Thrombectomy of a Complex Deep Vein Thrombosis: A Case Report.

A deep vein thrombosis (DVT) is a multifactorial condition characterized by a thrombus or blood clot developing in the deep veins of the upper or lower extremities. The presentation of DVT is characterized by unilateral peripheral edema and signs of inflammation in the affected extremity. The treatment of DVT is complex and case-dependent; however, most individuals are managed with oral anticoagulation therapy, while complex cases can be treated with advanced interventions. This report discusses a singular case of an atypical or complex DVT in a middle-aged woman with prior venous thromboembolic events undergoing a thrombectomy using an Inari FlowTriever system.

Quantitative methodology using CT for predicting survival in patients with metastatic colorectal carcinoma: a pilot study.

OBJECTIVE: To develop a methodology which quantifies multiple changing lesion features resulting in an optimized computed tomography (CT) response score (CRS) for prediction of overall survival (OS) in response to treatment for metastatic colorectal carcinoma (MCRC). SUBJECTS AND METHODS: This Health Insurance Portability and Accountability Act-compliant, institutional review board-approved retrospective study evaluated multiple changing imaging findings and their correlation with OS with a new methodology comparing the baseline and first post-treatment CT scans in 38 MCRC patients on last-line chemotherapy (cetuximab and irinotecan). Tumor size/enhancement changes and interval development of new lesions were quantified with either Likert-type scales (all parameters) or Response Evaluation Criteria in Solid Tumors (RECIST) (size change only). The most predictive parameters for OS were used to generate the CRS with an overall range of -3 (complete disappearance) to +2 (definite tumor increase). The Cox Hazard Ratio was used to assess prediction of survival. Reader agreement was evaluated by the kappa statistic. RESULTS: Tumor size was the best predictor of OS using the Likert-type scale or RECIST. The CRS was not improved combining size change with other parameters. Use of the Likert-type scale resulted in predicting OS with a Cox hazard ratio of 1.697 (P=.0004) and good agreement (kappa=0.73, 95% CI=0.41-1.10) between observers with no significant difference using RECIST. CONCLUSION: The methodology produces a CRS for MCRC predicting OS resulting from therapy which expands standard RECIST guidelines to allow critical evaluation of multiple additional imaging parameters. Size change alone was found to be the best parameter of those considered in terms of maximizing agreement and prediction of OS.

Isolated extramedullary relapse of acute lymphoblastic leukemia in the breast of an adolescent girl: radiologic findings and discussion.

We report a case of isolated extramedullary leukemia relapse in the breast of an adolescent girl. A 13-year-old girl with acute lymphoblastic leukemia in remission, post-chemotherapy and unrelated cord blood transplant, presented with a breast lump. US and mammography demonstrated a large hypervascular heterogeneous mass. Examination of tissue provided by US-guided core biopsy confirmed focal leukemic relapse. US is a commonly used diagnostic tool in children and adolescents with a breast mass, for both characterization and guided biopsy.