scholarly journals Imaging Features of Renal Capsule Leiomyoma on Contrast-Enhanced Ultrasonography: A Case Report

2017 ◽  
Vol 33 (6) ◽  
pp. 514-519 ◽  
Author(s):  
José Andrade Moura Neto ◽  
Ana Flavia Perpétuo de Souza ◽  
José Hermógenes Rocco Suassuna ◽  
Luiz Carlos Aguiar Vaz ◽  
Nordeval Cavalcante Araújo
Keyword(s):  
Transplant Recipient ◽  
Kidney Transplant Recipient ◽  
Malignant Lesion ◽  
Immunosuppressive Drugs ◽  
Imaging Features ◽  
Diagnostic Challenge ◽  
Contrast Enhanced ◽  
Increased Risk ◽  
Contrast Enhanced Ultrasonography ◽  
Histopathologic Analysis

Leiomyomas of the kidney are rare, mostly occurring in adults as incidental findings, and are a diagnostic challenge. In a renal transplant recipient population, an increased risk of tumors is observed due to the effect of immunosuppressive drugs. A differential diagnosis between leiomyomas and other malignant lesions is not possible with current imaging methods. This report presents a case of a native kidney capsular leiomyoma in a kidney transplant recipient and highlights the features of computed tomography and contrast-enhanced ultrasound (CEUS), along with the histopathologic analysis. The CEUS and quantification studies are helpful in demonstrating the vascularization pattern of the renal capsular leiomyoma. This entity appearing with chronic kidney disease can resemble a renal cell carcinoma, in an otherwise healthy kidney. In this case, CEUS was useful for diagnosing the vascularization of the renal mass, although the pattern of intense vascularization could be diagnostically misleading, implying a malignant lesion. However, the pattern of enhancement due to CEUS showed no peculiarities that indicated histopathologic diagnosis.

scholarly journals Renal oncocytoma in a kidney transplant patient: the imaging features on contrast-enhanced ultrasonography (CEUS): a case report

2018 ◽  
Vol 40 (1) ◽  
pp. 86-90 ◽  
Author(s):  
Lucia Alejandra Alfaro Villanueva ◽  
Maira Knust ◽  
Leonardo Quintella ◽  
José Hermógenes R Suassuna ◽  
Nordeval C Araújo
Keyword(s):  
Case Report ◽  
Kidney Transplant ◽  
Kidney Transplant Recipient ◽  
Malignant Lesion ◽  
Renal Tumors ◽  
Renal Oncocytoma ◽  
Kidney Transplant Patient ◽  
Renal Neoplasm ◽  
Imaging Features ◽  
Contrast Enhanced

Abstract Renal oncocytoma is an infrequently reported renal neoplasm, often asymptomatic, which usually behaves as a benign entity and is identified accidentally on radiological imaging. Transplant patients under long-term immunosuppressive drugs have a high prevalence of cancers, such as skin cancers, lymphoproliferative disorders, and renal carcinomas. We present a case report of an asymptomatic renal oncocytoma in a kidney transplant recipient presenting persistent hematuria. The features of computed tomography and contrast-enhanced ultrasound (CEUS) are presented. This was the first time we used CEUS in a transplant kidney recipient presenting a renal mass, allowing the real-time visualization of contrast-enhancement patterns during all vascular phases for the differential diagnosis of renal tumors. Although the pattern of intense vascularization could mislead to an early judgment as a malignant lesion, it could help to exclude other renal lesions without inducing nephrotoxicity.

Arterial Aneurysmal Degeneration With Venous Varicosity Following Ligation of an Arteriovenous Fistula in a Kidney Transplant Recipient

2018 ◽  
Vol 53 (3) ◽  
pp. 242-245 ◽  
Author(s):  
Hyun Yong Lee ◽  
Young Nam Roh ◽  
Hyoung Tae Kim ◽  
Ui Jun Park
Keyword(s):  
Arteriovenous Fistula ◽  
Perioperative Complications ◽  
Kidney Transplant Recipient ◽  
Left Elbow ◽  
Contrast Enhanced ◽  
Contrast Enhanced Ultrasonography ◽  
Related Donor ◽  
Living Related ◽  
Arterial Aneurysms ◽  
Donor Kidney Transplantation

