Search Our Scientific Publications & Authors

BMJ Case Rep 2022 Apr 8;15(4). Epub 2022 Apr 8.

Department of Obstetrics and Gynaecology, Division of Gynaecology, Taipei Veterans General Hospital, Taipei, Taiwan

Primary vaginal neuroendocrine tumours are extremely rare but aggressive. We report a case of primary poorly differentiated vaginal carcinoma with focal neuroendocrine differentiation. The clinical stage was cT3N1M0, FIGO stage III. Read More

Curr Oncol 2022 03 10;29(3):1890-1901. Epub 2022 Mar 10.

Department of Hygiene, "Victor Babeș" University of Medicine and Pharmacy, Bd. Victor Babes No. 16, 300226 Timisoara, Romania.

The safety profile and effectiveness of existing anti-HER2-targeted therapies have not been evaluated in patients with breast cancer and visceral crisis. We report the case of a 26-year-old woman who was diagnosed with advanced HER2-positive breast cancer and initially treated with curative intent therapy in a neoadjuvant setting, using Trastuzumab and Pertuzumab in combination with Docetaxel; her cancer recurred two years later, with liver metastases and pulmonary lymphangitic carcinomatosis, causing visceral crisis. Furthermore, the patient's clinical status worsened when she developed respiratory failure, hepatomegaly and a severe hepatocytolysis. Read More

Transl Lung Cancer Res 2021 Nov;10(11):4130-4140

Division of Pulmonary and Critical Care Medicine, Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea.

Background: The eighth edition of the TNM classification for lung cancer does not provide a definite guideline for pulmonary lymphangitic carcinomatosis. The purpose of this retrospective case-control study is to evaluate the prognosis of pulmonary lymphangitic carcinomatosis in patients with non-small cell lung cancer compared with those with intrapulmonary metastases.

Methods: Non-small cell lung cancer (NSCLC) patients with pulmonary lymphangitic carcinomatosis detected on chest computed tomography scan during staging evaluation between 2000 and 2016 were included. Read More

Jpn J Radiol 2022 Apr 9;40(4):367-375. Epub 2021 Nov 9.

Department of Radiology, Graduate School of Medical Science, University of the Ryukyus, 207 Uehara, Nishihara-cho, Nakagami-Gun, Okinawa, 903-0215, Japan.

Purpose: Kerley A-lines are generally apparent in patients with pulmonary edema or lymphangitic carcinomatosis. There are two main thoughts regarding the etiology of Kerley A-lines, but no general agreement. Specifically, the lines are caused by thickened interlobular septa or dilated anastomotic lymphatics. Read More

Cancers (Basel) 2021 Jul 16;13(14). Epub 2021 Jul 16.

Department of Radiology, Division of Thoracic Imaging and Intervention, Massachusetts General Hospital, Boston, MA 02114, USA.

KRAS G12C mutations are important oncogenic mutations that confer sensitivity to direct G12C inhibitors. We retrospectively identified patients with KRAS+ NSCLC from 2015 to 2019 and assessed the imaging features of the primary tumor and the distribution of metastases of G12C NSCLC compared to those of non-G12C KRAS NSCLC and NSCLC driven by oncogenic fusion events (RET, ALK, ROS1) and EGFR mutations at the time of initial diagnosis. Two hundred fifteen patients with KRAS+ NSCLC (G12C: 83; non-G12C: 132) were included. Read More

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

Curr Probl Diagn Radiol 2021 Jan - Feb;50(1):104-107. Epub 2018 Jul 23.

University of Florida, Division of Pulmonary, Critical Care and Sleep Medicine, Gainesville, FL. Electronic address:

Lymphangitic carcinomatosis, the presence of tumor within the pulmonary lymphatics, occurs in the setting of malignant tumors and is associated with a poor prognosis. Here we describe a case of lymphangitic carcinomatosis in the setting of renal cell carcinoma and review the radiological manifestations of this disease. 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