Fibrous Dysplasia at Unusual Anatomic Sites: A Series of 86 Cases With Emphasis on Histologic Patterns

2021 ◽  
pp. 106689692199714
Author(s):  
Nicholas J. Olson ◽  
Carrie Y. Inwards ◽  
Doris E. Wenger ◽  
Karen J. Fritchie
Keyword(s):  
Bone Formation ◽  
Fibrous Dysplasia ◽  
Giant Cells ◽  
Imaging Features ◽  
Expert Consultation ◽  
Imaging Studies ◽  
Radiologic Imaging ◽  
Type Giant ◽  
Small Bones ◽  
Tubular Bones

Aims. Fibrous dysplasia (FD) is a benign fibro-osseous neoplasm that most commonly arises in the ribs, femur, and craniofacial bones. We analyzed features of FD arising in the spine/short tubular/small bones of the hands/feet (STSBHF), specifically assessing for pattern of bone formation (conventional, complex/anastomosing, psammomatoid/cementum like), myxoid change, and presence of osteoclast-type giant cells. Materials and methods. A total of 1958 cases of FD were reviewed, of which 131 arose in the spine/STSBHF representing 2.5% of institutional and 10% of consultation cases, respectively. Eighty-six cases had material available for review. Anatomic sites included vertebrae ( n = 58, 67%), short tubular bones ( n = 20, 23%), and small bones of the hands/feet ( n = 8, 9%). The most common morphologic pattern of bone identified was conventional ( n = 77, 90%), followed by complex/anastomosing ( n = 22, 26%) and psammomatoid/cementum like ( n = 22, 26%). Eighteen cases (21%) had matrix-poor areas. Hypercellular areas were identified in 6 cases, 2 cases of which showed matrix-poor areas. Osteoclast-type giant cells were noted in 9 cases and myxoid change was present in 3 cases. Radiologic imaging studies available for 41 cases nearly all demonstrated features typical of FD, but the diagnosis was not predicted due to the unexpected location. Conclusions. FD arising in the spine/STSBHF is rare and frequently results in expert consultation. A significant number of cases exhibited less commonly recognized patterns of bone formation, and stromal changes including osteoclast-type giant cells, and matrix poor areas. Furthermore, imaging features in the STSBHF are often less specific. Awareness of the morphologic spectrum at these locations coupled with radiologic correlation should aid in accurate classification.

Comparison of Polymerase Chain Reaction With Histopathologic Features for Diagnosis of Tuberculosis in Formalin-Fixed, Paraffin-Embedded Histologic Specimens

2003 ◽  
Vol 127 (3) ◽  
pp. 326-330 ◽  
Author(s):  
Do Youn Park ◽  
Jee Yeon Kim ◽  
Kyung Un Choi ◽  
Jin Sook Lee ◽  
Chang Hun Lee ◽  
...  
Keyword(s):  
Chronic Inflammation ◽  
Granulomatous Inflammation ◽  
Giant Cells ◽  
Caseous Necrosis ◽  
Formalin Fixed Paraffin ◽  
Formalin Fixed Paraffin Embedded ◽  
Type Giant ◽  
Tb Pcr ◽  
Formalin Fixed ◽  
Histopathologic Features

Abstract Objective.—To investigate the relationship between various histopathologic features and the results of the tuberculosis (TB)–polymerase chain reaction (PCR) method in routinely submitted histologic specimens for the histopathologic diagnosis of TB. Design.—We used 95 formalin-fixed, paraffin-embedded tissue blocks from 81 patients who were clinically suspected of having TB. We assessed the presence of histopathologic features including well-formed granuloma, poorly formed granuloma, caseous necrosis, and Langhans-type giant cells. We performed nested PCR for IS6110 and Ziehl-Neelsen staining for acid-fast bacilli (AFB). Results.—Of the 81 patients studied, 53 patients had chronic granulomatous inflammation, whereas 28 patients had only chronic inflammation without definite granulomatous inflammation. Of the 53 cases with chronic granulomatous inflammation, 17 (32%) were AFB positive and 36 (68%) were TB-PCR positive. Among cases with chronic granulomatous inflammation, the percentage that were positive and negative by TB-PCR differed significantly with the presence of various histopathologic features. All of the 13 cases with well-formed granuloma, caseous necrosis, and Langhans-type giant cells were TB-PCR positive; however, 10 (36%) of the 28 cases with chronic inflammation without granulomatous lesions were also TB-PCR positive. Conclusions.—TB-PCR is a rapid, sensitive method for the diagnosis of TB in routinely processed formalin-fixed, paraffin-embedded histologic specimens and is readily available in histopathology laboratories. We recommend use of TB-PCR when TB is suspected clinically, especially in cases of chronic inflammation without definite evidence of granulomatous inflammation.

scholarly journals Imaging of intractable paediatric epilepsy

2015 ◽  
Vol 19 (2) ◽  
Author(s):  
Sanjay Prabhu ◽  
Nasreen Mahomed
Keyword(s):  
Imaging Techniques ◽  
Intractable Epilepsy ◽  
Imaging Features ◽  
Imaging Studies ◽  
Non Invasive ◽  
Multidisciplinary Meetings ◽  
Interdisciplinary Approaches ◽  
Structural Lesion ◽  
Patients With Epilepsy ◽  
Epileptogenic Foci

