Saccular mycotic aneurysm of descending thoracic aorta secondary to vertebral hydatid disease: A rare case

Vascular ◽  
2021 ◽  
pp. 170853812199437
Author(s):  
Mohammad Mozafar ◽  
Hamidreza Haghighatkhah ◽  
Reza Jalili Khoshnoud ◽  
Sina Zarrintan ◽  
Nasser Rakhshani ◽  
...  
Keyword(s):  
Computed Tomography ◽  
Thoracic Aorta ◽  
Hydatid Disease ◽  
Fine Needle Aspiration ◽  
Rare Case ◽  
Cystic Lesion ◽  
Mycotic Aneurysm ◽  
Needle Aspiration ◽  
Descending Thoracic Aorta ◽  
Fine Needle

Background/Objective Hydatid disease of the aorta is very rare. Hydatid disease can result in saccular aneurysm of the thoracic and abdominal aorta. Case report We report a rare case of saccular aneurysm of the distal descending thoracic aorta. The diameter of the aneurysm was 60 mm. It was managed by Thoracic Endovascular Aneurysm Repair. After 41 months, computed tomography angiography revealed a multi-loculated cystic lesion with 86 × 83×80 mm dimensions in the prevertebral area at the T10-T11 level with bony destruction and erosion of the anterior margin of the vertebral bodies. A computed tomography-guided fine-needle aspiration of the paravertebral cystic lesion was performed. Microscopic study of the fine-needle aspiration specimen demonstrated Echinococcosis granulosus diagnostic of hydatid disease. Conclusion It is concluded that the case was a mycotic aneurysm of the thoracic aorta secondary to vertebral hydatid disease.

Pre-operative Diagnosis of Pancreatic Neuroendocrine Tumors with Endoscopic Ultrasonography and Computed Tomography in a Large Series

2016 ◽  
Vol 25 (3) ◽  
pp. 317-321 ◽  
Author(s):  
Raffaele Manta ◽  
Elisabetta Nardi ◽  
Nico Pagano ◽  
Claudio Ricci ◽  
Mariano Sica ◽  
...  
Keyword(s):  
Computed Tomography ◽  
Neuroendocrine Tumors ◽  
Endoscopic Ultrasonography ◽  
Fine Needle Aspiration ◽  
Chromogranin A ◽  
Needle Aspiration ◽  
Large Series ◽  
Tumor Diameter ◽  
Pancreatic Neuroendocrine Tumors ◽  
Fine Needle

Background & Aims: Diagnosis of pancreatic neuroendocrine tumors (p-NETs) is frequently challenging. We describe a large series of patients with p-NETs in whom both pre-operative Computed Tomography (CT) and Endoscopic Ultrasonography (EUS) were performed. Methods: This was a retrospective analysis of prospectively collected sporadic p-NET cases. All patients underwent both standard multidetector CT study and EUS with fine-needle aspiration (FNA). The final histological diagnosis was achieved on a post-surgical specimen. Chromogranin A (CgA) levels were measured. Results: A total of 80 patients (mean age: 58 ± 14.2 years; males: 42) were enrolled. The diameter of functioning was significantly lower than that of non-functioning p-NETs (11.2 ± 8.5 mm vs 19.8 ± 12.2 mm; P = 0.0004). The CgA levels were more frequently elevated in non-functioning than functioning pNET patients (71.4% vs 46.9%; P = 0.049). Overall, the CT study detected the lesion in 51 (63.7%) cases, being negative in 26 (68.4%) patients with a tumor ≤10 mm, and in a further 3 (15%) cases with a tumor diameter ≤20 mm. CT overlooked the pancreatic lesion more frequently in patients with functioning than non-functioning p-NETs (46.5% vs 24.3%; P = 0.002). EUS allowed a more precise pre-operative tumor measurement, with an overall incorrect dimension in only 9 (11.2%) patients. Of note, the EUS-guided FNA suspected the neuroendocrine nature of tumor in all cases. Conclusions: Data of this large case series would suggest that the EUS should be included in the diagnostic work-up in all patients with a suspected p-NET, even when the CT study was negative for a primary lesion in the pancreas.– . Abbrevations: CgA: chromogranin A; EUS: Endoscopic Ultrasonography; FNA: fine-needle aspiration; p-NETs: pancreatic neuroendocrine tumors.

scholarly journals Improvement of the Diagnosis of Isoattenuating Pancreatic Carcinomas by Defining their Characteristics on Contrast Enhanced Computed Tomography and Endosonography with Fine-Needle Aspiration (EUS-FNA)

Diagnostics ◽  
2021 ◽  
Vol 11 (5) ◽  
pp. 776
Author(s):  
Robert Psar ◽  
Ondrej Urban ◽  
Marie Cerna ◽  
Tomas Rohan ◽  
Martin Hill
Keyword(s):  
Computed Tomography ◽  
Pancreatic Cancer ◽  
Pancreatic Duct ◽  
Fine Needle Aspiration ◽  
Pancreatic Head ◽  
Needle Aspiration ◽  
Characteristic Analysis ◽  
Fine Needle ◽  
Contrast Enhanced ◽  
Secondary Signs