Late occurrence of arterial aneurysms following ligation of a hemodialysis arteriovenous fistula (AVF) is rare. Here, we report the case of 51-year-old male patient with an AVF in which arterial aneurysms developed. The patient had undergone left arm radiocephalic (RC) AVF creation for hemodialysis in 2000. He had received a living related donor kidney transplantation from his father in the same year. His RC AVF was ligated in 2009. However, his arm continued to gradually grow in size even after ligation and he visited a hospital for acute pain and erythema around the left elbow in 2017. Since his renal allograft function had been deteriorating, duplex ultrasonography was performed. It revealed 2 giant aneurysms in the distal brachial artery and proximal radial artery with diameters of 3.0 and 2.8 cm, respectively. The superficial veins of the left upper arm showed varicosity and had multifocal thrombi. Microfistula between the artery and vein was revealed by contrast-enhanced ultrasonography and the contrast agent microbubbles flowed from the artery toward the superficial veins. The aneurysms were resected and the arteries were reconstructed with great saphenous vein. There were no perioperative complications and the patient was discharged on postoperative day 3. No complications in the arm or bypass conduit have occurred at 6 months after the surgery.

scholarly journals Adult pancreatoblastoma: a case report

2021 ◽  
Vol 49 (8) ◽  
pp. 030006052110395
Author(s):  
Jianchun Li ◽  
Chengzhong Peng ◽  
Xiaoming Fan ◽  
Ligang Wang ◽  
Jing Wang
Keyword(s):  
Preoperative Diagnosis ◽  
Paediatric Population ◽  
Emission Tomography ◽  
Imaging Features ◽  
Resonance Imaging ◽  
Ultrasound Contrast ◽  
Positron Emission ◽  
Contrast Enhanced ◽  
Pancreatic Masses ◽  
Contrast Enhanced Ultrasonography

Pancreatoblastoma (PB) is a rare epithelial malignancy usually occurring in the paediatric population. Adult PB is rare, and its imaging findings are similar to those of other tumours, making preoperative diagnosis a considerable challenge. We report correlative ultrasound, contrast-enhanced ultrasonography, contrast-enhanced magnetic resonance imaging, and positron emission tomography-computed tomography findings in a 60-year-old woman with PB. PB often presents with uncommon imaging features and should be considered in the differential diagnosis of pancreatic masses. It is important for clinicians to be aware of these differences to provide effective treatment.

scholarly journals Belatacept associated - cytomegalovirus retinitis in a kidney transplant recipient: a case report and review of the literature

2020 ◽  
Vol 20 (1) ◽  
Author(s):  
Pierre-Guillaume Deliège ◽  
Justine Bastien ◽  
Laetitia Mokri ◽  
Charlotte Guyot-Colosio ◽  
Carl Arndt ◽  
...  
Keyword(s):  
Transplant Recipient ◽  
Kidney Transplant ◽  
Kidney Transplant Recipient ◽  
Cytomegalovirus Retinitis ◽  
Renal Allograft Recipient ◽  
Ophthalmological Examination ◽  
Transplant Recipients ◽  
Kidney Transplant Recipients ◽  
Increased Risk ◽  
The Right

Abstract Background To report the first case of belatacept-associated multidrug-resistant Cytomegalovirus retinitis in a kidney transplant recipient. Case presentation A 76-year-old African male renal allograft recipient was admitted for acute visual loss of the right eye. Ophthalmological examination of the right eye showed anterior uveitis and vitritis associated with large paravascular haemorrhages and yellow necrotic borders, involving the posterior pole but not the fovea. Both Cytomegalovirus DNA in plasma and aqueous humor were positive. The patient had had several episodes of Cytomegalovirus reactivation subsequent to the introduction of belatacept. His cytomegalovirus was multi-drug resistant, and was treated with maribarir, intravitreal and systemic injections of foscarnet, and anti-Cytomegalovirus human immunoglobulin. In parallel, belatacept was stopped and switched to tacrolimus. Cytomegalovirus DNA became undetectable and there was partial improvement of visual acuity at the last ophthalmologic examination, 18 months after the initial diagnosis of Cytomegalovirus retinitis. Conclusion Cytomegalovirus retinitis is an uncommon opportunistic infection in kidney transplant recipients. Cytomegalovirus retinitis is a serious infection because of the risk of blindness and the occurrence of associated life-threatening opportunistic infections. In view of the recent literature, kidney transplant recipients treated by belatacept immunosuppression may be at increased risk for Cytomegalovirus disease, notably Cytomegalovirus retinitis. The occurrence of Cytomegalovirus retinitis may help improve the selection of patients converted to belatacept.

