scholarly journals A retroperitoneal bronchogenic cyst clinically mimicking an adrenal mass: three case reports and a literature review

2022 ◽  
Vol 50 (1) ◽  
pp. 030006052110726
Author(s):  
Bi-yue Hu ◽  
Hong Yu ◽  
Jiang Shen
Keyword(s):  
Adrenal Mass ◽  
Clinical Symptoms ◽  
Imaging Techniques ◽  
Case Reports ◽  
Hormone Secretion ◽  
Symptomatic Patient ◽  
Posterior Mediastinum ◽  
Imaging Features ◽  
Retroperitoneal Bronchogenic Cyst ◽  
Bronchogenic Cysts

Bronchogenic cysts are a congenital primitive foregut-derived developmental malformation, generally occurring in the posterior mediastinum. Their development in the retroperitoneum is extremely rare. Imaging techniques, such as multidetector computed tomography (MDCT), are typically effective in the detection of these lesions. Here, we describe three cases of a retroperitoneal cyst presenting as a para-adrenal mass. Only one boy presented with abdominal pain, and the other two showed no clinical symptoms. Endocrinological evaluation of all three cases was performed, and no adrenal hormone secretion was detected. All three cases were misdiagnosed preoperatively. Each patient underwent surgery, and one symptomatic patient became asymptomatic after surgery. Pathologic examination confirmed all three masses as bronchogenic cysts. The three cases showed some similar MDCT imaging features, including a complete adrenal structure, a cystic or solid mass in the adrenal region, and no obvious enhancement. Therefore, bronchogenic cysts should be considered in the differential diagnosis of retroperitoneal masses, even though accurate preoperative diagnosis remains difficult. A contrast-enhanced MDCT scan may be useful for differentiating hyper-attenuated cysts from other soft tissue masses.

scholarly journals Retroperitoneal bronchogenic cyst resembling an adrenal tumor: two case reports and literature review

2020 ◽  
Vol 48 (5) ◽  
pp. 030006052092567
Author(s):  
Yang Wen ◽  
Wanyuan Chen ◽  
Junfa Chen ◽  
Xiaodong He
Keyword(s):  
Bronchogenic Cyst ◽  
Clinical Symptoms ◽  
Imaging Techniques ◽  
Case Reports ◽  
Imaging Features ◽  
Computed Tomography Imaging ◽  
Accurate Preoperative Diagnosis ◽  
Retroperitoneal Bronchogenic Cyst ◽  
Routine Physical Examination ◽  
Bronchogenic Cysts

Bronchogenic cysts are primitive, foregut-derived developmental anomalies with bronchial-type, pseudostratified cylindrical epithelium. They are usually discovered in the thorax. The occurrence of such cysts in the retroperitoneum is extremely rare. Imaging techniques are generally effective in the detection of retroperitoneal bronchogenic cyst. Here, we report two cases (a 27-year-old man and a 33-year-old man) who had no clinical symptoms and were found by chance to have masses in the adrenal gland area during routine physical examination. We found that they had some similar computed tomography imaging features, including complete adrenal structure, cystic fusiform mass in adrenal region, and inclusion of calcifications in the lesions. However, accurate preoperative diagnosis remains difficult and only histology can provide a definitive diagnosis. Surgery remains the treatment of choice.

scholarly journals CT and MRI manifestations of mediastinal cavernous hemangioma and a review of the literature

2019 ◽  
Vol 17 (1) ◽  
Author(s):  
Yu Bai ◽  
Guoshu Zhao ◽  
Yongming Tan
Keyword(s):  
Cavernous Hemangioma ◽  
Clinical Symptoms ◽  
Benign Lesion ◽  
Posterior Mediastinum ◽  
Anterior Mediastinum ◽  
High Signal ◽  
Imaging Features ◽  
Contrast Enhanced Ct ◽  
Contrast Enhanced ◽  
Ct And Mri

