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Background We subjected chemokine (C-X-C motif) ligand 12 (CXCL12) to immunohistochemistry to determine its utility as a novel diagnostic marker for papillary thyroid carcinoma (PTC) in comparison to cytokeratin 19 (CK19), Hector Battifora mesothelial epitope-1 (HBME-1), and galectin-3. Methods We analyzed the expressions of CXCL12, CK19, HBME-1, and galectin-3 using immunohistochemical staining in 258 cases of thyroid lesions (196 PTCs and 62 thyroid lesions excluding PTC). Results Remarkably, CXCL12 expression was exclusively found in PTC compared to other thyroid lesions (90.8% vs 3.2%; p < .001). In total, 91.1% (62 of 68) of the variant PTCs and 90.6% of conventional type (116 of 128) were associated with CXCL12 immunohistochemical expression, irrespective of the histological subtype. In contrast, very few of the thyroid lesions, excluding PTC, were positive for CXCL12 (2 of 62; 3.2%). Diagnostic performances for PTCs were as follows: sensitivity, 90.8%; specificity, 96.8%; positive predictive value, 98.9%; negative predictive value, 76.9%; and diagnostic accuracy, 92.2%. Conclusion Our findings indicate that CXCL12 might serve as an effective novel supplementary diagnostic marker for PTC. © 2013 Wiley Periodicals, Inc. Head Neck 36: 1005–1012, 2014

Primary liposarcoma of the liver is extremely rare. We report here on a case of primary well-differentiated liposarcoma in the left hepatic lobe of a 63-year-old woman. Abdominal ultrasonography showed a well-defined, echogenic, round mass. Abdominal computed tomography (CT) and magnetic resonance (MR) images showed an almost fatty, lobulated mass with a few, random distributed vascular structures and a small area of nodular enhancement. The resected tumor appeared as a well-defined, round, tan-yellow mass. Histological analysis showed a well-differentiated liposarcoma.

Purposes Lung squamous cell carcinoma (SQCC) is the second-largest histological subtype of non-small cell lung cancer, but relatively few biomarkers are available compared to adenocarcinoma. Recently, chemokines and their receptors have been suggested to play important roles in the initiation or progression of cancers. In this study we examined the expression of chemokines and their receptors in human lung SQCC. Methods For mRNA expression of chemokines their receptors study, tumors and their matched normal lung specimens were collected from fresh frozen samples of 10 patients. For immunohistochemistry (IHC) study, formalin-fixed paraffine-embedded samples of 35 patients with primary lung SQCC were collected. All samples were from patients who were subjected to curative surgical resection at Dongnam Institute of Radiological and Medical Sciences. The mRNA was extracted by Quiagen RNeasy kit and the human RT2ProfilerPCR arrays for Chemokines/Receptors (SA Biosciences) was employed to determine the mRNA expression. Also, IHC was used to demonstrate their protein expression. Results The expression profiles of 84 chemokines and their related genes were compared across the tumors and their matched normal lung tissues. Among them, mRNA expression levels of CXCL14 (p=0.000) and CXCR7 (p=0.025) were significantly upregulated in tumor. CXCL14 and CXCR7 protein expression by IHC were detected in 25 (71%, p=0.000) and 21 (60%, p=0.000) of 35 cases for tumor, respectively. However, normal lung tissues showed no protein expression for CXCL14 and CXCR7. We also analyzed the correlation between clinicopathologic features (age, stage, tumor size, lymph node involvement, lymphovascular and perineural invasion and differentiation of tumor) and protein expression of CXCL14 and CXCR7. Although not significant, CXCL14 protein expression was more detected in the advanced stage (stage I/II, 60% vs III/IV, 90%) (p=0.120), lymphatic invasion (Yes, 82% vs No, 41%) (p=0.146) and perineural invasion (Yes, 100% vs No, 57%) (p=0.067). CXCR7 protein expression was significantly higher in advanced stage (stage I/II, 11/24, 46% vs III/IV, 10/10, 100%) (p=0.005) and lymphatic invasion (Yes, 13/16, 81% vs No, 8/18, 44%) (p=0.039). Conclusions This study demonstrated that mRNA expression level of CXCL14 and CXCR7 were significantly higher in SQCC compared to those in normal tissue. CXCR7 protein expression was detected significantly higher in advanced stage and lymphatic invasion. Our results indicated that CXCL14 and CXCR7 might play important roles in carcinogenesis and further study to elucidate their role in SQCC is required. Citation Format: YoonHee Choi, Soo Young Chung, Yoo Sang Yoon, Jae Hyun Kim, Ha-young Lee, Kyung A Kwon, Bong-Gun Seo, Hee Sam Na, Sung Sook Lee. CXCL14 and CXCR7 expression are upregulated in human squamous lung cancers [abstract]. In: Proceedings of the American Association for Cancer Research Annual Meeting 2017; 2017 Apr 1-5; Washington, DC. Philadelphia (PA): AACR; Cancer Res 2017;77(13 Suppl):Abstract nr 4664. doi:10.1158/1538-7445.AM2017-4664