(1) Background. The aim was to define typical features of isoattenuating pancreatic carcinomas on computed tomography (CT) and endosonography and determine the yield of fine-needle aspiration endosonography (EUS-FNA) in their diagnosis. (2) Methods. One hundred and seventy-three patients with pancreatic carcinomas underwent multiphase contrast-enhanced CT followed by EUS-FNA at the time of diagnosis. Secondary signs on CT, size and location on EUS, and the yield of EUS-FNA in isoattenuating and hypoattenuating pancreatic cancer, were evaluated. (3) Results. Isoattenuating pancreatic carcinomas occurred in 12.1% of patients. Secondary signs of isoattenuating pancreatic carcinomas on CT were present in 95.2% cases and included dilatation of the pancreatic duct and/or the common bile duct (85.7%), interruption of the pancreatic duct (76.2%), abnormal pancreatic contour (33.3%), and atrophy of the distal parenchyma (9.5%) Compared to hypoattenuating pancreatic carcinomas, isoattenuating carcinomas were more often localized in the pancreatic head (100% vs. 59.2%; p < 0.001). In ROC (receiver operating characteristic) analysis, the optimal cut-off value for the size of isoattenuating carcinomas on EUS was ≤ 25 mm (AUC = 0.898). The sensitivity of EUS-FNA in confirmation of isoattenuating and hypoattenuating pancreatic cancer were 90.5% and 92.8% (p = 0.886). (4) Conclusions. Isoattenuating pancreatic head carcinoma can be revealed by indirect signs on CT and confirmed with high sensitivity by EUS-FNA.

scholarly journals Diagnosis of atypical mass-forming chronic pancreatitis mimicking pancreatic carcinoma: A case report

2021 ◽  
Vol 2 (5) ◽  
Author(s):  
Han-Yue Wang ◽  
◽  
Hao-Su Huang ◽  
Meng Wang ◽  
Jie Peng ◽  
...  
Keyword(s):  
Computed Tomography ◽  
Chronic Pancreatitis ◽  
Pancreatic Carcinoma ◽  
Endoscopic Ultrasonography ◽  
Fine Needle Aspiration ◽  
Multimodal Imaging ◽  
Needle Aspiration ◽  
Imaging Features ◽  
Pathological Findings ◽  
Fine Needle

Background: Mass-Forming Chronic Pancreatitis (MFCP) is rare. Moreover, atypical MFCP is difficult to differentiate from Pancreatic Carcinoma (PC) in clinical manifestations, laboratory, and imaging examinations. Diagnosis could be supported by the pathological findings of focal inflammatory fibrosis without evidence of tumor in the pancreas. Case summary: A 52-year-old man had acute pancreatitis twice over 7 months. Amylase and lipase levels were three times higher than the normal range without any clinical symptoms. At the 6th month, the patient lost 15 kg of weight, and abdominal ultrasonography revealed pancreatic head space occupied. All the findings in multimodal imaging including computed tomography image, Magnetic Resonance (MR) imaging with MR cholangiopancreatography, and 18F-FDG positron emission tomography/computed tomography showed an irregular nodule with low density, low signal, and low echo in the head of the pancreas, which were lower than those in the normal pancreatic tissue. The proximal main pancreatic duct was truncated and stenosed, and the distal duct was dilated. Subsequently, he developed progressive painless jaundice, and the specific tumor marker levels were increased. Most of these manifestations were suggestive of the pancreatic malignant tumor; however, multiple specimen pathological findings obtained from laparotomy and endoscopic ultrasonography-guided fine-needle aspiration revealed focal chronic inflammation, fibrosis, and necrosis. Conclusion: This report describes a case of atypical MFCP mimicking PC at clinical presentation and laboratory findings, especially in multimodal imaging. However, the combination of atypical multimodal imaging features, which support MFCP rather than PC, and endoscopic ultrasonography-guided fine-needle aspiration are useful for improving the diagnostic rate of atypical MFCP and avoiding unnecessary surgery.

scholarly journals A rare case: Covid-19 infection diagnosed by transthoracic fine needle aspiration biopsy

2021 ◽  
Vol 38 (4) ◽  
pp. 682-684
Author(s):  
Tuğçe ŞAHİN ÖZDEMİREL ◽  
Esma Sevil AKKURT ◽  
Özlem ERTAN ◽  
Hakan NOMENOĞLU ◽  
Sadi KAYA ◽  
...  
Keyword(s):  
Computed Tomography ◽  
Fine Needle Aspiration ◽  
Fine Needle Aspiration Biopsy ◽  
Interstitial Fibrosis ◽  
Pulmonary Involvement ◽  
Needle Aspiration ◽  
Aspiration Biopsy ◽  
Fine Needle ◽  
Halo Sign ◽  
Needle Aspiration Biopsy

Covid 19 is an acute respiratory disease caused by a novel type of Coronavirus (SARS-CoV-2) that was first detected in Wuhan, Hubei Province of China. Its most common symptoms are fever, cough, and weakness; and in the early stages, there may not be findings on chest computed tomography. In pulmonary involvement, peripheral ground-glass areas, a cobblestone appearance, consolidated areas, and interlobular septal thickening, which are usually prominent in the lower lobes may be seen in thorax computed tomography. Consolidation, solid nodules, halo sign, inverted halo sign, vascular enlargement, subpleural line, air bronchograms, and bronchiectasis are other less common findings. In our case, we aimed to present our 69 years old female patient with bilateral nodular densities on thoracic CT and transthoracic fine-needle aspiration biopsy result was reported as lesions compatible with interstitial fibrosis due to Covid-19 inflammation.

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