Miscellaneous Lesions of the Mediastinum

Chest Imaging ◽  
2019 ◽  
pp. 505-510
Author(s):  
Brett W. Carter
Keyword(s):  
Clinical History ◽  
Extramedullary Hematopoiesis ◽  
Vascular Lesions ◽  
Esophageal Hiatus ◽  
Malignant Neoplasms ◽  
Cross Sectional ◽  
Contrast Enhanced ◽  
Cross Sectional Imaging ◽  
Enhanced Computed Tomography ◽  
Omental Fat

A group of several miscellaneous lesions may arise within one or more of the mediastinal compartments that are distinct from benign or malignant neoplasms, cysts, lymphadenopathy, and vascular lesions. Such entities cannot be classified as one specific disease type, and include extramedullary hematopoiesis and multiple types of herniations, specifically hiatal, paraesophageal and Morgagni hernias. Extramedullary hematopoiesis typically manifests as paravertebral masses that may exhibit fat attenuation or signal. Hiatal and paraesophageal hernias are common abnormalities in which the stomach herniates into the thorax through the esophageal hiatus. Morgagni hernias occur through an anterior diaphragmatic defect and typically contain omental fat but may also contain liver and bowel. As with other abnormalities of the mediastinum, these lesions may first be identified on chest radiography. However, correlation with pertinent clinical history and cross-sectional imaging, typically contrast-enhanced computed tomography, is necessary for definitive diagnosis.

Vascular Lesions of the Mediastinum

Chest Imaging ◽  
2019 ◽  
pp. 499-503
Author(s):  
Brett W. Carter
Keyword(s):  
Chest Radiography ◽  
Pediatric Population ◽  
Pulmonary Arteries ◽  
Vascular Lesions ◽  
Cross Sectional ◽  
Vascular Abnormalities ◽  
Contrast Enhanced ◽  
Cross Sectional Imaging ◽  
Enhanced Computed Tomography ◽  
Arteries And Veins

Vascular lesions represent approximately 10% of mediastinal masses detected on chest radiography. The most common lesions include abnormalities of the systemic arteries and veins, pulmonary arteries and veins, and thoracic aorta. Benign neoplasms such as hemangiomas and lymphangiomas are rare. Vascular abnormalities may be congenital or acquired, and the former may be associated with congenital heart disease in the pediatric population. Most acquired lesions are degenerative, post-traumatic, or neoplastic. Vascular lesions of the mediastinum may be detected on chest radiography as loss of normal mediastinal contours, focal opacities, or thickening of lines and stripes. These abnormalities are best evaluated with cross-sectional imaging such as contrast-enhanced computed tomography (CT) or CT angiography (CTA).

scholarly journals Imaging of the adrenal gland lesions

2014 ◽  
Vol 47 (4) ◽  
pp. 228-239 ◽  
Author(s):  
Keith Herr ◽  
Valdair F. Muglia ◽  
Walter José Koff ◽  
Antonio Carlos Westphalen
Keyword(s):  
Computed Tomography ◽  
Magnetic Resonance ◽  
Adrenal Gland ◽  
Photon Emission ◽  
Resonance Imaging ◽  
Cross Sectional ◽  
Contrast Enhanced ◽  
Cross Sectional Imaging ◽  
Contrast Enhanced Ultrasonography ◽  
Photon Emission Tomography

With the steep increase in the use of cross-sectional imaging in recent years, the incidentally detected adrenal lesion, or "incidentaloma", has become an increasingly common diagnostic problem for the radiologist, and a need for an approach to classifying these lesions as benign, malignant or indeterminate with imaging has spurred an explosion of research. While most incidentalomas represent benign disease, typically an adenoma, the possibility of malignant involvement of the adrenal gland necessitates a reliance on imaging to inform management decisions. In this article, we review the literature on adrenal gland imaging, with particular emphasis on computed tomography, magnetic resonance imaging, and photon-emission tomography, and discuss how these findings relate to clinical practice. Emerging technologies, such as contrast-enhanced ultrasonography, dual-energy computed tomography, and magnetic resonance spectroscopic imaging will also be briefly addressed.

