scholarly journals Multidetector CT findings of primary pleural angiosarcoma : a systematic review, an additional cases report

2022 ◽  
Vol 22 (1) ◽  
Author(s):  
Bo Mi Gil ◽  
Myung Hee Chung ◽  
Ki-Nam Lee ◽  
Jung Im Jung ◽  
Won Jong Yoo ◽  
...  
Keyword(s):  
Pleural Effusion ◽  
Multidetector Ct ◽  
Mediastinal Lymph Node ◽  
Surgical Excision ◽  
The Other ◽  
Parietal Pleura ◽  
Ct Guided ◽  
Multiple Metastases ◽  
Chief Complaints ◽  
Immunohistochemical Studies

Abstract Background To demonstrate and analyze the relatively common imaging findings in this rare primary pleural angiosarcoma (PPA). Case presentation Three cases of PPA, proven by video-assisted thoracic surgery biopsies are retrospectively reviewed. Patients were all male. Age ranges from 65 to 75 years old age (mean; 69). Major chief complaints were dyspnea and chest pain. One has a history of colon cancer, the other has a tuberculosis history and the other has no known history. Multidetector chest CT and PET CT were all done. Immunohistochemical studies were performed including CD31, CD34, or factor VIII-related antigen, vimentin, and cytokeratin. We also review the literatures on recently published PPA. All masses were from 1 to 10 cm. All three patients had multiple pleural based masses, which were ovoid in shape with relatively sharp margin in unilateral hemithorax. Multiple small circumscribed pleural masses are limited in the pleural space in two patients, whereas two, huge lobulated masses about up to 10 cm were present with pleural and extrapleural involvement in one patient. In two patients with pleural mass only, multiple pleural masses were only seen in parietal pleura in one patient and were in both visceral and parietal pleura in one patient. Pleural effusion were found in one side in one patient and in both sides in one patient. One angiosarcoma was arised from chronic tuberculotic pleurisy sequelae. All pleural masses are heterogenous with irregular internal low densities in all patients. Hematogenous metastases were found in liver, vertebra, rib in one patient, and were in lungs with mediastinal lymph node metastases in the other patient. Three patients survived for longer than 3months after diagnosis, but continued to deteriorate rapidly. Two patients underwent chemotherapy after surgical excision, and the other one with multiple metastases treated chemotherapy after CT-guided biopsy, but eventually all died. As a result of comparative analysis of a total of 13 patients’ images including 10 cases previously published, there was pleural effusion in all except 2 cases. Conclusions PPA were all necrotic without any vascularized enhancing nature, and manifested as unilateral circumscribed or localized pleural-based masses.

Hepatic brucelloma: a rare complication of a common zoonotic disease

2020 ◽  
Vol 13 (12) ◽  
pp. e237076
Author(s):  
George Vatidis ◽  
Eirini I Rigopoulou ◽  
Konstantinos Tepetes ◽  
George N Dalekos
Keyword(s):  
Rare Complication ◽  
Surgical Excision ◽  
Coombs Test ◽  
Inflammation Markers ◽  
Laboratory Findings ◽  
Ct Guided ◽  
Rare Manifestation ◽  
Bone Marrow Cultures ◽  
History Of ◽  
The Right

Hepatic brucelloma (HB), a rare manifestation of brucellosis, refers to liver involvement in the form of abscess. A 35-year-old woman stockbreeder was admitted due to 1-month history of evening fever, sweating and weight loss, while she was on 3-week course of rifampicin/doxycycline for suspected brucellosis. On admission, she had hepatosplenomegaly and a systolic murmur, while cholestasis, increased inflammation markers and a strong-positive Wright-Coombs test were the main laboratory findings. As blood and bone marrow cultures were unrevealing, further investigation with CT imaging showed a central liver calcification surrounded by heterogeneous hypodense area being compatible with HB. Material from CT-guided drainage tested negative for Brucella spp. After failure to improve on a 10-week triple regiment, surgical excision was decided and Brucella spp were identified by PCR. Our case highlights challenges in establishing HB diagnosis, which should be considered on the right epidemiological context and when serological and radiological evidence favour its diagnosis.

scholarly journals Angiosarcoma of sigmoid colon with intraperitoneal bleeding: case report and literature review