Abstract Background The cavernous hemangioma of mediastinum (CHM) is a rare benign lesion caused by congenital vascular dysplasia. However, its incidence is extremely low, and patients often lack relevant clinical symptoms. So we analyzed retrospectively some cases to investigate the imaging features of cavernous hemangioma of mediastinum (CHM) and improve the diagnostic accuracy. Methods The CT/MRI imaging features and clinical information of 19 patients with CHM were analyzed retrospectively. Results The lesions of 18 CHM patients were single. Twelve cases in the anterior mediastinum and 8 in the posterior mediastinum. The diameter of CHM ranges from 2.0 to 7.0 cm. Thirteen cases were oval-shaped or round, 4 cases were lobulated, and 2 cases were irregular. Phleboliths or nodular calcification were identified in four cases. High signal of T2WI lipid suppression in two cases and blood vessel shadows were observed in two cases. After contrast-enhanced scan, the nodular enhancement of arteries were identified in 14 cases and contrast agent was further filled of the venous phase, where “fast in and slow out” feature was performed. One case showed inhomogeneous enhancement, one case performed “fast in and slow out” feature of multiphase-enhanced MRI. Besides, aberrant veins can be seen in or around the lesion among five cases. Conclusions CHM is more frequently located at the anterior mediastinum than at the posterior mediastinum. The performance of phleboliths, high signal on T2WI fat suppression and DWI, the nodular enhancement of the artery, venous and delayed phase filling, enhanced “fast in and slow out,” and aberrant veins in the lesion are helpful for the diagnosis and differential diagnosis. Multiple period contrast-enhanced CT and MRI scan is helpful for the diagnosis of CHM.

scholarly journals Pulmonary sequestration: Report of three cases

2009 ◽  
Vol 62 (5-6) ◽  
pp. 278-280
Author(s):  
Ruza Stevic ◽  
Dragan Mandaric ◽  
Dragana Jovanovic ◽  
Nada Vasic ◽  
Dragan Masulovic ◽  
...  
Keyword(s):  
Computerized Tomography ◽  
Blood Supply ◽  
Clinical Symptoms ◽  
Imaging Techniques ◽  
Case Reports ◽  
Pulmonary Sequestration ◽  
Tracheobronchial Tree ◽  
Cystic Tumor ◽  
X Ray ◽  
Systemic Arteries

Introduction Pulmonary sequestration is a non-functioning pulmonary parenchyma that is separated from tracheobronchial tree and receives its blood supply via systemic arteries. The diagnosis of sequestration pulmonis is based on clinical symptoms and characteristic radiologic findings. Case reports In this report, radiological findings of pulmonary sequester in three patients with non-resolving pneumonia were retrospectively reviewed. All patients underwent chest x-ray, computerized tomography of thorax and angiography. X-ray revealed in all cases tumorlike, unsharply bordered shadows in the posterior basal parts of the lung, two on the right and one on the left side. Computerized tomography(CT) finding showed solid-cystic tumor masses and angiography revealed anomalous blood supply from systemic arteries arising from aorta and running to the shadow in the lung. This finding is typical of bronchopulmonary sequestration. All patients were operated on and histological analysis of operative material confirmed diagnosis of intralobar pulmonary sequestration. Discussion Sequestratio pulmonis can cause a diagnostic problem due to unspecific symptoms and atypical radiographic and CT findings. Therefore, it is important to demonstrate the arterial supply and venous drainage of the sequestered segment preoperatively. Today, with the help of non-invasive imaging techniques such as CT and magnetic resonance imaging (MRI), preoperative diagnosis of pulmonary sequester can be made easily, so, invasive techniques such as angiography are not required frequently.

scholarly journals Recent advances in understanding and managing adenomyosis

F1000Research ◽  
2019 ◽  
Vol 8 ◽  
pp. 283 ◽  
Author(s):  
Silvia Vannuccini ◽  
Felice Petraglia
Keyword(s):  
Clinical Symptoms ◽  
Negative Impact ◽  
Imaging Techniques ◽  
Transvaginal Ultrasound ◽  
Abnormal Uterine Bleeding ◽  
Response To Treatment ◽  
Imaging Features ◽  
Gynecology And Obstetrics ◽  
Menstrual Symptoms

