Integrated imaging of non-small cell lung cancer recurrence: CT and PET-CT findings, possible pitfalls and risk of recurrence criteria.

OBJECTIVES: To review the role of imaging in the diagnosis of recurrent disease in previously treated non-small cell lung cancer (NSCLC) and discuss the imaging pitfalls. METHODS: A comprehensive review of published literature on CT and PET imaging of NSCLC recurrence was performed. Diagnostic and prognostic values are discussed. Representative imaging examples are illustrated. RESULTS: Up to 30% of NSCLC recurrences present as loco-regional, involving treated hemithorax and ipsilateral lymph nodes, while 70% present as metachronous distant metastases. CT and PET-CT play an important role in the early detection of recurrence; indications for imaging vary depending on pathological features. CONCLUSION: Imaging plays a central role in the identification of recurrence and may predict prognosis. KEY POINTS: Lung cancer recurs after surgery in 30% to 75% of patients. CT and PET-CT are crucial in identification of loco-regional recurrence. Knowledge of potential pitfalls is essential, especially for parenchymal or nodal recurrence. CT can diagnose metastases but further examinations (PET-CT, MRI) are often needed. Morphological and functional imaging criteria may help in predicting recurrence.

Multiple Papillomas of the Breast: A Review of Current Evidence and Challenges.

OBJECTIVES: To conduct a review of evidence about papillomatosis/multiple papillomas (MP), its clinical and imaging presentation, the association between MP and malignancy and the management strategies that follow. METHODS: A computerized literature search using PubMed and Google Scholar was performed up to January 2021 with the following search strategy: "papilloma" OR "intraductal papilloma" OR "intraductal papillary neoplasms" OR "papillomatosis" OR "papillary lesion" AND "breast". Two authors independently conducted a search, screening and extraction of data from the eligible studies. RESULTS: Of the 1881 articles identified, 29 articles met the inclusion criteria. The most common breast imaging methods (mammography, ultrasound) showed few specific signs of MP, and evidence about magnetic resonance imaging were weak. Regarding the association between MP and malignancy, the risk of underestimation to biopsy methods and the frequent coexistence of MP and other high-risk lesions needs to be taken into consideration. Results about the risk of developing breast carcinoma of patients affected by MP were inconsistent. CONCLUSIONS: MP is a challenge for all breast specialists, and familiarity with its features is required to make the correct diagnosis. Further studies are needed to evaluate the factors to take into account to plan management, time of follow-up and imaging methods.

Sister Mary Joseph nodule as the only sign of silent caecal adenocarcinoma.

Sister Mary Joseph nodule is a nodule localized in the umbilicus which represents a cutaneous metastasis from a primary cancer, mostly localized in the abdomen. We report the case of an 82-year-old woman who presented with an ulcerated umbilical nodule. Imaging identified it as a Sister Mary Joseph nodule, representing the only distant metastasis from a silent caecal adenocarcinoma. When an umbilical nodule is found at clinical examination imaging can play a crucial role in determining underlying pathology and in determining therapeutic strategy.

The 7th lung cancer TNM classification and staging system: Review of the changes and implications.

Lung cancer is the most common cause of death from cancer in males, accounting for more than 1.4 million deaths in 2008. It is a growing concern in China, Asia and Africa as well. Accurate staging of the disease is an important part of the management as it provides estimation of patient's prognosis and identifies treatment sterategies. It also helps to build a database for future staging projects. A major revision of lung cancer staging has been announced with effect from January 2010. The new classification is based on a larger surgical and non-surgical cohort of patients, and thus more accurate in terms of outcome prediction compared to the previous classification. There are several original papers regarding this new classification which give comprehensive description of the methodology, the changes in the staging and the statistical analysis. This overview is a simplified description of the changes in the new classification and their potential impact on patients' treatment and prognosis.