scholarly journals Rare Hepatic Arterial Anatomic Variants in Patients Requiring Pancreatoduodenectomy and Review of the Literature

2012 ◽  
Vol 2012 ◽  
pp. 1-3
Author(s):  
Smita Ramanadham ◽  
Seth M. Toomay ◽  
Adam C. Yopp ◽  
Glen C. Balch ◽  
Rohit Sharma ◽  
...  
Keyword(s):  
Uncinate Process ◽  
Arterial System ◽  
Cross Sectional ◽  
Replaced Right Hepatic Artery ◽  
Contrast Enhanced ◽  
Cross Sectional Imaging ◽  
Head Of The Pancreas ◽  
Anatomic Variants ◽  
Hepatobiliary And Pancreatic Surgery ◽  
Arterial Anatomy

Normal hepatic arterial anatomy occurs in approximately 50–80% of cases; for the remaining cases, multiple variations have been described. Knowledge of these anomalies is especially important in hepatobiliary and pancreatic surgery in order to avoid unnecessary complications. We describe two cases of patients undergoing pancreatoduodenectomy for abnormalities in the head of the pancreas. Preoperative contrast-enhanced cross-sectional imaging demonstrated relevant, rare hepatic arterial variants: (1) a completely replaced hepatic arterial system with a gastroduodenal artery (GDA) arising directly from the celiac axis and (2) a replaced right hepatic artery originating from the superior mesenteric artery and traveling anterior to the pancreatic uncinate process and head. These findings were confirmed during pancreatoduodenectomy. Both of these variants have been rarely described with an incidence of <1.0%. In the present paper, we describe the hepatic arterial anomalies commonly encountered and clarify the important details associated with these variants as they pertain to pancreatoduodenectomy.

Imaging of a Rare Case of Diaphragmatic Tumor

2017 ◽  
Vol 3 (1) ◽  
pp. 25-27
Author(s):  
Ajit Reddy ◽  
Anil K Shukla ◽  
Sowmya Anand ◽  
Nitish Suresh
Keyword(s):  
Rare Case ◽  
Surgical Excision ◽  
Malignant Neoplasms ◽  
Primary Tumors ◽  
Contrast Enhanced ◽  
History Of ◽  
Upper Abdominal ◽  
Diaphragmatic Tumor ◽  
Enhanced Computed Tomography ◽  
Upper Abdomen

ABSTRACT Primary tumors of the diaphragm are quite rare. About 150 cases have been reported in the literature. Fibrosarcomas are the most common malignant neoplasms of the diaphragm; however, only a few (less than 20) cases have been reported to date. We present a case of an extremely rare tumor of the diaphragm. A 65-year-old woman presented with history of vague upper abdominal pain since 2 months and distension for 2 weeks. Ultrasonography features were in favor of a mass arising from left dome of diaphragm with evidence of vascularity on Doppler; lesion was displacing spleen inferiorly. Contrast-enhanced computed tomography scan of the abdomen revealed a mass located in the region of the left dome of diaphragm and deriving blood supply from the branches of abdominal aorta. Surgical excision was planned, keeping in mind the diagnosis of a left diaphragmatic tumor. Laparotomy revealed a left diaphragmatic tumor growing caudally into the upper abdomen. How to cite this article Anand S, Suresh N, Reddy AK, Shukla AK. Imaging of a Rare Case of Diaphragmatic Tumor. J Med Sci 2017;3(1):25-27.

