Imaging
Those who care for patients with pulmonary, critical care or sleep disorders rely heavily on chest radiology and pathology to determine diagnoses. The Southwest Journal of Pulmonary, Critical Care & Sleep publishes case-based articles with characteristic chest imaging and related pathology.
The editor of this section will oversee and coordinate the publication of a core of the most important chest imaging topics. In doing so, they encourage the submission of unsolicited manuscripts. It cannot be overemphasized that both radiologic and pathologic images must be of excellent quality. As a rule, 600 DPI is sufficient for radiographic and pathologic images. Taking pictures of plain chest radiographs and CT scans with a digital camera is strongly discouraged. The figures should be cited in the text and numbered consecutively. The stain used for pathology specimens and magnification should be mentioned in the figure legend. Those who care for patients with pulmonary, critical care or sleep disorders rely heavily on chest radiology and pathology to determine diagnoses. The Southwest Journal of Pulmonary, Critical Care & Sleep publishes case-based articles with characteristic chest imaging and related pathology. The editor of this section will oversee and coordinate the publication of a core of the most important chest imaging topics. In doing so, they encourage the submission of unsolicited manuscripts. It cannot be overemphasized that both radiologic and pathologic images must be of excellent quality. As a rule, 600 DPI is sufficient for radiographic and pathologic images. Taking pictures of plain chest radiographs and CT scans with a digital camera is strongly discouraged. The figures should be cited in the text and numbered consecutively. The stain used for pathology specimens and magnification should be mentioned in the figure legend.
Medical Image of the Week: Hepatocellular Carcinoma with Pulmonary Metastasis
A 58-year-old man with a history of hepatitis-C, liver cirrhosis and hepatocellular carcinoma treated with sorafenib and chemoembolization was admitted with septic shock due to spontaneous bacterial peritonitis with concomitant hemorrhage and acute renal failure. The patient did not respond to broad-spectrum antibiotics, aggressive care with multiple vasopressors and ventilatory support and died shortly after admission. An autopsy was performed revealing hepatocellular carcinoma with extensive intra-abdominal and thoracic metastasis.
Figure 1. Axial CT image of upper abdomen revealing cirrhotic liver with a large mass in left hepatic lobe (star) and massive ascites.
Figure 2. Cross-section of liver showing green-yellow hepatocellular carcinoma in left hepatic lobe (star).
Figure 3. Cross-section of lung showing numerous green-yellow metastatic lesions in pulmonary parenchyma and hilar nodes.
Figure 4. Hematoxylin and eosin (40x [Panel A] and 100x [Panel B]) stained lung demonstrating micro-tumor emboli (arrows) of hepatocellular carcinoma.
Tauseef Afaq Siddiqi MD1, Sachin Chaudhary MD1,Nicholas Hernandez MD2, Christopher Geffre MD2 and Richard Sobonya MD2
1 Department of Medicine, Section of Pulmonary, Allergy, Critical Care and Sleep Medicine, The University of Arizona, Tucson, AZ 85724, United States
2 Department of Pathology, The University of Arizona, Tucson, AZ 85724, United States.
Reference as: Siddiqi TA, Chaudhary S, Hernandez N, Geffre C and Sobonya R. Medical image of the week: hepatocellular carcinoma with pulmonary metastasis. Southwest J Pulm Crit Care. 2013;6(5):234-6. PDF