scholarly journals Intracystic papillary neoplasm of the gallbladder concomitant with xanthogranulomatous cholecystitis: a case report

2021 ◽  
Vol 7 (1) ◽  
Author(s):  
Takashi Aida ◽  
Masashi Tsunematsu ◽  
Kenei Furukawa ◽  
Koichiro Haruki ◽  
Yoshihiro Shirai ◽  
...  
Keyword(s):  
Cystic Duct ◽  
Gallbladder Wall ◽  
Pathological Examination ◽  
Imaging Features ◽  
Limited Information ◽  
Xanthogranulomatous Cholecystitis ◽  
Neoplastic Lesion ◽  
Established Disease ◽  
Enhanced Computed Tomography ◽  
Papillary Neoplasm

Abstract Background The intracystic papillary neoplasm (ICPN) is a newly established disease concept. It has been regarded as a preinvasive neoplastic lesion, similar to intraductal papillary mucinous neoplasm of the pancreas. Limited information is available on the clinical and imaging features of ICPN. Case presentation A 65-year-old woman was referred to our hospital for assessment of a gallbladder tumor. Contrast-enhanced computed tomography showed a papillary tumor in the fundus of the gallbladder with irregular thickening of the gallbladder wall that spread into the cystic duct. The boundary between the tumor and liver was unclear. The patient was diagnosed with gallbladder cancer with liver invasion. We performed extended cholecystectomy with liver bed resection after confirming the absence of cancer cells in the resection margin of the cystic duct. After pathological examination, the tumor was diagnosed as an ICPN with xanthogranulomatous cholecystitis. The patient was discharged on postoperative day 8 with no complications. Conclusions We have described a rare case of ICPN concomitant with xanthogranulomatous cholecystitis. Clinicians should include ICPN as a differential diagnosis in patients with a papillary or polypoid tumor in the gallbladder.

scholarly journals Solitary fibrous tumor of the pleura in a 22-year-old woman: a case report

2020 ◽  
Vol 48 (9) ◽  
pp. 030006052095949
Author(s):  
Nina Sun ◽  
Jingluan Wang ◽  
Zhaozhong Cheng ◽  
Weizhong Han ◽  
Guo Li ◽  
...  
Keyword(s):  
Solitary Fibrous Tumor ◽  
Case Reports ◽  
Young Patients ◽  
Pathological Examination ◽  
Positive Staining ◽  
Imaging Features ◽  
Contrast Enhanced ◽  
Fibrous Tumor ◽  
Enhanced Computed Tomography ◽  
Over 40 Years

Solitary fibrous tumor of the pleura (SFTP) is a rare disease, and most published case reports are in patients over 40 years old. We report a case of SFTP in a 22-year-old woman. The imaging features were observed using contrast-enhanced computed tomography (CT), and histomorphological features were evaluated using pathology and immunohistochemistry. The CT showed a mass in the pleura inside the ninth rib on the left. Pathological results of percutaneous puncture in the chest suggested the possibility of solitary fibroma. The patient underwent surgical resection, and the tumor measured 2.5 × 1.5 × 1.5 cm with an intact capsule. Pathological examination revealed a spindle cell tumor, and immunohistochemistry showed strong positive staining for CD34 and STAT6, consistent with typical solitary fibroma. Although SFTP is rare in young patients, early diagnosis and intervention are needed to avoid the possibility of future complications.

Juvenile xanthogranuloma of the subdural spaces mimicking chronic hematoma with positive FDG uptake on PET: case report

2020 ◽  
Vol 26 (4) ◽  
pp. 449-453
Author(s):  
Jacob A. Kahn ◽  
Jeffrey T. Waltz ◽  
Ramin M. Eskandari ◽  
Cynthia T. Welsh ◽  
Michael U. Antonucci
Keyword(s):  
Potential Role ◽  
Response To Treatment ◽  
Juvenile Xanthogranuloma ◽  
Imaging Features ◽  
Limited Information ◽  
Advanced Imaging ◽  
Systemic Involvement ◽  
The Central Nervous System ◽  
Infancy And Early Childhood

