Cancer Cell Interaction with Adipose Tissue: Correlation with the Finding of Spiculation at Mammography.

PURPOSE: To investigate the relationship between spiculated masses at mammography and marginal adipose tissue invasion at histologic examination. MATERIALS AND METHODS: The institutional review board approved this retrospective study, and the requirement to obtain informed consent was waived. A total of 478 patients with invasive breast cancer who underwent surgery between 1999 and 2009 were included in this study. Clinical-pathologic findings from patients with spiculated masses on mammograms were compared with those from patients without spiculated masses by using logistic regression models, Cox proportional hazards regression models, and the Kaplan-Meier method. RESULTS: There were 136 spiculated tumors and 342 nonspiculated tumors. All 136 spiculated tumors (100%) were positive for adipose tissue invasion, whereas only 264 of the 342 nonspiculated tumors (77%) were positive for adipose tissue invasion (P < .001). Multivariate analysis revealed that adipose tissue invasion (P < .001), histologic grade (P < .001), dense breast (P = .002), and body mass index (P = .02) were independent factors associated with spiculation. With regard to survival, although many patients with spiculated tumors had a hormone-sensitive (estrogen receptor positive: P = .004; progesterone receptor positive: P = .001) or low-grade (P < .001) tumor, in contrast to the patients without spiculated masses, the prognosis in the two groups was similar (disease-free survival: P = .09; overall survival: P = .23). CONCLUSION: Cancer cell interaction with adipose tissue is crucial for the finding of spiculation at mammography.

Clinicoradiological outcomes of 33 cases of surgically resected pulmonary pleomorphic carcinoma: correlation with prognostic indicators.

OBJECTIVES: To retrospectively review the clinical, radiological and pathological data in patients who underwent surgical resection for pulmonary pleomorphic carcinoma (PC), and to analyse the prognostic predictors of survival. METHODS: The data were retrospectively examined for 33 consecutive patients (28 males and five females) who had undergone surgical resection for pulmonary PC. Cox's proportional-hazards model was used to analyse the prognostic predictors of survival. RESULTS: The size of the tumours ranged from 1.1 to 12.0 cm (mean 5.4 cm). The majority (26) of the tumours were located at the lung periphery, five tumours had cavitation, two had calcification and 14 had peritumoral ground-glass opacity. Most of the tumours showed heterogeneous enhancement and contained a low-density area (LDA) within the tumour. The 5-year overall survival of surgically resected PC was 36 % (standard error = 0.093). A multivariate analysis revealed the LDA grade [hazard ratio (HR), 2.019], pathological stage (HR, 7.552) and pathological N factor (HR, 0.370) to be significant predictors of a poorer prognosis. CONCLUSIONS: A greater component of LDA within the tumour on contrast-enhanced CT is associated with a poorer prognosis in patients with PC. KEY POINTS: PC has a poorer prognosis than other conventional NSCLC. The five-year OS of surgically resected PC was 36 %. A greater component of LDA on contrast-enhanced CT suggests a poorer prognosis.

[Normal radiographic anatomy of thoracic structures: analysis of 316 lateral chest radiographs].

PURPOSE: To study the frequency of visualization and characteristics of normal thoracic structures on lateral chest radiographs in the Japanese population. MATERIALS AND METHODS: We reviewed 316 lateral chest radiographs of men and women ranging in age from 20 to 90 years. The frequency of visualization and configuration of structures including major, minor, superior and inferior accessory fissures, and orifices of the right and left upper lobe bronchi were reviewed. RESULTS: On lateral chest radiographs, major fissure and minor fissure were visualized in 99.4% and 87.3%, respectively. Superior accessory fissure and inferior accessory fissure were visualized in 1.9% and 9.5%, respectively. Orifices of the right and left upper bronchi were seen in 92.4% and 98.4%, respectively. CONCLUSION: Frequency of visualization and characteristics of various normal anatomic structures on lateral chest radiographs in the Japanese population differ from those reported previously from the West. Familiarity with these normal thoracic structures and variations is important for daily image interpretation.