Adenomyosis is a benign uterine disorder in which endometrial glands and stroma are pathologically demonstrated in the uterine myometrium and it is considered a specific entity in the PALM-COEIN FIGO (polyp; adenomyosis; leiomyoma; malignancy and hyperplasia; coagulopathy; ovulatory dysfunction; endometrial; iatrogenic; and not yet classified – International Federation of Gynecology and Obstetrics) classification of causes of abnormal uterine bleeding (AUB). Although it has always been considered the classic condition of multiparous women over 40 years old who have pain and heavy menstrual bleeding, diagnosed at hysterectomy, the epidemiological scenario has completely changed. Adenomyosis is increasingly identified in young women with pain, AUB, infertility, or no symptoms by using imaging techniques such as transvaginal ultrasound and magnetic resonance. However, there is no agreement on the definition and classification of adenomyotic lesions from both the histopathology and the imaging point of view, and the diagnosis remains difficult and unclear. A uniform and shared reporting system needs to be implemented in order to improve our understanding on imaging features, their relationship with pathogenic theories, and their importance in terms of clinical symptoms and response to treatment. In fact, adenomyosis pathogenesis remains elusive and not a single theory can explain all of the different phenotypes of the disease. Furthermore, adenomyosis often coexists with other gynecological conditions, such as endometriosis and uterine fibroids, increasing the heterogeneity of available data. Treatment requires a lifelong management plan as the disease has a negative impact on quality of life in terms of menstrual symptoms, fertility, and pregnancy outcome and has a high risk of miscarriage and obstetric complications.

Retroperitoneal Foregut Duplication Cyst Presenting as an Adrenal Mass

2007 ◽  
Vol 73 (1) ◽  
pp. 89-92
Author(s):  
N. Elizabeth Terry ◽  
Christopher K. Senkowski ◽  
William Check ◽  
Steven T. Brower
Keyword(s):  
Abdominal Pain ◽  
Adrenal Gland ◽  
Laparoscopic Adrenalectomy ◽  
Adrenal Mass ◽  
Bronchogenic Cyst ◽  
Ct Scanning ◽  
Duplication Cyst ◽  
Early Satiety ◽  
Retroperitoneal Bronchogenic Cyst ◽  
Bronchogenic Cysts

A 75 year-old woman presented to the authors’ institution with abdominal pain and early satiety. An adrenal mass was found on CT scanning. Laparoscopic adrenalectomy was performed, and the patient was found to have a retroperitoneal bronchogenic cyst adherent to the adrenal gland. The workup of an adrenal mass is discussed as well as the pathophysiology of bronchogenic cysts.

scholarly journals A comprehensive approach to adrenal incidentalomas

2004 ◽  
Vol 48 (5) ◽  
pp. 583-591 ◽  
Author(s):  
Franco Mantero ◽  
Nora Albiger
Keyword(s):  
Health Care Professionals ◽  
Adrenal Mass ◽  
Imaging Techniques ◽  
Plasma Renin ◽  
Clinical Problem ◽  
Needle Aspiration ◽  
First Year ◽  
Imaging Features ◽  
Oncological Patients ◽  
Risk Of Malignancy

Improvements in abdominal imaging techniques have increased the detection of clinically inapparent adrenal masses, or incidentalomas (AI), the appropriate diagnosis and management of which have become a common clinical problem for health care professionals. Once an adrenal mass has been detected, the clinician needs to address two questions: 1) is the tumor hormonally active? and 2) is there any chance of the mass being malignant? The majority of AI is non-hypersecretory cortical adenomas, but an endocrine evaluation can lead to the identification of subtle hormone excess. An overnight low-dose dexamethasone suppression test, fractionated urinary or plasma metanephrine assay and, in hypertensive patients, establishing the upright plasma aldosterone/plasma renin activity ratio are recommended as preliminary screening steps. Masses greater than 4cm are at greater risk of malignancy. Morphological imaging features may be helpful in the distinction between benign and malignant forms. Fine-needle aspiration biopsy is an important tool in the evaluation of oncological patients to establish any metastatic disease. Adrenalectomy is indicated by evidence of a functional adrenal mass, or a suspected malignant form. We advocate adrenalectomy of subtle hypercortisolism, especially in the presence of hypertension, obesity, diabetes or osteoporosis potentially aggravated by glucocorticoid excess. A close follow-up is needed, particularly in the first year after diagnosis.

