‫حسين كاظم هاشم‬

Case of b lymphoma

Dx at 13-3-2023

9-3-2023 ct chest neck multip;r node mediastail 23x6mm

Pre cardiac node 18x8 mm with diffuse rt side paratial pleural effusion and thicking

9-3-2023 abd ct

Lage mass seen at gastro. Measuring 5.5x5.5 cm

Rt pelvuc wall mass 30mm x 7cm

Ldh 1892

14-3 srart pre cop

Csf cytospin normal

BMA … normal

20-3

Ct abd ,, colon thickness of 3cm …. Enlarge ln 4cm x 5cm

Ct chest same previous

20-3 histopath ……. Nonho. Lymphoma

20-3 2nd cop

29-3-2023 … COPADM 1 postponded

Only vcr was given

‫حسين نوفل‬

CASE OF NHL ( lymphoblastic lymphoma )

Dx at 12-3-2023

Mri of hip …. Soft tissue mass .. wiyh pathological fracture

Surgery wiyh biopsy done

Histopath>>>> lymphoblastic lymphoma

Ct chest …. Mulyiple lytic lestion n all bone

Ldh 214

16-3023 >.>>>> ukall 2019 group c

18-3023 >>>> bma normal

Csf for cyto>>>>> no immture crll seen

29.3.2023 wk3

‫محمد سليم نجم‬

Case of b. lymphoma

Dx at 17-3-2023

Ct abd ….. diffuse annular thickening with enhan.

3-7-23

Abd plvic ct mass 13x11x8cm

11-3 operation done ….. rt hemicoectomy done

17-3-2023 histopath … bur. Lyphoma

Ldh 661

23-3-2023 >>>>> COP proto

Csf cytospin normal

Bma >>>> normal

29-3-23 >>>> COPADM1

‫عذراء حسن‬

Case of NB

Daignosed at 6.9.2022

Abd us show rt Suprarenal mass (66 x 57 mm )

CT scan abd same mass 70x61mm

23.8.2022 biopsy... NB
6.9.22 NB protocol

24.8 BMA dilated marrow no abnormal cell

28.8 CT chest normal

26.9.22 COG protocol

27-11-2022 ct abd .. soft tisse mass 52x33mm

2-4-2023 wk 22

‫احمد حسن سعيد‬

Dx WT

2.3.22 rt renal mass 15x 8 cm

16.3 start chemotherapy

13.3 CT chest lung metastasis

10.5 wk1 SIoP protocol

22.6 MRI abd right renal mass 10cm x6cm x 5.5cm

22.6 CT chest normal

3.7 hepatitis b

11.10 pt received radiotherapy

18-2-2023 ct chest multiple variable size solitary and cavitary meatastatic lesions

20-2-2023 started relapse protocol

‫شهد حسين علي‬

Case of osteosarcoma

Dx at 12.3.22

Operated at 12.4.22

14.2 MRI of Lt thigh soft tissue mass 69x56x200mm

28.2.22 biopsy done ... Osteosarcoma

3.3.22 pet scan hyper metabolic distractive Lt distal femur lesion with metastasis to sacral
lesion

19.3.22 wk1 of osteosarcoma protocol

27.3 MRI of femur mass 19x11x10cm

Here do amputation

7.8.22 pet scan hypermetabolic at surgical site with Lt sacral bone metastasis

20.10 hepatitis b c

2-4-2023 wk 32

2-42023 ct chest normal

Hip mri mass 64x33x48 mm

Virology screen

‫إمير علي‬

Case of metastatic alveolar rms ( 33x23x36mm)

Start chemotherapy in 28.7.2022

1.8 MRI neck multiple mass ant.x post. 38.30mm

CT rt cervical (43x25mm) supraclavicular (37*27mm ) axilla 30x19mm

BM normocelluar hyperplasia

7.9 MRI ... Rt posterior triangle 3x2cm with multiple lap 2x2cm in suora renal gland with ant.
Medistanail 1.5x2cm

10.10 .... Neck MRI 18mmx15mm with Lt supraclavicular region 15x7mm

Reach to wk 13 ... Radiotherapy wk14+15

1.11 CT neck LN (27mmx13mm at posterior triangle

Normal lung

21-2-2023 start ICE protocol

‫كرار هيثم حميد مجبل‬

Date of birth : 17.10.2015

From Al Anbar

Date of diagnosis 17 . 10 2017

Retroperitoneal mass initial MRI ( the upper pole of right kidney is replaced by large mass
99×75×84 ) mm encasing abd aorta and IVC with liver invasion

22_10_2017

Patient started high risk protocol of NB 2nd block as he received first block ( carboplatin and
VP 16 ) IN DUHOK beefore doing true cut biposy depending on VMA & NSE

25.12.2017 abd Us and abd MRI normal

27.2.2018 abd Us right supra renal mass 1.97 × 1.22 × 1.3 cm heterogenous ecchogenesity
by doppler no vascularity

1.3.2018 BMA erythroid hypoplasia

26.3.2018 Abd MRI normal

27.6.2018 patient diagnosed with CMV infection and receieved Ganciclovir treatment

18.9.2018 recieved last dose of CTX wk 46

1.10.2018 abd MRI normal

22.10.2018

MIBG Done with residual disease operation done in india 10.11 2018 exicionql biopsy done
for the patient

Histopath show adrenal gland tissue with fibroadipose tissue with hemosiderophages and
foci of calcification no residual tumor seen

MIBG done after operation on 14.2.2019 in India no supra renal mass seen

Patient was off treatment for 20 month

22.6.2020

Evidence of residual mass in right adrenal gland 16×18 mm

PET SCAN hypermetabolic ill defined soft tissue mass at surgical bed at right supra renal
region
Hypermetabolic skeletal metastasis in left V column

