AIRP CASE PREPARATION AND SUBMISSION

CARDIOVASCULAR

Dr. Aletta A. Frazier afrazier@acr.org

Cardiovascular cases require histologic or culture proof to be accepted. Gross anatomic images are also helpful whenever available. Exception cases must be cleared by Dr. Frazier. Complete anatomic and functional imaging evaluations (CXR, CT, PET CT, MRI, echocardiography, angiography) should be provided as appropriate. Any well-correlated case will be accepted. However, the following subject areas are of particular interest:

• Acute aortic syndromes (intramural hematoma, aortic dissection, penetrating aortic ulcer)
• Infiltrative myocardial diseases
• Cardiomyopathies (dilated, restrictive, hypertrophic)
• Myocarditis
• Arrhythmogenic right ventricular dysplasia
• Congenital heart disease (pediatric and adult)
• Valvular heart disease
• Cardiac or vascular neoplasia
• Vasculitis (large, medium, small vessel disorders)
• Vascular malformations
• Pericardial diseases
  

CHEST

Dr. Jeffrey Galvin jgalvin@acr.org

All chest cases require histologic or culture proof to be accepted. Exception cases must be cleared by Dr. Galvin. (Cases should be accompanied by chest radiographs whenever possible.) CT cases should have both mediastinal and lung windows. Any well-correlated case will be accepted. However, the following subject areas are of particular interest:

• High resolution thin section CT of diffuse lung disease — Gross specimens are helpful but not critical. There must be, however, an open lung or transbronchial biopsy. A combination of thick and thin sections is optimal. Coronal reconstruction to demonstrate the distribution is also helpful.
• Diffuse lung disease treated with lung transplantation — If properly prepared, these cases allow gross photography of the sectioned lung. Imaging from multiple points in time is important to illustrate the natural course of disease.
• Tuberculosis
• Drug-Induced Pulmonary Disease
• Infectious Pulmonary Disease
• AIDS-Related Thoracic Disease
• Pulmonary Manifestations of Systemic Disease
• Granulomatous Pulmonary Disease
• Airways Disease
• Inhalational Lung Disease — To best correlate pathologic material with the chest radiographic studies, please work with your pathologist before the pulmonary tissue is resected to arrange for inflated and fixed lung specimens. A variety of techniques are nicely detailed in Dr. E.R. Heitzman's book, The Lung, 2nd edition, St. Louis: CV Mosby, 1984 (pp. 412). Macrosections as well as microsections of the inflated fixed tissue would significantly improve the radiologic/pathology correlation. Inflated whole lung (or lobar/segmental) specimen radiographs of any pulmonary case would be greatly appreciated.

GASTROINTESTINAL

Dr. Rachel Lewis RachelLewis@acr.org

All cases require histologic or culture proof. No cases will be accepted without gross pathology unless previously cleared by Dr. Lewis. The best correlation with pathologic material is provided by working with your pathologist and sectioning specimens in similar planes to imaging. We are especially interested in the following cases:

• Diseases of the esophagus, stomach, small bowel, colon, liver, spleen, pancreas, gallbladder, bile ducts, mesentery, and peritoneum with multimodality imaging correlation (especially including MRI)
• Systemic diseases
• Infectious and inflammatory processes
• Autoimmune diseases
• Radiologic-pathologic correlation of staging of neoplasms
• Cases that include advanced imaging techniques

Please do not submit cases of ordinary appendicitis; however, we are interested in unusual cases of appendicitis associated with tumors, parasites, or other uncommon entities.

Retroperitoneal cases are considered Genitourinary.

GENITOURINARY

Dr. Grant Lattin grant.lattin@usuhs.mil

All cases require histologic or culture proof. No cases will be accepted without gross pathology unless previously cleared by Dr. Lattin. We are especially interested in the following cases:

• Diseases of the male and female genitourinary systems with multimodality imaging correlation to include hollow and solid organs, retroperitoneum, and external genitalia (especially including MR)
• Systemic diseases
• Infections
• Autoimmune and inflammatory diseases
• Radiologic-pathologic correlation of staging of neoplasms
• Trauma
• Congenital uterine malformations with MRI
• Fetal anomalies, especially with in utero MRI. Photographs of the infant after delivery may be used as gross correlation

MAMMOGRAPHY

Dr. Leonard Glassman leonardglassman@hotmail.com

Breast imaging cases using multiple imaging modalities are particularly educationally valuable.  Gross photographs are required.  The provision of a quality gross photograph of the resected specimen greatly adds to the teaching value of the case.

Exceptions to the gross photograph requirement are made for rare diagnoses or presentations, but only with advance permission.  Email leonardglassman@hotmail.com for permission before submission.

MUSCULOSKELETAL

Dr. Mark Murphey mmurphey@acr.org

The ideal case for the radiologic-pathologic couse requirement provides direct imaging correlation between gross and histologic features and the imaging appearance.  For this reason, we require gross and histology images.  The best correlation with imaging is obtained with planning for intraoperative photographs and sectioned gross specimens (working with your surgeons and pathology colleagues at the time of treatment and diagnosis) in planes that complement imaging.  If the lesion is only biopsied or curetted for definitive treatment, then histology alone is acceptable. 

All cases should be accompanied by radiographs whenever possible. CT studies should have both bone and soft tissue windows. MR images should include some type of T1- and T2-weighted sequences. Pre- and post-contrast MR images should also be included, if available.  Sonography should include Doppler evaluation, if possible.

• MR and/or CT correlated bone and soft tissue tumors (benign and malignant)
• Arthropathies
• Metabolic bone diseases
• Bone and soft tissue infections (with CT and/or MR correlation)
• Developmental/congenital abnormalities
• Bone dysplasias/dwarfs/syndromes
• Systemic diseases (Sarcoid, Gauchers, Myelofibrosis, etc.)
• Traumatic abnormalities, particularly with arthroscopic and CT and/or MR correlation

If you submit a second case for the musculoskeletal section, the following criteria apply (in the order of preference):

• Cases with histology and gross pathology
• Cases with histology only
• Cases with arthroscopic correlation
• Pathognomonic cases

If you have questions or concerns about the acceptability of your musculoskeletal case, contact Dr. Murphey (mmurphey@acr.org)

NEURORADIOLOGY/HEAD AND NECK

Dr. Alice Smith alsmith@usuhs.mil

• Primary neoplasms of the brain and spinal cord 
• Infections
• White matter diseases
• Developmental disorders and anomalies (with gross photos and MR)
• Phakomatoses (especially with MR)
• Cerebrovascular Disease (especially with MR)
• Head and neck masses (including orbit)
• PET / SPECT thallium cases (radiation necrosis vs. tumor)
• Cases with MR spectroscopy, diffusion-weighted imaging, perfusion imaging and other advanced imaging procedures

• Please submit lesions involving the vertebral bodies under Musculoskeletal, and peripheral nerve sheath tumors under the organ system in which they are located

We would greatly appreciate gross brain sections (or autopsy photographs) of both common and unusual conditions. Films submitted should portray the full extent of the lesion.

PEDIATRICS

Dr. Ellen Chung echung@usuhs.mil

We are particularly interested in the following cases:

• Genitourinary and hindgut congenital/developmental anomalies —These will be accepted with surgical correlation alone if pathologic specimens are unavailable.
• AIDS-related disorders — all organ systems
• Umbilical abnormalities
• Perinatal brain abnormalities — congenital/acquired
• Congenital Biliary Disease