The authors report an unusual presentation of juvenile xanthogranuloma (JXG), a non–Langerhans cell histiocytosis of infancy and early childhood. This entity typically presents as a cutaneous head or neck nodule but can manifest with more systemic involvement including in the central nervous system. However, currently there is limited information regarding specific imaging features differentiating JXG from other neuropathological entities, with diagnosis typically made only after tissue sampling. The authors reviewed the initial images of a young patient with shunt-treated hydrocephalus and enlarging, chronic, extraaxial processes presumed to reflect subdural collections from overshunting, and they examine the operative discovery of a mass lesion that was pathologically proven to be JXG. Their results incorporate the important associated histological and advanced imaging features, including previously unreported metabolic activity on FDG PET. Ultimately, the case underscores the need to consider JXG in differential diagnoses of pediatric intracranial masses and highlights the potential role of PET in the initial diagnosis and response to treatment.

scholarly journals Mixed adenoneuroendocrine carcinoma (MANEC) of the ampulla of Vater in a Chinese patient: A case report

2020 ◽  
Vol 48 (8) ◽  
pp. 030006052094791
Author(s):  
Xu Li ◽  
Dezhao Li ◽  
Xiaodong Sun ◽  
Guoyue Lv
Keyword(s):  
Histopathological Examination ◽  
Distant Metastases ◽  
Ampulla Of Vater ◽  
Chinese Patient ◽  
Ki 67 ◽  
Rare Tumour ◽  
Mixed Adenoneuroendocrine Carcinoma ◽  
Dark Urine ◽  
Neoplastic Lesion ◽  
Enhanced Computed Tomography

Mixed adenoneuroendocrine carcinoma (MANEC) is a rare tumour of the gastrointestinal tract with both epithelial and neuroendocrine components. We describe a case of a 57-year-old man who presented with yellow sclera and dark urine. Contrast-enhanced computed tomography (CT) showed enlargement of the intra and extrahepatic bile ducts and a neoplastic lesion at the end of the common bile duct which was indistinguishable from the adjacent head of the pancreas and duodenum. A pancreaticoduodenectomy was performed and histopathological examination of resected samples showed that tumour was a complex lesion with adenocarcinoma and neuroendocrine components positive for neuroendocrine markers (chromogranin A and synaptophysin) with a Ki-67 labelling index of 40%. The patient was diagnosed with MANEC in the ampulla of Vater with a neuroendocrine carcinoma component of approximately 70%. Ampullary MANECs are highly aggressive tumours with a high risk for distant metastases and a poor prognosis. Therefore, establishing a standard therapeutic strategy is crucial.

scholarly journals Shoulder Periarthritis and its Imaging Features in Patients with Type 1 Diabetes Mellitus

2017 ◽  
Vol 53 (04) ◽  
pp. 222-229
Author(s):  
Abhilash Nair ◽  
Devasenathipathy Kandasamy ◽  
Raju Sharma ◽  
HL Nag ◽  
Upiderpal Singh ◽  
...  
Keyword(s):  
Diabetes Mellitus ◽  
Type 1 Diabetes ◽  
Type 1 Diabetes Mellitus ◽  
Clinical Features ◽  
External Rotation ◽  
Adhesive Capsulitis ◽  
Imaging Features ◽  
Limited Information ◽  
Limited Joint Mobility

ABSTRACT Aim: There is limited information on periarthritis/adhesive capsulitis of the shoulder (ACS) in patients with type-1-diabetes mellitus (T1D). We assessed the prevalence and characteristics of ACS in patients with type-1-diabetes mellitus. Methods: Consecutive 267 patients attending 'Diabetes of Young Clinic' were screened for ACS. Those with clinical features of ACS were further assessed by 'shoulder pain and disability index' (SPADI), radiograph and MRI of the shoulder. The average glycemic status (HbA1c) during preceding 2 years was assessed in patients with and without ACS. Controls were age and sex matched healthy subjects (1:1 ratio). Results: Sixteen of 267 patients (6.0%) with type-1-diabetes had clinical features of ACS, unlike none of the healthy controls (P < 0.001). Internal and external rotation of the shoulders was the most frequently restricted movements in ACS. Thickened coracohumeral ligament and axillary pouch obliteration was characteristic MRI feature, present in 80.0% in 73.3% cases, respectively. Though 14/16 type-1-diabetes patients with ACS were symptomatic, they never reported these complaints in diabetic clinic with the treating physicians. On regression analysis (odds ratio; 95% CI), duration of diabetes (1.1; 1.03-1.17, P < 0.01), retinopathy (3.6; 1.05-12.52, P = 0.04), and limited joint mobility (6.4; 1.88-21.95, P < 0.01) were independent predictors for presence of ACS in type-1-diabetes. The mean HbA1c and lipid levels were comparable in patients with or without ACS. Conclusions: Six percent of patients with type-1-diabetes had ACS, which can be detected on clinical screening and confirmed by imaging to help initiate early treatment.