7.7.2020 started COG high risk protocol for relapsed NB

9.11.2020 after discussion with NB team at medical city decission was because of small size
mass no role of surgey for 3 cycle of TZM 100mg oral for 5 days every 3 week followed by
radiotherapy followed by cis retinoic acid

21.12.2020 radiotherapy recieved from 21.12.2020 to 18.1.2021

18.3.2021 abd MRI small retroperitoneal lesion of tumor aspect in right suprarenal region
extending to the para aortic and intercostal region 15× 18 mm

22.3.2021 started 1st course of cis retinoic acid 100mg / day for 14 day

28.8.2021 last course of cis retinoic acid

1.9.2021 abd MRI , BMA and biopsy all Normal

10.11.2021 abd MRI abnormal bone marrow signal intensity of D11 D12 L1 L2 vertebral
bodies with irregular vertebral end plate picture of bony metastasis , otherwise normal
imaging

BM normal

21.11.2021 PET scan == progressive disease ( hypermetabolic foci in the sternum multiple
vertebra a, sacrum , pelvic bone lt proximal femur and rt proximal tibia

Patient start resistant and relapsed NB protocol

17.2.2022 evidence of abnormal signal of bone marrow involving vertebral bodies of D12 L1
and L2 with suspicious enhancement after contrast MIBG recommended

22.3.2022 MIBG normal

13.6.2022 abd us normal

14.8.2022 abd MRI abnormal bone marrow signal intensity involving verebral bodies D12 L1
L2

However metastasis cannot be excluded

22.10.2022 started 2nd line chemotherapy topatican and cyclophosphomide

Recieved 4th cycle on 24.12.2022

15.1.2023 abd MRI rught sided paramedian and median mass retroperitoneal homogenous
enhancing well defined mass lesion of 4 ×2× 3 cm with hypointense signal in T1 & T2
calcification as US related the mass encasing IVC & Right common illiac vessels and rt ext
illiac vessels causing mild displacement of related structure in doppler study normal venous
flow through IVC right external illiac vessels , otherwise normal

BONE SCAN == no pathological uptake in the skeleton

‫حسين ناظم‬

Ewing sarcoma

27-11-2022 mri pelvic spine ….. infiltration

29-1-2023 bm involved

2-4-2023 wk 9

‫يوسف سعد‬

RMS rt forearm

With relapse in lymph nodes

Relapse protocol

Ice protocol 14.5.22

PET scan /….. small hypermetabolic lesions near lt eye

12-12-2022 start resisitant refractory LCH

Now wk 44

‫حسين احمد جابر‬

Hepatoblastoma stage 3

18.10 liver mass 10x10cm

25.10 .21 CT chest multiple sort tissue lesion

25.10.21 abd MRI liver mass Lt lobe 11x9.5x9.7 cm

22.10 BMA normal

8.11.21 start siopet

10.1.22 MRI of abd mass 10x7.1x8.2 cm

10.1 CT chest multiple nodules

8.3.22 liver mass 5.2x4.7x3.8cm

25.5 mass 7.5x5.6x5.7cm

25.5 CT chest normal

28.6 PET scan only liver lesion

8.8.22 mass liver 55x40mm

25.8 abd CT liver mass 62x42x356mm

13.3.2023 surgery done

2-4-2023 ICE protocol extracycle

‫بركات اسماغيل‬

Ewing sarcoma

Dx 24.10

Started vide at 14.11

14.11 BM normal

29-1-2023 wk 7

2-4-2023 ct chest normsl

Mri hip mass 14x8x4,5 mm

20402023 wk 13

‫سارة عبد الرحمن روسي‬

‫الرمادي _ االنبار‬

DOB : 13.10.2011
A case of Ewing sarcoma right leg

Operated 28.6.2022

H.P 6.7.2022 Ewing sarcoma

3.8.2022 pulmonary metastasis

13.8.2022 bone scan diffuse uptake in distal part of right tibia

Started VIDE protocol 14.8.2022

25.9.2022 MRI leg == expansion of of abnormal bone marrow signal intensity distal right
tibial metadiaphysis to distal epiphysis causing cortical destruction and adjacent soft tissue
extension 83 × 31 mm

28.9 CT chest normal

20.11 Ct chest normal

20.11 .2022

MRI == the same as the previous one with measurment becoming 86× 33 mm with two
intramedullary lesion 10 and 7 mm in mid tibia

8.1.2023 she recieved wk 16 of protocol

29.1.2023 MRI the measurement increased to 113 × 41 mm with intramedullary lesion

increased to 50 mm nomal adjacent fibula

The surgeon opinion is to amputate and consult us as wether to do above knee or

disarticulation

‫عباس احمد عمران‬

Case of HL staye 3 bs

Dx at 22.11.2021

Cervical LN

Class HD

Neck us .... Lap 15x9mm

9x7mm

31.10.21 CT abd ...LAP 70x65mm

23.11.21 WBvD protocol

24.2.22 CT neck LAP 17x6mm

Bilateral axillary lap 12x5mm

24.2 MRI abd paraaortic LN 41x34mm

9.4.22 abd MRI normal

30.6.22 abd us mass Lt paraaortic region 50s35x25mm

5.7.22 neck CT LAP 14x5mm

Axillary lap 10x5 mm

20.9 pet scan active residual disease

4.10.22 pet scan resistance disease

25.10 start IGEV protocol

15.11 cycle 2

PET SCAN still hypermetabolic actitity

14-302023 ICE protocol wk 1