradually decreased in size.


Enhanced abdominal CT findings. C; About 5 years later. The liver tumors have shrunk considerably.


Spinal MRI, sagittal view: spinal cord compression in relation to the seventh dorsal vertebra.


Spinal MRI, frontal view: a large right supraclavicular mass with dorsal extension at C7-D1.


Spinal MRI, sagittal view: spinal cord compression in relation to the twelfth dorsal vertebra.


A 29-year-old man with underlying chronic hepatitis B and an incidentally detected hepatic nodule. A, On T1-weighted gradient-echo imaging (TR/TE: 3.6/1.4), there was a subtle low signal intensity nodule (upper left, arrow). On gadoxetic acid-enhanced MR imaging, the nodule demonstrated early homogeneous intense enhancement (upper right), subtle peripheral washout during the portal venous phase (lower left), and ring-like peripheral enhancement with a central washout pattern on 20 minutes delayed hepatobiliary phase (lower right).


A 29-year-old man with underlying chronic hepatitis B and an incidentally detected hepatic nodule. B, Histopathology reported proliferating hepatocytes and bile ductules with fibrous septae on the border compatible with focal nodular hyperplasia.


A 39-year-old man with a history of heavy alcoholism. A, T2-weighted fast-spin echo imaging (TR/TE: 3646.3/107. 0, upper left, arrow), and diffusion weighted imaging (b-factor, 800, upper right) showed a high signal intensity nodule in the subcapsular portion of the right hepatic lobe. On T1-weighted gradient-echo imaging (TR/TE: 3.6/1.4), there was a high signal-intensity nodule with a peripheral halo (middle left). On gadoxetic acid-enhanced MR imaging, the nodule was visualized with early homogeneous enhancement (middle right), washout during the equilibrium phase (lower left), and complete perfusion defect on the 20 minutes delayed hepatobiliary phase (lower right).


A 39-year-old man with a history of heavy alcoholism. B, On histopathology (HE stain, high-power field [x200], a fibrous septum was observed in the tumor nodule exhibiting signs of lymphocytic infiltration. The hepatocytes formed one or two cell thick trabecular cords and were cytologically benign proliferating hepatocytes compatible with a diagnosis of focal nodular hyperplasia.


low-power view showing uniform, short spindle-shaped cells.


Numerous small to medium-sized with thick and hyalinized walls.


tumour cells exhibiting diffuse positivity with CD34.


Metastatic adenocarcinoma on the left buccal gingiva in relation to teeth # 34 and 35.


Lingual view of the metastatic adenocarcinoma.


Histologic section of the adenocarcinoma showing squamous mucosa with infiltrating sub mucosal tumor.


TTF-1 immunostain highlights the tumor cells.


MRI of bilateral breast lumps- 3.8 x 3.5 x 3 cm irregular speculated mass in left breast (Suspicious of malignancy), 2.3 x 1.5 cm well defined mass lesion in right breast (less than 6% malignant probability).


Benign ductal epithelial cell cluster (Pap, x100).


Lesion with bare bipolar nuclei in the background (MGG, x400).


Medical image.


Clusters of cells with hyperchromatic nuclei and prominent nucleoli (MGG, x400).


Computed tomography (CT) findings at diagnosis. A; No metastasis was detected in the mediastinal lymph node.


Computed tomography (CT) findings at diagnosis. B; Right hilar lymphadenopathy was observed.


Computed tomography (CT) findings at diagnosis. C; Gastric cardia (primary lesion).


Computed tomography (CT) findings at diagnosis. D; No metastasis to the para-aortic lymph node was observed.


Computed tomography (CT) findings before radiotherapy. A; Metastasis to the pretracheal lymph node at the level of the esophagus.


Computed tomography (CT) findings before radiotherapy. B; Right hilar lymphadenopathy at the level of the esophagus.


Computed tomography (CT) findings before radiotherapy. C; Gastric cardia (primary lesion).


Computed tomography (CT) findings before radiotherapy. D; No metastasis was visible in the para-aortic lymph node.


Computed tomography (CT) findings before radiotherapy. E; The radiotherapy dose distribution.


Axial noncontrast (a) computed tomography images shows a well-defined intraconal mass in the posterior right orbit.


Postcontrast image (b) heterogenous enhancement of the lesion causing proptosis and medial displacement of optic nerve.


Tumor cells with strong and diffuse positivity to CD34.


But negativity for S-100.


Lung adenocarcinoma shown by radiologic and pathologic examinations. (A) Chest CT scan reveals a mass in right lung.


Lung adenocarcinoma shown by radiologic and pathologic examinations. (B) Hematoxylin and eosin staining shows a low differentiation adenocarcinoma (HE x 100).


Timeline of diagnosis and treatment of the patient, with CT and MRI scans of lesions during the treatment of crizotinib additionally provided.


40-year-old male presented with a lesion over the glans penis diagnosed as carcinoma penis. Contrast enhanced CT of. Abdomen axial view reveals bilateral inguinal nodes (arrows).


40-year-old male presented with a lesion over the glans penis diagnosed as carcinoma penis. Of. Chest shows cardiac lesion (arrow) suggestive of metastatic disease.


40-year-old male presented with a lesion over the glans penis diagnosed as carcinoma penis. PET CT scan of the patient reveals intense FDG uptake lesion in. Pelvic region by the bilateral inguinal nodes (arrows).


40-year-old male presented with a lesion over the glans penis diagnosed as carcinoma penis. In the. Chest region by the cardiac lesions (standardised standardized uptake value - 9.8) suggestive of metastatic disease.


40-year-old male presented with a lesion over the glans penis diagnosed as carcinoma penis. After six cycles of chemotherapy contrast enhanced CT of the. Pelvic region shows partial response in the bilateral inguinal nodes (arrows).


40-year-old male presented with a lesion over the glans penis diagnosed as carcinoma penis. CECT chest shows reduction the cardiac lesion (arrow).


40-year-old male presented with a lesion over the glans penis diagnosed as carcinoma penis. Post chemotherapy PET CT scan shows minimal FDG uptake in left inguinal node (arrow) and disappearance of right inguinal nodes suggestive of partial response.


40-year-old male presented with a lesion over the glans penis diagnosed as carcinoma penis. Histopathology slide of pericardial tissue stained with hematoxylin and eosin (10x magnification) shows islands and nest of cells surrounded by desmoplastic stroma (arrow) and immunopositivity with PAN - cytokeratin.


Abdominal CT scan showing a moderate amount of ascites and diffuse peritoneal infiltration with omental cake formation (arrows).


Microscopic findings. A; H&E staining (x100) reveals multiple variable-sized cysts lined with flattened epithelial cells.


Microscopic findings. B; Calretinin immunohistochemical staining (x100) reveals a positive reaction.


Axial.


Sagittal. T1-weighted Gd-enhanced magnetic resonance imaging (MRI) on admission, showing a contrast-enhancing sinonasal mass with intracranial extension through the cribriform plate into the anterior cranial fossa.


Postoperative axial.


Sagittal. T1-weighted Gd-enhanced MRI demonstrating complete removal of the sinonasal and intracranial tumor.


Magnetic resonance imaging on second admission. The T2-weighted images (WI).


Magnetic resonance imaging on second admission. Gd-enhanced T1-WI. Sagittal images show multiple intradural lesions between C3 and Th4.


Magnetic resonance imaging on second admission. Gd-enhanced axial T1-WI images reveal compression of the spinal cord along its right ventral aspect at C4/5.


Magnetic resonance imaging on second admission. And C5/6.


Magnetic resonance imaging performed 1 week after the surgery. The T2-weighted images (WI).


Magnetic resonance imaging performed 1 week after the surgery. Gd-enhanced T1-WI. Sagittal images demonstrate residual tumor.


Magnetic resonance imaging performed 1 week after the surgery. Gd-enhanced T1-WI axial images at the level of C4/5.


Magnetic resonance imaging performed 1 week after the surgery. C5/6. Show the decreased compression of the spinal cord.


(A): The tumor lesion at presentation. A large ulcerated neoplastic lesion affected the hoof of the horse hind leg.


(B): Surgical debulking of the hoof neoplasm.


(C, D): Ultrasound guided isolated limb perfusion chemotherapy.


Delivery of permeabilizing electric pulses by means of plate.


Different needle array electrodes : The patient 1 year after the last ECT session: there is no gross evidence of cancer disease in the hoof.


(A): Histological appearance of the neoplasia at presentation: cellular invasion of the laminar corium, a high tumor cell mitotic index, and the formation of several keratin pearls are visible (Hematoxylin and Eosin staining; original magnification X20).


(B): Histopathology exam after the third ECT session showing partial tumor regression (arrow) and local inflammation and fibrosis (asterisk).


(C): Histopathology exam after the fifth ECT session showing tumor regression and osteomyelitis.


(D): Histopathology exam three months after the fifth ECT session showing complete tumor regression and its replacement by fibrovascular tissue.


Coronal T1-weighted.


T2-weighted contrast- enhanced. Magnetic resonance imaging of the left arm and axillary region, showing a heterogeneous mass involving part of the left infraclavicular plexus and left brachial plexus.


Photograph taken during subtotal surgical resection of the lesion, showing the musculocutaneous nerve (black arrow), median nerve (white arrow), and antebrachial medial cutaneous nerve (white arrowhead), all liberated from the tumor, while the brachial artery (under the median nerve, circled by the red loop) still enveloped by tumor.


Fragments of the tumor after resection, all of very firm consistency that collectively weighed roughly 250 g.


Microscopic view of the tumor. (a) Intense and diffuse cytoplasmic dot-like desmin stain of tumor cells. Desmin, original x200.


