scholarly journals Clinical and imaging features of myeloid sarcoma: a German multicenter study

BMC Cancer ◽  
2019 ◽  
Vol 19 (1) ◽  
Author(s):  
Hans-Jonas Meyer ◽  
Wolfram Pönisch ◽  
Stefan Andreas Schmidt ◽  
Susanne Wienbeck ◽  
Friederike Braulke ◽  
...  
Keyword(s):  
Clinical Symptoms ◽  
Initial Diagnosis ◽  
Myeloid Sarcoma ◽  
Imaging Features ◽  
University Hospitals ◽  
Hematological Disease ◽  
Cutaneous Lesions ◽  
Adc Value ◽  
Patient Sample ◽  
Large Patient

Abstract Background Myeloid sarcoma (MS), also known as chloroma, is an extramedullary manifestation of malignant primitive myeloid cells. Previously, only small studies investigated clinical and imaging features of MS. The purpose of this study was to elucidate clinical and imaging features of MS based upon a multicenter patient sample. Methods Patient records of radiological databases of 4 German university hospitals were retrospectively screened for MS in the time period 01/2001 and 06/2019. Overall, 151 cases/76 females (50.3%) with a mean age of 55.5 ± 15.1 years and 183 histopathological confirmation or clinically suspicious lesions of MS were included into this study. The underlying hematological disease, localizations, and clinical symptoms as well as imaging features on CT and MRI were investigated. Results In 15 patients (9.9% of all 151 cases) the manifestation of MS preceded the systemic hematological disease. In 43 cases (28.4%), first presentation of MS occurred simultaneously with the initial diagnosis of leukemia, and 92 (60.9%) patients presented MS after the initial diagnosis. In 37 patients (24.5%), the diagnosis was made incidentally by imaging. Clinically, cutaneous lesions were detected in 35 of 151 cases (23.2%). Other leading symptoms were pain (n = 28/151, 18.5%), neurological deficit (n = 27/151, 17.9%), swelling (n = 14/151, 9.3%) and dysfunction of the affected organ (n = 10/151, 6.0%). Most commonly, skin was affected (n = 30/151, 16.6%), followed by bone (n = 29/151, 16.0%) and lymphatic tissue (n = 21/151, 11.4%). Other localizations were rare. On CT, most lesions were homogenous. On T2-weighted imaging, most of the lesions were hyperintense. On T1-weighted images, MS was hypointense in n = 22/54 (40.7%) and isointense in n = 30/54 (55.6%). A diffusion restriction was identified in most cases with a mean ADC value of 0.76 ± 0.19 × 10− 3 mm2/s. Conclusions The present study shows clinical and imaging features of MS based upon a large patient sample in a multicenter design. MS occurs in most cases meta-chronous to the hematological disease and most commonly affects the cutis. One fourth of cases were identified incidentally on imaging, which needs awareness of the radiologists for possible diagnosis of MS.

scholarly journals Radiological and clinical patterns of myeloid sarcoma

2019 ◽  
Vol 53 (2) ◽  
pp. 213-218 ◽  
Author(s):  
Hans-Jonas Meyer ◽  
Maximilian Beimler ◽  
Gudrun Borte ◽  
Wolfram Pönisch ◽  
Alexey Surov
Keyword(s):  
Clinical Symptoms ◽  
Rare Complication ◽  
Granulocytic Sarcoma ◽  
Initial Diagnosis ◽  
The Body ◽  
Myeloid Sarcoma ◽  
Imaging Features ◽  
Hematological Disease ◽  
Large Patient ◽  
Underlying Malignancy

Abstract Background Myeloid sarcoma (MS), also known as granulocytic sarcoma or chloroma, is a solid tumor of extramedullary localization composed of malignant primitive myeloid cells. The purpose of the study was to identify clinical and imaging features in a large patient sample. Patients and methods Overall, 71 cases (34 females (47.9%) and 37 males (52.1%) with a median age of 56 (± 16 years) of histopathologically confirmed myeloid sarcoma were included into this study. The underlying hematological disease, occurrence, localizations and clinical symptoms as well as imaging features on computed tomography and magnetic resonance imaging were investigated. Results In 4 cases (5.63%) the manifestation of MS preceded the systemic hematological disease by a mean value of 3.8 ± 2.1 months. In 13 cases, first presentation of MS occurred simultaneously with the initial diagnosis of leukemia, and 51 patients presented MS after the initial diagnosis of the underlying malignancy with a mean latency of 39.8 ± 44.9 SD months. The visceral soft tissue was affected in 26 cases, followed by the cutis/subcutis was affected in 21 cases. Further localizations were bones (n = 13), central nervous system (n = 9), lymph nodes (n = 4) and visceral organs (n = 9). Conclusions MS is a rare complication of several hematological malignancies, predominantly of acute myeloid leukemia, which can affect any part of the body. In most cases it occurs after the diagnosis of the underlying malignancy, and affects frequently the cutis and subcutis.