2011 ◽  
Vol 93 (6) ◽  
pp. e91-e93 ◽  
Author(s):  
Tse-Hua Lo ◽  
Mu-Shiun Tsai ◽  
Tzu-An Chen
Keyword(s):  
Sigmoid Colon ◽  
Alimentary Tract ◽  
Surgical Excision ◽  
Sigmoid Colectomy ◽  
Epithelioid Cells ◽  
Spindle Cells ◽  
Choice Of Treatment ◽  
Intraperitoneal Bleeding ◽  
Immunohistochemical Studies

Primary angiosarcomas arising from the alimentary tract are rare and only a few cases have been reported in the literature. We report a case of an angiosarcoma of the sigmoid colon with intraperitoneal bleeding but not rectal bleeding. A 21-year-old female patient received a laparotomy and a mass lesion over the sigmoid colon was found with active bleeding. A sigmoid colectomy was performed as a curative resection. Grossly, the sigmoid colon contained a kidney shaped, hemorrhagic tumour from the submucosal layer extension to the antimesenteric side. Intraluminally, the mucosa of the colon was intact. Microscopic examination revealed a high grade angiosarcoma composed of fascicles of spindle cells and solid sheets of epithelioid cells. Immunohistochemical stains revealed a positive result for CD31 and the endothelial nature of the malignancy was confirmed. Smooth muscle antigens, desmins, cytokeratins AE1/AE3 and CD117 were all negative. The patient is still alive without evidence of recurrence or metastasis at a three-year follow-up appointment. Owing to the availability of immunohistochemical studies, some atypical sarcomas would now be correctly classified as angiosarcomas. Since no optimal adjuvant treatment is effective, curative surgical excision is still the best choice of treatment.

scholarly journals Retroperitoneal pelvic schwannoma in pregnancy: a case report

2017 ◽  
Vol 6 (8) ◽  
pp. 3689 ◽  
Author(s):  
Nithya J. ◽  
Banumathy M. ◽  
Radha A.
Keyword(s):  
Spindle Cell ◽  
Surgical Excision ◽  
Needle Aspiration ◽  
Nerve Sheath Tumor ◽  
Ct Guided ◽  
Spindle Cell Neoplasm ◽  
Complete Surgical Excision ◽  
S 100 ◽  
Needle Aspiration Cytology ◽  
In Pregnancy

Solitary nerve sheath tumor such as Benign schwannomas arising in the pelvic retro peritoneum is infrequently reported. Retroperitoneal location accounts for 0.3-3.2% of primary schwannomas. We report a case of benign retroperitoneal pelvic schwannoma in pregnancy that was incidentally diagnosed when it presented with Preterm premature rupture of membranes and mechanical obstruction for labour. She underwent caesarean section and delivered a healthy baby. She was evaluated in the postoperative period by computerized tomography (CT) imaging studies and CT guided fine needle aspiration cytology (FNAC) was not diagnostic. Complete surgical excision of the tumor was achieved in the postpartum period. The adjacent vascular and urinary channels sustained no injuries and she had no neurologic deficit. Histology revealed spindle cell neoplasm composed of interlacing fascicles and sheets of spindle cell with focal areas of nuclear palisading and thick walled blood vessels. Immunohistochemistry was positive for S 100 suggesting schwannoma. Retroperitoneal location of schwannomas is rare and surgery is curative. Prognosis is good, since recurrence is rare. 

scholarly journals Diagnostic Value of Flexible Thoracoscopy in Undiagnosed Cases of Exudative Pleural Effusion

2020 ◽  
Vol 7 (47) ◽  
pp. 2783-2786
Author(s):  
Vengada Krishnaraj S.P. ◽  
Gayathri S. Mohan ◽  
Vinod Kumar V ◽  
Sridhar R
Keyword(s):  
Pleural Effusion ◽  
Pleural Fluid ◽  
Complete Blood Count ◽  
Diagnostic Yield ◽  
Diagnostic Value ◽  
Parietal Pleura ◽  
Pleural Biopsy ◽  
Cardiac Evaluation ◽  
Exudative Pleural Effusion ◽  
Fluid Cytology

