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Recurrent thoracic duct cyst of the left supraclavicular fossa: A retrospective study of 6 observational case series and literature review.
Planchette, J, Jaccard, C, Nigron, A, Chadeyras, JB, Le Guenno, G, Castagne, B, Jamilloux, Y, Resseguier, AS, Sève, P
Medicine. 2021;(50):e28213
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Abstract
The transient occlusion of the terminal thoracic duct is a rare disease responsible for renitent supraclavicular cysts. The aim of this study was to describe the clinical characteristics, evolution, and treatment.A retrospective multicenter study and literature review was carried out. The literature search (PubMed) was conducted including data up to 31 December 2020 and PRISMA guidelines were respected.This study identified 6 observational cases between September 2010 and December 2020. The search results indicated a total of 24 articles of which 19 were excluded due to the lack of recurrent swelling or the unavailability of full texts (n = 5). Fourteen patients (8 from literature) mostly reported a noninflammatory, painless renitent mass in the supraclavicular fossa which appeared rapidly over a few hours and disappeared spontaneously over an average of 8 days (range: from about 2 hours to 10 days). Anamnesis indicated a high-fat intake during the preceding days in all cases and 7 from literature found in the Medline databases. Recurrences were noted in 10 patients. Thoracic duct imaging was performed in all cases to detect abnormalities or extrinsic compression as well as to eliminate differential diagnoses.A painless, fluctuating, noninflammatory, and recurrent swelling of the left supraclavicular fossa in patients evoking an intermittent obstruction of the terminal portion of the thoracic duct was identified. A low-fat diet was found as safe and effective treatment.
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Renal Pseudo-tumor Related to Renal Splenosis: Imaging Features.
Tordjman, M, Eiss, D, Dbjay, J, Crosnier, A, Comperat, E, Correas, JM, De Saint Aubert, N, Helenon, O
Urology. 2018;:e11-e15
Abstract
OBJECTIVE To report the case of a 29-year-old patient presenting with renal splenosis along with a complete review of literature on this condition. Splenosis is a frequent condition following abdominal trauma or splenectomy, described as splenic tissue that autotransplants into a heterotopic location. However, renal splenosis is rare and often mistaken with renal carcinoma. MATERIALS AND METHODS The patient was initially referred to our department for a renal mass incidentally discovered on ultrasound. Further investigation included with computed tomography and magnetic resonance imaging. RESULTS Imaging features revealed a well circumscribed solid renal mass, exhibiting an isosignal on T1- and T2-weighted sequences in comparison with the renal cortex. The mass exhibited a heterogeneous enhancement on the arterial and portal phases, homogeneous patterns during the delayed phases, and high signal intensity on diffusion-weighted images. A partial nephrectomy was performed and pathological examination revealed the final diagnosis of renal splenosis. CONCLUSION Imaging features alone do not provide a definitive diagnosis of splenosis but suggestive past history associated with imaging findings consistent with splenic tissue should lead to 99m technetium-sulfur colloid scanning or ferumoxid-enhanced MRI to avoid useless surgery.
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Surgical Management of a Bilateral Bifid Condyle: Diagnosis, Three-dimensional Reconstruction, and Treatment - A Report of a Case and Review of the Literature.
Ulutürk, H, Yücel, E, Okur, B, Akinci, O, Atac, MS
Nigerian journal of clinical practice. 2018;(2):251-255
Abstract
Bifid condyle is a rare entity with a difficult diagnosis and usually identified as an incidental finding on routine radiographic examination. The etiology is not well known, possible causes may be developmental, traumatic, vascular, abnormal muscle pulling, nutritional, endocrinal, teratogenic, and infections. The orientation of the condylar heads can behelpful for the etiological diagnosis.This case report describes a 56-year-old woman who suffered from a unilateral, progressively increasing, radiating pain which intensified with the movement of the mandible and includes information about the diagnosis, management, radiographic and three-dimensional model features and review of the literature.
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(18)F-FDG PET/CT imaging in systemic lupus erythematosus related autoimmune haemolytic anaemia and lymphadenopathy.
Zhang, X, Xu, C, Wang, X
Hellenic journal of nuclear medicine. 2016;(1):42-5
Abstract
OBJECTIVE We present a case of systemic lupus erythematosus (SLE) related autoimmune haemolytic anaemia (AIHA) and lymphadenopathy. AIHA as a serious complication of SLE, requiring urgent appropriate management. The timely differential diagnosis between SLE with lymphadenopathy and lymphoma, primary and SLE-related AIHA often looms as practical challenge under clinical scenario. Fluorine-18 fluorodeoxyglucose position emission tomography/computed tomography ((18)F-FDG PET/CT) performed for fever of a known origin and for possible malignancy, showed increased (18)F-FDG uptake in lymph nodes, as well as increased spleen uptake, which was probably due to lymphoma. CONCLUSIONS A symmetrically increased (18)F-FDG uptake in small lymph nodes with multiple serous cavity effusion helped the differential diagnosis between SLE related AIHA and lymphoma. In addition, PET/CT can visualize not only the degree of disease activity or the "burden of inflammation" but also the distribution of the disease in the entire body.
