The patient was a 60-year-old woman who had visited a clinic with the chief complaint of a mass in the right breast prior to being referred to our hospital. Breast examination revealed the presence of a 3-cm hard elastic mass in the C region of the right breast. Computed tomography (CT) further indicated metastases to the liver and lungs. Upon needle biopsy of the primary tumor, the patient was diagnosed with triple-negative (ER (-), PgR (-), HER2 (-)) invasive lobular carcinoma. Chemotherapy was successful in achieving a transient partial response (PR); however, the tumor later advanced to a progressive disease (PD) after five cycles of oral fluoropyrimidine derivative therapy (S-1). Re-biopsy of the primary tumor revealed that the tumor was triple-positive (ER (+), PgR (+), HER2 (+)). The patient was subsequently treated with anti-HER2 therapy and has since achieved complete response (CR). Although biological changes sometimes occur from the primary to the metastatic tumor, changes in the primary tumor itself during the course of treatment is a rare event. Furthermore, the transition from triple-negative to triple-positive status is very uncommon. Re-biopsy rarely changes the biological characteristics of a tumor; however, biological changes can have a significant impact on treatment if they do occur. Thus, it is important to perform a re-biopsy if the current treatment results in PD.
{"title":"Change from triple negative type to triple positive type: A case report of discordance of re-biopsy from primary breast cancer","authors":"","doi":"10.36879/jcmi.20.000126","DOIUrl":"https://doi.org/10.36879/jcmi.20.000126","url":null,"abstract":"The patient was a 60-year-old woman who had visited a clinic with the chief complaint of a mass in the right breast prior to being referred to our\u0000hospital. Breast examination revealed the presence of a 3-cm hard elastic mass in the C region of the right breast. Computed tomography (CT)\u0000further indicated metastases to the liver and lungs. Upon needle biopsy of the primary tumor, the patient was diagnosed with triple-negative (ER\u0000(-), PgR (-), HER2 (-)) invasive lobular carcinoma. Chemotherapy was successful in achieving a transient partial response (PR); however, the\u0000tumor later advanced to a progressive disease (PD) after five cycles of oral fluoropyrimidine derivative therapy (S-1). Re-biopsy of the primary\u0000tumor revealed that the tumor was triple-positive (ER (+), PgR (+), HER2 (+)). The patient was subsequently treated with anti-HER2 therapy\u0000and has since achieved complete response (CR). Although biological changes sometimes occur from the primary to the metastatic tumor, changes\u0000in the primary tumor itself during the course of treatment is a rare event. Furthermore, the transition from triple-negative to triple-positive status\u0000is very uncommon. Re-biopsy rarely changes the biological characteristics of a tumor; however, biological changes can have a significant impact\u0000on treatment if they do occur. Thus, it is important to perform a re-biopsy if the current treatment results in PD.","PeriodicalId":91401,"journal":{"name":"SM journal of clinical and medical imaging","volume":"4 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2020-12-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"74430959","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Objectives: Dixon sequence is a chemical shift-based MR sequence that produces four sets of images (water only, fat only, in-phase, and out-of-phase) images and is currently being used in various musculoskeletal applications. The aim of this study was to test the sensitivity of detection and determine the extent of the lesion on the Dixon imaging versus conventional proton density weighted (PDW) imaging in the domain of bone stress injury (BSI) and obtain inter-reader performance. Methods: In this retrospective cross-sectional study, 32 consecutive BSI were compared on conventional imaging versus different Dixon images in terms of area of bone marrow edema, inter-trabecular fracture detection and fracture conspicuity. Inter-reader reliability was also evaluated. p<0.05 was considered statistically significant. Results: The Dixon imaging showed excellent quality except two cases with some motion degradation. BSI detection on Dixon water image is equivalent to the routine fat suppressed fluid sensitive intermediate weighted sequence. BSI area on water image is not significantly different from the intertrabecular lesion area on opposed-phase imaging (p=0.9531). The opposed-phase images detected more number of fractures than the water, PDW, & in-phase images (p<0.0001, =0.0008, and <0.0001, respectively) with superior fracture conspicuity than the water, PDW, & in-phase images (p value <0.0001, =0.0085, and =0.0035, respectively). Fair to moderate inter-reader agreement was seen. Conclusions: Dixon imaging is as sensitive as conventional fat suppressed fluid sensitive imaging of the knee for the identification of bone bruise with superior detection and improved characterization of the intertrabecular fractures. Advances in knowledge: In the domain of bone stress injury (BSI), Dixon opposed-phase MR images detect more number of fractures with better conspicuity than water-only, PDW, and in-phase images.
