scholarly journals Laparoscopic Resection of Appendiceal Schwannoma

2018 ◽  
Vol 2018 ◽  
pp. 1-5
Author(s):  
Toru Imagami ◽  
Satoru Takayama ◽  
Yohei Maeda ◽  
Ryohei Matsui ◽  
Masaki Sakamoto ◽  
...  
Keyword(s):  
Preoperative Diagnosis ◽  
Equilibrium Phase ◽  
Ileocecal Resection ◽  
Arterial Phase ◽  
Abdominal Ct ◽  
Case Presentation ◽  
Contrast Enhanced Ct ◽  
Contrast Enhanced ◽  
Enhanced Ct ◽  
Abdominal Fullness

Background. Schwannoma arises from Schwann’s cell of the neural sheath. Schwannoma of the large intestine, particularly of the appendix, is rare. We report a case of appendiceal schwannoma resected using laparoscopic surgery. Case Presentation. A 75-year-old man was referred to our hospital for abdominal fullness and nausea since 2 months. Abdominal CT revealed a well-demarcated oval mass of 25 mm at the tip of the appendix. Contrast-enhanced CT revealed a lesion with gradually enhanced contrast from the arterial phase to the equilibrium phase. Abdominal US revealed a well-demarcated hypoechoic tumor. Preoperative diagnosis indicated appendiceal mesenchymal or neuroendocrine tumor. Ileocecal resection with D3 lymph node dissection was performed. Pathological and immunohistochemical findings confirmed the diagnosis of appendiceal schwannoma. Conclusions. For determining the surgical procedure of nonepithelial tumor of the appendix, preoperative diagnosis of mesenchymal or neuroendocrine tumors is required. However, appendiceal schwannoma is extremely rare, and its characteristic findings have not yet been established. Accumulating cases of appendiceal schwannomas is necessary for improving imaging diagnosis and surgical treatment.

scholarly journals Delayed response to proton beam treatment of hepatocellular carcinoma

2020 ◽  
Vol 6 (1) ◽  
pp. 20180125
Author(s):  
Chee-Wai Cheng ◽  
Mitchell Machtay ◽  
Jennifer Dorth ◽  
Olga Sergeeva ◽  
Hangsheng Xia ◽  
...  
Keyword(s):  
Hepatocellular Carcinoma ◽  
Ct Scan ◽  
Proton Beam ◽  
Arterial Phase ◽  
Delayed Response ◽  
Data Set ◽  
Contrast Enhanced Ct ◽  
Contrast Enhanced ◽  
Enhanced Ct ◽  
Imaging Response

Hepatocellular carcinoma (HCC) has become one of the leading causes of cancer death worldwide. There has been anecdotal report regarding the effectiveness of proton beam treatment for HCC. In this pre-clinical investigation, the woodchuck model of viral hepatitis infection-induced HCC was used for proton beam treatment experiment. The radiopaque fiducial markers that are biodegradable were injected around the tumor under ultrasound guidance to facilitate positioning in sequential treatments. An α cradle mode was used to ensure reproducibility of animal positioning on the treatment couch. A CT scan was performed first for contouring by a radiation oncologist. The CT data set with contours was then exported for dose planning. Three fractionations, each 750 CcGyE, were applied every other day with a Mevion S250 passive scattering proton therapy system. Multiphase contrast-enhanced CT scans were performed after the treatment and at later times for follow-ups. 3 weeks post-treatment, shrinking of the HCC nodule was detected and constituted to a partial response (30% reduction along the long axis). By week nine after treatment, the nodule disappeared during the arterial phase of multiphase contrast-enhanced CT scan. Pathological evaluation corroborated with this imaging response. A delayed, but complete imaging response to proton beam treatment applied to HCC was achieved with this unique and clinically relevant animal model of HCC.

Utility of non-contrast-enhanced CT for improved detection of arterial phase hyperenhancement in hepatocellular carcinoma

2014 ◽  
Vol 39 (6) ◽  
pp. 1247-1254 ◽  
Author(s):  
Tiffany Hennedige ◽  
Zhineng Jayson Yang ◽  
Cheng Kang Ong ◽  
Sudhakar Kundapur Venkatesh
Keyword(s):  
Hepatocellular Carcinoma ◽  
Arterial Phase ◽  
Contrast Enhanced Ct ◽  
Contrast Enhanced ◽  
Enhanced Ct

scholarly journals CT volume of enhancement of disease (VED) can predict the early response to treatment and overall survival in patients with advanced HCC treated with sorafenib

2020 ◽  
Author(s):  
S. Colagrande ◽  
L. Calistri ◽  
C. Campani ◽  
G. Dragoni ◽  
C. Lorini ◽  
...  
Keyword(s):  
Response To Treatment ◽  
Arterial Phase ◽  
Lesion Volume ◽  
Advanced Hepatocellular Carcinoma ◽  
Response Evaluation ◽  
Advanced Hcc ◽  
Contrast Enhanced Ct ◽  
Contrast Enhanced ◽  
Enhanced Ct ◽  
The Impact