scholarly journals Mesenteric Cysts: A Retrospective Review. Its Not All That Simple

2020 ◽  
Vol 154 (Supplement_1) ◽  
pp. S117-S118
Author(s):  
M Bourgeau ◽  
V Avadhani
Keyword(s):  
Cyst Wall ◽  
Imaging Techniques ◽  
Case Reports ◽  
Lymphatic Vessels ◽  
Mucinous Cystadenoma ◽  
Final Diagnosis ◽  
Cystic Mass ◽  
Pathological Examination ◽  
Urachal Cyst ◽  
Mesenteric Cysts

Abstract Introduction/Objective Mesenteric cysts are rare intra-abdominal lesions in adults. However, with the advanced imaging techniques and laparoscopic techniques, they are more often being identified and resected when clinically significant. There is a lack of detailed information in histopathology (except as case reports) since mesentery is generally neglected in our organ-based textbooks. The aim of our study is to highlight the importance of identifying and classifying mesenteric cystic lesions; they are not all that simple. Methods We performed a retrospective search on all mesenteric cysts submitted as excisions in our electronic database from 2013-2019. We classified them as per the de Perrot (PMID: 11053936) classification with modification. Results Our search showed: A. Lymphatic origin-11 (lymphangioma-10, Lymphangioma hamartomatous-1, associated with LAM-0), B. Mesothelial origin-68 (Benign mesothelial cysts-57, multilocular mesothelial cyst-11), C. Enteric origin- 3, D. Urogenital origin (Urachal cyst, mullerian inclusion cyst)-9, E. Mature cystic teratom-2, F. Pseudocyst-12, G. Epithelial cyst (not urogenital)- 11 (a/w LAMN-3, MCN-4, Mucinous cystadenoma-4), H. Associated with carcinoma-2. Case illustration: A 61-year-old male presented with worsening dysphagia, emesis and hiccups. A CT scan showed a 21.2 cm cystic mass with at least one septation (Fig 1). The cyst was resected. On gross pathological examination, the cyst measured 18 cm in greatest dimension with a thick, rough, tan-brown capsule. Microscopic examination showed a fibrous capsule, and cyst wall composed of numerous lymphatic vessels (CD31 positive) and prominent smooth muscle proliferation (Desmin positive). Scattered lymphoid aggregates were also present throughout the cyst wall. No definite epithelial lining was identified and was suspected to have been denuded. HMB-45 immunostain was negative, ruling out association with LAM. The final diagnosis of a Lymphangiomyoma, hamartomatous was rendered. Conclusion Though most of the mesenteric cysts are benign, some of them are significantly important such as Lymphangiomyoma (esp secondary to LAM), MCN, those associated with LAMN etc. and identifying and differentiating from their mimics has distinct clinical implications.

Intelligent diagnosis and analysis of brain lymphoma based on imaging features

2021 ◽  
pp. 1-11
Author(s):  
Yipu Mao ◽  
Muliang Jiang ◽  
Fanyu Zhao ◽  
Liling Long
Keyword(s):  
Imaging Techniques ◽  
Experimental Studies ◽  
Diagnostic Value ◽  
Imaging Features ◽  
Flow Properties ◽  
Brain Lymphoma ◽  
Diagnosis And Prognosis ◽  
Primary Brain Lymphoma ◽  
Set Up ◽  
Prognosis Evaluation

Currently, DSC has been extensively studied in the diagnosis, differential diagnosis and prognosis evaluation of brain lymphoma, but it has not obtained a uniform standard. By combining DSC imaging features, this study investigated the imaging features and diagnostic value of several types of tumors such as primary brain lymphoma. At the same time, this study obtained data from brain lymphoma patients by data collection and set up different groups to conduct experimental studies to explore the correlation between IVIM-MRI perfusion parameters and DSC perfusion parameters in brain lymphoma. Through experimental research, it can be seen that the combination of two perfusion imaging techniques can more fully reflect the blood flow properties of the lesion, which is beneficial to determine the nature of the lesion.