Cross-Sectional Imaging Evaluation of Vascular Lesions in the Gastrointestinal Tract and Mesentery

2020 ◽  
Vol 44 (6) ◽  
pp. 870-881
Author(s):  
Yanqiu Zheng ◽  
Amr Shabana ◽  
Khaled M. Elsayes ◽  
Aws Hamid ◽  
Amr Abdelaziz ◽  
...  
Keyword(s):  
Gastrointestinal Tract ◽  
Vascular Lesions ◽  
Imaging Evaluation ◽  
Cross Sectional ◽  
Cross Sectional Imaging ◽  
Sectional Imaging

scholarly journals Pilimiction, A Rare Manifestation of Ovarian Teratoma: A Case Report

2021 ◽  
Author(s):  
Feysel Hassen Issack ◽  
Seid Mohammed Hassen ◽  
Seid Kedir Hassen ◽  
Kaleab Habtemichael Gebreselassie ◽  
Ferid Ousman Mummed ◽  
...  
Keyword(s):  
Mature Teratoma ◽  
Bladder Wall ◽  
Lower Abdominal Pain ◽  
Rare Condition ◽  
Ovarian Teratoma ◽  
Cross Sectional ◽  
Patient Reported ◽  
Rare Manifestation ◽  
Cross Sectional Imaging ◽  
Enhanced Computed Tomography

Abstract Introduction: Adnexal teratoma involving the urinary bladder is a very rare condition. Presentation is variable ranging from irritative LUTS (lower urinary tract symptoms) to pilimiction or trichiuria (passage of hair in the urine).Case presentation: We report a case of 42-year-old woman who presented with pilimiction and lower abdominal pain. Contrast enhanced computed tomography scan (CECT) and Cystoscopy were used for the diagnosis. Tumor markers were negative. Right side salpingo-oophorectomy and partial bladder wall excision were performed. Histopathology of the specimen showed features consistent with mature teratoma. The Patient reported improvement of symptoms in the subsequent follow up visits.Conclusion: Pilimiction is a pathognomonic sign of bladder teratomas. Therefore, it is wise to think of this pathology in patients who report passage of hair through the urine (trichiuria or pilimiction), as in our case. Cystoscopy and cross-sectional imaging aided in the initial diagnosis. However, definitive diagnosis was provided by histopathology.

scholarly journals Multiple renal infarctions in a patient caused by granulomatosis with polyangiitis

2020 ◽  
Vol 48 (12) ◽  
pp. 030006052097744
Author(s):  
Xiao Lu ◽  
ChengYing Yuan ◽  
RongShan Li
Keyword(s):  
Granulomatosis With Polyangiitis ◽  
Small Vessel Vasculitis ◽  
High Dose ◽  
Nasal Discharge ◽  
Renal Infarction ◽  
Cross Sectional ◽  
Computed Tomography Images ◽  
Contrast Enhanced ◽  
Increased Risk ◽  
Enhanced Computed Tomography

Granulomatosis with polyangiitis (GPA) is a small-vessel vasculitis that is highly associated with anti-neutrophil cytoplasmic antibodies. GPA carries an increased risk of organ infarction, but renal infarction is rare. We herein describe a case of multiple renal infarctions caused by GPA. A 66-year-old man presented with hearing loss, nasal discharge, fatigue, and weight loss for several months. Cross-sectional contrast-enhanced computed tomography images revealed multiple low-attenuation areas in both kidneys. He subsequently developed fever and impaired renal function. Blood serum was positive for cytoplasmic anti-neutrophil cytoplasmic antibody and a renal biopsy showed granulomatous necrotizing vasculitis. He was diagnosed with GPA and treated with high-dose corticosteroids, plasma exchange, and cyclophosphamide. The patient ultimately entered clinical remission.

scholarly journals Advanced Fusion Imaging and Contrast-Enhanced Imaging (CT/MRI–CEUS) in Oncology

Cancers ◽  
2020 ◽  
Vol 12 (10) ◽  
pp. 2821 ◽  
Author(s):  
Vincent Schwarze ◽  
Johannes Rübenthaler ◽  
Constantin Marschner ◽  
Matthias Philipp Fabritius ◽  
Johannes Rueckel ◽  
...  
Keyword(s):  
Fusion Imaging ◽  
Resonance Imaging ◽  
Renal Surgery ◽  
Cross Sectional ◽  
Renal Lesions ◽  
Contrast Enhanced ◽  
Cross Sectional Imaging ◽  
Excellent Safety Profile ◽  
Hepatic Lesions

