Lung carcinoma is the most common and lethal malignancy in men. Non-small cell lung carcinoma is more aggressive than small cell lung carcinoma and often presents in advanced stage with metastasis. Cytology, histopathology, immunohistochemistry and metabolic imaging play an important role in classifying lung carcinomas. TTF 1 and Napsin A are highly sensitive and specific for adenocarcinoma lung, but the sensitivity and specificity decreases in high grade tumours. Elevated serum CA 19-9 tumour marker is not always related to pancreatico-biliary adenocarcinomas. It can be positive in adenocarcinoma lung and its elevation confers poor prognosis. Quintessential role of metabolic imaging like 18 F-FDG PET CT scan in high grade carcinomas is well known. With the advent of targeted therapy, molecular and receptor studies of EGFR, ROS 1 and ALK gene rearrangement becomes mandatory in all lung adenocarcinomas. Hence, both oncologist and pathologist should diagnose advanced stage tumours without bias with good clinical, radiological and pathological correlation.

Purpose: Xerostomia is a well known complication of radiation for head and neck cancer. It causes significant impairment of Quality Of Life (QOL).Comprehensive assessment is possible with the help of scintigraphy, Dose-volume histogram (DVH) parameters as well as QOL questionnaire. Methods: Thirty patients of head and neck cancer undergoing radiation were assessed for xerostomia. Scintigraphic assessment of parotid gland function was done before and at six weeks after radiation. QOL questionnaire was administered before, during, and at six weeks after radiation as well as at two years of follow up. Dose received by parotids were correlated with scintigraphic and QOL outcomes. Results: Mean parotid gland volume and dose received were 24.9 cc and 45.3 Gy respectively. Mean Salivary Excretion Factor (SEF) decreased from 54.1 to 12 at six weeks after radiation. QOL scores worsened from first week (mean value: 2.37) of radiotherapy (RT) to fourth week (mean value: 15.50, p < 0.0000) , remained same till completion of RT (mean value: 17.57, p = 0.1063) and at six weeks after radiation (mean value:16.10, p = 0.2519). There was a significant decrease in QOL scores between post RT six weeks versus two years follow up (p < 0.0000). Mean parotid dose and QOL scores correlated at six weeks (p < 0.0000), whereas no correlation was found between SEF and QOL. Conclusion: Comprehensive assessment of parotid gland function with Scintigraphy, QOL questionnaire and its correlation with dose volume parameters is helpful in quantifying xerostomia. Even though radiation induced xerostomia persisted for a long time after radiation, it did not translate to decreased QOL.

The authors report an unusual clinical phenomenon of head-and-neck radiotherapy-induced thyroiditis presenting with clinical features of hyperthyroidism on immediate clinical follow-up with raised thyroid hormone levels. Conventional technetium thyroid scan showed a discordantly absent thyroid gland uptake instead of expected thyroid avidity in hyperthyroidism. The thyroid gland subsequently reverting to normal uptake in the postrecovery stage confirmed the thyroiditis nature, with prior radiation to the neck being the possible inciting factor.

The authors report a series of cases of treated nodal, solid malignancies showing persisting physical residue after completion of treatment with 18-F fluorodeoxyglucose positron emission tomography-computerized tomography showing non-avid status conjuring a nondisease desmoplastic residue over morphological disease.