Laryngeal Cysts in Adults: Simplifying Classification and Management

2017 ◽  
Vol 157 (6) ◽  
pp. 928-939 ◽  
Author(s):  
Richard Heyes ◽  
David G. Lott
Keyword(s):  
Literature Search ◽  
Rapid Onset ◽  
Definitive Diagnosis ◽  
Transoral Approach ◽  
New Classification ◽  
Cross Sectional ◽  
Primary Literature ◽  
Cross Sectional Imaging ◽  
Laryngeal Cyst

Objective Laryngeal cysts may occur at any mucosa-lined location within the larynx and account for 5% to 10% of nonmalignant laryngeal lesions. A number of proposed classifications for laryngeal cysts exist; however, no previously published classification aims to guide management. This review analyzes contemporary laryngeal cyst management and proposes a framework for the terminology and management of cystic lesions in the larynx. Data Sources PubMed/Medline. Review Methods A primary literature search of the entire Medline database was performed for all titles of publications pertaining to laryngeal cysts and reviewed for relevance. Full manuscripts were reviewed per the relevance of their titles and abstracts, and selection into this review was according to their clinical and scientific relevance. Conclusion Laryngeal cysts have been associated with rapid-onset epiglottitis, dyspnea, stridor, and death; therefore, they should not be considered of little significance. Symptoms are varied and nonspecific. Laryngoscopy is the primary initial diagnostic tool. Cross-sectional imaging may be required, and future use of endolaryngeal ultrasound and optical coherence tomography may revolutionize practice. Where possible, cysts should be completely excised, and there is growing evidence that a transoral approach is superior to transcervical excision for nearly all cysts. Histology provides definitive diagnosis, and oncocytic cysts require close follow-up. Implications for Practice A new classification system is proposed that increases clarity in terminology, with the aim of better preparing surgeons and authors for future advances in the understanding and management of laryngeal cysts.

State-of-the-art aortic imaging: Part II - applications in transcatheter aortic valve replacement and endovascular aortic aneurysm repair

VASA ◽  
2014 ◽  
Vol 43 (1) ◽  
pp. 6-26 ◽  
Author(s):  
Fabian Rengier ◽  
Philipp Geisbüsch ◽  
Paul Schoenhagen ◽  
Matthias Müller-Eschner ◽  
Rolf Vosshenrich ◽  
...  
Keyword(s):  
Aortic Valve ◽  
Transcatheter Aortic Valve Replacement ◽  
Surgical Repair ◽  
Imaging Modality ◽  
Open Surgical Repair ◽  
Cross Sectional ◽  
Transcatheter Aortic Valve ◽  
Cross Sectional Imaging ◽  
Sectional Imaging

Transcatheter aortic valve replacement (TAVR) as well as thoracic and abdominal endovascular aortic repair (TEVAR and EVAR) rely on accurate pre- and postprocedural imaging. This review article discusses the application of imaging, including preprocedural assessment and measurements as well as postprocedural imaging of complications. Furthermore, the exciting perspective of computational fluid dynamics (CFD) based on cross-sectional imaging is presented. TAVR is a minimally invasive alternative for treatment of aortic valve stenosis in patients with high age and multiple comorbidities who cannot undergo traditional open surgical repair. Given the lack of direct visualization during the procedure, pre- and peri-procedural imaging forms an essential part of the intervention. Computed tomography angiography (CTA) is the imaging modality of choice for preprocedural planning. Routine postprocedural follow-up is performed by echocardiography to confirm treatment success and detect complications. EVAR and TEVAR are minimally invasive alternatives to open surgical repair of aortic pathologies. CTA constitutes the preferred imaging modality for both preoperative planning and postoperative follow-up including detection of endoleaks. Magnetic resonance imaging is an excellent alternative to CT for postoperative follow-up, and is especially beneficial for younger patients given the lack of radiation. Ultrasound is applied in screening and postoperative follow-up of abdominal aortic aneurysms, but cross-sectional imaging is required once abnormalities are detected. Contrast-enhanced ultrasound may be as sensitive as CTA in detecting endoleaks.

Cross-Sectional Imaging of Small Bowel Malignancies

2012 ◽  
Vol 63 (3) ◽  
pp. 215-221 ◽  
Author(s):  
Dellano D. Fernandes ◽  
Ram Prakash Galwa ◽  
Najla Fasih ◽  
Margaret Fraser-Hill
Keyword(s):  
Small Bowel ◽  
Accurate Diagnosis ◽  
Imaging Features ◽  
Cross Sectional ◽  
Conventional Endoscopy ◽  
Cross Sectional Imaging ◽  
Pretreatment Staging ◽  
Sectional Imaging ◽  
Histologic Subtypes

Small bowel malignancies are rare neoplasms, usually inaccessible to conventional endoscopy but detectable in many cases by cross-sectional imaging. Modern multidetector computed tomographies permit accurate diagnosis, complete pretreatment staging, and follow-up of these lesions. In this review, we describe the cross-sectional imaging features of the most frequent histologic subtypes of the small bowel malignancies.