scholarly journals Tuberculosis or Not Tuberculosis: Temporal Evolution of Patellar Tuberculosis

2020 ◽  
Vol 2 ◽  
pp. 62-65
Author(s):  
Suvinay Saxena ◽  
Palak Patel ◽  
Drushi Patel ◽  
Ankur Shah
Keyword(s):  
Temporal Evolution ◽  
Clinical Symptoms ◽  
Imaging Features ◽  
Serial Imaging

Patellar tuberculosis (TB) is an uncommon occurrence and has been sparsely reported in the literature. Imaging plays a key role in its diagnosis, as clinical symptoms vary and are often unspecific. We present two cases of isolated patellar tuberculosis, its classical imaging features, and follow-up serial imaging.

scholarly journals Comparison of the Clinical Characteristics of Patients With COVID-19 in Suining and Wuhan

2020 ◽  
Author(s):  
Xiao-juan Wu ◽  
Chao-Ping Wang ◽  
Xiao-Bin Luo ◽  
Gao-Yan He ◽  
Bao-Lin Jia ◽  
...  
Keyword(s):  
Blood Glucose ◽  
Incidence Rate ◽  
Clinical Characteristics ◽  
Clinical Symptoms ◽  
Average Length ◽  
Severe Disease ◽  
Imaging Features ◽  
Lung Consolidation ◽  
Laboratory Test Results ◽  
D Dimer

Abstract Background Coronavirus disease 2019 (COVID-19), caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), which was first identified in December 2019 in Wuhan. This study mainly analyzed the clinical characteristics, imaging features, and prognosis of patients with COVID-19 in Suining, one of China's fourth-tier cities, and Wuhan in 2019 and compared data between the 2 cities. Methods A retrospective analysis of the epidemiological history, clinical data, symptom presentation, laboratory test results, chest computed tomography (CT) imaging features, treatment measures and prognosis of 68 patients with COVID-19 diagnosed at Wuhan Red Cross Hospital and 17 patients with COVID-19 diagnosed at Suining Central Hospital from January 23, 2020, to February 27, 2020, was conducted. Results 1) The incidence rate of COVID-19 in Wuhan was 52.99‱, and the incidence rate in Suining was 0.04‱. The median age of patients with COVID-19 was 40.71 years old in Suining and 56.04 years old in Wuhan. The age of patients with COVID-19 in Wuhan was significantly older than that of patients with COVID-19 in Suining. Among the 68 patients with COVID-19 in Wuhan, 30 (44.1%) had hypertension, and 25 (36.8%) had diabetes. Three out of the 17 patients in Suining (17.6%) had hypertension, and 2 patients (11.8%) had diabetes. The proportion of patients with diabetes or hypertension in Wuhan was significantly higher than that in Suining (P<0.05). In the clinical classification, there were 1 (5.9%) and 23 (33.8%) patients with severe COVID-19 in Suining and Wuhan, respectively. The proportion of patients with severe COVID-19 in Wuhan was significantly higher than that in Suining (P<0.05).Fever and cough were the most common clinical symptoms, with 9 cases (52.9%) and 8 cases (47.1%) in Suining, respectively, and 54 cases (79.4%) and 42 cases (61.8%) in Wuhan, respectively. There was 1 patient (5.9%) with COVID-19 with dyspnea in Suining and 23 patients (33.8%) with COVID-19 with dyspnea in Wuhan; the difference was statistically significant (P<0.05). Chest CT showed that lung consolidation occurred in 2 (11.8%) and 26 (38.2%) patients with COVID-19 in Suining and Wuhan, respectively. The proportion of lung consolidation in patients in Wuhan was significantly higher than that in patients in Suining (P<0.05). The laboratory tests suggested that percentage ofelevated C-reactive protein (CRP) (58.8%), ALT (33.8%), blood glucose (45.6%), creatine kinase (CK) (33.8%) or D-dimer (47.1%) of patients in Wuhan were significantly increased than those in Suining (29.4%, 5.9%, 17.6%, 5.9%, and 17.7%, respectively). Moreover, the average length of hospital stay of patients in Wuhan was 17.49 days, which was significantly longer than that of patients in Suining (12.29 days). Conclusions The incidence of COVID-19 in fourth-tier cities, Suining, in China was significantly lower than that in Wuhan, and the disease severity was generally lower than that in Wuhan, with mostly good prognoses. Advanced age, diabetes, and hypertension are important factors that aggravate COVID-19, while elevated CRP, ALT, blood glucose, CK, and D-dimer levels are important indicators for severe disease.

scholarly journals Clinical Characteristics and CT Manifestations of 143 Patients With 2019 Novel Coronavirus Disease (COVID-19) in Taizhou City, Zhejiang, China