Fusion imaging depicts an innovative technique that facilitates combining assets and reducing restrictions of advanced ultrasound and cross-sectional imaging. The purpose of the present retrospective study was to evaluate the role of fusion imaging for assessing hepatic and renal lesions. Between 02/2011–08/2020, 92 patients in total were included in the study, of which 32 patients had hepatic lesions, 60 patients had renal lesions. Fusion imaging was technically successful in all patients. No adverse side effects upon intravenous (i.v.) application of SonoVue® (Bracco, Milan, Italy) were registered. Fusion imaging could clarify all 11 (100%) initially as indeterminate described hepatic lesions by computed tomography/magnetic resonance imaging (CT/MRI). Moreover, 5/14 (36%) initially suspicious hepatic lesions could be validated by fusion imaging, whereas in 8/14 (57%), malignant morphology was disproved. Moreover, fusion imaging allowed for the clarification of 29/30 (97%) renal lesions initially characterized as suspicious by CT/MRI, of which 19/30 (63%) underwent renal surgery, histopathology revealed malignancy in 16/19 (84%), and benignity in 3/19 (16%). Indeterminate findings could be elucidated by fusion imaging in 20/20 (100%) renal lesions. Its accessibility and repeatability, even during pregnancy and in childhood, its cost-effectiveness, and its excellent safety profile, make fusion imaging a promising instrument for the thorough evaluation of hepatic and renal lesions in the future.

Point-of-care contrast enhanced lung ultrasound and COVID-19

Ultrasound ◽  
2021 ◽  
pp. 1742271X2110479
Author(s):  
Alice Tee ◽  
Gibran Timothy Yusuf ◽  
Adrian Wong ◽  
Deepak Rao ◽  
Sa Tran ◽  
...  
Keyword(s):  
Inflammatory Markers ◽  
Lung Ultrasound ◽  
Point Of Care ◽  
Contrast Enhanced Ultrasound ◽  
Cross Sectional ◽  
Patient Demographics ◽  
Pulmonary Angiogram ◽  
Contrast Enhanced ◽  
Cross Sectional Imaging ◽  
Ct Pulmonary Angiogram

Objectives Bedside lung ultrasound has been indispensable during the coronavirus disease 2019 (COVID-19) pandemic, allowing us to rapidly assess critically unwell patients. We demonstrate the unique application of contrast-enhanced ultrasound with the aim of further understanding this disease. Methods Patient demographics were recorded alongside recent cross-sectional imaging and inflammatory markers. Ultrasound was conducted by experienced operators in a portable setting. Conventional six-point lung ultrasound method was used to evaluate B-lines, small (subpleural) consolidation and the pleura. Areas of small consolidation were targeted after intravenous administration of ultrasound contrast. Results The areas of small consolidations, a potential sign of pneumonia on B-mode lung ultrasound, usually enhance on contrast-enhanced ultrasound. Our study revealed these areas to be avascular, indicating an underlying thrombotic/infarction process. Findings were present in 100% of the patients we examined. We have also shown that the degree of infarction correlates with CT severity (r = 0.4) and inflammatory markers, and that these areas improve as patients recover. Conclusions We confirmed the theory of immune thrombus by identifying the presence of microthrombi in the lungs of 100% of our patients, despite 79% having had a recent negative CT pulmonary angiogram study. contrast-enhanced ultrasound can be utilised to add confidence to an uncertain COVID-19 diagnosis and for prognosticating and monitoring progress in confirmed COVID-19 patients. Contrast-enhanced ultrasound is clearly very different to CT, the gold standard, and while there are specific pathologies that can only be detected on CT, contrast-enhanced ultrasound has many advantages, most notability the ability to pick up microthrombi at the periphery of the lungs.

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