Objective Cervical tuberculous lymphadenitis (CTBL) is still an important cause of neck mass in many countries. The purpose of this study is to analyze the CT findings of CTBL and compare them with those of malignant lymphadenopathies and pyogenic abscesses in the neck. Materials and methods We retrospectively reviewed the CT scans of 32 CTBLs, 25 malignant lymphadenopathies, and 12 pyogenic abscesses in the neck. Attenuation value, enhancement pattern, and surrounding fat plane were evaluated. Results The CT findings of CTBL were classified into four types: type 1, homogeneous soft tissue density; type 2, central low density and peripheral rim enhancement with relative preservation of surrounding fat planes; type 3, multilocular central low densities and peripheral rim enhancement with obliteration of surrounding fat planes; and type 4, large confluent low density with peripheral rim enhancement and loss of lymph node architecture. Among the 32 cases of CTBL, type 3 was most frequently noted (59.4%) followed by type 2 (21.9%), type 4 (15.6%), and type 1 (12.5%). The enhancing rim of CTBL was usually thick and irregular in contrast to some malignant lymph nodes showing thin and regular rim enhancement. The degree of surrounding fat plane obliteration was less in type 4 CTBL than in pyogenic cervical abscess. Conclusion Cervical tuberculous lymphadenitis usually shows a central low density and peripheral rim enhancement that tends to be thick and irregular compared with a malignant lymphadenopathy. Multilocular low densities with peripheral enhancement and a large confluent low density with less degree of fat plane obliteration than a pyogenic abscess are suggestive features of advanced CTBL.

e22099 Background: Lung squamous cell carcinoma (SQCC) is the second-largest histological subtype of non-small-cell lung cancer, but relatively less biomarkers are available compared to adenocarcin...

To assess the frequency and degree of air trapping at thin-section computed tomography (CT) of the lung in relation to age and smoking history in asymptomatic subjects.Thin-section CT of the lung was performed prospectively at end inspiration and end expiration in 82 subjects (27 smokers, 55 nonsmokers) without any history of pulmonary diseases and without present pulmonary symptoms. The frequency and degree of air trapping were evaluated according to age and smoking status.The overall frequency of air trapping was 52% (43 of 82 subjects, kappa = 0.72). Air trapping was found in three of 13 (23%), seven of 17 (41%), nine of 18 (50%), 11 of 17 (65%), and 13 of 17 (76%) subjects aged 21-30, 31-40, 41-50, 51-60, and greater than or equal to 61 years, respectively. The frequency of air trapping increased with age (P.05). The degree of air trapping had a significant correlation with age (r = 0.523, P.001) and was higher in smokers with a smoking history of more than 10 pack-years (P.05).Air trapping was found in approximately 50% of asymptomatic subjects. The frequency of air trapping increased with age, and its severity increased with age and smoking.

Purpose : Our goal was to evaluate CT findings of tuberculous abscess in the retromammary region of the breast. Method : Four patients with tuberculosis extending from the retromammary region to the pleura were examined by CT and the findings were evaluated. All cases were also examined with mammography and two cases were evaluated with sonography. Diagnosis was confirmed by acid-fast bacillus stain, culture, and histologic examination. Results : Mammography showed relatively smoothly marginated, round mass density in two cases, nodular density in one, and focal bulging of the pectoral wall in one. A sonogram demonstrated in two cases a fistulous connection from the heterogeneous, fluid-containing lesion with floating internal debris in the retromammary region to the thoracic cavity. In all four cases, CT showed relatively smoothly marginated, inhomogeneous, hypodense lesions with surrounding rims of the cold abscess type. A direct fistulous connection from the retromammary lesion through the thoracic wall into the pleura was seen in two cases. Destroyed rib fragments within the abscess were noted in two cases. Conclusion : A tuberculous abscess in the retromammary region usually showed on CT a focal, smoothly marginated, inhomogeneous, hypodense lesion with a surrounding enhancing rim. A direct fistulous connection with the pleura or a destroyed rib fragment in the abscess as revealed by CT can be helpful in the differential diagnosis of other infectious types of retromammary abscess.