Microscopic view of the tumor. (b) Nests of round and rhabdoid tumor cells. Hematoxylin and eosin stain, original x400.


Sagittal.


Axial. Preoperative MRI showing epidural compression and circumferential vertebral involvement.


Computed tomography scan showing the left renal mass. . Note:. Is arterial phase.


Computed tomography scan showing the left renal mass. Is venous phase.


Tumor cells with eosinophilic cytoplasm with inconspicuous nucleoli and rare appearance of mitosis. . Note: Stained with Hematoxylin and eosin; magnification x100.


Swelling in the right supraclavicular area.


Plain X-ray showing soft tissue density in the supraclavicular area.


Intraoperative image showing the intrathoracic large cyst.


Representative area of the tumor stained with (H and E, x10 and x20), illustrating nests of round blue cells with round-to-ovoid nuclei and distinct cytoplasmic borders.


Resection of Dural-based Brain Metastasis. Pre- and postoperative MRI images demonstrate resection of a breast cancer dural-based metastasis. Preoperative axial T2.


Resection of Dural-based Brain Metastasis. Pre- and postoperative MRI images demonstrate resection of a breast cancer dural-based metastasis. T1 with contrast images. Show a heterogeneously enhancing 2.9 x 5.9 x 2.9 cm dural-based tumor in the right temporal-parietal region associated with significant peri-tumoral edema and midline shift.


Resection of Dural-based Brain Metastasis. Pre- and postoperative MRI images demonstrate resection of a breast cancer dural-based metastasis. Postoperative T2.


Resection of Dural-based Brain Metastasis. Pre- and postoperative MRI images demonstrate resection of a breast cancer dural-based metastasis. T1 with contrast images. Demonstrate tumor resection.


Slit-lamp image of the cornea after surgery. The optical zone was clear and transparent after 1 week.


Slit-lamp image of the cornea after surgery. And 3 months.


Computed tomographic image highlighting right sided gynaecomastia (yellow arrow) and left sided postoperative changes with seroma formation.


Photomicrographs of the tumor cells. Magnification; x40: Tumor cells arranged in aggregates and as cords (A).


Photomicrographs of the tumor cells. Magnification; x 40: Tumor cells exhibiting pleomorphic cells along with a focus of dermal lymphatic invasion (B).


Magnification; x 20: Negative E-cadherin immunostaining of tumor cells with positive internal control in skin adnexal structures.


The control CT images after the first tumourectomy. A) After two weeks. An oedema with haematoma along with air bubbles can be seen.


The control CT images after the first tumourectomy. B) After two months. The residuals of the tumour can be seen.


Images of primary . A) Angiocentric pattern in H&E.


Images of primary . B) Ki-67 index below 5.


Images of primary . C) Small areas with Ki67 index of 5-10.


Images of primary . D) Dot-like epithelial membrane antigen (EMA).


Images of primary . E) Diffuse EMA staining.


Recurrent. Tumours. F) Reaming angiocentric pattern.


Recurrent. Tumours. G) Microvascular proliferations and cellular atypia.


Recurrent. Tumours. H) Focal necrosis and residual angiocentric pattern.


3-D images of the skull base tumor generated from the patient's preoperative CT (a, b).


Median maxillotomy was performed with preservation of anterior nasal spine (a).


Each segment of hemi-maxillae was retracted inferiorly and laterally with stabilization of the clivus (b).


Stereotactic neuronavigation was used intraoperatively to ensure adequacy of exposure before beginning microdissection (a-c).


Anterior surface of tumor was exposed followed by coagulation of tumor capsule (d).


Microdissection of the tumor continued in a piecemeal fashion (a-c).


Prior to completion, stereotactic neuronavigation was used to check the margins of the gross total resection including inferior margin.


Superior margin.


Posterior margin.


The medial aspect of the right carotid was inspected for sufficient decompression and decompression of the optic nerve (d).


Maxilla continuity was restored (a).


Postoperative panorex orthopantogram demonstrated healing of the maxilla segment (b).


Postoperative Postcontrast CT Scans of the Head. CT images show fat graft in the center of resection cavity along with surrounding surgifoam and postoperative products (a, b).


Postoperative Postcontrast CT Scans of the Head. CT confirms midline fat graft placement during surgery (c).


Images of neck tumor. (a) Before second-line chemotherapy, MRI revealed a soft tissue mass with a volume of about 7.5 cm3 x 5.5 cm3 x 7 cm3 on the right neck that invaded adjacent muscles and skin, and multiple enlarged cervical lymph nodes.


Images of neck tumor. (b) After the second cycle of second-line chemotherapy, MRI examination revealed a slight decrease in the volume of the tumor.


Images of neck tumor. (c) After apatinib treatment for 10 days, the computed tomography revealed the neck tumor was markedly reduced.


Clinical pictures of neck tumor. (a) Before treatment with apatinib on 16 December 2019.


Clinical pictures of neck tumor. (b) After apatinib treatment for 5 days on 21 December 2019.


Activity of Trabectedin in DSRCT. Reduction in size of a nodule deep to the xiphisternum.


Activity of Trabectedin in DSRCT. Significant reduction of the omental disease. After three cycles of Trabectedin in case 2.


Preoperative frontal view.


Preoperative intraoral view.


Preoperative CT scan showing medial extent.


Preoperative CT scan in coronal view.


Chest X-ray.


Postoperative frontal view.


Postoperative intraoral view.


(a,b) Photographs of the 58-year-old man with metastatic follicular thyroid carcinoma showing multiple scalp and facial masses.


(a,b) Photographs of the 58-year-old man with metastatic follicular thyroid carcinoma showing multiple scalp and facial masses. Note in a and b the tortuous and engorged superficial vessels on the left upper aspect of the face and in (b) the right sided thyroid swelling.


(a,b) Skull radiographs of the same patient. (a) Occipitofrontal view showing overlapping shadows of the skull masses and masses within the nasal cavity causing ill-definition of the nasal septum.


(a,b) Skull radiographs of the same patient. (b) Multiple lytic skull vault lesions with ragged edges and radiating bony stands from the vault into the skull masses. Note the branching lucencies to the direction of the lytic lesion and the overlying masses, suggesting hypervascularity.


Patient chest radiograph showing thyroid mass essentially to the right of midline in the lower aspect of the neck, tracheal deviation to the left, coronal tracheal narrowing and retrosternal extension. Note the hilar soft tissue masses with lobulated margin presumed to be lymphadenopathy.


(a and b) X-ray showing radiolucent lesion over epiphysis of the distal end of femur.


(a and b) Magnetic resonance imaging showing hyperintense lesion over distal femoral epiphysis extending into physis and metaphysis.


(a) High power showing chondroblastoma cells surrounded by chicken wire type of calcification.


(b) Low power showing scattered osteoclasts, focal cartilage, and calcification.


Intraoperative picture showing cartilage thinning and intercondylar breach of the tumor.


(a and b) Cartilage window elevation, curettage, and closure.


(a and b) Immediate post-operative X-ray showing entire removal of lesion and the cavity filled with bone graft.


(a and b) One-year follow-up X ray showing graft incorporation and remodeling with no signs of recurrence.


Biopsy of the primary nasopharyngeal neoplasm (A) Epithelial papillary hyperplasia (hematoxylin and eosin, original magnification x10).


Biopsy of the primary nasopharyngeal neoplasm (B) Squamous differentiation (hematoxylin and eosin, original magnification x20).


Biopsy of the primary nasopharyngeal neoplasm (C) Base-like arrangement (hematoxylin and eosin, original magnification x20).


Right upper arm lesion (D) Representative images of the metastatic carcinoma in the right upper arm (hematoxylin and eosin, original magnification x20).


Lung metastases lesion (E) Representative images of the metastatic carcinoma in the lung (hematoxylin and eosin, original magnification x20).


MRI of the dural and multiple brain metastases. (A) T1-weighted axial image shows cerebellum lesions.


MRI of the dural and multiple brain metastases. (B) T1-weighted sagittal image shows lesions in the cerebellum, occipital lobe, parietal lobe, and frontal lobe.


MRI of the dural and multiple brain metastases. (C) T1-weighted coronal image shows dural metastasis and lesions in the parietal and temporal lobes.


Cytologic smears. (A) Isolated mononucleated and binucleated cells, some with cytoplasmic granules (Wright stain, x400).


Cytologic smears. (B) Amyloid-like materials (Wright stain, x400).


Cytologic smears. Round cells with multiple Auer rods in the cytoplasm (arrow). Wright stain, x400.


Cytologic smears. . Wright stain, x1000).


Histologic section. Sheets of neoplastic cells with stippled chromatin and amyloid deposition (H&E stain, x400).


Showing mass (arrow).


Intra-operative view.


Microscopic view showing malignant cells.


The sagittal section of the eye reveals an irregular pigmented lesion of the ciliary body (left panel). Gross appearance of the liver (right panel).


Pigmented cells with atypia and pleomorphism prominent ovoid nuclei with epithelioid features which originate in the choroid and focally infiltrate the sclera and ciliary body base (hematoxylin-eosin stain, left panel). Diffuse hepatic infiltration. Atypical pleomorphic cells with prominent ovoid nuclei and epithelioid features. Abundant pigment was evident in their cytoplasm and between hepatic sinusoids (right panel).


Characteristics of IMT. (A) Fascicular proliferation of monotonous spindle cells within myxoid stroma (left), and immunohistochemical staining with anti-ALK antibody (right).


Characteristics of IMT. (B) Computed tomography (CT) scan before initiating entrectinib (top), and after 9 months of entrectinib (bottom). Arrows indicate lung micronodules.


