Mastitis and More: A Pictorial Review of the Red, Swollen, and Painful Breast

2020 ◽  
Author(s):  
Genevieve A Woodard ◽  
Asha A Bhatt ◽  
Erica M Knavel ◽  
Katie N Hunt
Keyword(s):  
Clinical Presentation ◽  
Clinical Course ◽  
Fluid Collection ◽  
Percutaneous Biopsy ◽  
Imaging Features ◽  
Idiopathic Granulomatous Mastitis ◽  
Targeted Ultrasound ◽  
Pictorial Review ◽  
Acute Mastitis

Abstract Clinically, acute mastitis presents as a red, swollen, and painful breast. Targeted ultrasound can be performed to evaluate the extent of infection and for an underlying abscess. Noncomplicated mastitis or a small fluid collection may respond to oral antibiotics without further intervention, but a larger or more complex abscess may require single or serial percutaneous aspiration. Breast infections, particularly those complicated by an abscess, can have a prolonged clinical course, and close follow-up is required. Since the clinical presentation and imaging features of acute infectious mastitis can overlap with other etiologies, such as inflammatory breast cancer and idiopathic granulomatous mastitis, a percutaneous biopsy may be indicated to accurately diagnose patients.

scholarly journals The Imaging Spectrum of Synovial Sarcomas: A Pictorial Review From a Single-Centre Tertiary Referral Institution

2020 ◽  
pp. 084653711989928
Author(s):  
David Jueyu Wang ◽  
Leena Alwafi ◽  
Stephany Lynn Pritchett ◽  
Bret Michael Wehrli ◽  
Alison Rosemary Isobel Spouge
Keyword(s):  
Clinical Presentation ◽  
Delayed Diagnosis ◽  
Young Patients ◽  
Soft Tissue Tumors ◽  
The Body ◽  
Imaging Features ◽  
Pictorial Review ◽  
Synovial Sarcomas ◽  
Malignant Soft Tissue

Synovial sarcomas are malignant soft-tissue tumors that typically affect young patients. They can arise from nearly anywhere in the body, most commonly the extremities, head and neck, and thorax. The imaging features are highly variable and depend on the anatomic origin. Most lesions present as large aggressive heterogeneous masses containing hemorrhagic and cystic foci, often with calcification. However, up to one-third of lesions have commonly benign features and can appear homogeneously solid or cystic. Especially in these cases, their innocuous imaging and clinical presentation can lead to delayed diagnosis. Therefore, knowledge of the imaging spectrum is crucial to ensuring adequate follow-up or timely pathologic sampling. We reviewed 30 pathologically proven cases in various anatomic sites from our institution to illustrate these characteristics.

Imaging appearances of toxic and acquired metabolic encephalopathic disorders

2019 ◽  
Vol 80 (7) ◽  
pp. 372-376
Author(s):  
Tharunniya Vamadevan ◽  
David Howlett ◽  
Maria Filyridou
Keyword(s):  
Magnetic Resonance Imaging ◽  
Magnetic Resonance ◽  
Metabolic Disorders ◽  
Clinical Presentation ◽  
Carbon Monoxide Poisoning ◽  
District General Hospital ◽  
Imaging Features ◽  
Resonance Imaging ◽  
Diagnostic Uncertainty ◽  
Pictorial Review

Most imaging findings relating to toxic and acquired metabolic disorders follow a certain pattern with affinity to a specific topographic area, which can help narrow the differential diagnosis. This is especially useful when the clinical presentation can be variable and there is diagnostic uncertainty. Usually, there is bilateral symmetrical abnormality within the deep grey matter structures and the cerebral cortex because of the high metabolic activity and raised oxygen requirements in these areas. Magnetic resonance imaging, particularly diffusion weighted imaging and fluid-attenuated inversion recovery sequences, is very important in differentiating between various aetiologies in this group. Magnetic resonance imaging can be useful in demonstrating both acute and chronic damage, in evaluating treatment response and in disease prognostication. This pictorial review discusses the computed tomography and magnetic resonance imaging appearances of a spectrum of toxic and metabolic disorders observed in a district general hospital with reference to clinical presentation and imaging features that may allow diagnosis. This includes carbon monoxide poisoning, hypoglycaemia, non-ketotic hyperglycaemia, osmotic demyelination syndrome, posterior reversible encephalopathy syndrome, hypoxic ischaemic encephalopathy, the syndrome of delayed post-hypoxic leukoencephalopathy, hepatic encephalopathy and cocaine toxicity.