2020 ◽  
Author(s):  
Yani Kuang ◽  
Susu He ◽  
Shuangxiang Lin ◽  
Rui Zhu ◽  
Rongzhen Zhou ◽  
...  
Keyword(s):  
Clinical Symptoms ◽  
Protein A ◽  
Clinical Manifestations ◽  
Imaging Features ◽  
First Case ◽  
Severe Group ◽  
Laboratory Examinations ◽  
The Difference ◽  
Severity Of The Disease ◽  
Novel Coronavirus

Abstract Background: In December 2019, the first case of pneumonia associated with the SARS-CoV-2 was found in Wuhan and rapidly spread throughout China, so data are needed on the affected patients. The purpose of our study was to find the clinical manifestations and CT features of COVID-19.Methods: All patients with COVID-19 in Taizhou city were retrospectively included and divided into non-severe group and severe group according to the severity of the disease. The clinical manifestations, laboratory examinations and imaging features of COVID-19 patients were analyzed, and the differences between the two groups were compared.Results: A total of 143 laboratory-confirmed cases were included in the study, including 110 non-severe patients and 33 severe patients. The median age of patients was 47 (range 4–86 years). Fever (73.4%) and cough (63.6%) were the most common initial clinical symptoms. Between two groups of cases, the results of aspartate transaminase, creatine kinase and lactate dehydrogenase, serum albumin, CR, glomerular filtration rate, amyloid protein A, fibrinogen, calcitonin level and oxygen partial pressure, IL – 10, absolute value of CD3, CD4, CD8 were different, and the difference was statistically significant (P < 0.05). Therefore, these quantitative indicators can be used to help assess the severity. On admission, the CT showed that the lesions were mostly distributed in the periphery of the lung or subpleural (135 cases (98%)), and most of lesions presented as patchy (81%), mixed density (63%) shadow. Consolidation (68% vs 41%), bronchial inflation signs (59% vs 41%), and bronchiectasis (71% vs 39%) were more common in the severe group.Conclusions: Most of the cases of COVID-19 in Taizhou have mild symptoms and no death. In addition to clinical symptoms, some laboratory tests (such as absolute values of CD4 and CD8) and CT findings can be used to assess the severity of the disease.

Operatively Treated Talus Fractures: Complications and Survivorship in a Large Patient Sample

2018 ◽  
Vol 57 (4) ◽  
pp. 737-741
Author(s):  
Michael A. Stone ◽  
Russell R. Flato ◽  
William Pannell ◽  
Jeremiah R. Cohen ◽  
Jeffrey C. Wang ◽  
...  
Keyword(s):  
Patient Sample ◽  
Large Patient

Perioperative posterior reversible encephalopathy syndrome in 2 pediatric neurosurgery patients with brainstem ependymoma

2011 ◽  
Vol 7 (3) ◽  
pp. 235-237 ◽  
Author(s):  
Melanie G. Hayden Gephart ◽  
Bonnie P. Taft ◽  
Anne-Katrin Giese ◽  
Raphael Guzman ◽  
Michael S. B. Edwards
Keyword(s):  
Mr Imaging ◽  
Posterior Reversible Encephalopathy Syndrome ◽  
Clinical Symptoms ◽  
Pediatric Neurosurgery ◽  
Altered Mental Status ◽  
Hemodynamic Instability ◽  
Imaging Features ◽  
Posterior Reversible Encephalopathy ◽  
Reversible Encephalopathy ◽  
Pediatric Neurooncology

Posterior reversible encephalopathy syndrome (PRES) has been described in pediatric neurooncology patients, although it has not been documented perioperatively in pediatric neurosurgery patients not actively receiving chemotherapy. Recently at the authors' facility, 2 cases of PRES were diagnosed perioperatively in children with brainstem ependymoma. Both patients had presented with hypertension, altered mental status, and seizures and demonstrated MR imaging features consistent with PRES. The patients were treated with antiseizure and antihypertension medications, leading to improvement in both clinical symptoms and neuroimaging findings. These cases are the first to document PRES in perioperative pediatric neurosurgery patients not actively receiving chemotherapy. Both patients had ependymoma involving the brainstem, which may have led to intra- and perioperative hemodynamic instability (including hypertension) and predisposed them to this syndrome. An awareness of PRES in similar scenarios will aid in the prevention, diagnosis, and treatment of pediatric neurosurgery patients with this syndrome.

scholarly journals A rare case of primary pulmonary diffuse large B cell lymphoma with CD5 positive expression