Characteristics of IMT. (C) Workflow for CT scan and longitudinal CTCs collection during treatment.


Axial computed tomography abdomen and pelvis demonstrating L4 vertebral body destructive metastases (*) with extraosseous extension into the spinal canal, spinous process, and left paraspinal musculature measuring 7.8 x 7.1 cm.


L3 posterior vertebral body metastasis (arrow head) with intraosseous extension into the spinal canal measuring 2.1 x 2.0 cm.


Sagittal magnetic resonance imaging of the lumbar spine demonstrating near-complete marrow replacement of the L4 vertebral body (*) with expansile, locally destructive soft tissue with extension into the left posterior elements and spinous process (a). Associated extra cortical extension of disease with circumferential encasement of the epidural space resulting in extremely severe spinal canal stenosis with compression of the cauda equina nerve roots.


There is also replacement of the posterior aspect of the L3 vertebral body (arrow head) and associated 20 percent posterior pathological compression fracture deformity (b). Frank extra cortical disease extension at this level results in moderate spinal canal narrowing with asymmetric effacement of the left lateral recess and compression of the traversing left L4 nerve roots.


Lateral.


Anterosuperior. X-rays of the lumbar spine demonstrating placement of a L4 corpectomy with placement of a cage and quad rod, pedicle screw instrumentation at L1, L2 and L3, L5, S1, and across the sacroiliac joints with an interlock at the L4 level.


Computed tomography head demonstrating a large expansile transcalvarial lesion centered at the right occipital convexity measuring approximately 7.1 x 2.3 cm transaxially (a) with resultant sulcal effacement of the subject temporal, parietal, and occipital lobes and expansion into the adjacent scalp soft tissues.


Magnetic resonance imaging of the mass is also demonstrated (b).


A well-defined heterogeneous lesion in the right lobe of liver with solid echogenic areas, and ,anechoic cystic areas.


No obvious internal vascularity on Doppler imaging.


Axial contrast-enhanced CT images demonstrating the cystic appearance of the mass with eccentric internal vascularity (red arrow heads).


Sagittal maximum intensity projection image showing a tortuous artery supplying the periphery of the lesion as denoted by the black arrow.


Axial.


Coronal T2W images showing a hyperintense cystic appearing lesion with heterogeneous internal components, and ,fluid-fluid levels.


Axial T1W image revealing hyperintense, internal haemorrhagic contents.


Post-contrast T1W image indicating only peripheral vascularity (red arrow heads) with no obvious internal solid enhancing soft tissue.


Medical image.


Axial diffusion-weighted images image at b = 800 sec/mm2 shows heterogeneous content with hyperintensity areas that reveal low signal on the corresponding apparent diffusion coefficient map , indicating diffusion restriction. This was related to the internal haemorrhage and necrotic tissue. White arrows mark a focal haemorrhagic focus (marked T1 hyperintensity as seen in Figure 3C), showing significant restricted diffusion.


(A-D) MR-Images of the brain and spine showing multiple periventricular, parenchymal and leptomeningeal contrast enhancements at the time of diagnosis. T1-weighted contrast-enhancement MRI sequence of the brain.


(A-D) MR-Images of the brain and spine showing multiple periventricular, parenchymal and leptomeningeal contrast enhancements at the time of diagnosis. T1-weighted contrast-enhancement MRI sequence of the brain Arrow pointing to the site of biopsy (C).


(A-D) MR-Images of the brain and spine showing multiple periventricular, parenchymal and leptomeningeal contrast enhancements at the time of diagnosis. And T2- weighted MRI sequence of the spine.


(E-H) MR-Images 6 weeks after high-dose steroid treatment showing near complete remission. T1-weighted contrast-enhancement MRI sequence of the brain after steroid treatment.


(E-H) MR-Images 6 weeks after high-dose steroid treatment showing near complete remission. And T2- weighted MRI sequence of the spine after steroid treatment.


(I-L) Histology of the stereotactic biopsy. Demyelinated areas are shown in Kluver-Barrera staining.


(I-L) Histology of the stereotactic biopsy. CNP-ase staining , with numerous foamy macrophages [CD68.


(I-L) Histology of the stereotactic biopsy.


(I-L) Histology of the stereotactic biopsy. Scattered CD45+ lymphocytes are present in the demyelinated areas (L).


(a) Magnetic resonance imaging (MRI): T1-weighted images after gadolinium administration, showing a neoplastic involvement of T7-T8 vertebral body.


(b) T2-weighted images showing impingement of the spinal cord and an initial segmental thoracic kyphosis.


(c) Short-T1 Inversion Recovery sequence shows an osteolytic lesion on T7 and T8 vertebral body.


(a) Magnetic resonance imaging (MRI), T1-weighted images after gadolinium administration, showing the reduction of volume of T7-T8 vertebral bodies, with reduced impingement on the spinal cord.


(b) T2-weighted images showing an improvement in segmental thoracic kyphosis.


(c and d) Computed tomography (CT) scan of the thoracic spine showing the posterior transpedicle fixation and vertebral partial augmentation.


Gross view of the tumor.


CT scan view of the tumor.


Pathologic view of the tumor.


Microscopic view of the tumor.


Zosteriform metastatic skin-colored solid papules, nodules, and papulovesicles scattered and confluent with few crusted plaques seen on the left side of the neck in a typical zosteriform distribution involving the left C3 dermatome.


A superficial ulcer of 2 x 2 cm over the hard palate in the oral cavity with an eroded surface with irregular margins and pseudomembrane formation.


Response after external cobalt therapy, showing complete clearance of oral ulcer.


Response to cobalt therapy; healing of zosteriform lesions over neck with scarring.


Endoscopic images of the abnormal mucosa noted in our patient. A; Erythematous swollen ileocecal valve, denoted by an asterisk.


Endoscopic images of the abnormal mucosa noted in our patient. B; Inflammatory nodular mucosa in the upper half of terminal ileum, denoted by an arrow. This contrasts with the normal mucosa noted in the lower half of the same image.


Histology from the ileal biopsy. It reveals 3 coccidioidomycosis spherules, denoted by arrows. The spherule on the right-hand side is actively releasing endospores.


(A) Doppler ultrasonogram showing hyperechogenic, cystic, and hypervascular hepatic perivascular epithelioid cell tumor.


(B) Computed tomography scan of tumor.


(A) Intraoperative view of tumor mass.


(B) View of surgical margin.


(C) Size of tumor mass.


(D) Postoperative cross-sectional area of the liver.


(A) Tumor areas infiltrating the hepatic parenchyma (shown with yellow arrow).


(B) Perivascular epithelioid cells with round to ovoid nuclei and abundant eosinophilic cytoplasm, which are occasionally spindle-shaped but mostly epithelioid (shown with yellow arrow).


(C) Diffuse positive immunohistochemical staining in cytoplasmic area for HMB-45.


(D) Diffuse positive immunohistochemical staining in cytoplasmic area for smooth muscle actin.


Computed tomographic follow-up image 10 months after surgery.


Pre-operative MRI (a, b) T1-weighted post gadolinium images show an avidly enhancing mass with well-defined, lobulated borders in the left frontoparietal region.


Preoperative transcranial magnetic stimulation ,intraoperative motor mapping.


Monitoring. Demonstrate that the primary motor cortex was located in front of the tumor, confirming the location of the tumor within the central sulcus.


Post-operative MRI axial T1-weighted pre gadolinium.


Post gadolinium. Show a small volume of hemorrhage in the surgical bed but no residual tumor.


Toluidine blue stained smear preparation (a) shows spindle shaped, monomorphic neoplastic cells with prominent nucleoli in a loose matrix and mast cells.


Epithelioid and spindle-shaped cells arranged in mucoid/myxoid background with hyalinised elements (b, c).


Epithelioid and spindle-shaped cells arranged in mucoid/myxoid background with hyalinised elements (b, c). The cytoplasm is frequently vacuolated and a mitotic figure is noted (c).


Eosinophilic cytoplasmic inclusions in keeping with rhabdoid cells (d).


Strong, diffuse immunoreactivity with CD34 (e).


Loss of expression in the tumor cells by INI1, while the nuclear staining is preserved in the endothelial cells (f).


Left renal upper pole enhancement.


Left inguinal lymph nodes.


Left axillary lymph node.


CT image. . Notes: (A) Infiltration of the right upper lobe of the lung before treatment.


CT image. (B) Infiltration of the right upper lobe of the lung after IL-2 therapy.


CT image. (C) Infiltration of the right upper lobe of lung worsened after PD-1 inhibition.


CT image. (D) Infiltration of the right upper lobe of lung absorbed after 6 weeks of anti-TB treatment. . Abbreviations: CT, computed tomography; TB, tuberculosis.


Histopathological findings of TB granuloma from the lung biopsy. . Notes: A large amount of caseous necrosis surrounded with epithelioid cells and diffused infiltrating lymphocytes (paraffin-embedded tissue by H&E staining). (A) Original magnification (20x). Local magnification of. (400x). Solar marking: caseous necrosis; blue arrows: epithelioid cells. . Abbreviation: TB, tuberculosis.


Histopathological findings of TB granuloma from the lung biopsy. . Notes: A large amount of caseous necrosis surrounded with epithelioid cells and diffused infiltrating lymphocytes (paraffin-embedded tissue by H&E staining).


Postoperative sagittal T2 magnetic resonance imaging of the lumbar spine demonstrating postoperative changes of laminectomy with residual intradural lesions at L1. This was the only postoperative image obtained as patient discomfort led to an early terminated examination.


Axial section of MRI images - Case 1.


Tumor cells showing strong positivity for synaptophysin.