To compare the specific information provided by ultrasound (US) and galactography and to appreciate the clinical applicability of US as a primary diagnostic method for breast tumors associated with nipple discharge, a comparative study of each method in 15 patients with ductal tumors of the breast was performed. To evaluate the smallest anatomical unit of the lactiferous system demonstrable by US, 30 patients with normal lactating breasts were examined prospectively. The smallest anatomical ductal unit that could be evaluated with US in the normal lactating breast was the terminal duct lobular unit (TDLU). US is superior to galactography in detecting masses smaller than 0.5 cm or lesions involving multiple ducts. Galactography is better for visualizing the duct system and detecting calcification. In conclusion, US serves as a primary noninvasive diagnostic tool in patients with clinically suspicious breast tumor associated with bloody nipple discharge, but galactography also should be done in specific circumstances.

Recognition that many patients with benign sclerosing mediastinitis have smoldering disease responsible for failure of surgical procedures or for development of collateral circulation in patients with superior vena caval obstruction has markedly improved management of these difficult patients. Histoplasmosis complement fixation titers have been used to detect unsuspected subacute disease and to follow the therapeutic adjunctive management with ketoconazole, an oral antifungal agent. Twenty-two patients with benign sclerosing mediastinitis demonstrated a variety of symptoms relating to the area of compression: superior vena cava, 13; esophagus, 3; pulmonary artery and pericardium, 3; and trachea, 3. Histoplasmosis was documented in 12 patients. Operation is used initially for diagnosis, to rule out carcinoma, and to treat the complications: superior vena caval reconstruction, 6; tracheal decompression, 2; right middle lobectomy, 1; esophageal decompression, 2; division of tracheoesophageal fistula, 1; and release of pericardial effusion and cardiac tamponade, 1. Postcardiotomy syndrome occurred in 1 patient and wound infection in another. No deaths resulted. In 6 cases of histoplasmosis, symptoms recurred in 100% of patients and were successfully managed with ketoconazole treatment, and then clinical progress was monitored with serial histoplasmosis complement fixation studies. One patient had four superior vena caval reconstructions at an outside hospital, each 1 year apart, with symptoms recurring each time. With ketoconazole therapy alone, she has been asymptomatic for more than 2 years. Vigorous search for a fungal cause may even obviate the necessity for surgical intervention. If an operation is necessary, preoperative and postoperative use of ketoconazole has assured success.

Purpose: To evaluate the radiologic findings of direct invasion of the spleen by malignant tumors of adjacent organs. Materials and Methods: We retrospectively reviewed the CT(n=6) and MR(n=3) images of six patients with direct invasion of the spleen by malignant tumor of left lower lung, stomach, colon, pancreas, left kidney, and left adrenal gland. We evaluated the tumor margin, attenuation or intensity, perisplenic fat infiltration, regional lymphnode enlargement, and invaded site of the spleen. Results: Ill-defined masses were found in the spleen with central necrosis and infiltration into perisplenic fatty tissue in all six patients; left adrenal mass was present also in three patients. Regional lymphnode enlargement was found in four patients. The masses showed heterogenous low attenuation on CT. The invaded site was variable and corresponding to their anatomical connections to the spleen. Conclusion: Direct invasion of the spleen by malignant tumors of adjacent organs showed ill-defined masses with central necrosis and were commonly associated with infiltration to perisplenic fatty tissue and adrenal invasion. The pattern and invaded site can be helpful to assess the primary cancer.