scholarly journals A rare imaging case of bilateral plasmacytoma of the breast

2020 ◽  
Vol 6 (2) ◽  
pp. 20190131
Author(s):  
Joleen Kirsty Eden ◽  
Rita Borgen ◽  
Rabea Haq ◽  
Richard Dobrashian
Keyword(s):  
Breast Cancer ◽  
Multiple Myeloma ◽  
Learning Outcomes ◽  
Case Reports ◽  
Definitive Diagnosis ◽  
High Grade ◽  
Nodal Involvement ◽  
Cross Sectional ◽  
Cross Sectional Imaging ◽  
Sectional Imaging

This case reports on secondary extramedullary multiple myeloma within both breasts in the absence of axillary nodal involvement and discusses the difficulty in interpretation with clinical recommendations and learning outcomes. Differentiating plasmacytic lesions in the breast is often difficult as clinical and radiological appearances are known to mimic benignity and high-grade primary breast cancer. Extramedullary presentation can determine progression of the disease and can necessitate cross-sectional imaging. Therefore definitive diagnosis is essential as the clinical management of the patient may be altered.

A Tour of the Thymus: A Review of Thymic Lesions with Radiologic and Pathologic Correlation

2015 ◽  
Vol 66 (1) ◽  
pp. 5-15 ◽  
Author(s):  
Alan J. Goldstein ◽  
Isabel Oliva ◽  
Hedieh Honarpisheh ◽  
Ami Rubinowitz
Keyword(s):  
Imaging Studies ◽  
Dynamic Changes ◽  
Cross Sectional ◽  
Radiographic Diagnosis ◽  
Imaging Characteristics ◽  
Pathologic Features ◽  
Cross Sectional Imaging ◽  
Pathologic Lesions ◽  
Periods Of Stress

The thymus is routinely encountered on cross-sectional imaging studies of the chest. It has a variable appearance, undergoes dynamic changes during periods of stress, and demonstrates numerous different pathologic lesions. Understanding the imaging characteristics of these different lesions facilitates accurate radiographic diagnosis and can prevent unnecessary follow-up imaging and intervention. This article will review normal thymic anatomy and development, thymic hyperplasia and associated medical conditions, and the imaging and pathologic features of various benign and malignant thymic lesions.

Benign non-cystic scrotal tumors and pseudotumors

2012 ◽  
Vol 53 (1) ◽  
pp. 102-111 ◽  
Author(s):  
Shaile Philips ◽  
Arpit Nagar ◽  
Manjiri Dighe ◽  
Raghunandan Vikram ◽  
Abhijit Sunnapwar ◽  
...  
Keyword(s):  
Problem Solving ◽  
Natural History ◽  
Conservative Management ◽  
Wide Spectrum ◽  
Definitive Diagnosis ◽  
Imaging Features ◽  
Cross Sectional ◽  
Cross Sectional Imaging ◽  
Sectional Imaging ◽  
The Cross

There is a wide spectrum of benign, non-cystic scrotal lesions that show characteristic histo-morphology and natural history. While sonography is the preferred modality for the diagnosis of both testicular and extratesticular masses, MRI is used as a problem-solving modality when sonographic findings are inconclusive. This article reviews the cross-sectional imaging features of benign, non-cystic, intra- and extratesticular lesions. Definitive diagnosis of benign scrotal lesions may lead to conservative management including testicular preserving surgery.

Republished: Bilateral carotid and vertebral rete mirabile with vein of Galen aneurysmal malformation: an unreported association

2014 ◽  
Vol 8 (1) ◽  
pp. e1-e1 ◽  
Author(s):  
Prabath Kumar Mondel ◽  
Rashmi Saraf ◽  
Uday S Limaye
Keyword(s):  
Parent Artery ◽  
Vein Of Galen ◽  
Cross Sectional ◽  
The Past ◽  
Rete Mirabile ◽  
Bilateral Carotid ◽  
Recurrent Vomiting ◽  
Cross Sectional Imaging ◽  
Surgical Options

Rete mirabile is a fine meshwork of anastomosing vessels that replace the parent artery. A 30-year-old woman complained of slurring of speech, right eye proptosis, recurrent vomiting, and loss of bladder and bowel control, followed by drowsiness lasting 30–40 min, for the past 6 months. On cross sectional imaging and angiography, the patient was found to have a vein of Galen aneurysmal malformation, with bilateral carotid and vertebral rete mirabile. The patient was offered both endovascular and open surgical options but she refused any form of surgical treatment and opted for conservative management. At the 6 month follow-up, she continued to have occasional episodes of headache and vomiting but was otherwise normal. We describe the clinical, cross sectional, and angiographic features of this patient. A comparison with other patients with bilateral carotid and vertebral rete mirabile is also reported.

scholarly journals P357 Long-term outcomes of biologic therapy in Crohn’s disease complicated with internal fistulizing disease: BIOSCOPE study from GETECCU

