Search Our Scientific Publications & Authors

Clin Nucl Med 2021 Jul;46(7):e355-e357

Abstract: A 55-year-old man with cough, bone pain, and cervical lymphadenopathy underwent both 18F-FDG and 18F-PSMA-1007 PET/CT scans with clinical suspicion of malignant disease. Compared with 18F-FDG PET/CT, 18F-PSMA PET/CT showed intense tracer uptake in the prostate gland, lungs, osteogenic lesions, and multiple lymph nodes. Interestingly, we also found the high tracer concentration of pulmonary lymphangitic carcinomatosis, a very rare form of prostate cancer metastasis to the lung, on 18F-PSMA-1007 PET/CT images. Read More

Clin Radiol 2021 Jun 7;76(6):399-406. Epub 2021 Feb 7.

Department of Radiology, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA. Electronic address:

With the advent of high-resolution computed tomography (HRCT), micronodular lung disease is a routinely encountered pathology in thoracic imaging. This article will review how to differentiate the three main micronodular patterns and review the differential diagnosis for each. Differential diagnosis of micronodular lung disease may be extensive, but by identifying the pattern and using additional clues, such as distribution, additional imaging findings, and clinical history, a radiologist can make an accurate diagnosis. Read More

BMJ Case Rep 2021 Feb 4;14(2). Epub 2021 Feb 4.

Hematology/Oncology, UF Health Cancer Center-Orlando Health, Orlando, Florida, USA.

Multiple endocrine neoplasia type 2B (MEN2B) is the rarest and most aggressive of the MEN syndromes. It is characterised by medullary thyroid cancer (MTC), pheochromocytoma, marfanoid body habitus, mucosal neuromas and colonic dysfunction. Patients typically present with chronic constipation and MTC in early childhood. Read More

Gastrointest Endosc 2021 May 21;93(5):1185-1186. Epub 2021 Jan 21.

Mayo Clinic Arizona, Phoenix, Arizona, USA.

J Pancreat Cancer 2020 16;6(1):102-106. Epub 2020 Nov 16.

Division of Oncology, Department of Medicine, Stanford University, Stanford, California, USA.

The CA 19-9 tumor marker is commonly used alongside imaging to trend chemotherapy response in patients with pancreatic ductal adenocarcinoma. We describe an unusual clinical case of metastatic pancreatic cancer who achieved a marked decline in CA 19-9 but paradoxically developed widespread pulmonary lymphangitic carcinomatosis leading to rapid clinical decline and death. This case highlights the limitations of using the CA 19-9 tumor marker in isolation. Read More

Respir Med Case Rep 2020 28;31:101240. Epub 2020 Sep 28.

Mount Sinai Medical Center, Miami Beach, 33140, FL, USA.

Collecting duct carcinoma is a rare neoplasm of the kidney, accounting for only 1-2% of renal tumors. These tumors arise from the principal cells of the renal collecting ducts of Bellini. The majority of patients have lymph node involvement and metastases to lungs, liver, bone, adrenal glands, and brain. Read More

Pediatr Radiol 2021 01 23;51(1):131-139. Epub 2020 Sep 23.

Pediatric Imaging, Mallinckrodt Institute of Radiology, Washington University in St. Louis, 510 S. Kingshighway, Campus Box 8131, St. Louis, MO, 63110, USA.

Pulmonary metastases typically present as well-circumscribed solid nodules, often with a basilar and peripheral distribution due to hematogenous spread. When an atypical pattern of metastasis occurs, a lack of recognition may result in understaging or a delay in diagnosis. The purpose of this article is to review the imaging findings of atypical pulmonary metastatic disease in children. Read More

Int J Surg Case Rep 2020 13;72:322-325. Epub 2020 Jun 13.

Division of Anatomical Pathology, Faculty of Health Sciences, University of Cape Town and National Health Laboratory Service - Red Cross War Memorial Children's Hospital, Cape Town, South Africa. Electronic address:

Introduction: Papillary thyroid carcinoma (PTC) is the most common carcinoma to occur in childhood with a peak incidence between 11-17 years, and typically presents with advanced locoregional disease. Pulmonary metastases are seen in up to 46% of cases and should enter the differential diagnosis of miliary nodules seen on chest roentgenogram, even in regions where tuberculosis is endemic.

Presentation Of Case: An 11-year-old male presented with a short history of cough, shortness of breath and constitutional symptoms. Read More

Clin Nucl Med 2020 Sep;45(9):727-729

Department of Oncology, Western University, London, Ontario, Canada.