Atypical pediatric ganglioglioma is common and associated with a less favorable clinical course

2016 ◽  
Vol 17 (1) ◽  
pp. 41-48 ◽  
Author(s):  
Mohana Rao Patibandla ◽  
Thomas Ridder ◽  
Kathleen Dorris ◽  
Michelle R. Torok ◽  
Arthur K. Liu ◽  
...  
Keyword(s):  
Temporal Lobe ◽  
Clinical Course ◽  
Oncological Outcome ◽  
Tumor Location ◽  
Complete Resection ◽  
Low Grade ◽  
Imaging Features ◽  
Total Resection ◽  
Brainstem Death

OBJECT Ganglioglioma (GG) is commonly recognized as a low-grade tumor located in the temporal lobe, often presenting with seizures. Most are amenable to complete resection and are associated with excellent oncological outcome. The authors encountered several GGs in various locations, which seem to have a less favorable clinical course than GGs in the temporal lobe. METHODS The authors performed a single-center retrospective review of all children with a histological diagnosis of GG who were treated at Children’s Hospital Colorado between 1997 and 2013. Each tumor was categorized by 2 pediatric neuroradiologists as typical or atypical based on preoperative MRI appearance. Typical lesions were cortically based, within a single cerebral lobe, well-circumscribed, and solid or mixed solid/cystic. The treatment and clinical course of each patient was analyzed. RESULTS Thirty-seven children were identified, with a median age at presentation of 8.2 years and median follow-up of 38.0 months. Eighteen tumors (48.6%) were typical and 19 (51.4%) were atypical. All typical lesions presented with seizures, whereas no atypical lesions did so. Sixteen (88.9%) typical lesions were located in the temporal lobe. In the atypical group, tumor location was variable, including 11 (57.9%) in the brainstem. Death during follow-up was statistically more common in the atypical group (31.6% vs 0%, p = 0.02). Gross-total resection (GTR) was achieved for 15 of 16 typical tumors (93.8%), compared with 3 atypical tumors (15.8%, p < 0.0001). Presentation with seizure or non-brainstem location were each associated with survival (p = 0.02 and 0.004, respectively). The presence of mutation in BRAF exon 15 did not differ between the 2 groups. CONCLUSIONS Pediatric GG with typical imaging features is associated with excellent rates of GTR and overall survival. Atypical GG is commonly encountered, less amenable to GTR, and associated with a worse outcome. This may relate to anatomical or biological characteristics and merits further investigation.

Clinical presentation, natural history and outcomes of intramedullary spinal cord cavernous malformations

2019 ◽  
Vol 90 (6) ◽  
pp. 695-703 ◽  
Author(s):  
Anshit Goyal ◽  
Lorenzo Rinaldo ◽  
Redab Alkhataybeh ◽  
Panagiotis Kerezoudis ◽  
Mohammed Ali Alvi ◽  
...  
Keyword(s):  
Natural History ◽  
Surgical Resection ◽  
Clinical Presentation ◽  
Clinical Course ◽  
Univariate Analysis ◽  
Case Series ◽  
Intramedullary Spinal Cord ◽  
Cavernous Malformations ◽  
Increased Risk

ObjectiveThere is a paucity of literature investigating the clinical course of patients with spinal intramedullary cavernous malformations (ISCMs). We present a large case series of ISCMs to describe clinical presentation, natural history and outcomes of both surgical and conservative management.MethodsWe retrospectively reviewed the clinical course of patients diagnosed with ISCMs at our institution between 1995 and 2016. Haemorrhage was defined as clinical worsening in tandem with imaging changes visualised on follow-up MRI. Outcomes assessed included neurological status and annual haemorrhage rates.ResultsA total of 107 patients met inclusion criteria. Follow-up data were available for 85 patients. While 21 (24.7%) patients underwent immediate surgical resection, 64 (75.3%) were initially managed conservatively. Among this latter group, 16 (25.0%) suffered a haemorrhage during follow-up and 11 (17.2%) required surgical resection due to interval bleeding or neurological worsening. The overall annual risk of haemorrhage was 5.5% per person year. The rate among patients who were symptomatic and asymptomatic on presentation was 9.5% and 0.8%, respectively. Median time to haemorrhage was 2.3 years (0.1–12.3). Univariate analysis identified higher ISCM size (p=0.024), history of prior haemorrhage (p=0.013) and presence of symptoms (p=0.003) as risk factors for subsequent haemorrhage. Multivariable proportional hazards analysis revealed presence of symptoms to be independently associated with haemorrhage during follow-up (HR 9.39, CI 1.86 to 170.8, p=0.013).ConclusionLarge, symptomatic ISCMs appear to be at increased risk for subsequent haemorrhage. Surgery may be considered in such lesions to prevent rebleeding and subsequent neurological worsening.