{"title":"Dixon Imaging of Bone stress injury of knee- comparison to conventional Intermediate-weighted MR imaging","authors":"","doi":"10.36879/jcmi.20.000125","DOIUrl":"https://doi.org/10.36879/jcmi.20.000125","url":null,"abstract":"Objectives: Dixon sequence is a chemical shift-based MR sequence that produces four sets of images (water only, fat only, in-phase,\u0000and out-of-phase) images and is currently being used in various musculoskeletal applications. The aim of this study was to test the\u0000sensitivity of detection and determine the extent of the lesion on the Dixon imaging versus conventional proton density weighted\u0000(PDW) imaging in the domain of bone stress injury (BSI) and obtain inter-reader performance.\u0000Methods: In this retrospective cross-sectional study, 32 consecutive BSI were compared on conventional imaging versus different\u0000Dixon images in terms of area of bone marrow edema, inter-trabecular fracture detection and fracture conspicuity. Inter-reader\u0000reliability was also evaluated. p<0.05 was considered statistically significant.\u0000Results: The Dixon imaging showed excellent quality except two cases with some motion degradation. BSI detection on Dixon\u0000water image is equivalent to the routine fat suppressed fluid sensitive intermediate weighted sequence. BSI area on water image is\u0000not significantly different from the intertrabecular lesion area on opposed-phase imaging (p=0.9531). The opposed-phase images\u0000detected more number of fractures than the water, PDW, & in-phase images (p<0.0001, =0.0008, and <0.0001, respectively) with\u0000superior fracture conspicuity than the water, PDW, & in-phase images (p value <0.0001, =0.0085, and =0.0035, respectively). Fair\u0000to moderate inter-reader agreement was seen.\u0000Conclusions: Dixon imaging is as sensitive as conventional fat suppressed fluid sensitive imaging of the knee for the identification of\u0000bone bruise with superior detection and improved characterization of the intertrabecular fractures.\u0000Advances in knowledge: In the domain of bone stress injury (BSI), Dixon opposed-phase MR images detect more number of fractures\u0000with better conspicuity than water-only, PDW, and in-phase images.","PeriodicalId":91401,"journal":{"name":"SM journal of clinical and medical imaging","volume":"13 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2020-09-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"78217290","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Erythema multiforme (EM) is an acute, self-limiting, mucocutaneous disease. While the histopathologic and immunopathologic feature of EM is not highly specific, the diagnosis is mainly based on the etiology and clinical manifestations. This report presented a patient whose clinical investigation indicated EM while histopathology suggested lichenoid mucositis. Considering the classic oral and skin presentation matching EM, as well as the acute onsite and spontaneous resolution of the lesions, the diagnosis highly favored EM. The immunofluorescent findings might suggest a potential common pathologic process on EM and lichenoid mucositis, which requires further investigation.
{"title":"Erythema multiforme complicated with lichenoid mucositis: A case report","authors":"","doi":"10.36879/jcmi.20.000124","DOIUrl":"https://doi.org/10.36879/jcmi.20.000124","url":null,"abstract":"Erythema multiforme (EM) is an acute, self-limiting, mucocutaneous disease. While the histopathologic and immunopathologic\u0000feature of EM is not highly specific, the diagnosis is mainly based on the etiology and clinical manifestations. This report presented\u0000a patient whose clinical investigation indicated EM while histopathology suggested lichenoid mucositis. Considering the classic oral\u0000and skin presentation matching EM, as well as the acute onsite and spontaneous resolution of the lesions, the diagnosis highly favored\u0000EM. The immunofluorescent findings might suggest a potential common pathologic process on EM and lichenoid mucositis, which\u0000requires further investigation.","PeriodicalId":91401,"journal":{"name":"SM journal of clinical and medical imaging","volume":"10 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2020-08-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"80993356","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Tuberculosis is a global public health problem and is among the top ten causes of mortality in the world. We present the unusual case of a 37-year-old woman, referred for fever, progressive headache, nausea, vomiting and change in mental status. Brain imaging studies. showed a left frontal brain abscess with subfalcin herniation. As an urgent procedure, surgical drainage of the brain abscess was performed, and in the culture of pus there was growth of an anaerobic Streptococcus. The histopathological study of the abscess wall showed data on tuberculosis. The patient was pregnant at surgery, for about five weeks and received anti-tuberculous medications with close maternal fetal follow-up. Pregnancy came to term and was resolved by an elective cesarean section, both mother and child had a favorable evolution.
