here is increasing awareness of the clinical importance of incidentally detected interstitial lung abnormalities (ILAs) on non-contrast-enhanced chest CT images (1). Large cohort studies (2-5) of lung cancer screening have reported that ILAs are present in 8%-10% of participants. ILAs have been associated with a greater risk of all-cause mortality (l,2). Miller et al ( 6) recently reported that some subclinical ILAs at CT represent an early stage or a mild form of pulmonary fibrosis. Moreover, ILAs influence survival in patients with advanced lung cancer (7). Outcomes are reported to be poorer in patients with lung cancer with idiopathic pulmonary fibrosis (IPF) than in patients without IPF (8-10). However, quantitative evaluation of ILAs in patients with lung cancer and their influence on survival have not yet been fully investigated.Many computer-aided detection (CAD) systems have been developed to quantify diffuse lung abnormalities at . Subpleural abnormalities at CT, as measured by using the Gaussian histogram normalized correlation (GHNC) system, correspond to a histologic usual interstitial pneumonia (UIP) pattern of fibrosis in patients with interstitial lung diseases (ILDs) (15).Thus, we hypothesized that the volume of ILAs at CT measured using a GHNC-CAD system would be associated with the UIP CT pattern and worse prognosis in patients with lung cancer. The purpose of this study was to quantify ILAs at preoperative CT by using a GHNC-CAD system and to evaluate the extent of ILAs as a predictor of disease-free survival (DFS) in patients with lung cancer. We also evaluated the
These results suggest that these models might quantify contributions of specific climate conditions and other seasonal factors on the number of emergency visits per night for childhood asthma attack in Tokyo, Japan.
A 31-year-old man underwent living-related kidney transplantation in 2004 as a consequence of primary focal segmental glomerulosclerosis (FSGS). Four years after the transplantation, we confirmed nephrotic syndrome caused by recurrent FSGS. We performed plasmapheresis and low-density lipoprotein adsorption. We also combined steroid therapy with a reduction in the dose of tacrolimus and an increased dose of mycophenolate mofetil. The nephrotic syndrome improved dramatically with this combined therapeutic approach. However, 10 months after these treatments, he revisited our hospital because of altered consciousness. We detected multiple tumor masses in his brain that were ring enhanced on contrast magnetic resonance imaging. Consequently, we suspected primary central nervous system post-transplantation lymphoproliferative disorder (CNS-PTLD). We performed a craniotomy to biopsy the brain tumors. The biopsy specimen showed Epstein-Barr virus-associated diffuse large B-cell lymphoma. There is no definitive treatment for CNS-PTLD. Therefore, we treated the primary CNS-PTLD successfully with whole-brain radiation and discontinuation of immunosuppression therapy.
There was moderate or substantial agreement for the diagnosis of small bowel ischemia between radiologists and residents. However, there was substantial agreement for the presence of closed loop obstruction.
Metastatic neuroendocrine tumors of the liver typically appear as solid, hypervascular masses on imaging. Pseudocysts mimicking simple cysts are extremely rare. A 42-year-old Japanese woman was referred with a single pulmonary mass in the left lower lobe. No metastatic lesion was detected and no occupying lesion in the liver was observed. The lung tumor was diagnosed as an atypical carcinoid. Postoperative investigation revealed new hepatic simple cysts in the liver, which increased in size over time and changed into hemorrhagic cysts. Fluorodeoxyglucose positron emission tomography and somatostatin receptor scintigraphy using
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In-octreotide demonstrated no accumulation in the liver. Our patient did not have symptoms consistent with carcinoid syndrome. The patient underwent partial resection of the cystic lesions of the liver. Gross examination of the tumors demonstrated thin-wall cavitated lesions with hemorrhage which were metastases from the atypical carcinoid of the lung. When a growing cystic lesion with intracystic hemorrhage is found in the liver of a patient with a history of carcinoid tumors, pseudocysts caused by degeneration of a carcinoid metastasis should be considered as a differential diagnosis.
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