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A Summer Filled A Summer Filled With Lymph Nodes With Lymph Nodes Massachusetts General Hospital Molecular Imaging Department Boston, MA David Borczuk October 15, 2009
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Page 1: Dave Borczuk Internship

A Summer Filled A Summer Filled With Lymph NodesWith Lymph Nodes

Massachusetts General HospitalMolecular Imaging Department

Boston, MA

David BorczukOctober 15, 2009

Page 2: Dave Borczuk Internship

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 

Page 3: Dave Borczuk Internship

MentorsMentors

Veena Iyer◦ Research fellow who assisted me in my

research.

Page 4: Dave Borczuk Internship

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

Page 5: Dave Borczuk Internship

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

Page 6: Dave Borczuk Internship

Transverse Pelvic/Abdominal CTTransverse Pelvic/Abdominal CT

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

Transitional Tumor

Page 7: Dave Borczuk Internship

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

Page 8: Dave Borczuk Internship

A Sample SpreadsheetA Sample Spreadsheet

Page 9: Dave Borczuk Internship

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!

Page 10: Dave Borczuk Internship

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

Page 11: Dave Borczuk Internship

Sample SpreadsheetSample Spreadsheet

Page 12: Dave Borczuk Internship

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.

Page 13: Dave Borczuk Internship

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.