A 51-year-old man diagnosed with high-grade, high-volume metastatic castration-sensitive prostate adenocarcinoma received pelvic radiation, androgen deprivation therapy, and intravenous docetaxel. Serum prostate-specific antigen became undetectable following treatment. Within a year, his cancer progressed to castration-resistant disease, and he was treated with oral abiraterone acetate 1000 mg and prednisone 10 mg daily. Read More

Cancers (Basel) 2020 Mar 15;12(3). Epub 2020 Mar 15.

Massachusetts General Hospital Cancer Center and Department of Medicine, Massachusetts General Hospital, Boston, MA 02114, USA.

Rearranged during transfection proto-oncogene () fusions represent a potentially targetable oncogenic driver in non-small cell lung cancer (NSCLC). Imaging features and metastatic patterns of advanced fusion-positive (+) NSCLC are not well established. Our goal was to compare the imaging features and patterns of metastases in +, + and + NSCLC. Read More

J Thorac Dis 2019 Nov;11(11):E239-E242

Division of Thoracic Imaging and Intervention, Department of Radiology, Massachusetts General Hospital, Boston, MA, USA.

AJR Am J Roentgenol 2020 04 30;214(4):766-774. Epub 2019 Dec 30.

Department of Radiology, Massachusetts General Hospital, 55 Fruit St, Founders 202, Boston, MA 02114.

rearrangements are an established targetable oncogenic driver in non-small cell lung cancer (NSCLC). The goal of this study was to determine the imaging features of the primary tumor and metastatic patterns in advanced -rearranged (+) NSCLC that may be different from those in -mutant (+) or wild-type (-/-) NSCLC. Patients with advanced +, +, or NSCLC were retrospectively identified. Read More

In Vivo 2020 Jan-Feb;34(1):315-319

Veterans Affairs North Texas Healthcare System, Dallas, TX and Division of Hematology/Oncology, University of Texas Southwestern Medical Center, Dallas, TX, U.S.A.

Osimertinib is an oral, irreversible epidermal growth factor receptor inhibitor that is associated with various pulmonary manifestations including transient asymptomatic pulmonary opacities (TAPOs) and pneumonitis. We present a case of a 61-year-old female with Stage IV lung adenocarcinoma, who developed bilateral ground glass opacities on her chest-computed tomography (CT) three months after initiating osimertinib. Her imaging findings were thought to represent lymphangitic carcinomatosis responding to chemotherapy rather than drug induced toxicity, and she was continued on osimertinib. Read More

Clin Lung Cancer 2020 03 16;21(2):153-159.e3. Epub 2019 Oct 16.

Massachusetts General Hospital Cancer Center and Department of Medicine, Massachusetts General Hospital, Boston, MA.

Background: ROS proto-oncogene 1 (ROS1) rearrangements are a known molecular target in non-small-cell lung cancer (NSCLC). Our goal was to determine whether ROS1-rearranged NSCLC has imaging features and patterns of metastasis, which differ from those of anaplastic lymphoma kinase (ALK)-rearranged or epidermal growth factor receptor (EGFR)-mutant NSCLC.

Patients And Methods: We retrospectively identified patients with metastatic ROS1-rearranged, ALK-rearranged, or EGFR-mutant NSCLC from January 2014 to June 2018 and included those with pretreatment imaging studies available. Read More

Radiol Case Rep 2019 Dec 17;14(12):1500-1505. Epub 2019 Oct 17.

Department of Radiology, Eastern Virginia Medical School, P.O. Box 1980, Norfolk, VA 23501, USA.

While metastatic disease to the breast has been documented from many primary neoplasms with incidence ranging from 0.2% to approximately 2.7% among reported clinical cases, breast cancer metastases resulting from a primary lung neoplasm is significantly less commonly reported in the literature. Read More

Medicine (Baltimore) 2019 Oct;98(41):e17446

Department of Nuclear Medicine, West China Hospital, Sichuan University, Chengdu City, Sichuan Province, China.

Rationale: The infiltration of tumor cells to pulmonary lymphatic system, as known as pulmonary lymphangitis carcinomatosis (PLC), is a rare presentation of pulmonary metastases.

Patient Concerns: We reported a case of a 66-year-old man after surgery, chemotherapy, and radiation therapy for colon cancer. Two months after these therapies, the patient complained of nonproductive cough for 1 week. Read More

Clin Nucl Med 2020 Jan;45(1):e15-e19

From the Department of Nuclear Medicine, AIIMS, New Delhi, India.