Ki67 immunostaining: proliferative index of 4%.


Axial section of MRI images of - Case 2.


Contrast-enhanced CT-scan showing an air-filled communication between trachea and mediastinum.


Transversal section of the trachea with evidence of wall disruption.


Sections of the hearth at ventricular level, with evidence of metastases at the interventricular septum and the walls of the right and the left ventricle.


Abdominal axial computed tomography (CT) scan shows a 0.7 cm hypodense mass in the pancreas (arrow).


A: HE staining (20x) of the epithelial component of carcinosarcoma.


B: CK staining positivity in the carcinoma component.


C: Vimentin positivity in the sarcomatous component.


CK staining positivity in the carcinomatous component.


Vimentin positivity in the sarcomatous component.


A: Positron emission tomography-CT of chest, abdomen, and pelvis revealing post-surgical changes in the liver with no focal uptake suggestive of local recurrence. Fatty changes are noted. A soft tissue lesion with areas of coarse calcification is seen in the anterior abdominal wall on the right, next to the midline; it is in close proximity to the site of the previous surgical incision, and measures 8.3 x 6.9 cm, with a maximum standardized uptake value of 6.5.


B: Sagittal view of the same image.


A large tumor in patient's right breast upon first clinical examination. The tumor had an exogenous growth with an ulcer measuring 5x5 cm in the center, covered with white and yellow exudate.


The outcome of breast and axillary B ultrasonography. (A) B ultrasonography showed a 12.5-cm diameter mass in the lateral quadrant of the right breast.


The outcome of breast and axillary B ultrasonography. (B) B ultrasonography showed enlarged axillary lymph nodes. The larger node had a diameter of 1.2 cm.


Results of chest computed tomography (CT). (A) The red arrow shows a large breast tumor with thickened skin.


Results of chest computed tomography (CT). (B) The red arrow shows a nodule in the upper lobe of the right lung, indicating lung metastasis.


Results of chest computed tomography (CT). (C) The red arrow shows another nodule in the upper lobe of the right lung, suggesting lung metastasis.


Results of chest computed tomography (CT). (D) The red arrow shows abnormal bone density on the thoracic third vertebral body (T3), indicating bone metastasis.


Results of pathological examination. (A) Blue arrow shows invasive ductal carcinoma, while the red arrow shows squamous cell carcinoma.


Results of pathological examination. (B) High-grade sarcoma.


The pathological examination confirmed an epidermal nevus at the periphery of the lesion. H&E staining, x50 magnification.


Sheets of poorly differentiated, atypical, pleomorphic keratinocytes migrated from the epidermis into hair follicles.


The tumour exhibited a maximal depth of 7 mm.


Metastasis is visible in both lungs.


In the spinal cord. On a CT image and bone scan, respectively.


Primary sigmoid cancer. A; Macroscopic appearance of the primary sigmoid colon cancer.


Primary sigmoid cancer. B; Microscopic appearance of the primary sigmoid colon cancer.


Follow-up colonoscopy after the primary operation. A; Colonoscopy showing no evidence of recurrence at the anastomotic site 3 years after the primary operation.


Follow-up colonoscopy after the primary operation. B; Colonoscopy showing anastomotic recurrence 5 years after the primary operation.


The resected intestine exhibiting anastomotic recurrence. A; Macroscopic appearance of the resected intestine demonstrating anastomotic recurrence. The arrows indicate the previous anastomotic line.


The resected intestine exhibiting anastomotic recurrence. B; Microscopic appearance of the resected intestine demonstrating anastomotic recurrence.


Intra oral extension of lesion with floating premolar within the lesion.


Ortho pantamo graph showing soap bubble appearance, and arrow mark showing eroded bone.


Computed tomography image showing perforation of cortical plates of mandible.


Gross image showing glistening gelatinous creamy white tissue bits.


Spindle- or stellate-shaped mesenchymal cells within loose myxoid stroma. Arrow representing odontogenic epithelial islands (H&E, x40).


Arrow mark showing alcian blue positive mucoid material.


Photomicrograph showing negative reactivity for BCl2 marker.


Proximal nailfold demonstrating several enlarged capillaries.


Telangiectasias along the marginal gingivae (arrow) and interdental papillae.


Clinical manifestations of melanotic neuroectodermal tumor of infancy originating in the mandible.


Cancer cell types of melanotic neuroectodermal tumor of infancy in the fibrous connective tissue. Larger pigmented cells (magnification, 40).


Cancer cell types of melanotic neuroectodermal tumor of infancy in the fibrous connective tissue. Nested small round cells (magnification, x400) (stain, hematoxylin and eosin).


Tumor cell invasion into the surrounding sclerotin. (A) Tumor cells separate from the bone trabecula (magnification, x400).


Tumor cell invasion into the surrounding sclerotin. (B) Tumor cell invasion of the bone trabecula (magnification, x40) (stain, hematoxylin and eosin).


Inferior alveolar neural tube invasion by the tumor cells in the. Soft tissue.


Sclerotin (stain, hematoxylin and eosin; magnification, x40).


Computed tomography images acquired to observe mandible development. Immediately after surgery.


Four months after surgery.


One year after surgery.


Chest CT presentations during the whole treatment (from June 26th, 2016 to June 3rd, 2019). (A1/A2) Chest CT images on June 26th, 2016. (B1/B2) Chest CT images on September 9th, 2016. (C1/C2) Chest CT images on October 15th, 2016. (D1/D2) Chest CT images on December 2nd, 2016. (E1/E2) Chest CT images on January 7th, 2017. (F1/F2) Chest CT images on March 1st, 2017. (G1/G2) Chest CT images on May 19th, 2017. (H1/H2) Chest CT images on July 14th, 2017. (I1/I2) Chest CT images on August 26th, 2017. (J1/J2) Chest CT images on September 7th, 2017. (K1/K2) Chest CT images on November 2nd, 2017. (L1/L2) Chest CT images on December 23rd, 2017. (M1/M2) Chest CT images on February 18th, 2018. (N1/N2) Chest CT images on April 8th, 2018. (O1/O2) Chest CT images on April 27th, 2018. (P1/P2) Chest CT images on June 1st, 2018. (Q1/Q2) Chest CT images on August 20th, 2018. (R1/R2) Chest CT images on October 28th, 2018. (S1/S2) Chest CT images on November 21st, 2018. (T1/T2) Chest CT images on January 9th, 2019. (U1/U2) Chest CT images on March 5th, 2019. (V1/V2) Chest CT images on March 17th, 2019. (W1/W2) Chest CT images on May 21st, 2019. (X1/X2) Chest CT images on June 3rd, 2019.


Histological finding with hematoxylin and eosin-stained biopsy specimen from percutaneous lung biopsy on June 30th, 2016.


The variation of tumor markers including CEA (normal range, 0 to 5 ng/mL), CA72-4 (normal range, 0 to 6.9 U/mL), SCC (normal range, 0 to 1.5 ng/mL), and CA19-9 (normal range, 0 to 37 U/mL) for each visit from the initial treatment to the present.


Preoperative imaging. (a) NCCT - Non contrast CT image showing low-density mass lesion with irregular margins in the right lateral ventricle.


Preoperative imaging. (b) MRI T1W - MRI T1-weighted axial image showing heterogeneous signal intensity mass in the right lateral ventricle.


Preoperative imaging. (c) MRI T2W - MRI T2-weighted image showing well circumscribed lesion in right lateral ventricle with cystic changes and heterogeneous signal intensity.


Postoperative imaging. (a) MRIT1W at 36 months - MRI T1-weighted axial image at 36 months post therapy.


Postoperative imaging. (b) MRI T2Wat 36 months - MRI T1-weighted with contrast at 36 months post therapy.


Postoperative imaging. (c) MRI T1W with contrast - MRI T2-weighted axial image at 36 months post therapy complete remission.


(a) Cervical intraepithelial neoplasia III of the uterine cervix with nuclear atypia (x100).


(b) In situ tumor sweeps over the endometrium of the lower uterine segment (x40).


(c) Strong expression of CD138 in the cervix in situ tumor (x40).


(d) strong expression of CD138 in the in situ tumor in the lower uterine segment (x40).


Histopathological examination shows the pulmonary nodules were metastatic pheochromocytoma. (A) Hematoxylin and eosin staining of biopsy specimens shows nests of tumor cells separated by vascular septa (Zellballen).


Histopathological examination shows the pulmonary nodules were metastatic pheochromocytoma. Chromogranin.


Histopathological examination shows the pulmonary nodules were metastatic pheochromocytoma. Synaptophysin immunostaining is diffuse strong positive in the tumor cells.


Histopathological examination shows the pulmonary nodules were metastatic pheochromocytoma. (D) CD56 immunostaining is positive in the membrane of the tumor cells.


Histopathological examination shows the pulmonary nodules were metastatic pheochromocytoma. (E) Ki-67 immunostaining shows approximately 5% of cells are positive. Original magnification x 200.


(a,b) Coronal and Saggital sections from CT Skeletal survey for paraproteinaemia. Single 3.2 x 1.5 cm medium low attenuation lesion with a thin sclerotic margin in the midshaft of the right femur causing mild scalloping of the adjacent inner aspect of the medial cortex.


MRI with standard multi-planar technique. (a, b) Coronal and sagittal T2 weighted MRI images of a 1.4 x 2.0 x 3.3 cm showed a hyperintense, well marginated, eccentrically located and marginally expansile lesion involving the mid right femoral shaft.


MRI with standard multi-planar technique. (c) Coronal T1-weighted image showed a well circumscribed cystic lesion of the right femoral shaft with a narrow zone of transition. It was fluid filled and has a relatively homogenous consistency with no cortical expansion. No other focal lesion seen.


