ABSTRACT. The purpose of this study is to evaluate the role of diffusion-weighted imaging (DWI) in combination with T 1 and T 2 weighted MRI for the characterisation of renal carcinoma. The institutional review board approved the study protocols and waived informed consent from all of the patients. 47 patients (32 male and 15 female; age range, 21-85 years; median age, 65 years) who had suspected renal lesions on abdominal CT underwent MRI for further evaluation and characterisation of the lesions from April 2005 to August 2007 in our university hospital. A region of interest was drawn around the tumour area on apparent diffusion coefficient (ADC) maps. Final diagnosis was confirmed by histological examination of surgical specimens from all patients. The ADC value was significantly higher in renal cell carcinoma (RCC) ; p50.0004), whereas intensity on T 1 and T 2 weighted imaging did not reach statistical significance. In conclusion, DWI has clinical value in the characterisation of renal carcinomas and could be applied in clinical practice for their management. Renal cell carcinoma (RCC) is the most common primary malignant tumour of the kidney; it accounts for 2-3% of all adult cancers and is the sixth cause of death by tumour throughout the world. More than 80% of renal cancers that arise in the renal parenchyma are RCC, whereas the majority of renal pelvis cancers are transitional cell carcinomas (TCCs) [1][2][3]. The three most common subtypes of RCC are (i) clear cell carcinoma, one of the most common types, accounting for 70-80% of cases; (ii) papillary renal cell carcinoma, accounting for about 10-15% of cases; and (iii) chromophobe renal carcinoma, which is the least common, accounting for 5% of all RCCs. The annual rate of RCC diagnosis is increasing as a result of incidental detection by crosssectional abdominal imaging of patients with suspected abdominal disorders. Increased detection rates carry a favourable prognosis; however, mortality from RCC has not decreased [2][3][4].Diffusion-weighted imaging (DWI) is frequently used in cranial MRI studies and has shown potential for the characterisation of lesions such as acute cerebral infarctions, intracranial tumours, various infectious diseases and metabolic disorders [5][6][7][8]. The role of DWI is limited outside the central nervous system, owing to its inherent extreme sensitivity to motion, such as that related to respiration, peristalsis and artefacts, thus resulting in a high signal to noise ratio. With the development of advanced MR technology and the use of faster robust sequences, better quality has been obtained in abdominal imaging [9]. DWI with high b-values has been reported to have a high sensitivity for depicting malignant disease. Apparent diffusion coefficient (ADC) values of malignant hepatic, ovarian, breast, prostatic, colonic and uterine cervical tumours were lower than those of benign lesions or normal tissue [10][11][12][13][14][15][16][17][18].Previous studies have suggested that patients with chromophobe and papillary RCC ha...

BackgroundLiquid‐based cytology (LBC) allows immunohistochemistry (IHC), fluorescence in situ hybridization, and molecular testing to be performed in fixed cell materials. We examined the feasibility of subtyping and EGFR mutation testing of bronchoscopic samples from patients with lung cancer using cell blocks (CB) based on LBC fixation (LBC‐CB).MethodsWe included 35 consecutive patients with peripheral lung nodules who underwent endobronchial ultrasonography with a guide sheath in our hospital. Thirty of these patients were diagnosed with lung cancer by obtaining cytological samples. Cytological subtyping was performed with IHC using LBC‐CB, and the Cobas EGFR Mutation Test ver. 2 was performed using extracted genomic DNA from the LBC‐CB, formalin‐fixed paraffin‐embedded (FFPE) tissue, and matched plasma.ResultsOf the 30 cases, 25 were classified cytomorphologically as adenocarcinoma (ADC, n = 17) and squamous‐cell carcinoma (SQCC, n = 8). The remaining five cases were classified by IHC as favor ADC (n = 3) and favor SQCC (n = 2) according to the WHO criteria. In the final ADC group (n = 20), EGFR mutations on the LBC‐CB were identified in eight cases (40%; 1 exon 19 deletion, 6 L858R, and 1 L861Q). Mutations in FFPE samples were identified in seven cases (35%) at the same site in each case. Plasma EGFR mutations were identified in four cases (20%) at the same site. The CB detection rate was higher than for FFPE and plasma.ConclusionLBC‐CB is suitable for subtyping and EGFR mutation testing in lung cancers.

OS for PTC decreases incrementally with age, but OS for FTC decreases significantly in patients aged 45 years and older. A higher age threshold may inappropriately downstage some high-risk follicular cancer patients.

The present study demonstrated that preoperative CEA level, pathological T-factor, lymphatic permeation, vascular invasion, and pleural invasion were independent prognostic factors for early recurrence within one year, even in patients with pathological stage I. In patients with these factors, adjuvant therapy may be indicated since this may improve their survival.

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