Abstract Objectives To analyse the predictive value of the volume of enhancement of disease (VED), based on the CT arterial enhancement coefficient (ΔArt%), in the evaluation of the sorafenib response in patients with advanced hepatocellular carcinoma (HCC). Methods Patients with sorafenib-treated advanced HCC, who underwent a multiphase contrast-enhanced CT before (T0) and after 60–70 days of starting therapy (T1), were included. The same target lesions utilised for the response evaluation according to modified Response Evaluation Criteria in Solid Tumors criteria were retrospectively used for the ΔArt% calculation ([(HUarterial phase − HUunenhanced phase) / HUunenhanced phase] × 100). ΔArt% was weighted for the lesion volume to obtain the VED. We compared VEDT0 and VEDT1 values in patients with clinical benefit (CB) or progressive disease (PD). The impact of VED, ancillary imaging findings, and blood chemistries on survival probability was evaluated. Results Thirty-two patients (25 men, mean age 65.8 years) analysed between 2012 and 2016 were selected. At T1, 8 patients had CB and 24 had PD. VEDT0 was > 70% in 8/8 CB patients compared with 12/24 PD patients (p = 0.011). Patients with VEDT0 > 70% showed a significantly higher median survival than those with lower VEDT0 (451.5 days vs. 209.5 days, p = 0.032). Patients with VEDT0 > 70% and alpha-fetoproteinT0 ≤ 400 ng/ml had significantly longer survival than all other three combinations. In multivariate analysis, VEDT0 > 70% emerged as the only factor independently associated with survival (p = 0.037). Conclusion In patients with advanced HCC treated with sorafenib, VED is a novel radiologic parameter obtained by contrast-enhanced CT, which could be helpful in selecting patients who are more likely to respond to sorafenib, and with a longer survival. Key Points • To achieve the best results of treatment with sorafenib in advanced HCC, a strict selection of patients is needed. • New radiologic parameters predictive of the response to sorafenib would be essential. • Volume of enhancement of disease (VED) is a novel radiologic parameter obtained by contrast-enhanced CT, which could be helpful in selecting patients who are more likely to respond to therapy, and with a longer survival.

scholarly journals Application of Contrast-Enhanced Ultrasound (CEUS) in Lymphomatous Lymph Nodes: A Comparison between PET/CT and Contrast-Enhanced CT

2019 ◽  
Vol 2019 ◽  
pp. 1-7 ◽  
Author(s):  
Xuelei Ma ◽  
Wenwu Ling ◽  
Fan Xia ◽  
Yifan Zhang ◽  
Chenjing Zhu ◽  
...  
Keyword(s):  
Lymph Nodes ◽  
False Negative ◽  
False Negative Rate ◽  
Arterial Phase ◽  
Contrast Enhanced Ultrasound ◽  
Contrast Enhanced Ct ◽  
Contrast Enhanced ◽  
Therapeutic Decisions ◽  
Pet Ct ◽  
Enhanced Ct

Purpose. We described imaging characteristics of different types of lymphomas using contrast-enhanced ultrasound (CEUS) and summarized some simple criteria to distinguish between normal lymph nodes and lymphomatous lymph nodes for clinical diagnosis. Materials and methods. Sixty-one lymphoma patients from 2014 to 2015 with 140 suspicious lymph nodes, who had been confirmed by histology and underwent chemotherapy, were enrolled in our study. The responses to chemotherapy were recorded by PET/CT, contrast-enhanced CT, or CEUS. Results. We summarized the CEUS enhancement patterns as two types when detecting lymphomatous lymph nodes, which could be the specific diagnostic criteria: (1) rapid well-distributed hyperenhancement, with 83.1% lesions exhibiting a fast-in hyperenhancement pattern in the arterial phase, and (2) rapid heterogeneous hyperenhancement, with 16.9% lesions exhibiting heterogeneous in the arterial phase. Particularly, we found that all the suspicious lesions of indolent lymphomas were rapid well-distributed hyperenhancement. CEUS successfully identified 117 lymphomatous lymph nodes, while PET/CT and contrast-enhanced CT detected 124 and 113 lymphomatous lymph nodes, respectively. CEUS had an accuracy of 83.57%, and the accuracy of PET/CT and contrast-enhanced CT was 88.57% and 80.71%, respectively (p=0.188). The false-negative rate was 16.43%, 11.43%, and 19.29%, respectively (p=0.188). Conclusion. CEUS could be a useful tool in detecting lymphomatous nodes. A rapid well-distributed hyperenhancement pattern in CEUS could be a useful diagnostic criterion in both aggressive lymphoma and indolent lymphoma. These results can help us distinguish between lymphomatous and benign lymph nodes and make better diagnostic and therapeutic decisions.

scholarly journals A surgical case of mediastinal hematoma caused by a minor traffic injury

