Figure 1
A 50-year-old man with chronic, atypical right chest pain. Pleuroscopy was performed and initial diagnosis of chronic pleurisy due a history of asbestos exposure was made. (A and B) CT images before pleurodesis and (C and D) PET-CT images after talc pleurodesis showed no additional features. (E and E’) The anatomical T2-weighted MR image as well as the T1-weighted MR image after Gadolinium give no additional information. (E’’) The EPI-based DWI sequence showed the pointillism sign, (E’’’) visible on B1000 overlay on the T2-weighted MR image. (F) The MPA folder showed no risk-zones (all MPM foci are green spots) but the presence of a pointillism sign must alert us for possible underlying malignancy. (G) The surgical biopsies were positive, TTF-1 stains were positive for epitheloid MPM.
Figure 2
(A) CXR of a 65-year-old woman with chronic fatigue and a family history of rheumatism. The right suprahilar region showed a SPL. (B and C) PET-CT confirms a FDG-avid nodule in the right upper lobe. An MR examination with (D) T2-weighted MR sequence and (E) DCE-MR sequence showed (F) a type B enhancement curve, with additional (G) DWI showing a restrictive lesion in the malignant range (ADCavg 1.11x10–³ mm²/s). MPA differences found in the (H) cranial and (H’) caudal areas of the lesion confirm inhomogeneity of the SPL, with (I) malignant tissue cranial and benign foci in the basal pole. Histopathological correlation was made with (J) H&E staining, with findings of moderate differentiated squamous cell carcinoma in the upper pole. (J’) The basal pole of the specimen consist of discrete fibrosis with smooth muscle cell hyperplasia.
Figure 3
A 25-year-old man complains of hoarseness for several months. (A and B) PET-CT investigation showed a tumoral process in the anterior mediastinum with calcifications and thrombi in the VCS. The lesion and thrombus tissue are partially FDG avid. Fat-saturated (C) coronal and (D) axial T1-weighted MR images showed parallel results. (E) MPA maps in 2D and (F) 3D visualisations show that the malignant parts of this process are more centrally located, with invasion of the VCS. (G) The histopathological specimen with H&E stains confirmed thymus carcinoma with intravascular involvement. A laborious surgical resection with vascular reconstruction made a complete resection possible.
Figure 4
This collage of pictures is of a good CRT responder with SCLC-ED (PFS 236 days and OS 705 days). Upper row shows malignant cells in lymph nodes of region 4R and 6 on CT (A and B), PET (C), and in the left anterior mediastinum, 2R, 7 and 10L (see spots D, E, F), which were histopathologically proven to be SCLC (G). Second row shows axial, coronal MR Vibe (A, B), with MPA (C) and b1000 image (D) at Base. The tumour volume load at b1000_Ba is 126.2 ml. The third row shows parallel images during therapy at 1M. TLV_b1000_1M is 28.27 ml. The fourth row shows an acceptable tumoral response after 6 months, but there is a new lesion left parahilar (white arrow, C) and after 24 months (D) a brain metastasis on the thalamus become visible (arrowhead).