Approximately 20% of paediatric patients with epilepsy are refractory to medical therapies. In this subgroup of patients, neuroimaging plays an important role in identifying an epileptogenic focus. Successful identification of a structural lesion results in a better outcome following epilepsy surgery. Advances in imaging technologies, methods of epileptogenic region localisation and refinement of clinical evaluation of this group of patients in epilepsy centres have helped to widen the spectrum of children who could potentially benefit from surgical treatment. In this review, we discuss ways to optimise imaging techniques, list typical imaging features of common pathologies that can cause epilepsy, and potential pitfalls to be aware of whilst reviewing imaging studies in this challenging group of patients. The importance of multidisciplinary meetings to analyse and synthesise all the non-invasive data is emphasised. Our objectives are: to describe the four phases of evaluation of children with drug-resistant localisation-related epilepsy; to describe optimal imaging techniques that can help maximise detection of epileptogenic foci; to describe a systematic approach to reviewing magnetic resonance imaging of children with intractable epilepsy; to describe the features of common epileptogenic substrates; to list potential pitfalls whilst reviewing imaging studies in these patients; and to highlight the value of multimodality and interdisciplinary approaches to the management of this group of children.

scholarly journals Acute bacterial nephritis. A descriptive study of an underdiagnosed entity

2020 ◽  
Vol 80 (3) ◽  
pp. 1-10
Author(s):  
Pedro Antonio Madero-Morales ◽  
Rigoberto Pallares-Méndez ◽  
Rodrigo Romero-Mata ◽  
Guillermo Vizcarra-Mata ◽  
Andrés Guillén-Lozoya
Keyword(s):  
Acute Pyelonephritis ◽  
Clinical Characteristics ◽  
Clinical Course ◽  
Case Series ◽  
Therapy Response ◽  
Time Frame ◽  
Clinical Findings ◽  
Imaging Features ◽  
Imaging Studies ◽  
Retrospective Case

Background: Acute bacterial nephritis is an infectious process diagnosed through imaging studies. The clinical course of the disease has been shown to be more aggressive than acute pyelonephritis. It continues to be underdiagnosed, thus there are few studies on the entity in the literature. Objective: To describe the clinical characteristics and imaging features of acute bacterial nephritis, as well as its clinical course. Design: A descriptive, retrospective case series was conducted. Materials and methods: Thirty-two cases of acute bacterial nephritis in patients admitted to the hospital within the time frame of 2009 to 2016 were reviewed. The patients’ clinical characteristics upon admission were registered, as well as inpatient clinical progression, culture results, and antibiotic therapy response. The imaging studies were re-evaluated and the diagnostic consistency with either the focal or multifocal disease presentation was confirmed. Results: Cases predominated in women (n=29, 90.62%) and the most frequently associated comorbidities were diabetes (n=16, 50%) and obesity (n=9, 28.25%). The most important clinical findings upon admission were fever (n=15, 46.87%) and leukocytosis (n=27, 84.38%). Escherichia coli was the most commonly isolated bacterium (63.63%). Both acute focal bacterial nephritis and acute multifocal bacterial nephritis were observed in 46.87% (n=15) and 53.13% (n=17) of the patients, respectively. Imaging studies were required for all diagnoses. Conclusion: Fever and leukocytosis are the main findings in acute bacterial nephritis. Imaging studies are necessary for making the diagnosis, given that acute pyelonephritis and acute bacterial nephritis cannot be clinically differentiated.

Imaging features of undifferentiated carcinoma with osteoclastic giant cells of the pancreas

2020 ◽  
Vol 101 (12) ◽  
pp. 839-841
Author(s):  
R. Aldhaheri ◽  
M. Barat ◽  
A. Dohan ◽  
S. Gaujoux ◽  
R. Coriat ◽  
...  
Keyword(s):  
Giant Cells ◽  
Undifferentiated Carcinoma ◽  
Imaging Features

Primary Clear Cell Sarcoma of the Tongue

2013 ◽  
Vol 137 (11) ◽  
pp. 1680-1683 ◽  
Author(s):  
Stefan Kraft ◽  
Cristina R. Antonescu ◽  
Andrew E Rosenberg ◽  
Daniel G. Deschler ◽  
G. Petur Nielsen
Keyword(s):  
Soft Tissues ◽  
Clear Cell ◽  
S100 Protein ◽  
Neck Region ◽  
Clear Cell Sarcoma ◽  
Giant Cells ◽  
Cell Sarcoma ◽  
Node Metastases ◽  
Type Giant

Clear cell sarcoma shares features with melanoma, but frequently shows EWSR1 rearrangements. It is an aggressive tumor typically occurring in the soft tissues of the extremities, with a gastrointestinal variant with less consistent melanocytic differentiation. It is extremely rare in the head and neck region, with no reported cases in the oral cavity. We report a case of an 82-year-old woman with a clear cell sarcoma arising in the tongue, with cervical lymph node metastases. Histologically, the tumor showed some features of gastrointestinal clear cell sarcoma. No osteoclast-type giant cells were present. The tumor cells were positive for S100 protein and negative for other melanocytic markers. Fluorescence in situ hybridization showed rearrangements of EWSR1 and ATF1. This case expands the spectrum of clear cell sarcoma with a gastrointestinal-like variant in a novel site, emphasizing the need to consider it as a differential diagnosis to melanoma in mucosal sites.