Contrast-enhanced ultrasonography for assessing neovascularization of carotid atherosclerotic plaque

2019 ◽  
pp. 24-31
Author(s):  
A.N. Evdokimenko ◽  
A.O. Chechetkin ◽  
L.D. Druina ◽  
M.M. Tanashyan
Keyword(s):  
Atherosclerotic Plaque ◽  
Quantitative Methods ◽  
Analysis Data ◽  
Carotid Atherosclerotic Plaque ◽  
Visual Scale ◽  
Plaque Area ◽  
Contrast Enhanced ◽  
Increased Risk ◽  
Contrast Enhanced Ultrasonography

Neovascularization of a carotid atherosclerotic plaque (AP) is associated with an increased risk of stroke. Contrast-enhanced ultrasonography (CEUS) is a widely used method for imaging intraplaque neovascularization in vivo. Unfortunately, there are no standardized guidelines for CEUS interpretation. The aim of this study was to identify the most reliable method for CEUS-based assessment of AP neovascularization. Seventy-eight AP were removed during carotid endarterectomy in 73 patients, of whom 5 had AP on both sides, and examined morphologically. All patients underwent preoperative duplex scanning and CEUS; Sonovue was used as a contrast agent. AP neovascularization was assessed on a 4-grade visual scale and with 3 different quantitative methods using QLAB software. On the visual scale (method 1), poorly (37%) and moderately (51%) vascularized plaques were the most common. Quantitative analysis (data were presented as Me (Q1; Q3)) revealed that the number of blood vessels per 1 cm2 of the plaque (method 2) was 16 (10; 26), the ratio of the total vessel area to the plaque area (method 3) was 6% (3; 9), and AP ROI (method 4) was 2.6 dB (1.8; 4.1). Significant correlations were demonstrated between the results produced by method 2 and method 3 (р < 0.0001), method 3 and method 2 (p = 0.0006), and between pathomorphological findings and the results produced by methods 1–3, especially method 2 (p < 0.004). AP ROI brightness did not correlate with other results. The presence of hyperechoic components (calcifications) in AP dramatically reduced the reliability of US-based intraplaque neovascularization assessment. The most accurate CEUS-based quantitative method for assessing intraplaque neovascularization is estimation of blood vessel number per 1 cm2 of the plaque.

Contrast-enhanced ultrasonography promotes differential diagnosis of ureteral neoplasms

2021 ◽  
pp. 20210078
Author(s):  
Yun Bai ◽  
Jun Lin ◽  
An Chen ◽  
Min Bai ◽  
Chunxiao Li ◽  
...  
Keyword(s):  
Differential Diagnosis ◽  
Clinical Information ◽  
Benign Tumors ◽  
Ct Urography ◽  
Imaging Features ◽  
Urothelial Carcinomas ◽  
Pathological Result ◽  
Contrast Enhanced ◽  
Ureteral Neoplasms ◽  
Contrast Enhanced Ultrasonography

