Relationship of thyroid transcription factor 1 to EGFR status in non-small-cell lung cancer.

BACKGROUND: Activating mutations of the epidermal growth factor receptor (EGFR) gene are known to drive a proportion of non-small-cell lung cancers. Identification of lung cancers harbouring such mutations can lead to effective treatment using one of the agents that targets and blocks egfr-mediated signalling. METHODS: All specimens received at the BC Cancer Agency (Vancouver) for EGFR testing were prospectively identified and catalogued, together with clinical information and EGFR status, over a 14-month period. RESULTS: Specimens from 586 patients were received for EGFR testing, and EGFR status was reported for 509 patients. No relationship between specimen type or site of origin and EGFR test failure rate was identified. Concurrent immunohistochemical (ihc) status for thyroid transcription factor 1 (ttf1) was available for 309 patients. The negative predictive value of ttf1-negative status by ihc was 94.2% for predicting negative EGFR status. CONCLUSIONS: In patients with limited tissue available for testing, a surrogate for EGFR status would aid in timely management. Immunohistochemistry for ttf1 is readily available and correlates highly with EGFR status. In conjunction with genetic assays, ttf1 could be used to optimize an EGFR testing strategy.

Traumatic internal carotid artery dissection presenting as delayed hemilingual paresis.

A case of internal carotid artery dissection presenting as delayed right hemilingual paresis after blunt craniocervical trauma is presented. Diagnosis is discussed with emphasis on MR and MR angiographic findings. Mechanisms of injury and lower cranial nerve palsy are also briefly discussed.

Retroclival arachnoid cyst.

Retroclival arachnoid cyst is a rare mass lesion, with only seven cases previously reported in literature. MR is the imaging modality of choice in its evaluation and in its differentiation from epidermoid cyst. The case reported here was surgically proved and had an uncharacteristic MR signal intensity that was higher than that of cerebrospinal fluid due to previous hemorrhage.

Technetium-99m HMPAO labeled leukocytes as the primary diagnostic tool in a case of brain abscess.

The authors present a case in which Tc-99m HMPAO labeled autologous leukocytes were used to demonstrate a brain abscess in a patient undergoing evaluation for fever of unknown origin. The abscess was demonstrated on both 1-hour and 24-hour images. The positive 1-hour image led to CT and MRI studies, which are included for correlation. In addition to its previously identified role as a secondary diagnostic test in the differentiation of tumor and abscess, the authors propose that Tc-99m HMPAO is useful as a primary diagnostic tool in the identification of brain abscess. Furthermore, the authors suggest that Tc-99m HMPAO is preferable to In-111 labeled leukocytes because of its better resolution and earlier imaging characteristics.

Amyloidoma of the stomach.

Localized amyloid deposit in the gastric antrum presented as an ulcerated mass on upper gastrointestinal series. Radiographic and autopsy findings are correlated and the literature is reviewed.

CT demonstration of cervical spinal cord compression--cause of reversible itching and burning in the lower extremities.

Cervical spinal cord compression is easily and accurately demonstrated by CT. Isolated atypical sensory symptoms in the saddle area and lower extremities may be the earliest and only manifestations of cervical spinal cord compression from cervical spondylosis. A case is presented manifesting such symptoms, which were reversed completely by surgical decompression of the cervical spine.

Orbital varix: color flow imaging correlated with CT and MR studies.

A case of orbital varix is presented in which the lesion is well demonstrated by color flow Doppler sonography. Correlation is made with CT and MR studies. We believe that color flow sonography should be used as the initial screening test in cases of suspected orbital varix.

Tomography in expansile lesions of the nasal and paranasal sinuses.

Of 35 nasal and paranasal sinus masses examined by radiography and tomography, 22 malignant tumors showed purely destructive growth. Bone expansion was observed in 13 benign, and 2 slowly growing malignant masses. Pluridirectional tomography in carefully selected projections is often necessary to reveal expansile growth. The 13 expansile lesions, including mucocele, neurofibroma, dermoid, epidermoid, cementifying fibroma, angiofibroma, inverting papilloma, and cylindroma, are briefly described. Tomographic appearance alone did not characterize histopathologic entities. However, distinctions may be made between fibro-osseous and epithelial tumors, and between fast growing and slowly growing tumors.