Occupational cancer burden in Great Britain.

A sound knowledge base is required to target resources to reduce workplace exposure to carcinogens. This project aimed to provide an objective estimate of the burden of cancer in Britain due to occupation. This volume presents extensive analyses for all carcinogens and occupational circumstances defined as definite or probable human occupational carcinogens by the International Agency for Research on Cancer. This article outlines the structure of the supplement - two methodological papers (statistical approach and exposure assessment), eight papers presenting the cancer-specific results grouped by broad anatomical site, a paper giving industry sector results and one discussing work-related cancer-prevention strategies. A brief summary of the methods and an overview of the updated overall results are given in this introductory paper. A general discussion of the overall strengths and limitations of the study is also presented. Overall, 8010 (5.3%) total cancer deaths in Britain and 13,598 cancer registrations were attributable to occupation in 2005 and 2004, respectively. The importance of cancer sites such as mesothelioma, sinonasal, lung, nasopharynx, breast, non-melanoma skin cancer, bladder, oesophagus, soft tissue sarcoma and stomach cancers are highlighted, as are carcinogens such as asbestos, mineral oils, solar radiation, silica, diesel engine exhaust, coal tars and pitches, dioxins, environmental tobacco smoke, radon, tetrachloroethylene, arsenic and strong inorganic mists, as well as occupational circumstances such as shift work and occupation as a painter or welder. The methods developed for this project are being adapted by other countries and extended to include social and economic impact evaluation.

Baker cyst as seen on a PET/CT scan.

We present the case of a 48-year-old woman who had been diagnosed with multiple myeloma a year ago. She had persistent pain in her right knee that she tended to ignore. As part of her follow-up she underwent a PET/CT scan that did not show any metastatic lesions. However, a focal rounded area of FDG uptake behind her right knee showed a fluid density on the CT scan. A presumptive diagnosis of Baker cyst was suggested. Review of her previous MRI report performed at another hospital corroborated this finding.

A corpus luteal cyst masquerading as a lymph node mass on PET/CT scan in a pregnant woman with an anterior mediastinal lymphomatous mass.

A 26-year-old woman presented with a history of dyspnea. The patient declined a pregnancy test before undergoing a noncontrast CT scan of the chest that showed an anterior mediastinal mass that was F-18 FDG avid on a subsequent PET/CT. Additionally, PET/CT demonstrated focal uptake in the right adnexal region. Surgical excision of the anterior mediastinal mass revealed Hodgkin lymphoma. A contrast-enhanced CT scan of the chest, abdomen, and pelvis after surgery showed no residual tumor in the mediastinum. An enhancing 1.2-cm round lesion was noted in the right adnexal region. An ultrasound examination revealed a corpus luteal cyst in the right adnexa and an intrauterine pregnancy thus discounting pelvic lymph node involvement. The patient was counseled about radiation exposure. She elected to have a therapeutic abortion and received chemotherapy. This case highlights the need to be cognizant of physiologic changes associated with possible pregnancy.

Rheumatoid lung disease as seen on PET/CT scan.

We present the case of a 63-year-old woman chronic smoker with a history of severe rheumatoid arthritis, who presented with dyspnea and cough. Her chest x-ray film and CT scan (as part of a PET/CT scan) showed multiple lung nodules and a left pleural effusion. A PET scan (as part of a PET/CT scan) revealed no uptake in the larger lung nodules and intense left pleural uptake. The findings favored rheumatoid lung disease with rheumatoid pleural involvement, but malignant involvement was not excluded. A CT-guided lung and pleural biopsy confirmed the diagnosis of rheumatoid lung disease. On the basis of these findings, the patient was put on immunomodulators and responded to treatment.

Imaging of an invasive malignant thymoma on PET Scan: CT and histopathologic correlation.

Thymomas are common primary mediastinal neoplasms. They can be benign or malignant. The diagnosis of malignant thymomas is based on capsular invasion, cellular atypia and distant metastases. We present a case of invasive malignant thymoma as diagnosed on PET and CT scan with histologic correlation and review of literature. A seventy year old Asian man presented with cough and dyspnea. A CT scan showed an anterior mediastinal mass, and a PET scan showed a hypermetabolic mass in the corresponding location. Resection of the mass revealed a minimally invasive thymoma based on evidence of capsular invasion. PET scan proved invaluable in correctly diagnosing, staging the lesion, and excluding any extramediastinal involvement.