Sung Shick Jou

Remarkable Effect of Gefitinib Retreatment in a Lung Cancer Patient With Lepidic Predominat Adenocarcinoma who had Experienced Favorable Results From Initial Treatment With Gefitinib: A Case Report

Gefitnib is an oral agent of epidermal growth factor receptor tyrosine kinase inhibitor, and it has a certain efficacy against non-small cell lung cancer. There are some reports that the non-small cell lung cancer patients who experienced disease progression after responding to gefitinib were again sensitive to re-administration of gefitinib following temporary cessation of gefitinib. This is the case report showing a remarkable effect of gefitinib re-treatment in a patient with metastatic invasive adenocarinoma who had experienced favorable results from the initial treatment with gefitinib.

Pancreas Ductal Adenocarcinoma and its Mimics: Review of Cross-sectional Imaging Findings for Differential Diagnosis

Ductal adenocarcinoma is the most common pancreatic neoplasm. A variety of pancreatic lesions mimic pancreas ductal adenocarcinoma (PDAC), such as high-grade neuroendocrine tumors, small solid pseudopapillary tumors, metastases, focal autoimmune pancreatitis, and groove pancreatitis. These occasionally look similar in images, but they have differential diagnosis points. Familiarity with the imaging features of PDAC and its mimics is paramount for correct diagnosis and management of patients. In this essay, we describe imaging findings of PDAC and its mimics for differential diagnosis.

LI-RADS v2017 categorisation of HCC using CT: Does moderate to severe fatty liver affect accuracy?

ObjectivesTo compare the sensitivity of Liver Imaging Reporting and Data System (LI-RADS) v2017 for diagnosis of hepatocellular carcinoma (HCC) using multiphasic computed tomography (CT) between patients with and without moderate to severe fatty liver (MSFL).MethodsThis retrospective study included a total of 106 high-risk patients with 112 pathologically proven HCCs who underwent multiphasic CT. Patients were classified as MSFL (24 men, 2 women; mean age, 59.5 years [range, 38–79 years]) and non-MSFL (64 men, 16 women; mean age, 62.9 years [range, 40–89 years]) groups according to unenhanced CT liver and spleen parenchymal attenuation. Two independent radiologists assigned LI-RADS categories and accessed HCC features on CT. Sensitivities for LR-5 assignment and frequencies of HCC features were compared between the two groups.ResultsSensitivities of LR-5 assignment for diagnosing HCCs were not significantly different between MSFL and non-MSFL groups (65.4% [17/26] vs. 76.7% [66/86] for reviewer 1, p = 0.247; 73.1% [19/26] vs. 76.74% [66/86] for reviewer 2, p = 0.702). No significant differences in the frequencies of arterial hyperenhancement, washout, and capsule were observed between the two groups (96.2% [25/26] vs. 98.8% [85/86], p = 0.412; 80.8% [21/26] vs. 89.5% [77/86], p = 0.308; and 53.8% [14/26] vs. 57% [49/86], p = 0.778, respectively).ConclusionsLI-RADS v2017 using CT showed comparable sensitivity for diagnosing HCC regardless of MSFL.Key Points• Using LI-RADS v2017 with CT, diagnosis of HCC in patients with MSFL showed similar sensitivity to that in patients without MSFL.• Frequencies of major HCC features (arterial hyperenhancement, washout, and capsule) on CT between the MSFL and non-MSFL groups were not significantly different.• LI-RADS using CT may be feasible for diagnosing HCC in patients with fatty liver.

Various congenital anomalies of the inferior vena cava: review of cross-sectional imaging findings and report of a new variant

The inferior vena cava (IVC) is an important structure receiving a large amount of venous return and is associated with various congenital disorders. Advances in diagnostic imaging and its increasing accessibility have led to an increase in the incidental detection of IVC anomalies. Congenital anomalies of the IVC are not uncommon and are occasionally critical to treatment planning. However, they are frequently overlooked in abdominal imaging. The IVC is composed of four segments (intrahepatic, suprarenal, renal, and infrarenal), and each segment arises from different embryonic structures in a complex process. Anomalies of the IVC can be classified according to the involved segment. Familiarity with the variety of IVC anomalies seen on imaging is vital for correctly diagnosing and managing patients in daily practice.

A Case of Adult Congenital Cystic Adenomatoid Malformation of the Lung with Atypical Adenomatous Hyperplasia

Congenital cystic adenomatoid malformation of the lung is a rare disease that shows multiple cystic lesions in pulmonary tissues in the development process. It was first described by Chin et al.1 in 1949 and its incidence is known to be 1:25,000 to 1:35,0002. With the development of prenatal diagnosis, this disease can be diagnosed in 60% and detected within 2 years because of such symptoms as respiratory distress by compression of surrounding lung tissues immediately after birth and repeated respiratory infections in infancy. Among adults, it is detected accidentally on X-ray or by such symptoms as pneumonia, pneumothorax, and hemoptysis. In Korea, the first case in a 28 year-old woman was reported by Geun-Heung Ki et al.3 in 1989. Since then, about 25 adult cases were reported until 2006.