Purpose : To evaluate the usefulness of MR imaging in the differential diagnosis of the underlying causes of early-stage acute renal failure (ARF) by comparing the MRI findings of experimentally-induced crescentic glomerulonephritis (CGN) and acute tubular necrosis (ATN) in rabbits. Materials and Methods : Experimental CGN was induced by injecting anti-glomerular basement membrane antibody into six rabbits, and ATN by injecting glycerol solution into six rabbits. A normal control group of three rabbits was also used. Renal MR imaging (T1-and T2-weighted coronal images and dynamic MRI : DMRI) was performed the day before, and one, four, and seven days after the induction of CGN; and immediately before, and four, and eight hours, and one, four, and seven days after the induction of ATN. Sequential renal gun-biopsies and blood sampling (serum creatinine, sCr) were performed. Renal area, corticomedullary differentiation(CMD), and the passage of Gd-DTPA (pattern of dark band), as seen on MRI, were analyzed and correlated with serial change of sCr. Results : In normal kidneys, CMD was clearly apparent on both T1- and T2-weighted images. DMRI demonstrated a progressively inwardly migrating dark band in the kidneys. CMD was relatively clearly demonstrated in the ATN group but less clearly identified in the CGN group. Renal size (area) and sCr gradually increased in both the CGN and ATN groups, and dark bands were moderately to poorly defined in both. Conclusion : We conclude that DMRI could be used to differentiate and evaluate disease processing and compromised renal function in cases of CGN and ATN. On T1- and T2-weighted images, CMD was relatively well preserved in the ATN group, but was less clear in the CGN group. These MRI findings may be helpful for differentiation of the underlying causes of early-stage ARF, particularly between CGN and ATN.

Localized fibrous tumor of the scrotum is a very rare disease, and few radiologic features have been report-ed. We report the sonographic and CT findings of a case of localized fibrous tumor, which developed in the scrotum of a thirty-years-old man.

Pituitary abscess is a rare condition of the pituitary gland. We report MR imaging findings in two cases of surgically-confirmed pituitary abscess occuring in women aged 39 and 28. In both a peripheral rim enhancing lesion, similar to abscesses in other areas of brain, was seen in the pituitary fossa.

Purpose : To evaluate MR imaging findings of degenerating parenchymal neurocysticercosis and to determine the characteristics which distinguish it from other brain diseases. Methods : MR imagings of 19 patients (56 lesions) of degenerating parenchymal neurocysticercosis were retrospectively evaluated, focusing on the size and location of lesions, signal intensity patterns of cyst fluid and wall, the extent of the surrounding edema and features of contrast enhancement. Results: Degenerating parenchymal neurocysticercosis was located in gray or subcortical white matter in 89.3% of 56 lesions(50/56) ; most of these (98.2%) were smaller than 2cm in diameter. Cyst fluid signal was hyperintense relative to CSF on T1 and proton density weighted images (92.9%). A hypointense signal rim of the cyst wall was noted in the lesions on proton density (92.9%) and T2 weighted (98.2%) images. Surrounding edema was mostly mild. Peripheral rim enhancement was noted in all lesions, and this was frequently irregular and lobulated (67.9%) with a focal defect in the enhancing rim (41.1%). Conclusion : Findings which could be helpful in distinguishing degenerating parencymal neurocysticerosis from other brain diseases are as follows : small, superficial lesions ; hyperintense signal of the cyst fluid on T1 and proton density weighted images ; hypointense signal of the cyst wall on proton density and T2 weighted images ; relatively mild extent of surrounding edema, and peripheral rim enhancement which is frequently irregular and lobulated with a focal defect in the enhancing rim.

Background: Silibinin has been known for its role in anti-cancer and radio-protective effect. Radiation therapy for treating lung cancer might lead to late-phase pulmonary inflammation and fibrosis. Thus, this study aimed to investigate the effects of silibinin in radiation-induced lung injury with a mouse model. Methods: In this study, we examined the ability of silibinin to mitigate lung injury in, and improve survival of, C57BL/6 mice given 13 Gy thoracic irradiation and silibinin treatments orally at 100 mg/kg/day for seven days after irradiation. In addition, Lewis lung cancer (LLC) cells were injected intravenously in C57BL/6 mice to generate lung tumor nodules. Lung tumor-bearing mice were treated with lung radiation therapy at 13 Gy and with silibinin at a dose of 100 mg/day for seven days after irradiation. Results: Silibinin was shown to increase mouse survival, to ameliorate radiation-induced hemorrhage, inflammation and fibrosis in lung tissue, to reduce the number of inflammatory cells in the bronchoalveolar lavage fluid (BALF) and to reduce inflammatory cell infiltration in the respiratory tract. In LLC tumor injected mice, lung tissue from mice treated with both radiation and silibinin showed no differences compared to lung tissue from mice treated with radiation alone. Conclusions: Silibinin treatment mitigated the radiation-induced lung injury possibly by reducing inflammation and fibrosis, which might be related with the improved survival rate. Silibinin might be a useful agent for lung cancer patients as a non-toxic complementary approach to alleviate the side effects by thorax irradiation.