2021 ◽  
Vol 15 (Supplement_1) ◽  
pp. S377-S378
Author(s):  
I Rodríguez-Lago ◽  
A Fernández-Clotet ◽  
F Mesonero ◽  
F J García-Alonso ◽  
M J Casanova ◽  
...  
Keyword(s):  
Crohn’S Disease ◽  
Crohn's Disease ◽  
Biologic Agent ◽  
Fistula Closure ◽  
Biologic Drugs ◽  
Biologic Treatment ◽  
Cross Sectional ◽  
Urinary Fistulas ◽  
Cross Sectional Imaging

Abstract Background The prevalence of penetrating disease in Crohn’s disease (CD) increases progressively over time, and evidence on the medical treatment of this complication is limited. The aim of this study was to evaluate the efficacy of biologic agents in CD complicated with internal fistulising disease. Methods A retrospective analysis of all adult patients from the ENEIDA registry (>68,000 patients) with CD who received at least one biologic agent -anti-TNF, ustekinumab or vedolizumab- for penetrating disease was performed. Exclusion criteria comprised treatment for perianal disease, enterocutaneous, anastomotic or periostomal fistula tracts. The main outcomes were fistula-related surgery and fistula closure on cross-sectional imaging. Preestablished secondary outcomes included the rate of abdominal abscess, the need for percutaneous drainage, the changes in the number of fistula tracts, fistula closure rates, and the safety profile.The baseline characteristics were analyzed by means of descriptive statistics and were compared by non-parametric tests. Predictive factors associated with surgery and fistula closure were evaluated by a multivariable logistic regression and survival analyses. Results A total of 710 patients (median age 38 years [IQR, 28-48], 59% male, 55% L3) receiving 791 biologic treatments were included at 53 sites (701 anti-TNF, 71 ustekinumab, and 19 vedolizumab). Patients had a median of 1 (range 1-5) fistula tracts, 49% of them entero-enteric followed by entero-colic (28%). After a median follow-up of 59 months (IQR, 27-105), 244 patients (31%) required surgery due to internal fistulising complications after 8.5 months (IQR, 3-24). Patients with ileocolonic disease (OR 1.99 [1.22-3.23]), entero-urinary fistulas (OR 2.35 [1.17-4.73]), or with a stricture distal to the fistula (OR 2.1 [1.31-3.36]) showed a higher risk of surgery, with no differences between biologic drugs (Figure 1). Combination therapy reduced the risk of surgery (HR 0.58 [0.37-0.90]). Fistula closure was observed in 24% of patients after a median of 15 months (IQR, 7.5-27). Patients with a lower number of fistula tracts showed a higher probability of closure (OR 1.72 [1.09-2.7]). Conclusion A high proportion of patients with internal fistulizing CD benefit from biologic treatment after a median of 5 years. During this follow-up, around two thirds of patients are free of surgery and one in every four patients achieves fistula closure.

scholarly journals Simple vs ugly adnexal lesions: is ultrasonography alone good enough?

2019 ◽  
Vol 7 (8) ◽  
pp. 3020
Author(s):  
Rahul Dev Chauhan ◽  
Yashvir Mathur
Keyword(s):  
Histopathological Examination ◽  
Imaging Modality ◽  
Cross Sectional Study ◽  
Colour Doppler ◽  
Benign Lesions ◽  
Cross Sectional ◽  
Adnexal Masses ◽  
Cross Sectional Imaging ◽  
Ovarian Masses

Background: Ultrasound (USG) is easily available and effective imaging modality for adnexal lesions. A simple looking lesion on ultrasound is usually benign and an ugly looking adnexal lesion is either benign or malignant. This study aims to evaluate the varied appearance of simple and ugly benign adnexal lesions on USG and to find out any additional role of colour Doppler in such suspected benign lesions. The confirmation of diagnosis was done either by follow up appearance of lesions on USG or by histopathological evaluation.Methods: A total of 55 consecutive female patients with age between 18 to 50 years were enrolled in this prospective cross sectional study. USG and colour Doppler for all the lesions were done. The patients found to have malignant lesions on histopathological examination, were later excluded from the analysis. Follow up USG was done for all the cases. Those cases wherein there was no resolution of lesions even after 08 weeks, were given an option to undergo laparoscopy as next management step.Results: Out of 50 benign adnexal masses, 88% masses were ovarian in origin and 12% were tubal masses. Ovarian masses included hemorrhagic cysts, endometriosis, simple cysts, serous cystadenomas and ovarian dermoid. All extra-ovarian masses were hydrosalpinx. Colour Doppler did not add any additional finding. Some of the patients underwent diagnostic laparoscopy followed by excision of masses in majority of them.Conclusions: Benign adnexal lesions can have varied appearance ranging from simple to ugly on USG. Ultrasonographic features of benign lesions on USG can be appreciated very well even without further use of colour Doppler or cross sectional imaging. Follow up USG remains key modality for benign adnexal masses in absence of MRI.

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