Intrahepatic cholangiocarcinomas account for approximately 20% of cases of cholangiocarcinomas.Three growth patterns or morphologic subtypes exist, including mass-forming, periductal-infiltrating, and intraductal-growth subtypes. Knowledge of these morphologic subtypes and their radiologic appearance aids in timely diagnosis, a key to optimizing patient outcomes. The morphologic variability of intrahepatic cholangiocarcinomas has a direct impact on the diagnostic sensitivity and specificity of various diagnostic imaging modalities, including ultrasound (US), computed tomography (CT), magnetic resonance imaging (MRI)/magnetic resonance cholangiopancreatography (MRCP), and positron emission tomography (PET).The following review emphasizes optimal imaging technique for each of these modalities and reviews the imaging appearance of each morphologic subtype of intrahepatic cholangiocarcinoma.

Ultrasound is frequently used in conjunction with mammography in order to detect breast cancer as early as possible. However, due largely to the heterogeneity of breast tissue, ultrasound images are plagued with clutter that obstructs important diagnostic features. Short-lag spatial coherence (SLSC) imaging has proven to be effective at clutter reduction in noisy ultrasound images. M-Weighted SLSC and Robust-SLSC (R-SLSC) imaging were recently introduced to further improve image quality at higher lag values, while R-SLSC imaging has the added benefit of enabling the adjustment of tissue texture to produce a tissue signal-to-noise ratio (SNR) that is quantitatively similar to B-mode speckle SNR. This paper investigates the initial application of SLSC, M-Weighted SLSC, and R-SLSC imaging to nine targets in the female breast [two simple cysts, one complicated cyst, two fibroadenomas, one hematoma, one complex cystic and solid mass, one invasive ductal carcinoma (IDC), and one ductal carcinoma in situ (DCIS)]. As expected, R-SLSC beamforming improves cyst and hematoma contrast by up to 6.35 and 1.55 dB, respectively, when compared to the original B-mode image, and similar improvements are achieved with SLSC and M-Weighted SLSC imaging. However, an interesting finding from this initial investigation is that the solid masses (i.e., fibroadenoma, complex cystic and solid mass, IDC, and DCIS), which appear as hypoechoic in the B-mode image, have similarly high coherence to that of surrounding tissue in coherence-based images. This work holds promise for using SLSC, M-Weighted SLSC, and/or R-SLSC imaging to distinguish between fluid-filled and solid hypoechoic breast masses.

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Dermatofibrosarcoma protuberans (DFSP) is a rare, indolent, cutaneous sarcoma originating in the dermis, and although nearly half of cases occur on the trunk, DFSP of the breast is exceedingly rare, and imaging findings may resemble primary breast neoplasms. In this case report, a previously healthy, middle-aged female patient presented to the clinic with the complaint of abnormal growth in her left breast, which had been gradually increasing in size over the course of four years. Imaging of the left breast demonstrated a large, exophytic, partially intradermal mass with internal vascularity, raising concern for a primary breast neoplasm. Ultrasound-guided core needle biopsy revealed a diagnosis of DFSP. She underwent successful left skin-and nipple-sparing mastectomy with complete resection of the mass with negative margins confirmed on surgical pathology.Recognizing key features of DFSP on conventional breast imaging modalities, such as mammography and ultrasound, can be helpful in differentiating DFSP from primary breast neoplasms, but imaging findings alone may be nonspecific and biopsy is necessary for a definitive diagnosis. On mammography, DFSP typically presents as an exophytic, gently lobulated, non-calcified, and circumscribed mass. On sonographic examination, DFSP appears as a circumscribed, parallel-oriented mass that is hypoechoic relative to the surrounding fat, with intervening echogenic bands, posterior acoustic enhancement, and intralesional hypervascularity visualized on color Doppler. Although DFSP is slow-growing with a low incidence of metastatic disease, it has a high local recurrence rate and aggressive local resection is necessary to minimize the chance of recurrence.