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Imaging of Spinal Cord Disorders.
Singh, K, Mechtler, LL, Klein, JP
Continuum (Minneapolis, Minn.). 2016;(5, Neuroimaging):1595-1612
Abstract
PURPOSE OF REVIEW Spinal cord disorders are common and can be caused by a myriad of pathologies. Confidently interpreting spine imaging studies is an essential skill for neurologists as many spinal cord disorders can produce significant disability if not diagnosed and treated correctly. RECENT FINDINGS Advances in imaging have revolutionized the care of patients with spinal cord disorders by allowing noninvasive visualization of normal and abnormal structures. SUMMARY This article summarizes the imaging patterns of common spinal cord disorders.
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Fluorodeoxyglucose-positron-emission tomography/computed tomography imaging for adrenal masses in patients with lung cancer: review and diagnostic algorithm.
Stone, WZ, Wymer, DC, Canales, BK
Journal of endourology. 2014;(1):104-11
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Abstract
BACKGROUND AND PURPOSE Positron-emission tomography/computed tomography (PET/CT) with fluorine-18 fluorodeoxyglucose (FDG) is used as first-line staging for patients with newly diagnosed non-small cell lung cancer (NSCLC). Our purpose was to review the accuracy of FDG-PET/CT to predict adrenal gland metastasis, explain the causes for false-positive PET, and provide a diagnostic algorithm. PATIENTS AND METHODS Two patients with incidentally discovered lung masses were found to have hypermetabolic adrenal activity by FDG-PET/CT with maximal standard uptake value (SUV) of 4.5 and 6.5. A MEDLINE search was performed on the topic of FDG-PET/CT, adrenal gland metastasis, and NSCLC. Literature was reviewed with regard to diagnosis, accuracy, outcomes, and alternative imaging or diagnostic strategies. RESULTS Both patients underwent transabdominal laparoscopic adrenalectomy and were found to have nodular hyperplasia without evidence of adrenal tumor. A total of seven articles containing 343 patients were identified as having pertinent oncologic information for NSCLC patients with adrenal lesions. Sensitivity and specificity of PET/CT for distant metastasis was 94% and 85%, respectively, but only 13% (44/343) of these patients had histologically confirmed adrenal diagnoses. Based on this, a diagnostic algorithm was created to aid in decision making. CONCLUSIONS Although PET/CT has high sensitivity and specificity for adrenal metastasis in the setting of NSCLC, adrenal biopsy or other secondary imaging should be considered to confirm the finding. Adrenalectomy in lieu of biopsy may have both diagnostic and therapeutic benefit in cases where the adrenal mass is ≥10 mm with high PET maximum SUV (≥3.1) and SUV ratios (>2.5), where washout CT or chemical shift MRI is positive, or where percutaneous biopsy is deemed too difficult or unsafe.
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Unusual CT hyperattenuating dermoid cyst of cerebellum: a new case report and literature review.
Li, ZJ, Miao, YX, Sun, P, Li, YJ, Dou, YH, Xu, J, Chen, X, Jiang, YX
Cerebellum (London, England). 2011;(3):536-9
Abstract
Almost all intracranial dermoid cysts typically display low-density lesions on plain computerized tomography (CT) scans due to abundant lipids content. CT hyperattenuating dermoid cyst (CHADC) is very uncommon with only nine case reports in the literature update, which occurs exclusively in the posterior fossa. Moreover, CHADC with mural nodule is exceptionally rare, and only one such case was documented previously. Here, we report a new case of cerebellar CHADC with mural nodule in a 14-year-old male patient who presented with a 4-week history of dull headache and 5-day history of gait disturbance. With an average attenuation value of 89.9 Hounsfield units on CT scans, the lesion mainly displayed T1 hyperintensity, T2 hypointensity, and FLAIR hypointensity on magnetic resonance imaging. The patient underwent lesion gross total resection and symptomatic improvement, and final pathology was consistent with dermoid cyst. For further clarifying the mechanism of unusual CT hyperdensity, we sampled the cystic content and quantified its protein, calcium, and cholesterol, and our result suggested the high protein, high calcium, and low lipids in contents was the main mechanism of increased CT attenuation for CHADC.
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FDG-PET/CT for the evaluation of response to therapy of cutaneous T-cell lymphoma to vorinostat (suberoylanilide hydroxamic acid, SAHA) in a phase II trial.