(a,b) Femur XR post-operatively. The Intramedullary nail in situ in satisfactory position with evidence of excision biopsy site and cortical erosion.


(a) Low power image showed a fragmented spindle cell lesion and accellular necrotic bone.


(b) High power image showed biphasic appearance with hypercellular Antoni A areas and myxoid hypocellular Antoni B areas. There was evidence of nuclear pallisading around fibrillary processes (verocay bodies) and variable cellular spindle cell proliferation consistent with schwannoma. No atypical infiltrate or evidence of malignancy was seen.


(c) Cytoplasmic and nuclear immunohistochemical staining demontrated that the neoplastic cells are positive for S100.


Chest CT scan of the patient treated with carboplatin and paclitaxel: the CT scan showed bilateral intrapulmonary metastases during initial workup with a 7.6 cm x 7.3 cm dominant mass in right lower lobe and a 7.4 cm x 8.2 cm dominant mass in left lower lobe.


Partial response after chemotherapy with carboplatin and paclitaxel.


On latest follow-up, the intrapulmonary masses and nodules had significantly reduced in size or remained stable There was no evidence of any enlarging or new intrapulmonary lesions.


The timeline showing the history of treatment and examinations for the patient under current study.


In terminally differentiated CD8+ T cells, the proportion of exhausted cells varied with the treatment time. The results were tested by flow cytometry, in which the terminally differentiated CD8+ T cells were labeled CD3+CD8+CD27-, in which PD-1+, was considered a marker of exhaustion and non-exhausted cells were PD-1.


Ultrasound shows a 0.58 cm solid mass (red arrow).


Shows a 3.08 x 2.82 x 2.11 cm ovoid cystic mass (yellow arrow) both located at the right thyroid lobe.


Shows a 0.21 cm ovoid cyst (black arrow) at left thyroid lobe.


0.5 cm solid nodule seen on ultrasound. Black arrows show papillae with fibrovascular cores (H&E, 40x).


0.5 cm solid nodule seen on ultrasound. Red arrow shows cuboidal cells with overlapping nuclei (H&E, 100x).


Staining for HBME-1 which appears as a brownish tan stain (HBME-1, 40x).


On higher magnification, shows HBME-1 positive seen within the plasma membrane of the tumor cells (HBME-1, 400x).


There is marked thickening of parts of the appendix up to a diameter of 7 mm (open arrowheads) compared with the normal adjacent part of the appendix (closed arrowheads). Technique: B mode sonography and color-coded sonography, Siemens ACUSON S2000, 14 MHz linear probe.


The thickened appendix shows complete loss of the regular bowel layers, in general is hypoechoic (between arrows). There is no marked hyperperfusion of the tissue.


The periappendiceal tissue is hyperechoic, representing edema (asterisks).


Photograph of the lesion on the left nipple. Erosion and crust on the left nipple.


(A and B) Histopathology reveals ductal differentiation. (Hematoxylin-eosin stain, Original magnificationx40.


(A and B) Histopathology reveals ductal differentiation. Original magnificationx200.


The luminal epithelial cells were positive for (C) CK5/6 stain. (Immunohistochemistry, original magnificationx100).


The out-layer myoepithelial cells were positive for. SMA.


P63 stains. (Immunohistochemistry, original magnificationx100).


CT of the chest on admission to hospital. . CT of the chest demonstrating several nodular opacities throughout both lungs. Two nodules are measured to show size. Arrows point to pleural effusions on both lungs.


CT of the chest during hospitalization. . CT of the chest showing nodular opacities that persisted in both lung fields and worsening bilateral pleural effusions (arrows).


Bronchoscopy performed during hospitalization. . Photographs of the bronchoscopy performed after patient's symptoms were not improving with appropriate antibiotic therapy. (
a) Diffusely hyperemic and edematous mucosa of lower airways.


Bronchoscopy performed during hospitalization. . Photographs of the bronchoscopy performed after patient's symptoms were not improving with appropriate antibiotic therapy. (
b) Arrow points to airway with significant mucopurulent secretions.


Clinical picture showing the biopsy site and the extent of the lesion.


Dermoscopy of pigmented nail fold squamous cell carcinoma shows areas of homogeneous brown pigmentation, pigmented dots or globules, polymorphic vessels.


SBRT plan with volumetric modulated arc technique. . Note: Three arcs were used from 340. to 179. (clockwise and counterclockwise) and from 215. to 180. . Abbreviation: SBRT, stereotactic body radiation therapy.


Successive gadolinium-enhanced magnetic resonance images (MRIs) showing the clinical course of the craniopharyngioma during a 6-year period. (a) Tumor regrowth in the left cavernous sinus at 31 years of age.


Successive gadolinium-enhanced magnetic resonance images (MRIs) showing the clinical course of the craniopharyngioma during a 6-year period. (b) MRI after removal of the lesion and gamma knife surgery.


Successive gadolinium-enhanced magnetic resonance images (MRIs) showing the clinical course of the craniopharyngioma during a 6-year period. (c) Tumor regrowth at 36 years and 3 months of age. The tumor grew around the left optic nerve.


Successive gadolinium-enhanced magnetic resonance images (MRIs) showing the clinical course of the craniopharyngioma during a 6-year period. (d) MRI after transsphenoidal biopsy.


Successive gadolinium-enhanced magnetic resonance images (MRIs) showing the clinical course of the craniopharyngioma during a 6-year period. (e, f) MRIs at 31 years and 8 months of age. Tumor size increased drastically, and the tumor invaded the cavernous sinus and the internal carotid artery.


Computed tomography scans with contrast enhancement before.


After. The operation of transcranial and transsphenoidal dual surgeries with an extracranial-intracranial bypass. The tumor was totally removed.


Pathological findings of a specimen from the transcranial and transsphenoidal dual surgeries at 36 years and 9 months of age. (a) The number of squamous cells has increased.


Pathological findings of a specimen from the transcranial and transsphenoidal dual surgeries at 36 years and 9 months of age. (b) The lamina propria has collapsed, and infiltration of atypical cells is seen.


Pathological findings of a specimen from the transcranial and transsphenoidal dual surgeries at 36 years and 9 months of age. (c) Tumor cells have enlarged nuclei and clarification of the nucleolus.


Pathological findings of a specimen from the transcranial and transsphenoidal dual surgeries at 36 years and 9 months of age. (d) Parakeratosis and intercellular bridges are present in the tissue. Hematoxylin and eosin staining at the original magnification.


Chest CT on admission. The lung window of the left upper lobar bronchus level.


Chest CT on admission. The white arrow indicated the lobular mass with heterogeneous enhancement on mediastinal window in the right hilar region (B).


Chest CT on admission. , the left lung basal trunk bronchus level.


Chest CT on admission. And the basal vein level.


Microscopic findings. The squamous cell carcinoma cells in multiple areas.


Microscopic findings. And tuberculous necrosis inflammation (Hematoxylin-eosin stain, x200).


CT-guided percutaneous lung biopsy. The second specimen was obtained at the peripheral site of the mass.


Gadolinium-enhanced T1-weighted MR images showing an irregularly enhanced intramedullary lesion at the C6-T6 spinal level with enhancement along the dorsal surface of the spinal cord.


Intracranial enhanced lesions located along the ventricular surface.


Gadolinium-enhanced T1-weighted MR images showing marked reduction in the size of the enhanced lesion of the spinal cord.


The disappearance of the periventricular dissemination.


(a and b) Axial computed tomography scan showing a left temporobasal lesion with hypertrophic bone changes.


(c and d) Axial postcontrast magnetic resonance imaging showing an extra-axial left temporobasal lesion with extension to the midline subfrontal region with poorly demarcated margins from the left temporal lobe.


Sequence chromatogram of the
TRIP11-PDGFRB
fusion junction showing the fusion between exon 16 of
TRIP11
and exon 11 of
PDGFRB. Black arrows indicate the location of primers. The white arrow indicates the location of breakage and reunion. E: exon.


Subungual painful mass in the left thumb at presentation.


Macroscopic appearance the subungual mass: infiltrative soft tumor, paler than normal tissue.


CK7 staining comparison of primary HCC.


Nail-bed metastasis , both negative (10X).


Another immunohistochemistry (IHC) features of the nail-bed HCC metastasis: AFP positive.


Glypican 3 positive.


Ki67. (10X).


Histology of the surgical specimen. (A) Calcitonin-positive medullary thyroid cancer is adjacent to normal thyroid tissue (immunohistochemistry, x10).


Histology of the surgical specimen. (B) Solid nests of metastatic medullary thyroid cancer (arrows) in a lymph node (hematoxylin and eosin, x10).


After the operation, the left exophytic tumor was ischemic and gradually reduced. A; Day 3.


After the operation, the left exophytic tumor was ischemic and gradually reduced. B; Day 5.


By day 40 after the interventional operation, the skin defect at the left labia majora had healed.


Preoperative magnetic resonance imaging and digital subtraction angiography. Preoperative axial.


Preoperative magnetic resonance imaging and digital subtraction angiography. Sagittal. Views in gadolinium-enhanced T1-weighted MRI, showing a prominent enhanced mass lesion and enhanced vessel-like structures in surrounding parenchyma in the left cerebellar hemisphere.


Preoperative magnetic resonance imaging and digital subtraction angiography. Anteroposterior.


Preoperative magnetic resonance imaging and digital subtraction angiography. Lateral. Views in angiography, showing strong tumor staining with a feeding artery from the left posterior inferior cerebellar artery, and ,a draining vein into the left inferior vermian vein.