Multiple evanescent white dot syndrome: clinical course and factors influencing visual acuity recovery

2020 ◽  
pp. bjophthalmol-2020-317357
Author(s):  
Francesca Bosello ◽  
Mark Westcott ◽  
Giuseppe Casalino ◽  
Georgios Agorogiannis ◽  
Rocco Micciolo ◽  
...  
Keyword(s):  
Visual Acuity ◽  
Near Infrared ◽  
Clinical Course ◽  
Fundus Autofluorescence ◽  
Young Age ◽  
Imaging Features ◽  
Near Infrared Reflectance ◽  
White Dot Syndrome ◽  
Group 2

ObjectiveTo report the demographics and the clinical course of patients with multiple evanescent white dot syndrome (MEWDS) and to investigate for those factors which influence visual acuity (VA) recovery.MethodsThis is a retrospective single-centre observational study. Electronic medical records and retinal imaging of patients with a diagnosis of MEWDS with a minimum follow-up of 3 months were reviewed. Patients were categorised into three groups according to the VA at presentation and at the last visit: group 1 >0.48 logarithm of the minimum angle of resolution (LogMAR), group 2 ≤0.48 and ≥0.18 LogMAR and group 3 <0.18 LogMAR. All patients had non-invasive multimodal imaging including optical coherence tomography, near-infrared reflectance imaging and blue fundus autofluorescence at presentation and during follow-up.ResultsA total of 51 eyes from 51 patients (41 women, mean age 29.8±7.8 years) were included. Significantly more patients presented in the autumn (X2=8.69, p=0.034). The percentage of eyes recovering vision to 0.0 LogMAR or better was 80.3% (41/51). Worse presenting vision and young age at presentation were independent significant predictive variables for poorer final VA (p=0.002 and p=0.02, respectively). No imaging features were significantly predictive of complete versus incomplete recovery, but disc hyperfluorescence on fluorescein angiography was more common in those with incomplete recovery.ConclusionsAlthough the majority of cases have a benign prognosis, the clinical spectrum of MEWDS includes incomplete visual recovery. In our series, poor presenting VA and young age were associated with poor VA outcome. Further study is warranted to confirm these findings.

Favorable Conservative Management of a Rare Primary Aortitis Secondary to Listeria Monocytogenes: Case Report and Review of the Literature

2021 ◽  
pp. 153857442110040
Author(s):  
Luis H. Arzola ◽  
Javier E. Anaya-Ayala ◽  
Gabriel Lopez-Pena ◽  
Lizeth Luna ◽  
Christopher Ruben-Castillo ◽  
...  
Keyword(s):  
Computed Tomography ◽  
Listeria Monocytogenes ◽  
Conservative Management ◽  
Rare Case ◽  
Clinical Presentation ◽  
Clinical Course ◽  
Diabetic Woman ◽  
Review Of The Literature ◽  
Thoracic Computed Tomography

Primary aortitis (PA) secondary to Listeria monocytogenes is extremely rare with only a few cases reported in the literature. Presently, there is no consensus concerning the best treatment when no complications are found in the thoracic computed tomography (CT) imaging. This report illustrates the clinical presentation and favorable clinical course of a rare case of PA secondary to Listeria monocytogenes in an 82-year-old diabetic woman, successfully treated with conservative management with 18 months of follow up. Included in this article, we additionally present a review of the literature of this uncommon etiology of infectious aortitis.

scholarly journals Clinical characteristics and survival of children with Langerhans cell hystiocytosis

2008 ◽  
Vol 136 (9-10) ◽  
pp. 514-518
Author(s):  
Nada Krstovski ◽  
Dragana Janic ◽  
Lidija Dokmanovic ◽  
Radivoj Brdar
Keyword(s):  
Langerhans Cell Histiocytosis ◽  
Clinical Characteristics ◽  
Clinical Presentation ◽  
Clinical Course ◽  
Langerhans Cell ◽  
Single System ◽  
Multisystem Disease ◽  
System Disease ◽  
The Central Nervous System