BACKGROUND The diagnostic yield of thoracoscopy is 95 %, of pleural fluid cytology it is 62 % and of closed pleural biopsy is 44 %, in malignant effusion. We wanted to study the diagnostic utility of flexible thoracoscopy in undiagnosed exudative pleural effusion and compare the thoracoscopy findings with the histopathology results. METHODS The study was conducted in the Department of Respiratory Medicine, Government Stanley Medical College, Chennai, from January 2019 to January 2020. 40 patients were enrolled in this longitudinal observational study with moderate to massive effusion and were evaluated with pleural fluid aspiration and sent for cytology, protein sugar analysis, total count, and ADA. Those cases which are exudative pleural effusions, with ADA value of less than 40 IU / L were subjected to thoracoscopy after being evaluated for fitness for thoracoscopy with complete blood count, bleeding time, clotting time, sputum for AFB, ECG, pulse oximetry, cardiac evaluation and CT chest. RESULTS Thoracoscopy was done in 40 enrolled patients. In this study, biopsy was taken from the parietal pleura in all the cases. Of these 40 cases, 30 were male and 10 were female, that is 75 % males and 25 % females. The mean age of the study population was 43 ± 14.9. Patient with the lowest age in this study group was 18 years and highest was 71 years. 16 cases (40 %) presented with left sided pleural effusion. 24 cases (60 %) presented with right sided pleural effusion. 30 cases presented with massive effusion, and 10 cases with moderate effusion. Of the 40 cases, 27 cases presented with straw coloured pleural effusion. 13 cases were haemorrhagic effusion. Histopathologic examination showed 11 cases as malignant and 29 cases as non-malignant out of which 18 cases were of tuberculosis aetiology. Thoracoscopy revealed adhesions in 13 cases and mass lesion in 4 cases. Of the 4 mass lesions 3 came as malignant, normal pleura in 11 cases, 10 were non-malignant and 1 was malignant. Nodules were seen in 12 cases of which 7 came as malignant. Straw coloured effusion was seen in 27 cases, of which 2 were malignant. CONCLUSIONS The most important indication for thoracoscopy is exudative undiagnosed pleural effusion. The overall diagnostic yield in pleural fluid cytology is 62 % and blind pleural biopsy is 44 %. The diagnostic yield of thoracoscopy varies from 60 % to 97 % in various studies, whereas, in our study, it is 72.5 %. Visualization of the visceral and parietal pleura is another advantage, so that we can take biopsy from the abnormal areas. KEYWORDS Flexible Thoracoscopy, Undiagnosed Exudative Pleural Effusion

scholarly journals Infravesical obstruction results as giant bladder calculi

2013 ◽  
Vol 5 (4) ◽  
pp. 77
Author(s):  
Ozgu Aydogdu ◽  
Onur Telli ◽  
Berk Burgu ◽  
Yasar Beduk
Keyword(s):  
Abdominal Pain ◽  
Pelvic Trauma ◽  
Bladder Stone ◽  
The Other ◽  
Infravesical Obstruction ◽  
Bladder Calculi ◽  
Chief Complaints

A 48-year-old man was hospitalized with the chief complaints oflower abdominal pain, pain during micturation and pollakuria.Plain radiography showed 2 giant bladder stone shadows: one as6.0 × 5.0 cm and the other one 5.0 × 5.0 cm in size. Cystolithotomywas performed. The first stone weighed 400 g and measured6.0 × 5.0 × 6.0 cm in size, and the other stone was fragmented tosmaller particles with pneumatic lithotriptor. Although a bladderstone is not rare, this case is interesting for 2 huge bladder calculithat were completely obstructing the bladder outlet and observedseveral years following pelvic trauma. To the best of our knowledge,our patient represents one of the largest bladder stone casesreported to date.