Preoperative magnetic resonance imaging and digital subtraction angiography. Indicating arteriovenous shunt [anteroposterior view.


Preoperative magnetic resonance imaging and digital subtraction angiography. Lateral view.


CT scan upper abdomen with IV contrast shows no abdominal organs metastases.


CT scan of the chest with IV contrast shows bilateral hilar and mediastinal enlarged lymph nodes.


A) The tumor involved the dermis and subcutaneous tissue [hematoxylin-eosin (H&E), original magnification x40.


B) The tumor consisted of complex and single neoplastic glandular structures with intervening desmoplastic stroma [H&E, original magnification x100.


C) Immunohistochemical staining for CDX2 shows diffuse and strong nuclear staining in the neoplastic cells [original magnification x100.


Response characteristics from combination TTFields and bevacizumab therapy. At the time of first recurrence, the tumor cyst measured 3.4 x 4.4 cm on gadolinium-enhanced T1-weighted.


Response characteristics from combination TTFields and bevacizumab therapy. FLAIR. Images.


Response characteristics from combination TTFields and bevacizumab therapy. After 2 cycles of bevacizumab, there was a partial decrease in the size of the cystic tumor to 1.9 x 3.6 cm as seen on gadolinium-enhanced T1-weighted images.


Response characteristics from combination TTFields and bevacizumab therapy. A partial resolution of the edema as detected on FLAIR. Images.


Response characteristics from combination TTFields and bevacizumab therapy. After 6 cycles of combination TTFields and bevacizumab therapy, there was a further decrease of the cystic tumor to 1.7 x 3.1 cm, or 65% reduction, as seen on gadolinium-enhanced T1-weighted images.


Response characteristics from combination TTFields and bevacizumab therapy. A resolution of edema as detected on FLAIR. Images.


Foci of relapsed disease outside of the previously irradiated glioblastoma. Gadolinium enhancement was detected in the internal capsule.


Foci of relapsed disease outside of the previously irradiated glioblastoma. Medial left frontal brain. After 6 cycles of TTFields and bevacizumab therapy.


Sagittal plane computed tomography showing severe extensive sclerotic osseous metastatic lesions in the sternum and vertebrae.


Sagittal plane computed tomography showing severe extensive sclerotic osseous metastatic lesions throughout the vertebral column.


Sagittal plane computed tomography showing severe extensive sclerotic osseous metastatic lesions in the sacrum.


CT scan and MRI performed 6 months after endoprosthesis placement show a large lateral aortic tumor mass (white stars) with a progressive contrast enhancement (white arrows). CT scan shows a minimal contrast enhancement on portal phase.


CT scan and MRI performed 6 months after endoprosthesis placement show a large lateral aortic tumor mass (white stars) with a progressive contrast enhancement (white arrows). And an important one on delayed phase.


CT scan and MRI performed 6 months after endoprosthesis placement show a large lateral aortic tumor mass (white stars) with a progressive contrast enhancement (white arrows). Axial non-contrast.


CT scan and MRI performed 6 months after endoprosthesis placement show a large lateral aortic tumor mass (white stars) with a progressive contrast enhancement (white arrows). Gadolinium-enhanced T1-weighted images with fat saturation on arterial phase.


CT scan and MRI performed 6 months after endoprosthesis placement show a large lateral aortic tumor mass (white stars) with a progressive contrast enhancement (white arrows). Portal phase.


CT scan and MRI performed 6 months after endoprosthesis placement show a large lateral aortic tumor mass (white stars) with a progressive contrast enhancement (white arrows). Delayed phase. Show also a progressive tumor enhancement.


A soft tissue density enhancing expansile lytic lesion involving the spinous process of the L5 vertebra.


Low power magnificationx10; Follicular carcinoma showing multiple variable colloid filled thyroid follicles infiltrating into the darkly stained bony trabeculae (Lumbar specimen.


Low power magnificationx10; Follicular carcinoma showing multiple variable colloid filled thyroid follicles infiltrating into the darkly stained bony trabeculae (rib specimen.


Initial panoramic radiograph showing a radiolucent oval image with radiopaque halo in the premolar region (arrow).


Photomicrography of the biopsy specimen showing in A positivity for chromogranin A (200X), and in B positivity for TTF-1 (200X).


Panoramic radiograph 1 month after chemotherapy, showing new bone formation in the previously metastatic region.


Ulceroproliferative growth over the right shin.


Post-operative photograph showing no evidence of recurrence.


MRI showing expansile osseous lesion seen along the floor of posterior cranial fossa involving the posterior portion of right petrous temporal bone.


CT-Temporal bone showing locally destructive lesion involving the right mastoid air cells with disruption and erosion of the right temporal bone.


Microphotograph showing diffuse sheets of plasma cells. (Hematoxylene and Eosin stain).


Immunohistochemisty for CD 138 showing strong positivity in tumor cells.


Positron emission tomography-computed tomography examination of metabolically active sternal tumor (white circle: maximum standardized uptake value of fluorine 18 fluorodeoxyglucose =3.5).


3D model of the implant prepared based on software program including the date of the patient's computed tomography scan.


Intraoperative picture: 3D sternal implant filling the defect after tumor resection fixed to bone scaffolds by titanium plates.


Skin scar 3 months after the operation.


Contrast-enhanced T1-weighted image showing enhancing lesion of the left external auditory canal. No bony erosion was seen.


Gross specimen of lateral temporal bone resection specimen.


Postoperative picture of the patient 1 year and 11 months after surgery.


2-Dimensional echocardiographic imaging (apical 4 chamber view) demonstrating dilated right side of the heart with most of the right ventricular cavity occupied by the tumor mass.


2D apical 4 chamber view showing forward tricuspid flow through the residual RV cavity.


A; The tumor was present on the abdominal wall and pressed the cecum.


B; The tumor measured 5.5 x 4.0 x 3.8 cm.


C; Histological examination showed diffuse growth of large spindle cells. HE. X200.


D; Immunohistochemically, the tumor reacted positively to both cytokeratin (CK7) and vimentin, but did not react to DOG1, S100, or antibodies (CD45LCA), suggesting a lymphoma.


A; The tumor measured 7 x 6 x 5 cm.


B; The tumor was composed of both adenocarcinoma and sarcomatous components. A ductogenic image was observed in the tumor. HE. X200.


On immunohistochemical staining, the tumor reacted positively to cytokeratin-7 (CK7), EMA, and HHF35, but negatively to hepatocytes and . Kit.


Cases of a recurrent RRD at 10 and 11 years after a successful initial reattachment by PPV. A; Fundus photograph of the left eye of a 42-year-old Japanese woman (Case 1). A retinal detachment that extended to the 4 quadrants including macula can be seen. Her visual acuity was 20/250.


Cases of a recurrent RRD at 10 and 11 years after a successful initial reattachment by PPV. B; Fundus drawing of the left eye showing an epiretinal membrane and reopened breaks at the superior temporal retina (arrow). There were also multiple breaks at the nasal retina (arrowhead).


Cases of a recurrent RRD at 10 and 11 years after a successful initial reattachment by PPV. C; Fundus photograph at 6 months after surgery. The retina is reattached, and the protrusion of the encircling scleral buckle is evident. Her visual acuity was 20/200.


Cases of a recurrent RRD at 10 and 11 years after a successful initial reattachment by PPV. D; OCT image showing the attached fovea with foveal depression. A dome-shaped macular can also be seen.


Cases of a recurrent RRD at 10 and 11 years after a successful initial reattachment by PPV. E; Fundus photograph of the left eye of a 70-year-old Japanese man (Case 2). A retinal detachment that extends to the inferior 2 quadrants including the macula can be seen. His visual acuity was 20/150.


Cases of a recurrent RRD at 10 and 11 years after a successful initial reattachment by PPV. F; Fundus drawing of the left eye showing an inferior retinal detachment. There is a suspicious retinal break at 6 o'clock of the retina (arrow). The scar lesions surrounding a previous break are not detached (arrowhead).


Cases of a recurrent RRD at 10 and 11 years after a successful initial reattachment by PPV. G; Fundus photograph at 4 months after surgery. The retina is successfully reattached with a mild protrusion of the encircling buckle. A newly treated retinal break and lattice degeneration by photocoagulation can be seen on the buckle (arrow). His visual acuity was 20/30.


Magnetic resonance imaging of the spine. T2 sagittal.


Magnetic resonance imaging of the spine. T2 axial.


Magnetic resonance imaging of the spine. Sagittal contrast.


Magnetic resonance imaging of the spine. Axial contrast images, showing a well-defined intradural extramedullary mass lesion at D8 level.


(a) Initial gadolinium-enhanced MRI showing irregular-shaped pituitary macroadenoma with multiple cyst formations invading the cavernous sinus, completely encasing the right ICA.


(b) Preoperative MRA indicating no abnormal findings (right oblique projection).


(a) Dosimetry of the GKS procedure. The marginal dose to the tumor margin was 15 Gy at the 50% isodose curve.


(b) Isodose lines on the dosimetry planning showing the dose received by the intracavernous segment of the ICA, retrospectively (red line = 20-22 Gy isodose line, yellow line = 15 Gy isodose line).


Five years postradiosurgical MRI and MRA. (a) Nonenhanced MRI demonstrating a remarkable reduction of the tumor volume.


Five years postradiosurgical MRI and MRA. (b) MRA indicating severe stenosis and disappearance at the distal portion of the intracavernous segment of the right ICA (right oblique projection).


Angiogram of the right common carotid artery showing slight restenosis of cavernous segment of the ICA (arrowhead) one year after the treatment.