Bilateral lung parenchymal involvement is seen in infective as well as noninfective conditions, appearing as focal or diffuse lung disease. PET/CT with FDG helps in characterization (increased glucose utilization is seen by both inflammatory and neoplastic cells). In this article, we describe the spectrum of patterns of FDG uptake and associated CT changes involving bilateral lung parenchyma. Read More

Clin Imaging 2019 Nov - Dec;58:187-190. Epub 2019 Aug 13.

Department of Radiology, UT Southwestern Medical Center, 5323 Harry Hines Blvd., Dallas, TX 75390, United States of America. Electronic address:

Breast cancer typically spreads primarily to regional lymph nodes and subsequently to distant sites via hematogenous routes. Occasionally metastasis can occur through lymphangitic spread, usually to the lungs, resulting in lymphangitic carcinomatosis. Lymphangitic spread of several malignancies have been reported at other sites in the body with varying degrees of clinical significance. Read More

AJR Am J Roentgenol 2019 11 15;213(5):1059-1072. Epub 2019 Aug 15.

Department of Radiology and Research Institute of Radiology, Asan Medical Center, Seoul, Korea.

The purpose of this study was to perform a systematic review and meta-analysis regarding CT features of non-small cell lung cancer (NSCLC) with anaplastic lymphoma kinase (ALK) rearrangement. The PubMed and Embase databases were searched up to February 20, 2019. Studies that evaluated CT features of NSCLC with and without ALK rearrangement was included. Read More

J Nucl Med 2020 01 21;61(1):26-32. Epub 2019 Jun 21.

Department of Nuclear Medicine and Molecular Imaging, Lausanne University Hospital, Lausanne, Switzerland.

The rationale of this study was to investigate the performance of high-resolution CT (HRCT) versus F-FDG PET/CT for the diagnosis of pulmonary lymphangitic carcinomatosis (PLC). In this retrospective institution-approved study, 94 patients addressed for initial staging of lung cancer with suspicion of PLC were included. Using double-blind analysis, we assessed the presence of signs favoring PLC on HRCT (smooth or nodular septal lines, subpleural nodularity, peribronchovascular thickening, satellite nodules, lymph node enlargement, and pleural effusion). Read More

Clin Lung Cancer 2019 09 11;20(5):339-349. Epub 2019 May 11.

Department of Radiology, Massachusetts General Hospital, Boston, MA. Electronic address:

Introduction: Several studies have suggested that non-small-cell lung cancer (NSCLC) patients who harbor anaplastic lymphoma kinase (ALK) rearrangement might have different imaging features compared with those without the rearrangement. The goal of this work was to systematically investigate the computed tomography (CT) imaging features of ALK-rearranged NSCLC.

Materials And Methods: We searched published studies that investigated CT imaging features of ALK-rearranged NSCLC compared with ALK-negative, including epidermal growth factor receptor (EGFR)-mutant and ALK/EGFR-negative, NSCLC. Read More

Lung Cancer 2019 06 26;132:94-98. Epub 2019 Mar 26.

University of Pennsylvania Perelman School of Medicine, Philadelphia, PA, United States. Electronic address:

Introduction: The lymphangitic carcinomatosis (LC) pattern of metastatic malignancy is associated with a poor prognosis but is currently not well defined in malignant pleural mesothelioma (MPM). Here, we report the incidence and prognostic significance of the radiographic development of LC in MPM following extended pleurectomy/decortication (EPD).

Methods: Consecutive patients with biopsy-proven MPM undergoing EPD with intraoperative photodynamic therapy (PDT) at our institution from 2008 to 2014 were included in this retrospective study. Read More

J Med Case Rep 2018 Dec 15;12(1):369. Epub 2018 Dec 15.

Department of Maternal-Fetal Medicine Pregnancy Research Centre, Royal Women's Hospital, Parkville, Australia.

Background: Gestational diabetes mellitus is strongly related to the risk of pancreatic cancer in pregnant women, but gestational diabetes can precede a diagnosis of pancreatic cancer by many years. Women with a history of gestational diabetes showed a relative risk of pancreatic cancer of 7.1. Read More

Intern Med 2018 Sep 18;57(18):2709-2712. Epub 2018 May 18.

Department of Respiratory Medicine, Allergy and Clinical Immunology, Nagoya City University Graduate School of Medical Sciences, Japan.