Objective: To compare the diagnostic value of contrast-enhanced ultrasonography (CEUS) with baseline ultrasound (B-US) in ureteral neoplasms. Methods: Retrospective analysis, comprising clinical presentation, image appearances, and diagnostic results on B-ultrasound and CEUS, considering pathological result as a gold-standard, was conducted on the clinical information of 39 patients with ureteral neoplasms. CT urography was used to detect and confirm the presence of ureteral neoplasms. Both B-ultrasound and CEUS investigations of those 39 patients under study were performed by a senior radiologist. Results: Pathological outcomes established 27 ureteral malignancies and 12 ureteral benignancies. Ureteral malignancies were observed to occur in older patients than benignancies (p = 0.002). Only the morphological indicator of the ureteric wall on B-ultrasound was different in ureteral malignancies and benignancies (p = 0.030). Tumors with hyperenhancement, larger width, and hyperenhanced ureteric wall were easily diagnosed as malignant on CEUS, whereas iso-/hypoenhanced, narrower, and iso-/hypoenhanced ureteric wall indicated benign tumors. Moreover, the lesion widths, enhanced morphologies of the ureteric wall, and the ureteral wall’s linear boundaries on CEUS were different between high- and low-stage ureteral urothelial carcinomas (p = 0.012, 0.002, 0.001, respectively). Conclusion: The display of microvessels in ureteral neoplasms was significantly enhanced by CEUS, thus contributing to the differential diagnosis of ureteral neoplasms while assisting the staging of ureteral urothelial carcinoma. Advances in knowledge: The imaging features of different ureteral neoplasms on CEUS were analyzed in this study. The diagnostic performances of CEUS and B-ultrasound in ureteral urothelial carcinomas were also explored.

scholarly journals Transfusion-Dependent Anemia in a Simultaneous Pancreas and Kidney Transplant Recipient

2020 ◽  
Vol 2020 ◽  
pp. 1-4
Author(s):  
Jeevan Prakash Gopal ◽  
David Taube ◽  
John Martin ◽  
Simona Deplano ◽  
Saral Desai ◽  
...  
Keyword(s):  
Computed Tomography ◽  
Transplant Recipient ◽  
Gastrointestinal Bleeding ◽  
Kidney Transplant Recipient ◽  
Final Diagnosis ◽  
Contrast Enhanced ◽  
Computed Tomography Scans ◽  
Diagnostic Difficulties ◽  
Enhanced Computed Tomography ◽  
Contrast Enhanced Computed Tomography

A case of transfusion-dependent anemia in a simultaneous pancreas and kidney (SPK) transplant recipient that masqueraded as gastrointestinal bleeding (GIB) is described. The anemia was attributed to bleeding from the donor duodenal cuff based on balloon enteroscopy findings. The patient underwent multiple contrast-enhanced computed tomography scans and multiple endoscopies with confounding features until, eventually, the diagnosis was established. We discuss the diagnostic difficulties and the therapeutic dilemma, along with the pitfalls in ascertaining the final diagnosis.

scholarly journals Double contrast-enhanced ultrasonography of a small intestinal neuroendocrine tumor: a case report of a recommendable imaging modality

2020 ◽  
Vol 3 (2) ◽  
pp. 147-152
Author(s):  
Jie-ying Zhao ◽  
Hua Zhuang ◽  
Yuan Luo ◽  
Ming-gang Su ◽  
Mo-li Xiong ◽  
...  
Keyword(s):  
Computed Tomography ◽  
Neuroendocrine Tumor ◽  
Neuroendocrine Tumors ◽  
Imaging Modality ◽  
Intestinal Tumors ◽  
Double Contrast ◽  
Diagnostic Challenge ◽  
Contrast Enhanced ◽  
Contrast Enhanced Ultrasonography ◽  
Small Intestinal

Abstract A 57-year-old male presenting with spontaneously relieved abdominal cramp and distension was admitted to the West China Hospital. The diagnosis remained unclear after colonoscopy and computed tomography. Double contrast-enhanced ultrasonography was then performed and a neoplasm in the small intestine was suspected, supported by a thin-section computed tomography and positron emission tomography/computed tomography. This was confirmed pathologically after surgery to be a small intestinal G1 neuroendocrine tumor. Surgery was performed to remove approximately 25 cm of small bowel and a 3-cm solid mass located in the mesentery. The patient had a complete recovery and was tumor-free at the final follow-up. Small intestinal tumors including neuroendocrine tumors have always posed a diagnostic challenge. This case indicated that double contrast-enhanced ultrasonography is feasible in detection of small intestinal neuroendocrine tumors, and it may be an advisable approach assisting diagnosis of small intestinal tumors.

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