A Summer Filled A Summer Filled With Lymph NodesWith Lymph Nodes

Massachusetts General HospitalMolecular Imaging Department

Boston, MA

David BorczukOctober 15, 2009

MentorsMentors

Dr. Sanjay SainiProfessor of Radiology, Harvard Medical School

Mukesh Harisinghani, M.DAssociate Professor of Radiology, Harvard Medical School

Assistant Radiologist, Dept. of Abdominal Imaging 

MentorsMentors

Veena Iyer◦ Research fellow who assisted me in my

research.

A Typical Workday:A Typical Workday:

Catch the 9:48 AM commuter rail

Arrive at North Station at 10:30 AM

Start work

Lunch at 1:00 PM

Take train back home at 3:00 PM

Project 1Project 1: Transitional Cell Carcinoma (TCC): Transitional Cell Carcinoma (TCC)

Cancer of bladder or ureter lining.

Ages 50-70 y/o

Initial complaints:◦ Hematuria (blood in urine)◦ Abdominal Pain

Metastasis to lymph nodes

Transverse Pelvic/Abdominal CTTransverse Pelvic/Abdominal CT

http://emedicine.medscape.com/article/381323-overview

Transitional Tumor

The ProblemThe Problem

Tests can be negative or positive

Sometimes, tests can be wrong◦ False Positives◦ False Negatives

Goal: To test for false negatives◦ Increase in node size in f/u CT = potential

indication of TCC

A Sample SpreadsheetA Sample Spreadsheet

Project 2:Project 2: Periportal Lymphadenopathy Periportal Lymphadenopathy

Periportal Lymph Node Enlargement Causes◦ Cancer◦ Cirrhosis of liver◦ Excessive alcohol consumption◦ Hepatitis (HCV and HBV)◦ AIDS◦ UNKNOWN?

Goal: To explain this “unknown” cause!

Project 2:Project 2: Periportal Lymphadenopathy Periportal Lymphadenopathy

2005-2007 patients with enlarged periportal lymph nodes

Noted if patient had any causes

No causes = included in study

Sample SpreadsheetSample Spreadsheet

ConclusionsConclusions

Abstract to be presented 2010

About 50-70 patients out of 700 had unexplained periportal lymph node enlargement.

Around 20 patients with negative TCC images were actually positive.

What I learnedWhat I learned

A vast amount of medical vocabulary and jargon.

Background of many types of cancers. Ability to work with medical software.◦ CAS (digital patient record system).

How to read some types of CT and MRI images.