{"title":"Mixed brain abscess due to Streptococcus and Tuberculosis in a pregnant woman with favorable evolution. A case report","authors":"","doi":"10.36879/jcmi.20.000123","DOIUrl":"https://doi.org/10.36879/jcmi.20.000123","url":null,"abstract":"Tuberculosis is a global public health problem and is among the top ten causes of mortality in the world. We present the unusual\u0000case of a 37-year-old woman, referred for fever, progressive headache, nausea, vomiting and change in mental status. Brain imaging\u0000studies. showed a left frontal brain abscess with subfalcin herniation. As an urgent procedure, surgical drainage of the brain abscess\u0000was performed, and in the culture of pus there was growth of an anaerobic Streptococcus. The histopathological study of the abscess\u0000wall showed data on tuberculosis. The patient was pregnant at surgery, for about five weeks and received anti-tuberculous medications\u0000with close maternal fetal follow-up. Pregnancy came to term and was resolved by an elective cesarean section, both mother and child\u0000had a favorable evolution.","PeriodicalId":91401,"journal":{"name":"SM journal of clinical and medical imaging","volume":"24 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2020-07-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"80041335","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Cryoablation as a locoregional treatment for cancer has seen great advances over the past century. As a local thermal ablative method, cryoablation is unique in that it preserves tumor associated antigens, releasing them into the circulation and allowing the immune system to mount a targeted, systemic anti-cancer response in a phenomenon known as the abscopal effect. Advances in our understanding of tumor biology and cancer immunology have simultaneously led to the development of various anti-cancer immunotherapies. Whether through stimulating an immune response or inhibiting immunosuppression, these therapies have demonstrated efficacy in the treatment of numerous cancers and represent a new frontier in cancer treatment. In recent years, several pre-clinical and clinical studies have sought to elucidate the potential synergy between combination immunotherapy and cryoablation with the hope of augmenting the abscopal effect. This emerging field of “cryoimmune” therapy, although still in its infancy, represents an exciting new direction in cancer treatment.
{"title":"History and evolution of immunotherapeutic effect of cryoablation of solid tumors","authors":"","doi":"10.36879/jcmi.20.000121","DOIUrl":"https://doi.org/10.36879/jcmi.20.000121","url":null,"abstract":"Cryoablation as a locoregional treatment for cancer has seen great advances over the past century. As a local thermal ablative method,\u0000cryoablation is unique in that it preserves tumor associated antigens, releasing them into the circulation and allowing the immune system to\u0000mount a targeted, systemic anti-cancer response in a phenomenon known as the abscopal effect. Advances in our understanding of tumor biology\u0000and cancer immunology have simultaneously led to the development of various anti-cancer immunotherapies. Whether through stimulating an\u0000immune response or inhibiting immunosuppression, these therapies have demonstrated efficacy in the treatment of numerous cancers and\u0000represent a new frontier in cancer treatment. In recent years, several pre-clinical and clinical studies have sought to elucidate the potential\u0000synergy between combination immunotherapy and cryoablation with the hope of augmenting the abscopal effect. This emerging field of\u0000“cryoimmune” therapy, although still in its infancy, represents an exciting new direction in cancer treatment.","PeriodicalId":91401,"journal":{"name":"SM journal of clinical and medical imaging","volume":"6 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2020-03-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"72871775","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"An uncommon cause for mitralization of the heart: Graves' disease","authors":"","doi":"10.36879/jcmi.20.000120","DOIUrl":"https://doi.org/10.36879/jcmi.20.000120","url":null,"abstract":"","PeriodicalId":91401,"journal":{"name":"SM journal of clinical and medical imaging","volume":"35 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2020-02-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"87138860","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Adenomatoid hyperplasis of the soft palate","authors":"","doi":"10.36879/jcmi.20.000110","DOIUrl":"https://doi.org/10.36879/jcmi.20.000110","url":null,"abstract":"","PeriodicalId":91401,"journal":{"name":"SM journal of clinical and medical imaging","volume":"23 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2020-01-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"85091871","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Raccoon eyes-A case study","authors":"","doi":"10.36879/jcmi.19.000118","DOIUrl":"https://doi.org/10.36879/jcmi.19.000118","url":null,"abstract":"","PeriodicalId":91401,"journal":{"name":"SM journal of clinical and medical imaging","volume":"7 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2019-04-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"79723256","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Visualization of neuronal dendrites in human-derived cerebral organoids for use in studies of neurotoxicity","authors":"","doi":"10.36879/jcmi.19.000117","DOIUrl":"https://doi.org/10.36879/jcmi.19.000117","url":null,"abstract":"","PeriodicalId":91401,"journal":{"name":"SM journal of clinical and medical imaging","volume":"41 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2019-04-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"81952036","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Intrathoracic lipoblastoma in a 4-year-old male. A case report","authors":"","doi":"10.36879/jcmi.19.000116","DOIUrl":"https://doi.org/10.36879/jcmi.19.000116","url":null,"abstract":"","PeriodicalId":91401,"journal":{"name":"SM journal of clinical and medical imaging","volume":"1 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2019-03-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"73558187","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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