Timeline of 18F-FDG PET-CT findings, tracked with a pembrolizumab regimen and other diagnostic testing modalities. A transient intracardiac 18F-FDG avidity focal point on PET-CT is indicated by white arrows.


Timeline.


(coils) post radiofrequency of lesion.


Dose distribution of the stereotactic body of radiotherapy (50 Gy in five fractions) of lesion.


Testicular choriocarcinoma. Pathology/gross specimen. (a) Right testicle, gross.


Testicular choriocarcinoma. Pathology/gross specimen. (b) Gross right testicle, incised to reveal large, centrally necrotic lesion.


Testicular choriocarcinoma. Pathology/gross specimen. (c) Histopathology reveals complete replacement of parenchyma with tumor and epididymal invasion.


Testicular choriocarcinoma. Pathology/gross specimen. (d) Histopathology reveals multinucleated syncytiotrophoblasts.


Testicular choriocarcinoma. Pathology/gross specimen. (e) Histopathology reveals tumor emboli.


Testicular choriocarcinoma. Postoperative Imaging. Computed tomography imaging of the chest reveals left lower lobe pulmonary embolism (arrow).


Magnetic resonance imaging. Right adrenal mass.


Adrenal tumor relapse with liver involvement.


Capsular invasion is seen by neoplastic adrenocortical cells.


Hepatic tissue infiltrated by neoplastic adrenocortical cells.


Esophagogastroduodenoscopy showing Borrmann type 3 gastric cancer at the antrum of the stomach.


Three-dimensional computed tomography of the stomach showing an ulceroinfiltrative gastric lesion in the mid to lower body along the lesser curvature with perigastric infiltration, which was diagnosed as T3 advanced gastric cancer.


Abdominopelvic computed tomography scan after 2 cycles of chemotherapy showing an interval-improved ulceroinfiltrative gastric lesion and marked regression of multiple enlarged conglomerated metastatic lymph nodes in the perigastric, gastrophepatic, splenic hilum, retropancreatic, porta hepatis, portocaval, and aortocaval portions.


F-18fluorodeoxyglucose positron emission tomography-computed tomography scan taken 12 months after the operation showing the disappearance of preoperatively noted left gastric, splenic hilum, left para-aortic, aortocaval, and retrocaval lymph nodes.


Positron emission tomography-computed tomography scan taken 16 months after the operation showing multiple lymph node metastasis, including the left supraclavicular, paratracheal, para-aortic, retrocaval areas as well as a bone metastasis in both femurs, the sacrum, lumbar 4th and 5th vertebrae, and the left 6th rib.


Esophago-gastro-duodenoscopy imaging.


Histopathological imaging of lesions from the esophagus.


CT imaging of the esophageal and surrounding tissues.


Fine-needle aspiration biopsies imaging from the metastases in the right ring finger.


Pathology imaging from the metastases in the right ring finger.


Radiological bone imaging.


(a and b) Clinical photograph at presentation.


Axial).


Coronal): CT scan showing a large destructive soft tissue lesion in the left maxillary sinus with extensions into the left nasal cavity, ethmoid and sphenoid sinus, left alveolus and hard palate. Extensions were also noted into the temporal fossa, soft tissues of the cheek, masticator spaces and inferior orbit.


(a and b) Clinical photograph post-chemoradiation.


(c and d) A post-therapy CT scan (after 6 months) showing only residual thickening of the left maxillary antrum.


Graphical representation of tumor marker and alkaline phosphatase over time. Tumor marker CA 27-29 levels after each treatment with radium-223 (Ra-223) dichloride.


Graphical representation of tumor marker and alkaline phosphatase over time. Serial alkaline phosphate (ALP) levels after each treatment with Ra-223 dichloride.


Imaging study with 18Na-F Bone PET/CT. 18NA-F bone PET/CT imaging studies at baseline, before administration of radium-223 (Ra-223) dichloride.


Imaging study with 18Na-F Bone PET/CT. 8NA-F bone PET/CT imaging studies after 2 treatments with Ra-223 dichloride but before the third treatment.


Oesophagogastroduodenoscopy images of the duodenum. Initially, white villi are sparsely observed in the second portion of the duodenum (A).


Oesophagogastroduodenoscopy images of the duodenum. Eight months later, the duodenal lymphangiectasia is unchanged (B).


Oesophagogastroduodenoscopy images of the duodenum. Endoscopy examinations performed six months.


Oesophagogastroduodenoscopy images of the duodenum. Twelve months. After radiotherapy show gradual progression of the lymphangiectasia.


Oesophagogastroduodenoscopy images of the gastric MALT lymphoma. A pale lesion with indistinct boundaries is noted under white light observation.


Oesophagogastroduodenoscopy images of the gastric MALT lymphoma. And magnifying observation with narrow-band imaging.


Oesophagogastroduodenoscopy images of the gastric MALT lymphoma. Endoscopic ultrasonography confirms that the lymphoma is confined to the gastric mucosal layer (C).


Oesophagogastroduodenoscopy images taken 55 months after radiotherapy show obviously worsened duodenal lymphangiectasia (A).


Magnifying observation shows dilated, whitish duodenal villi (B). The margins of the villi are distinct.


Magnifying observation with narrow-band imaging reveals elongated microvasculature within the villi (C).


Pathological images of the duodenal lymphangiectasia. Biopsy examination reveals dilated lymphatic duct in the duodenal villi.


Orthopantomogram.


Previous computed tomography.


Current computed tomography.


Paranasal sinus - skull.


Chest X-ray.


Extraoral examination.


Cone beam computed tomography.


Cone beam computed tomography-three-dimensional image.


Cone beam computed tomography-three-dimensional view.


Bony window created on posterior antral wall.


Enucleation.


Enucleation - mandibular lesion.


Enucleated lesions from maxilla and mandible.


Satellite cyst.


Histopathologic slide view.


Abdominal X-ray revealing multiple liquid-gas surfaces.


Colonoscopy confirming that the intestinal mucosa was smooth without ulcers or lumps.


Magnetic resonance imaging of pelvic cavity revealing the lower intestinal obstruction.


Abdominal computed tomography scan revealing lower intestinal obstruction.


Microscopic examination of the intestinal tumor demonstrating typical histological findings of squamous cell carcinoma (staining with hematoxylin and eosin). Magnification, x100.


Microscopic examination of the intestinal tumor demonstrating typical histological findings of squamous cell carcinoma (staining with hematoxylin and eosin). Magnification, x400.


A; CT scan of the abdomen and pelvis showing a left renal mass 13 cm in diameter with features suggestive of primary RCC.


MRI of the spine sagittal section showing anterior and posterior parallel thick lines of avid enhancement corresponding to the leptomeninges, which is highly abnormal and indicates leptomeningeal carcinomatosis.


A histopathological exam confirming papillary RCC.


CT scan in September 2010. Intravesical mass on the bladder dome.


Breast MRI with multiple nodes in February 2015.


At the end of the treatment in May 2015.


Clinical examination of patient's penile shaft and glans: Multiple firm skin-colored papules, some with exophytic crusting and underlying edema, present on the right side of the patient's penile shaft, immediately proximal to the glans.


Histopathological image following biopsy of patient's penile lesions: Histopathological staining from biopsy by punch technique of distal dorsal penile shaft shows dilated vascular channels consistent with benign lymphangioma of the penis.


The hematoxylin-eosin (H&E) and immunohistochemical pictures of the tumor. (A) H&E, original magnification, x100.


The hematoxylin-eosin (H&E) and immunohistochemical pictures of the tumor. (B) H&E, original magnification, x400.


The hematoxylin-eosin (H&E) and immunohistochemical pictures of the tumor. (C) Immunohistochemical staining for CD68.


The hematoxylin-eosin (H&E) and immunohistochemical pictures of the tumor. (D) Immunohistochemical staining for CD163.


The hematoxylin-eosin (H&E) and immunohistochemical pictures of the tumor. (E) Immunohistochemical staining for S100.


Imatinib could inhibit MAPK and PI3K/AKT pathways in vitro. (A-C) Cells were exposed to different concentrations of imatinib, thalidomide (THD), and imatinib + thalidomide. Cell viability was assessed using CCK8 assays after treatment for 24 h. Data were obtained from three independent experiments. *
p < 0.05, **
p < 0.01, ***
p < 0.001 vs. Each control group.


Imatinib could inhibit MAPK and PI3K/AKT pathways in vitro. (D) KEGG pathway enrichment analysis of gene mutations in patient.


Imatinib could inhibit MAPK and PI3K/AKT pathways in vitro. (E) Representative immunohistochemistry staining images of p-AKT, p-JNK, and p-ERK in patient's tumor tissues (magnification, x200).


Imatinib could inhibit MAPK and PI3K/AKT pathways in vitro. (F) Total proteins were collected from the treated DH82 cells, and Western blot analyses for the expression of p-AKT, AKT, p-JNK, JNK, p-ERK, and ERK were performed. GAPDH was used as a loading control. Data were obtained from three independent experiments. ***
p < 0.001 vs. Each control group.


Magnetic resonance imaging revealing solid, cystic, irregular, and space-occupying lesions in the left adnexal area and before the rectum, presenting long T2 signals and equal short T1 signals. The solid part of the diffusion-weighted imaging lesion shows high signal intensity with unclear boundaries, the cystic part shows the liquid level, enhanced scanning of the solid part reveals obvious heterogeneous enhancement, and the boundary between the lesion and adjacent structures is unclear.


(A) High-grade serous carcinoma is contiguous with endometriosis, infiltrating throughout the sub-serosa. H&E, x200.


(B) The black arrow area is the endometrial gland, and the red arrow area is the stroma.