2020 ◽  
Vol 15 (1) ◽  
Author(s):  
Katsuyuki Suzuki ◽  
Satoshi Shiono ◽  
Kazuki Hayasaka ◽  
Makoto Endoh
Keyword(s):  
Inferior Thyroid Artery ◽  
Case Presentation ◽  
Mediastinal Hematoma ◽  
Traffic Injury ◽  
Contrast Enhanced Ct ◽  
Contrast Enhanced ◽  
Enhanced Ct ◽  
The Right ◽  
A Minor

Abstract Background Mediastinal hematoma rarely occurs after a minor traffic injury. Case presentation A woman in her forties was transferred to the emergency room by ambulance due to a traffic accident. Computed tomography (CT) revealed no abnormal findings, and she went home. Two days after the accident, the contrast-enhanced CT was repeated, which revealed cervical and mediastinal hematomas. Because it was possible that there was active bleeding from the right inferior thyroid artery, embolization of the right inferior thyroid artery was performed; however, her condition further deteriorated, so we performed emergency surgery to achieve hemostasis and remove the hematoma. Because of oozing from the right thyroid lobe, we performed right hemithyroidectomy and drainage of mediastinal space and right thoracic cavity. Since there was no bleeding site in the mediastinum, we thought that the mediastinal hematoma was due to bleeding from the thyroid gland. Her postoperative course was uneventful, and she is doing well at 9 months of follow-up after surgery. Conclusions It is possible that mediastinal hematoma might be caused by a minor traffic injury.

scholarly journals A rare jejunum retroperitoneal hernia case report and literature review

2020 ◽  
Vol 6 (4) ◽  
pp. 20200037
Author(s):  
Qiling Huang ◽  
Huiqing He ◽  
Yumin Li ◽  
Junjie Zeng
Keyword(s):  
Blood Flow ◽  
Small Intestine ◽  
Case Report ◽  
Literature Review ◽  
Preoperative Diagnosis ◽  
Rare Case ◽  
Contrast Enhanced Ct ◽  
Contrast Enhanced ◽  
Enhanced Ct ◽  
Primary Retroperitoneal

This report describes a rare case of retroperitoneal hernia and its preoperative diagnosis. Contrast-enhanced CT and multiplanar reconstruction were used to observe the hernia ring, hernia tract, contents and blood flow of a retroperitoneal hernia. The diagnosis of and conditions related to the retroperitoneal hernia were confirmed by CT soon after hospitalisation. There are no reports on the diagnosis of primary retroperitoneal hernia on CT in the literature to date, and we share this case to facilitate the accurate and timely identification of small intestine retroperitoneal hernias in the future.

scholarly journals Non-sebaceous Lymphadenoma of the Thymus: a Case Report

2021 ◽  
Author(s):  
Wu Shanlian ◽  
Bai Yuping ◽  
Xie xunlu ◽  
Guo Guangxiu
Keyword(s):  
Anterior Mediastinum ◽  
Costal Margin ◽  
Case Presentation ◽  
Contrast Enhanced Ct ◽  
Contrast Enhanced ◽  
Histopathologic Diagnosis ◽  
Enhanced Ct ◽  
Thymus Tissue ◽  
Rare Benign Tumor ◽  
Sebaceous Lymphadenoma

Abstract Background: non-sebaceous lymphadenoma (NSL) is a rare benign tumor with a predominant lymphoid background within which is embedded solid or duct-like structures squamous epithelial nests, lacking of sebaceous differentiation. Non-sebaceous lymphadenoma most commonly arises within the salivary glands. However, Non-sebaceous lymphadenoma arises in the thymus have not been reported.Case presentation: A 53-year-old female patient, computed tomography (CT) scan of the chest for patient showed a nodular (19 ×13 × 16-mm) in the anterior mediastinum, and with mild homogeneous enhancement on contrast-enhanced CT. The patients underwent total thymectomy with removal of the anterior mediastinal nodule by thoracoscope via below the costal margin of the Xiphoid process. Microscopically, the tumor was composed of epithelial nests and prominent lymphoid stroma, with a capsule and clearly demarcated from the surrounding thymus tissue. The epithelial nests are arranged in solid nests or duct-like structures, lacking of sebaceous differentiation and cytological atypia. The pathological diagnosis was lymphadenoma, non-sebaceous type. There were no signs of recurrence 6 months after the surgery.Conclusions: There are very few reported cases of non-sebaceous lymphadenoma occurred in thymus in the medical literature. So accurate understanding of the histopathologic diagnosis of this rare tumor is important to avoid unnecessary overtreatment.

Case 7.34

2014 ◽  
pp. 370-371
Author(s):  
Christine U. Lee ◽  
James F. Glockner
Keyword(s):  
Arterial Phase ◽  
Contrast Enhanced Ct ◽  
Contrast Enhanced ◽  
Enhanced Ct

66-year-old man with a recent episode of meningitis; hypointense lesions in the liver and kidneys were noted on a recent non–contrast-enhanced CT Axial fat-suppressed T2-weighted FRFSE images (Figure 7.34.1) show subtle hypointense nodules in the kidneys bilaterally. Axial arterial phase (Figure ...

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