Soft-Tissue Tumors of the Hand—Imaging Features

2020 ◽  
Vol 71 (2) ◽  
pp. 161-173 ◽  
Author(s):  
Gregory Scott Stacy ◽  
Jeffrey Bonham ◽  
Anthony Chang ◽  
Stephen Thomas
Keyword(s):  
Soft Tissue ◽  
Daily Practice ◽  
Soft Tissue Tumors ◽  
Vascular Lesions ◽  
Imaging Features ◽  
Imaging Studies ◽  
Adipocytic Tumors ◽  
Imaging Characteristics ◽  
Tumors Of The Hand ◽  
Structured Approach

Imaging studies of the hands and fingers are common, and radiologists are generally comfortable with traumatic and degenerative conditions which arise frequently in daily practice. However, a variety of common and uncommon soft-tissue tumors also occur in the hand, the appropriate diagnosis of which can be a source of confusion for both clinicians and radiologists. These lesions often have overlapping imaging characteristics; however, a structured approach can help provide a focused differential diagnosis and impact further workup and management. We discuss several such tumors, categorizing them as cystic-appearing, noncystic masses along tendons and aponeuroses, adipocytic tumors, vascular lesions, and miscellaneous lesions with imaging features that can aid diagnosis.

Incidental renal masses: Therapeutic management

1992 ◽  
Vol 59 (1_suppl) ◽  
pp. 153-155
Author(s):  
A. Prati ◽  
C. Cantoni ◽  
I. Pieri ◽  
P. Sacchini ◽  
A. Savino ◽  
...  
Keyword(s):  
Renal Mass ◽  
Percutaneous Biopsy ◽  
Imaging Studies ◽  
Benign Lesions ◽  
Renal Masses ◽  
Traditional Treatment ◽  
Radiologic Imaging ◽  
Management Alternatives ◽  
Total Nephrectomy

Evaluation and treatment of incidental renal masses is a problem facing urologists with increasing frequency since radiologic imaging (Echotomography and CT) has become routine. Traditional treatment by total nephrectomy may be unnecessary for small renal cell carcinoma and is often inappropriate for benign, lesions: whereas only observation by periodic follow-up with imaging studies and/or percutaneous biopsy is not always sufficient. So the problem of management alternatives is very important and no universal strategy can be employed. We report our experience with 15 pts with incidental renal mass treated in different ways.

Fibrous Dysplasia of the Clivus

Neurosurgery ◽  
2003 ◽  
Vol 52 (2) ◽  
pp. 318-323 ◽  
Author(s):  
Badih Adada ◽  
Ossama Al-Mefty
Keyword(s):  
Fibrous Dysplasia ◽  
Demographic Data ◽  
Disease Entity ◽  
Resonance Imaging ◽  
Imaging Studies ◽  
Radiological Findings ◽  
Nerve Paralysis ◽  
Computed Tomographic ◽  
Weighted Magnetic Resonance Imaging ◽  
Pathological Confirmation

Abstract OBJECTIVE Fibrous dysplasia is a developmental skeletal disorder that may lead to distortion, expansion, and weakening of the bone. Craniofacial involvement by this entity is well recognized and is known to cause neurovascular impingement and cosmetic deformity; fibrous dysplasia of the clivus, however, is unrecognized and seldom reported. Differentiating this entity from more aggressive disease processes affecting the clivus is central for the proper management of lesions in this area. We have studied fibrous dysplasia of the clivus with the goal of depicting its manifestations, outlining its management, and heightening awareness of this disease entity. METHODS We retrospectively reviewed our database and identified patients with the diagnosis of fibrous dysplasia of the clivus. The demographic data, the clinical and radiological findings, and the management of these patients were reviewed. RESULTS Eight patients who had experienced fibrous dysplasia of the clivus were identified. They either were asymptomatic (four patients) or presented with headache (four patients). Of the patients who presented with headache, one also had XIIth cranial nerve paralysis and another had dysphagia. The radiological findings for this entity were consistent, with typical findings of hypointensity on T1- and T2-weighted magnetic resonance imaging studies and ground-glass appearance on computed tomographic scans. Four of the patients in our series had pathological confirmation. Treatment was determined by the patient's symptoms. CONCLUSION Fibrous dysplasia should be considered in the differential diagnosis of lesions affecting the clivus. Its clinical and radiological presentations permit the establishment of the diagnosis. Its management is usually conservative, unless the patient presents with nerve compression or extensive symptomatic involvement of the condyle.

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