Journal of Radiological Science/放射線學雜誌
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社團法人中華民國放射線醫學會,正常發行
選擇卷期
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Inflammatory pseudotumor (IPT)-like follicular dendritic cell (FDC) sarcoma is an extremely rare neoplasm, almost exclusively occurring in spleen or liver. It is generally regarded as a distinctive pathological variant from the conventional FDC sarcoma. Herein, we present the case of a 65-year-old woman with an incidentally found splenic tumor, proven to be an IPT-like FDC sarcoma pathologically. According to previous case reports, splenic IPT-like FDC sarcoma may show mild enhancement initially with progressive and persistent enhancement on the delayed phase on computed tomography (CT) and magnetic resonance imaging. The CT findings of our case are consistent with those of previous reports. The imaging feature of this extremely rare IPT-like FDC sarcoma may help radiologists to differentiate it from other benign or malignant splenic tumors.
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Amyloidosis is a metabolic disorder that can affect multiple organs. However, pleural amyloidosis is rare and can mimic benign and malignant entity. Here we report a case of a 67-year-old asymptomatic female presenting with several nodular opacities in bilateral lung fields detected by chest radiography. Computed tomography revealed multiple circumscribed nodules along bilateral pleura. Video-assisted thoracoscopic surgery was performed and pleural amyloidosis was incidentally diagnosed by histopathological examination.
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Inflammatory pseudotumor (IPT) of the liver is a rare and benign disease. The clinical manifestations and radiographic features of hepatic IPT are variable and nonspecific, often leading to misdiagnosis as malignancy. We report a case of hepatic IPT mimicking cholangiocarcinoma, with delayed enhancement and left portal vein thrombosis. The diagnosis was made based on pathologic specimen of core needle biopsy.
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PURPOSE. To study the prevalence of the supra-aortic vessels involvement in Stanford type A aortic dissection, the characters of the involved supra-aortic vessels, the cerebral ischemic pattern, and its correlation to the characters of involved vessels in such patients. MATERIALS AND METHODS. We searched the picture archiving and communication system databank about the patients diagnosed to have Stanford type A aortic dissection and also acute ischemic stroke. We evaluated the supra-aortic vessels including the brachiocephalic, right common carotid, right internal carotid, right subclavian-vertebral, left common carotid, left internal carotid, and left subclavian-vertebral arteries. The demography, computed tomography angiography findings, and brain images were reviewed and analyzed. RESULTS. One hundred and five patients with type A aortic dissection were included in this study. They were 76 males and aged 27 to 95 years old (mean = 59.5, standard deviation = 14.4). Supra-aortic artery involved in 51 (48.6%) among them. They were 40 males and aged 29 to 87 years old (mean = 57.7, standard deviation = 14.0). Involvement of brachiocephalic artery and right common carotid was found in 30 patients (30/51 = 58.8%), right internal carotid artery (ICA) in 26 (51.0%), left common carotid artery in 26 (51.0%), left ICA in 24 (47.1%), left subclavian-vertebral artery in 22 (43.1%), and aberrant right subclavian artery in 1. Fifteen (14.3%) of these 51 patients were associated with cerebral ischemia. They were 8 males and aged 49 to 84 years old (mean = 70.3, standard deviation = 9.6). In these 15 patients, a total of 81 vessels were involved. Among them, double lumen with thrombotic false lumen noted in 21 vessels, patent both true and false lumen in 27, complete occlusion of artery in 23, and severe stenosis in 1. In their brain images, lesion found in one hemisphere in 8 patients (territorial infarction in 5 patients, borderzone infarction in 1 patient, embolic infarction in 2 patients), and in bilateral hemispheres in 7 patients (bilateral borderzone infarction in 2 patients, embolic in 1, diffuse loss of gray-white matter differentiation in 3, and 1 patient had right territorial infarction and left borderzone infarction). In the 4 patients with bilateral ICAs occlusion, they had bilateral lesions (3 loss of gray-white matter differentiation, 1 bilateral borderzone infarction). CONCLUSION. Type A aortic dissection complicated with acute ischemic stroke is not uncommon. The possibility of underlying aortic dissection in patient presenting as acute ischemic stroke should be kept in mind.