Open Medicine ◽  
2016 ◽  
Vol 11 (1) ◽  
pp. 49-51 ◽  
Author(s):  
Tao Wang ◽  
Mingming Zhang ◽  
Jianrong Sun ◽  
Dong Hao ◽  
Zhijiang Qi ◽  
...  
Keyword(s):  
B Cell ◽  
Clinical Symptoms ◽  
Cell Lymphoma ◽  
B Cell Lymphoma ◽  
Imaging Features ◽  
Ct Guided ◽  
Large B Cell Lymphoma ◽  
Halo Sign ◽  
Positive Expression ◽  
Large B Cell

AbstractPrimary pulmonary diffuse large B-cell lymphoma (PPDLBCL) is extremely rare. Its clinical symptoms and signs are nonspe cific, and imaging features also have not yet been well-defined. Further description is important for the diagnosis and treatment of PPDLBCL. Herein, we reported a case of a patient who suffered from bilateral chest pain and dyspnea. Computed tomography (CT) of chest demonstrated bilateral lung mass, consolidations and reverse halo sign, while consolidations and reverse halo sign are uncommon according to previous reports. Tissue samples were taken by CT guided needle biopsy. The histological samples showed PPDLBCL. This case was special in view of positive expression of CD5. After the case was treated by cyclophosphamide pirarubicin vindesine dexamethasone (CHOP) chemotherapy for six courses, her clinical symptoms were partially alleviated, while CT showed progression disease. This case report highlights different imaging features and characteristics of molecular biology, and reviews study progress of PPDLBCL.

scholarly journals Ultrasound imaging features of bronchial anthracofibrosis

2021 ◽  
Author(s):  
xiaofeng lu ◽  
daishun liu ◽  
xiaoyan cai ◽  
qingshong zeng ◽  
li zou ◽  
...  
Keyword(s):  
Ultrasound Imaging ◽  
Clinical Symptoms ◽  
Tube Wall ◽  
Airway Remodeling ◽  
Imaging Features ◽  
Clinical Markers ◽  
Bony Tissue ◽  
Imaging Characteristics ◽  
Flat Type ◽  
History Of

Abstract Purpose To determine the ultrasound imaging characteristics of participants with bronchial anthracofibrosis (BAF) and identify clinical markers for prevention and treatment. Methods We randomly selected 1,243 participants (including 113 with BAF) who underwent bronchoscopy and treatment at our institution from April 2018 to October 2019. BAF was classified as flat, deep seated retracted, or mucosal protrusion type, based on microscopy. Ultrasound probes were used to determine the maximum thickness of the tube wall and submucosa. The average values of the submucosal and bony tissue areas of the BAF subtypes were compared. Results The BAF group included 13 participants with a history of tuberculosis (11.5%) and 57 with biofuel exposure (50.4%). The average exposure time was 17.4 ± 6.2 years; BAF accounted for 10% of bronchoscopies performed. The maximum tube-wall thicknesses of the deep-seated retracted (17.3 ± 5.7) and black protruding (19.3 ± 5.4) groups were significantly greater than that of the flat group (12.5 ± 5.0; P < 0.05). The maximum thicknesses of the submucosa in the deep-retracted (9.8 ± 3.0) and black protruding (14.5 ± 5.0) groups were significantly greater than that of the flat group (6.6 ± 3.5; P < 0.05). The ratios of bone tissue in the flat and black protruding groups were 33.3 ± 9.3% and 34.9 ± 12.1%, respectively; the ratio in the deep-seated retracted group (65.2 ± 8.7%) was significantly reduced (P < 0.05). The flat type showed no significant change (P > 0.05). Conclusion Differences in BAF airway remodeling among the different subtypes may lead to varying clinical symptoms. Analyzing the characteristics of BAF airway remodeling and the regulatory pathway may provide new clues for treatment.

scholarly journals Red Blood Cell Stiffness Driving Patient Symptoms: A Study of Red Blood Cell Population Rigidity in Sickle Cell Patient Genotype SC Relation to Overlooked Clinical Symptoms

2021 ◽  
Author(s):  
Mark Shamoun ◽  
Mario Gutierrez ◽  
Omolola Eniola-Adefeso
Keyword(s):  
Blood Cell ◽  
Sickle Cell ◽  
Red Blood Cell ◽  
Clinical Symptoms ◽  
Severe Disease ◽  
Cell Stiffness ◽  
Severe Phenotype ◽  
Hematological Disease ◽  
Cell Deformability ◽  
Patients At Risk

Sickle cell disease (SCD) is a systemic hematological disease. Various genotypes of the disease exist; however, the two most common include hemoglobin SS (Hgb SS) and hemoglobin SC (Hgb SC) disease. Hgb SC is typically considered a less severe genotype; however, some patients with SC disease still have significant complications. Ektacytometry is utilized to measure red blood cell deformability in sickle cell patients and may help identify patients at risk for severe disease. We described a patient with genotype hemoglobin SC with a more severe phenotype, who we show to have very rigid red blood cells via ektacytometry.

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