Trevor Rose, MD, MPH, Jamie Caracciolo, MD, MBA, Robert Gatenby, MD

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Cancer Survivorship, a Unique and Growing Cohort in Medical Practice: Radiology Perspective Trevor Rose, MD, MPH, Jamie Caracciolo, MD, MBA, Robert Gatenby, MD The American Journal of Medicine Volume 126, Issue 9, Pages 759-767 (September 2013) DOI: 10.1016/j.amjmed.2013.03.020 Copyright © 2013 Elsevier Inc. Terms and Conditions

Figure 1 (A) CT scan in patient with Hodgkin's lymphoma demonstrates normal lung parenchyma at time of diagnosis before initiation of chemotherapy. (B) After 3 months of therapy with regimen including bleomycin CT through the lung bases, new areas of ground glass opacities and thickening of the septa (arrows) are demonstrated, consistent with interstitial pneumonitis. The American Journal of Medicine 2013 126, 759-767DOI: (10.1016/j.amjmed.2013.03.020) Copyright © 2013 Elsevier Inc. Terms and Conditions

Figure 2 A 70-year-old man with a history of right lung adenocarcinoma successfully treated with radiation therapy. (A) Axial CT image demonstrates traction bronchiectasis (arrow) and honeycombing (solid arrow), consistent with fibrotic changes from radiation. (B) Coronal image again demonstrates areas of traction bronchiectasis (arrow). The American Journal of Medicine 2013 126, 759-767DOI: (10.1016/j.amjmed.2013.03.020) Copyright © 2013 Elsevier Inc. Terms and Conditions

Figure 3 Patient with sarcoma with acute shortness of breath. (A) Axial image from CT scan demonstrates a filling defect within the right main pulmonary artery (solid arrow), consistent with pulmonary embolism. (B) Coronal image demonstrates filling defect within the right main and lower lobar pulmonary arteries (solid arrow). The American Journal of Medicine 2013 126, 759-767DOI: (10.1016/j.amjmed.2013.03.020) Copyright © 2013 Elsevier Inc. Terms and Conditions

Figure 4 Ultrasound images from 3 different oncology patients with a history of renal failure. (A) Sagittal ultrasound image demonstrates echogenic renal cortex (arrows) brighter than the adjacent liver (star), which can be seen in medical renal disease. The normal kidney should be less bright or equal in echogenicity to the liver. (B) Sagittal image of the right kidney in a separate patient demonstrates a bright focus with shadowing present (arrow) in the right lower pole consistent with a renal calculus. (C) Sagittal image of the left kidney in another patient demonstrates connected anechoic spaces (stars) representing dilated calyces and renal pelvis consistent with hydronephrosis. INF = inferior; LAT = lateral; LLD = left lateral decubitus; LT = left; RT = right; SAG = sagittal. The American Journal of Medicine 2013 126, 759-767DOI: (10.1016/j.amjmed.2013.03.020) Copyright © 2013 Elsevier Inc. Terms and Conditions

Figure 5 Images from childhood cancer survivor with right hip pain. (A) Plain film of the right hip demonstrates sclerosis of the right femoral head (arrow), consistent with avascular necrosis. (B) Axial MRI demonstrates bright abnormal signal within the femoral head (arrows), consistent with marrow changes that can be seen with avascular necrosis. Increased signal is seen adjacent to the femoral head (arrowhead), consistent with a small hip effusion. (C) Coronal MRI again demonstrated bright abnormal signal in the right femoral head (arrows). Low signal is identified within the femoral head (star) correlating with sclerosis seen on plain film. The American Journal of Medicine 2013 126, 759-767DOI: (10.1016/j.amjmed.2013.03.020) Copyright © 2013 Elsevier Inc. Terms and Conditions

Figure 6 Immunosuppressed patient with cancer with abdominal pain. Coronal CT images (A, B) demonstrate diffuse wall thickening throughout the entire colon (arrows), consistent with Clostridium difficile colitis. The American Journal of Medicine 2013 126, 759-767DOI: (10.1016/j.amjmed.2013.03.020) Copyright © 2013 Elsevier Inc. Terms and Conditions

Figure 7 Oncology patient who presented with nausea and vomiting. (A) Portable view of the abdomen demonstrates dilated loops of bowel centrally (arrows) suspicious of small bowel obstruction. Incidental note is made of consolidation in the right lower lobe, consistent with pneumonia (arrowhead). (B) CT coronal image from the same patient demonstrates dilated loops of small bowel (arrows), consistent with small bowel obstruction. The American Journal of Medicine 2013 126, 759-767DOI: (10.1016/j.amjmed.2013.03.020) Copyright © 2013 Elsevier Inc. Terms and Conditions

Figure 8 Patient with breast cancer who received remote radiation for breast cancer and developed left shoulder pain. (A) Axial CT image demonstrates sclerosis and expansion of the left clavicle with osseous matrix (arrow), consistent with secondary osteosarcoma. (B) Coronal pre-contrast T1-weighted MRI demonstrates a soft tissue mass involving the left clavicle. (C) Coronal post-contrast T1-weighted MRI demonstrates avid enhancement of patient's secondary osteosarcoma (arrowhead). The American Journal of Medicine 2013 126, 759-767DOI: (10.1016/j.amjmed.2013.03.020) Copyright © 2013 Elsevier Inc. Terms and Conditions