Whole brain atlas-based diffusion kurtosis imaging parameters for evaluation of minimal hepatic encephalopathy

2021 ◽  
pp. 197140092110269
Author(s):  
Prateek Gupta ◽  
Sameer Vyas ◽  
Teddy Salan ◽  
Chirag Jain ◽  
Sunil Taneja ◽  
...  
Keyword(s):  
Hepatic Encephalopathy ◽  
Clinical Symptoms ◽  
Early Stage ◽  
Imaging Techniques ◽  
Clinical Stage ◽  
Minimal Hepatic Encephalopathy ◽  
Brain Atlas ◽  
Diffusion Kurtosis Imaging ◽  
Whole Brain ◽  
Diffusion Kurtosis

Background and purposes Minimal hepatic encephalopathy (MHE) has no recognizable clinical symptoms, but patients have cognitive and psychomotor deficits. Hyperammonemia along with neuroinflammation lead to microstructural changes in cerebral parenchyma. Changes at conventional imaging are detected usually at the overt clinical stage, but microstructural alterations by advanced magnetic resonance imaging techniques can be detected at an early stage. Materials and methods Whole brain diffusion kurtosis imaging (DKI) data acquired at 3T was analyzed to investigate microstructural parenchymal changes in 15 patients with MHE and compared with 15 age- and sex-matched controls. DKI parametric maps, namely kurtosis fractional anisotropy (kFA), mean kurtosis (MK), axial kurtosis (AK) and radial kurtosis (RK), were evaluated at 64 white matter (WM) and gray matter (GM) regions of interest (ROIs) in the whole brain and correlated with the psychometric hepatic encephalopathy score (PHES). Results The MHE group showed a decrease in kFA and AK across the whole brain, whereas MK and RK decreased in WM ROIs but increased in several cortical and deep GM ROIs. These alterations were consistent with brain regions involved in cognitive function. Significant moderate to strong correlations (–0.52 to –0.66; 0.56) between RK, MK and kFA kurtosis metrics and PHES were observed. Conclusion DKI parameters show extensive microstructural brain abnormalities in MHE with minor correlation between the severity of tissue damage and psychometric scores.

scholarly journals Penanganan Obstruksi Duodenum pada Anjing: Laporan Kasus (Treatment of Duodenum Obstruction in Dogs: Case reports)

2018 ◽  
Vol 19 (1) ◽  
pp. 137
Author(s):  
Erwin Erwin ◽  
Rusli Rusli ◽  
Amiruddin Amiruddin ◽  
Deni Noviana ◽  
Raden Roro Soesatyoratih ◽  
...  
Keyword(s):  
Foreign Body ◽  
Clinical Symptoms ◽  
Case Reports ◽  
Contrast Material ◽  
Large Mass ◽  
Radiographic Examination ◽  
Blood Profile ◽  
Foreign Objects ◽  
Animal Bones ◽  
Veterinary Hospital

Veterinary Hospital of Education Faculty of Veterinary Medicine, Bogor Agricultural University, received a Golden Retriever with clinical symptoms of anorexia, abdominal pain, vomiting and constipation in April 2016. Blood profile examination showed leukocytosis, erythropenia and low hemoglobin level. Radiographic examination without contrast showed a foreign body which is characterized by a large mass radiopaque in intestinal area. Forty-five minutes after the administration of radiographic contrast, contrast material was still in gastrium and only reached partial intestinal. Endoscopy examination showed there was irritation symptoms of the esophagus to gastrium. Black colored liquid was seen while the endoscope inserted into the gastric. Enterotomy was carried out to remove foreign objects. The foreign body is consisted of bones fragments and the plastic that was eaten by the patient. One week after surgery, the animals showed clinical symptoms and had a good appetite. These case can be prevented by not giving foods that contain animal bones and keeping animals in a dirty environment.

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