Low Grade Lymphoma Mimicking Metastatic Urothelial Carcinoma: When Do We Need Further Histologic Staging?

Patients with urothelial carcinoma of the bladder often present with metastases to regional lymph nodes, with lymphadenopathy on physical examination or radiographic imaging. We present the case of a 73-year-old Caucasian man with presumed metastatic urothelial carcinoma of the bladder to regional pelvic and retroperitoneal lymph nodes. He underwent systemic chemotherapy for treatment of urothelial carcinoma and was discovered on restaging to have findings suggestive of disease progression but ultimately was found to have a concurrent secondary malignancy.

Prospective evaluation of CT esophagram findings after peroral endoscopic myotomy.

Background And Aims: Peroral endoscopic myotomy (POEM) is a procedure with potential for serious adverse events. Postprocedure imaging is routinely done, yet there is no consensus on the optimal imaging protocol. We describe a novel and simple CT esophagram protocol for evaluation after POEM and for reporting the full spectrum of radiographic findings and subsequent interventions.

Port-site recurrence of pancreatic adenocarcinoma following laparoscopic pancreaticoduodenectomy.

Introduction: Minimally invasive surgical approaches have only recently been applied to pancreatic adenocarcinoma.

Discussion: Significant apprehension exists that minimally invasive pancreatic surgery will not lead to equivalent or superior oncologic outcomes compared to traditional surgical approaches. This is the first case report of a port-site recurrence following laparoscopic pancreaticoduodenectomy.

Does surgical closure technique affect early mammographic detection of tumor recurrence after breast-conserving therapy?

Purpose: Scarring in the tumor bed may mask or mimic local recurrence of tumor on surveillance mammography. Type of surgical closure technique used during lumpectomy may impact the pattern or density of scar tissue apparent in the tumor bed on mammography. This study sought to determine whether surgical closure type affects tumor-bed scar formation and impacts interpretation of surveillance mammography in women treated with breast-conserving therapy for early-stage breast cancer.

Esophageal perforation in adults: aggressive, conservative treatment lowers morbidity and mortality.

Objective: To evaluate the outcome of aggressive conservative therapy in patients with esophageal perforation.

Summary Background Data: The treatment of esophageal perforation remains controversial with a bias toward early primary repair, resection, and/or proximal diversion. This review evaluates an alternate approach with a bias toward aggressive drainage of fluid collections and frequent CT and gastographin UGI examinations to evaluate progress.

Granulocytic sarcoma (chloroma) of the breast: a diagnostic dilemma and review of the literature.

Primary granulocytic sarcoma (GS) is a rare entity, and even more unusual is the presence of primary GS of the breast. We describe such a case and report on the 19 cases of primary breast GS in the literature. Primary GS presents most commonly in skin and lymph nodes, therefore when it presents in the breast, misdiagnosis is a common problem.

Ultrasonography of the liver. An update on new applications.

Sonography is highly useful in evaluating the patient with severe liver disease before and after the placement of a TIPS and before and after organ transplantation. Efforts to use ultrasound imaging to evaluate for primary and metastatic lesions to the liver have been reviewed. With its Doppler and color flow capabilities, ultrasound imaging will remain an important modality for hepatic imaging, especially in the evaluation of portal vein patency and hepatic artery thrombosis.