Kuo, PH, Carlson, KR, Christensen, I, Girardi, M, Heald, PW
Molecular imaging and biology. 2008;(6):306-14
Abstract
INTRODUCTION Harnessing the power of molecular imaging in particular positron emission tomography (PET) to assess response to therapy in early clinical trials has the potential to yield crucial data on efficacy and streamline drug development. Vorinostat (also known as SAHA, suberoylanilide hydroxamic acid) is a histone deacetylase (HDAC) inhibitor which alters gene transcription to inhibit proliferation and promote apoptosis. METHODS In a phase II trial of vorinostat for cutaneous T cell lymphoma (CTCL), 2-deoxy-2-[F-18]fluoro-D-glucose (FDG)-PET/computed tomography (CT) was performed on patients with both cutaneous and nodal disease. FDG-PET/CT fuses the power of metabolic imaging from FDG-PET with the anatomic detail of CT. Scans were conducted on subjects pre-therapy and during therapy. RESULTS Changes in the values of FDG uptake and measurements of nodal dimensions and thickness of cutaneous lesions were tabulated. FDG-PET/CT provided an objective measure of the response (or lack thereof) of both cutaneous and nodal disease to therapy with vorinostat. The results of this study are encouraging for the potential utility of FDG-PET/CT in future trials with HDAC inhibitors for other diseases and for CTCL with other therapies. CONCLUSION Further study will be required to determine the prognostic value of the initial PET/CT scan and response on follow-up scans.
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Computed tomography coronary calcium screening and myocardial perfusion imaging.
Raggi, P, Berman, DS
Journal of nuclear cardiology : official publication of the American Society of Nuclear Cardiology. 2005;(1):96-103
Abstract
Cardiac computed tomography (CT) has seen an exponential increase in interest as applications expanded from identification of coronary artery calcification to noninvasive coronary angiography and, more recently, identification of soft and noncalcified plaques. The interest arises from the well-known fact that cardiovascular disease remains the most prevalent cause of death in the Western hemisphere and the fact that in a large proportion of patients the initial event is either sudden death or a disabling myocardial infarction or stroke. Although traditional risk factors are extremely helpful in determining risk in a population, the prognostic ability of risk factors alone in the individual patient is limited. Hence, researchers have turned their attention to noninvasive modalities to image the atherosclerotic plaque in its preclinical stages, hoping to better address this ailment at its inception and change the natural history of the disease. Measurements of coronary artery calcium (CAC) serve as a quantitative reflection of the severity of coronary artery atherosclerosis, and greater calcium burdens correlate with more advanced disease. Indeed, CAC has been shown to add prognostic value to traditional risk factors in patients at intermediate risk, and in this group of patients, it is most cost-effective. Furthermore, CAC measurements providing an assessment of coronary atherosclerotic plaque burden appear to be complementary to myocardial perfusion single photon emission computed tomography that offers information regarding inducible ischemia. In this manner, a better assessment of risk in a patient suspected of harboring preclinical or early coronary artery disease can be achieved. In this article we review the most relevant literature regarding the utilization of CAC testing as a tool to refine risk assessment and use several case studies to exemplify the combination of CT imaging and functional myocardial perfusion studies, which may provide a better identification of patients in need of aggressive medical therapy and those needing invasive assessment for possible coronary revascularization.
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[Computerized helicoidal tomography of the coronary arteries vs coronary angiography].
Sierra-Galán, LM, Hernández-López, JE, Portos-Silva, JM
Archivos del Instituto de Cardiologia de Mexico. 2000;(6):569-79
Abstract
INTRODUCTION The calcium score (CS) of the coronary arteries by computed tomography (CT) is an useful procedure for the diagnosis of obstructive coronary disease (OCD), with an average sensitivity of 82 +/- 6%, specificity of 88 +/- 2%, positive predictive value (PPV) of 57 +/- 7% and negative predictive value (NPV) of 96 +/- 2%. The objective of this trial was to compare helicoidal CT Scan with the traditional method and define sensitivity, specificity, Positive predictive value and negative predictive value against the coronary angiography. METHODS From June of 1998 to March of 1999, one hundred and sixty six patients with coronary arteries CT were studied. The CT was done with an ELSCINT-CT Twin equipment and a software for the quantification of the coronary arteries CS in Hounsfield units. In forty one, coronary angiography was performed. A significant obstructive lesion was defined as > or = 70% of luminal stenosis in at least one artery, or > or = 50% in the left main and > or = 50% if some other artery was involved. This group was divided in accordance to the CS in two subgroups: A with a CS < or = 150 and B those with a CS > or = 151. RESULTS In group A, 45% had significative lesions vs 95% in group B (p = 0.001). The sensitivity was 65%, specificity 95%, PPV 64% and the NPV 92%. Relative risk 2.08 (CI 95% 1.38-3.54) and Odds ratio 21.6 (CI 95% 2.43-191.37). CONCLUSIONS Even though the small sample, CT is an useful procedure for the diagnosis of the OCD.