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Fracture of tunneled hemodialysis catheter is a rare but serious event during exchange or removal of the catheter. The fractured catheter could migrate and result in severe complications, so the migrated catheter should be removed percutaneously or surgically as soon as possible. We reported two methods of percutaneous retrieval of fractured tunneled hemodialysis catheters, using loop snare and balloon, respectively.
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PURPOSE. Stereotactic vacuum-assisted breast biopsy (VABB) is an important technique to diagnose isolated breast microcalcifications. Larger specimens obtained facilitate the early cancer assessment. MATERIALS AND METHODS. We retrospectively reviewed the stereotactic VABB on breast microcalcification in our hospital and compared the diagnostic performances of using 7-gauge (7-G) and 10-gauge (10-G) VABB needles. RESULTS. A total of 628 patients (187 biopsied by 7-G needle and 441 by 10-G needle) were included for analyses, showing 18.47% prevalence for breast cancers. Regarding the results of 153 cases with surgical pathology and 475 with clinical follow-up for at least 2-year, the overall cancer sensitivity was counted to 92.24%, specificity to 98.24% and accuracy to 98.63%. The accuracies, sensitivities and complete retrieval of microcalcifications by 7-G and 10-G needles were 100% to 97.27% (p = 0.022), 100% to 86.36% (p = 0.067) and 37.97% to 24.04% (p ＜ 0.001), respectively. Of the biopsies (42 by 7-G and 111 by 10-G) with subsequent surgical proof, the false negative rates were 0% and 9.01%, respectively; the upgrade rates of atypia lesions were 0% and 26.47%; and the upgrade rates of ductal carcinoma in situ were 15.38% and 9.10%. The cancer sensitivity of specimens with calcifications was higher for 7-G than 10-G VABB, but no significant difference for the specimens without calcifications. CONCLUSION. Both 7-G or 10-G VABB could diagnosed suspicious microcalcifications of the breasts; however, 7-G needle had higher cancer sensitivity, accuracy, upgrade rate of atypia lesions and complete retrieval of microcalcifications.
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Intracranial metastasis secondary to prostate cancer is rare, and dural metastasis is even rarer. Patients with dural metastases are often clinically asymptomatic or present with non-specific symptoms. Dural metastasis can be seen in conjunction with subdural hematomas or may mimic them. We report a rare case of dural metastasis from prostatic adenocarcinoma presenting as a subdural hematoma and subdural nodules. A description of the incidence, clinical presentation, imaging findings, treatment, and mechanisms of spread of dural metastasis is also included.
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The vein of Marshall (VOM) is usually very small and requires special attention to be visualized on cardiac computed tomography (CT). In this case report, we describe a patient with an incidentally found dilated VOM on cardiac CT angiography for the survey of coronary artery disease. Correct identification of this anatomical variant could be helpful before performing cardiac interventional procedures such as ablation for atrial fibrillation or implantation of biventricular devices, particularly when it is dilated.
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Benign fibrous histiocytoma (BFH) is a rare benign bone tumor. Its diagnosis is challenging considering the similarities in clinical symptoms, radiological characteristics, and histological features with other benign lesions. We present the case of a 56-year-old woman with BFH in the tibia. Radiograph demonstrated an osteolytic lesion with sclerotic rim at the epi-metaphysis of the left proximal tibia. Magnetic resonance imaging showed low signal intensity on T1-weighted images, heterogeneously high signal intensity with low signal in surrounding rims on T2-weighted images, and peripheral enhancement on T1-weighted images. Whole body bone scan showed a focal hot area at the left proximal tibia. The patient underwent tumor curettage and was diagnosed with BFH via pathological examination.
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Renal cell carcinoma (RCC) is less common in children than the Wilms tumor, but constitutes the most common renal malignancy in older children and adolescents. We report the evolutional computed tomography images of RCC in one adolescent.