ABSTRACT
OBJECTIVE: Poorly-differentiated thyroid cancer (PDTC) is a highly aggressive malignancy which is recently defined and understudied in the radiologic literature. Necrosis is a key histopathologic criterion for the diagnosis of PDTC. We illustrate the current difficulty in accurate identification of histopathologic necrosis on preoperative imaging. METHODS: A series of seven patients with the final diagnosis of PDTC from our institution were identified. Multimodality preoperative imaging was analyzed by two head and neck radiologists. Final pathology reports were queried confirming histopathologic evidence of necrosis. RESULTS: Patients presented with a wide range of preoperative imaging features. A consistent imaging appearance confirming necrosis was not identified. All patients were subsequently upstaged to PDTC following final pathological analysis. CONCLUSION: A lack of definitive evidence of necrosis on preoperative imaging does not exclude the possibility of PDTC. We demonstrate the need for further research to establish a clear methodology for the preoperative diagnosis of PDTC.
Subject(s)
Adenocarcinoma , Thyroid Neoplasms , Humans , Thyroid Neoplasms/diagnostic imaging , Thyroid Neoplasms/surgery , NecrosisABSTRACT
We present an exceedingly rare case of a Ewing sarcoma metastasis manifesting as a sellar mass mimicking a pituitary adenoma. The differential diagnosis of the young adult with a sellar mass is presented and correlated with a review of available literature, demonstrating this case's unique potential for clinical teaching. More specifically, this case illustrates that in a patient with a clinical history of Ewing sarcoma, a metastasis may involve the sella and suprasellar cistern without apparent osseous involvement.
Subject(s)
Bone Neoplasms/diagnostic imaging , Bone Neoplasms/pathology , Brain Neoplasms/diagnostic imaging , Brain Neoplasms/secondary , Sarcoma, Ewing/pathology , Sella Turcica/diagnostic imaging , Adult , Bone Neoplasms/therapy , Brain Neoplasms/therapy , Chemoradiotherapy , Diagnosis, Differential , Female , Humans , Magnetic Resonance Imaging , Positron Emission Tomography Computed Tomography , Sella Turcica/pathology , Sphenoid Bone/diagnostic imaging , Sphenoid Bone/pathologyABSTRACT
OBJECTIVE: The purpose of this article is to review the origins of the classic teaching on pulmonary tuberculosis, its evolution in the modern literature, and the evidence that led to its demise. CONCLUSION: Use of molecular epidemiologic techniques that entail DNA finger-printing has led to the discovery that the radiographic appearance of pulmonary tuberculosis does not depend on the time since infection. It has been confirmed that the upper lobe cavitary disease typical in adults is the disease of the immunocompetent host, whereas lower lung zone disease, adenopathy, and effusions, which are uncommon in adults, are the hallmarks of tuberculosis in an immunocompromised host.