Strong WT-1-positive staining of tumor cells. WT-1 (A).


Strong WT-1-positive staining of tumor cells. ER-positive staining of the endometrial glands and stromal cells (B). ER, estrogen receptor.


Normal eye, OD.


B-scan of both eyes. Longitudinal.


Transverse of OS showing diffuse choroidal thickening, and internal reflectivity representing a diffuse choroidal hemangioma with peripheral retinal detachment.


Pathologic findings: (A) the large-sized epithelioid tumor cells were arranged in a nest-like pattern, and they had wide cytoplasm with obvious atypia, large and clear cell nuclear, and nuclear fission. The pathologic diagnosis of the biopsy specimens was poorly differentiated lung adenocarcinoma (H&E, SP x200).


Immunohistochemical staining showed that tumor cells were positive for CK. SP x200), TTF-1 (focal positive.


SP x100).


NapsinA. SP x200).


Vimentin. SP x200).


Ki-67 was 60%. SP x100). SP, streptavidin-peroxidase.


Historical and current information from this episode of care organized as timeline. LADC, lung adenocarcinoma; MET, mesenchymal-epithelial transition factor; PR, partial response; PD, progressive disease; ILD, interstitial lung disease; Crizo, crizotinib; Crizo DC, crizotinib was discontinued.


Normalization of CD4:CD8 ratio followed by increase of CD3+ donor chimerism after alloHSCT confirming graft-vs-Sezary effect.


The superior pedicle seen under magnification.


Secured with sutures.


(a) Endoscopic view of dissection in the lateral compartment.


(b) The endoscope provides a magnified view of the parathyroids (white arrows).


The recurrent laryngeal nerve (white arrows) is seen during dissection.


After removal of the gland.


CT scan performed in February 2012, revealed a retroperitoneal mass.


Low-debit hemorrhage on the upper portion of the lesser curvature documented by endoscopy on November 27, 2012 between the endoscopic treatments.


HP identification (red circle) on gastric biopsy on December 7, 2012. Modified Giemsa staining. x900.


Documentation of radiotherapy response between by comparing the 18F-FDG PET-CT scans from October 2012 (left panel) and July 2013 (right panel).


Pre-operative T2-weighted.


T2-FLAIR weighted,enhanced axial, coronal.


Sagittal T1-weighted. Magnetic resonance images showed a heterogeneously enhancing solid mass in pineal gland region, extending into the bilateral thalamus and obliterating the third ventricle, with ventriculomegaly.


A flow chart showcased the timeline with relevant data from the episode of care (E).


H&E-stained sections showed the tumor was comprised of atypical glial tumor cells with vascular proliferation and necrosis (A).


Mitotic figures and perivascular pseudorosettes were easily identified (B).


Immunohistochemical sections presented positive expression of P53. ZM-0408, ZSGB-BIO).


CD99. ZM-0296, ZSGB-BIO).


GFAP. MXB Biotechnologies).


Syn. ZA-0506, ZSGB-BIO).


Olig-2. ZA-0561, ZSGB-BIO).


IDH1. ZM-0447, ZSGB-BIO).


The Ki-67 proliferative index was 30-40% (I, H10501, Ventata).


Negative expression of ATRX. ZA-0016, ZSGB-BIO) in the tumor.


Including multiple CXCL17 (Intergenic)-FGFR2 (Exon16-18).


FGFR2 (Exon1-16)-SIPA1L3 (Exon4-1).


FGFR2 (Exon1-16)-CEACAM1 (Intergenic). Fusions.


Hematoxylin, and ,eosin (H&E) stained section showing sheets of myoepithelial cells, and ,ductular structures lined with epithelial cells set in chondromyxoid stroma (H&E,. . X40.


Hematoxylin, and ,eosin (H&E) stained section showing sheets of myoepithelial cells, and ,ductular structures lined with epithelial cells set in chondromyxoid stroma (H&E,. . X100).


(C) Adjacent to the lesion, normal laryngeal cartilage can be seen (H&E, x100).


Immunohistochemistry indicates that the myoepithelial cells cytoplasm is focally positive for S100 protein . X100.


Glial fibrillary acidic protein (GFAP) . X100).


Chest computed tomography findings.


Mutational landscape of the three renal tumors in the patient's left kidney at first recurrence. We visualized the somatic mutation profiles of each tumor:angiomyolipoma (AML), clear cell renal cell carcinoma (RCC), and papillary RCC:as heat maps (black-colored genes indicate driver gene mutations in many cancer types). CDH11, Cadherin 11; CDK12, Cyclin Dependent Kinase 12; DICER1, Dicer 1; PABPC1, Poly(A) Binding Protein Cytoplasmic 1; PARP4, Poly(ADP-Ribose) Polymerase Family Member 4; PBRM1, Polybromo 1; POLQ, DNA Polymerase Theta; PTPN13, Protein Tyrosine Phosphatase Non-Receptor Type 13; PTPRK, Protein Tyrosine Phosphatase Receptor Type K; RET, Ret Proto-Oncogene; RPS3A, Ribosomal Protein S3A; SAMD3, Sterile Alpha Motif Domain Containing 3; SMARCA1, SWI/SNF Related, Matrix Associated, Actin Dependent Regulator Of Chromatin, Subfamily A, Member 1; SUSD2, Sushi Domain Containing 2; TSC1, TSC Complex Subunit 1; ZNF208, Zinc Finger Protein 208; ZNF721, Zinc Finger Protein 721.


CT slice through a primary caecal adenocarcinoma. The greatest dimension of the mass was 8 cm. The arrow indicates the cancer extension into the retroperitoneum. Colonoscopic biopsy showed a poorly differentiated cancer.


CT slice 4 months postoperatively through the upper abdomen. At the time of resection of recurrent cancer, tumor was located on the posterior surface of the liver. This anatomic site was a close margin of resection of the primary ascending colon cancer.


Breast MRI (2019.02.13).


Arterial phase computed tomography. The tumor showed no clear enhancement in this phase.


Venous phase computed tomography. The tumor showed marginal uneven enhancement in this phase.


Tumor was composed of small, elongated cords or tubules, in a tightly packed arrangement (hematoxylin and eosin; magnification, x10).


Myxoid stroma was interspersed among the tubular cells (hematoxylin and eosin; magnification, x40).


Tumor cells were smaller and cube-shaped or oval, with single small eosinophilic nucleoli and low-grade nuclei (hematoxylin and eosin; magnification, x40).


Myxoid stromal staining by acidic mucus (alcian blue; magnification, x40).


CK7 showed positive expression in tumoral cells (magnification, x20).


EMA showed positive expression in tumoral cells (magnification, x10).


Initial brain magnetic resonance imaging demonstrating a 3 cm, extra-axial mass along the right frontal convexity with some underlying edema and mild diffuse atrophy.


Formalin-fixed pathological specimen with brisk mitoses, small foci of necrosis rarely, and hypercellularity, all consistent with a World Health Organization Grade II or atypical meningioma.


Plain X-ray of the left clavicle demonstrating a mass lesion and adjacent pathological fracture.


Preoperative images. A : Chest PA imaging.


Preoperative images. B : Chest CT imaging reveals a right upper lobe mass (upper). PET imaging shows hypermetabolic lesion in the right upper lobe (lower). CT : computed tomography, PET : positron emission tomography.


Brain MR imaging (at present). The right frontal mass is iso- or hyperintense on the T2 weighted image and enhanced on the T2 weighted image. A calcification lesion is observed inside the mass on the CT scan image. MR : magnetic resonance.


Brain MR, and PET images show the increased size of the dural based mass (after 10 months). The size of the mass has suddenly increased. There are two round figures inside the mass which were not observed before compared to Fig. 1. The mass is hypointense on T2 weighted image, and heterogenously enhanced on T1 enhancing image. PET : positron emission tomography.


T1-weighted MRI scans with contrasts showing. Axial.


Coronal.


Sagittal images of the lesion.


Immunohistochemical stains of the biopsied tissue. CD68.


Immunohistochemical stains of the biopsied tissue. S100.


Immunohistochemical stains of the biopsied tissue. CD1a+ stains (original magnification, x100).


Electron micrograph of the biopsied tissue. Electron micrograph was of compromised quality as the thin sections were recovered from fixed paraffin embedded tissue. Membrane bound electron lucent vesicles suggestive of a component of Birbeck granules are seen within the histiocytes. The typical cross-striated rod domain is not as evident.


Diagnostic computerized tomography showing right lower lobe newly diagnosed non-small cell lung cancer.


The brain and cervical spine magnetic resonance imaging were normal at the first investigation (a).


After 7 months sagittal T1-weighted contrast-enhanced magnetic resonance imaging of brain and spine demonstrated a hypertensive hydrocephalus, leptomeningeal enhancement, and contrast-enhanced masses throughout the cervicothoracic spinal cord surfaces (b).


The anatomopathological and immunohistochemical study showed a hypercellular malignant spindle cell tumor with a high mitotic index and moderate pleomorphism in a nerve root, compatible with a malignant peripheral nerve sheath tumor.


Intraoral swelling on the palate having intact margins.


Gross specimen measuring 1.5 cm x 1.5 cm x 1 cm.


Histopathological image showing a well-circumscribed lesion composed of multiple cystic spaces (H&E, x40).


Histopathological image showing tumor stroma showing large number of cystic spaces having keratotic lamellae and lined by squamous cells (H&E, x200).


Histopathological image showing tumor stroma having numerous gland-like tubular structures (H&E, x100).


Histopathological image showing tumor stroma showing tumor cells composed of basaloid, plasmacytoid and angular cells (H&E, x400).