A 36-year old man was referred to our hospital due to isolated chronic cough that was refractory to anti-asthma medications, including inhaled corticosteroids/long-acting β agonists. Chest X-ray showed diffuse nodular and enhanced vascular shadows with Kerley lines in both lungs. A blood analysis showed elevated serum carcinoembryonic antigen (CEA) and CA19-9 levels. Read More

BMC Cancer 2018 03 16;18(1):300. Epub 2018 Mar 16.

Department of Radiology, Japanese Red Cross Kochi Hospital, 2-13-51, Shinhonmachi, Kochi-city, Kochi, 780-8562, Japan.

Background: Acantholytic squamous cell carcinoma (ASQCC), histologically characterized by intercellular bridge loosening, is recognized as a rare variant of squamous cell carcinoma (SQCC). ASQCC may demonstrate a worse prognosis than conventional SQCC. Pulmonary ASQCC is particularly rare; its biological behavior and prognostic data have not been reported. Read More

Urology 2018 Apr 29;114:e1-e2. Epub 2017 Dec 29.

Department of Nuclear Medicine, Royal Brisbane and Women's Hospital, Brisbane, Queensland, Australia.

Lymphangitic carcinomatosis refers to the rare process of diffuse malignant invasion of the pulmonary lymphatics. We describe the first reported case of lymphangitic carcinomatosis visualized with gallium-68 prostate-specific membrane antigen positron emission tomography and its clinical significance in a 53-year-old man with prostate carcinoma. This case highlights the ability of gallium-68 prostate-specific membrane antigen positron emission tomography for prostate carcinoma characterization and the importance of always considering atypical patterns of metastatic disease. Read More

Pediatr Radiol 2017 Nov 8;47(12):1615-1621. Epub 2017 Jul 8.

Mallinckrodt Institute of Radiology, Washington University School of Medicine, 510 S. Kingshighway, Campus Box 8131, St. Louis, MO, 63110, USA.

Background: Renal medullary carcinoma is a rare renal malignancy of childhood. There are no large series describing the imaging appearance of renal medullary carcinoma in children.

Objective: To characterize the clinical and imaging features of pediatric renal medullary carcinoma at initial presentation. Read More

World J Clin Oncol 2017 Jun;8(3):285-288

Virginia W Osborn, Andrea Leaf, Anna Lee, Elizabeth Garay, Joseph Safdieh, David Schwartz, David Schreiber, Veterans Affairs New York Harbor Healthcare System, Brooklyn, NY 11209, United States.

We are reporting a case of fatal radiation pneumonitis that developed six months following chemoradiation for limited stage small cell lung cancer. The patient was a 67-year-old man with a past medical history of Hashimoto's thyroiditis and remote suspicion for CREST, neither of which were active in the years leading up to treatment. He received 6600 cGy delivered in 200 cGy daily fractions intensity modulated radiation therapy with concurrent cisplatin/etoposide followed by additional chemotherapy with dose-reduced cisplatin/etoposide and carboplatin/etoposide and then received prophylactic cranial irradiation. Read More

Medicine (Baltimore) 2016 Nov;95(47):e5426

Department of Radiology, CHA Bundang Medical Center, CHA University, Yatap-dong, Bundang-gu, Seongnam-si, Gyeonggi-do Department of Radiology, St. Mary Dain Hospital, Mangpo-dong, Youngtong-gu, Suwon-si Department of Radiology, Seoul National University Hospital, Daehak-ro, Jongno-gu, Seoul, Republic of Korea.

The purpose of this study was to clarify the recognizable computed tomography (CT) features of small cell lung carcinoma (SCLC).Contrast enhanced CT scans were reviewed retrospectively for mass location, mediastinal extension, and other concomitant findings in 142 patients with pathologically proven SCLC. SCLC was classified into hilar mass only (type I), hilar mass with ipsilateral mediastinal extension (type II), hilar mass with bilateral mediastinal extension (type III), and peripheral mass (type IV). Read More

BJR Case Rep 2016 2;2(4):20150171. Epub 2016 Nov 2.

Southampton University Hospital NHS Trust, Southampton, UK.

This report highlights the diagnostic complexities involved in the case of a 63-year-old female who presented with a non-productive cough and shortness of breath on exertion. Initial chest radiograph demonstrated generalized abnormal interstitial lung markings with thickened peripheral septal lines. Further characterization was sought by CT scan of the chest, and given the possibility of lymphangitic carcinomatosis, a CT scan of the abdomen and pelvis was also performed. Read More