INTRODUCTION Langerhans cell histiocytosis is a rare disease in children, initial presentation is variable, clinical course, prognosis and survival are mostly unpredictable. OBJECTIVE To summarise clinical characteristics and treatment results in children with Langerhans cell histiocytosis. METHOD Retrospectively there were analyzed patients with LCH diagnosed and treated at Hematology Department of University Children's Hospital in Belgrade from 1990 to 2006. Clinical presentation, therapy and survival according to Kaplan-Meier's statistical test was analysed. RESULTS 30 patients were treated, aged from 4 months to 14 years, mean 3.9 years, median 2.3 years, 18 (60%) males, 12 (40%) females. A single system disease was diagnosed in 16 (53%) patients, of whom 6 patients with multifocal bone disease. All patients were in complete remission averagely following162 and 82 months respectively. Multisystem disease was found in 14 (47%) patients. The lymph nodes and skin were more frequently involved organs than the central nervous system (diabetes insipidus), lung, liver and spleen. The number of involved organs ranged from 2 to 8, mean 4.2. Four patients died due to disease progression 3, 16, 36 and 66 months after diagnosis. Nine patents with multisystem disease were in remission with 117 months of follow-up. One patient was lost on follow-up. CONCLUSION The clinical course of patients with a single system disease is usually benign while a multisystem disease has to be aggressively treated with precise initial evaluation and staging before therapy.

Evolution of the imaging features of osteoid osteoma treated with RFA or MRgFUS during a long-term follow-up: a pictorial review with clinical correlations

2020 ◽  
Vol 125 (6) ◽  
pp. 578-584 ◽  
Author(s):  
Francesco Arrigoni ◽  
Federico Bruno ◽  
Camilla Gianneramo ◽  
Pierpaolo Palumbo ◽  
Luigi Zugaro ◽  
...  
Keyword(s):  
Osteoid Osteoma ◽  
Imaging Features ◽  
Pictorial Review ◽  
Long Term Follow Up ◽  
Clinical Correlations

scholarly journals Intracranial Textiloma: Imaging Features and Literature Review

2021 ◽  
Author(s):  
Vivek Agarwal ◽  
Sameer Vyas ◽  
Chirag Kamal Ahuja ◽  
Vikas Bhatia ◽  
Manjul Tripathi ◽  
...  
Keyword(s):  
Clinical Presentation ◽  
Accurate Diagnosis ◽  
Neurological Deficits ◽  
Imaging Features ◽  
Imaging Findings ◽  
Characteristic Imaging ◽  
Retained Surgical Sponges ◽  
Mass Lesions ◽  
Time Of Presentation

Abstract Background and Importance Intracranial textilomas are retained surgical sponges presenting as pseudomass lesions in postoperative patients usually with surrounding inflammatory reaction. Though rare, these are commonly misdiagnosed as postoperative hemorrhagic collections, abscesses, radionecrosis, or residual/recurrent mass lesions. We describe the imaging findings of intracranial textilomas diagnosed in four patients on follow-up postoperative imaging along with their characteristic imaging findings to help radiologists/neurosurgeons make accurate diagnosis. Clinical Presentation One patient had chronic headache without any focal neurological deficits. Rest of the patients were asymptomatic at the time of presentation Conclusion In postoperative scans, possibility of textilomas should be considered apart from residual/recurrent lesions, postoperative abscesses, or radionecrosis. Correct and timely diagnosis is important for further treatment planning and patient care.

scholarly journals Idiopathic Granulomatous Mastitis- Challenges of Diagnosis and Treatment

2017 ◽  
Vol 28 (1) ◽  
pp. 14-16
Author(s):  
Sharmistha Roy ◽  
Samiron Kumar Mondal ◽  
Md Ruhul Amin ◽  
Indira Sufia Khan
Keyword(s):  
Benign Breast Disease ◽  
Clinical Presentation ◽  
Surgical Intervention ◽  
Breast Disease ◽  
Diagnosis And Treatment ◽  
Incisional Biopsy ◽  
Unknown Aetiology ◽  
Granulomatous Mastitis ◽  
Idiopathic Granulomatous Mastitis

Idiopathic Granulomatous Mastitis (IGM) is a benign breast disease. Owing to its unknown aetiology, rareness,variation of presentation - diagnosis and treatment is still a challenge. This is a retrospective review of clinical presentation and investigation finding of all patients histopathologically diagnosed as IGM from February 2010 to January 2014. Treatment outcome and follow up information were recorded. 6(42%) patient presented with breast abscess, 5(35.7%) patient had features of mastitis without abscess, 3(21.4%) patient had painful firm to hard lump. Diagnosis confirmed by excisional/ incisional biopsy. 9(64%) patients needed more than one surgical intervention. Mean follow up period was 27months. Standardization and optimization of treatment is yet to be achieved.Medicine Today 2016 Vol.28(1): 14-16

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