Preoperative computed tomography-guided percutaneous hookwire localization of metallic marker clips in the breast with a radial approach: initial experience

2007 ◽  
Vol 48 (5) ◽  
pp. 483-487 ◽  
Author(s):  
T. Uematsu ◽  
M. Kasami ◽  
Y. Uchida ◽  
J. Sanuki ◽  
K. Kimura ◽  
...  
Keyword(s):  
Computed Tomography ◽  
Breast Biopsy ◽  
Standard Technique ◽  
Surgical Excision ◽  
Wire Localization ◽  
Current Standard ◽  
Surgical Biopsy ◽  
Ct Guided ◽  
Radial Approach ◽  
Total Procedure Time

Background: Hookwire localization is the current standard technique for radiological marking of nonpalpable breast lesions. Stereotactic directional vacuum-assisted breast biopsy (SVAB) is of sufficient sensitivity and specificity to replace surgical biopsy. Wire localization for metallic marker clips placed after SVAB is needed. Purpose: To describe a method for performing computed tomography (CT)-guided hookwire localization using a radial approach for metallic marker clips placed percutaneously after SVAB. Material and Methods: Nineteen women scheduled for SVAB with marker-clip placement, CT-guided wire localization of marker clips, and, eventually, surgical excision were prospectively entered into the study. CT-guided wire localization was performed with a radial approach, followed by placement of a localizing marker-clip surgical excision. Feasibility and reliability of the procedure and the incidence of complications were examined. Results: CT-guided wire localization surgical excision was successfully performed in all 19 women without any complications. The mean total procedure time was 15 min. The median distance on CT image from marker clip to hookwire was 2 mm (range 0–3 mm). Conclusion: CT-guided preoperative hookwire localization with a radial approach for marker clips after SVAB is technically feasible.

Pleural effusion

2018 ◽  
Author(s):  
Seamus Grundy
Keyword(s):  
Pleural Effusion ◽  
Drainage System ◽  
Clinical Problem ◽  
Lymphatic Drainage ◽  
Parietal Pleura ◽  
Local Inflammation ◽  
Fluid Removal ◽  
Fluid Production ◽  
Systemic Symptoms ◽  
Common Clinical Problem

Pleural effusion is a common clinical problem which can present both to primary and secondary care. The process by which fluid accumulates can be divided into transudative or exudative. Transudative effusions occur in the presence of normal pleura and are caused by increased oncotic or hydrostatic pressures. Exudative effusions are associated with abnormal pleura and are caused either by increased pleural fluid production due to local inflammation or infiltration or by decreased fluid removal which is caused by obstruction of the lymphatic drainage system. Patients may be entirely asymptomatic or they may present with breathlessness, particularly if the effusion is large. Other symptoms include a cough and systemic symptoms such as weight loss, anorexia, and fever. Chest pain is suggestive of inflammation/infiltration of the parietal pleura and points towards malignancy or empyema. This chapter describes the assessment and diagnosis of the patient with pleural effusion.

Diagnostic Accuracy of Intra-abdominal Fluid Collection Characterization in the Era of Multidetector Computed Tomography

2012 ◽  
Vol 78 (2) ◽  
pp. 185-189 ◽  
Author(s):  
Brian C. Allen ◽  
Huiman Barnhart ◽  
Mustafa Bashir ◽  
Christopher Nieman ◽  
Steven Breault ◽  
...  
Keyword(s):  
Computed Tomography ◽  
Multidetector Ct ◽  
Imaging Finding ◽  
Fluid Collection ◽  
Ct Guided ◽  
High Attenuation ◽  
Institutional Review ◽  
Imaging Characteristics ◽  
Fluid Collections ◽  
Ct Density

The purpose of this study was to test the hypothesis that with improved technology, the presence of abscess in a postoperative fluid collection may be prospectively made. This is an Institutional Review Board-approved, Health Insurance Portability and Accountability Act-compliant retrospective review of computed tomography (CT)-guided intra-abdominal fluid collection drainages. The diagnostic CT scans of 95 consecutive patients performed on 16- and 64-multidetector CT (MDCT) were reviewed by four readers with varying abdominal imaging expertise. Readers were asked to determine fluid content, to document whether infection was present, and to rate reader confidence for infection. A fifth radiologist reviewed the collections for imaging characteristics. The gold standard for presence of infection was microbiological Gram stain and culture. The logistic regression model showed that both fluid collections containing gas or high attenuation fluid (average CT density 20 or greater Hounsfield units) are significant predictors of infection ( P = 0.001). The average sensitivity over the four readers for determining presence of infection was 83.4 per cent and specificity was 39.3 per cent. Even in the era of MDCT, the ability to predict whether or not a fluid collection is infected or not, based on imaging findings alone, is limited. Presence of gas is a strong indicator of infection, but no imaging finding is characteristic of a sterile fluid collection.

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