scholarly journals Gallbladder Metastases: A Report of Two Cases

2019 ◽  
Vol 12 (1) ◽  
pp. 235-240 ◽  
Author(s):  
Mohamad Mouchli ◽  
Douglas J. Grider ◽  
Paul Yeaton
Keyword(s):  
Computed Tomography ◽  
Invasive Ductal Carcinoma ◽  
Triple Negative ◽  
Ductal Carcinoma ◽  
Primary Lung Cancer ◽  
Gallbladder Wall ◽  
Metastatic Lesion ◽  
Quadrant Pain ◽  
Case Presentation ◽  
Enhanced Computed Tomography

Introduction: Metastasis to the gallbladder is not common and usually manifests an advanced stage of malignancy. Herein, we report a case of triple negative high grade invasive ductal carcinoma of breast with a metastatic lesion to the gallbladder. Case Presentation: The patient is a 52-year-old female diagnosed with invasive ductal carcinoma treated with mastectomy and chemotherapy. After 12 months, she presented to the emergency department with right upper quadrant pain and elevated liver chemistries. Abdominal enhanced computed tomography showed periportal and gallbladder wall edema. After cholecystectomy, the resected gallbladder was histologically considered to be a metastatic lesion arising from the primary lung cancer. The second case describes a case of a 77-year-old woman with multiple co-morbidities who presented to the hospital with sepsis secondary to biliary source. Abdominal enhanced computed tomography findings were concerning for acute cholecystitis. After cholecystectomy, the pathology of the resected gallbladder demonstrated cholecystitis and plasmacytoma. Conclusion: The atypical presentation of gallbladder metastases could mislead treating providers. The diagnosis might alter management decisions and prognosis.

scholarly journals Concomitant bilateral elastofibroma in the infrascapular and gluteal regions: a report of a rare case

2020 ◽  
Vol 21 (1) ◽  
Author(s):  
Omran Al Dandan ◽  
Ali Hassan ◽  
Mona Al Muhaish ◽  
Jumanah AlMatrouk ◽  
Haidar Almuhanna ◽  
...  
Keyword(s):  
Computed Tomography ◽  
Rare Case ◽  
Surgical Excision ◽  
Elastic Fibers ◽  
Histopathological Diagnosis ◽  
Imaging Features ◽  
Serratus Anterior ◽  
History Of ◽  
Benign Soft Tissue Tumor ◽  
Enhanced Computed Tomography

Abstract Background Elastofibroma is a benign soft tissue tumor characterized by the presence of elastic fibers in a stroma of collagen and mature adipose tissue. It is reported to have a prevalence of 2.73%, as shown by a study through computed tomography (CT) images. However, multiple elastofibromas are uncommon. Case presentation We report a case of concomitant bilateral elastofibroma in the infrascapular and gluteal regions. A 63-year-old male patient presented with a 6-month history of gradually increasing painless swellings in the upper back. On physical examination, firm, painless bilateral infrascapular masses were identified; these masses were more noticeable on forward arm flexion. Contrast-enhanced computed tomography showed well-defined bilateral infrascapular masses deep to the serratus anterior muscles as well as poorly defined bilateral gluteal masses with attenuation similar to that of the adjacent skeletal muscle. Magnetic resonance imaging revealed heterogenous masses with internal fatty streaks, consistent with elastofibroma. The histopathological diagnosis of elastofibroma was established based on the results of image-guided core-needle biopsy. The patient underwent surgical excision of both infrascapular elastofibromas with no post-operative complications. As the gluteal masses were incidental, surgical management was not warranted. Conclusion The presence of multiple elastofibromas is unusual. This report describes a rare case of multiple elastofibromas and its typical imaging features, and alerts us that elastofibromas are not exclusive to the periscapular region.

scholarly journals A Rare Finding During a Common Procedure: Xanthogranulomatous Cholecystitis

2014 ◽  
Vol 99 (5) ◽  
pp. 595-599 ◽  
Author(s):  
Fatih Taskesen ◽  
Zulfu Arikanoglu ◽  
Omer Uslukaya ◽  
Abdullah Oguz ◽  
Ibrahim Aliosmanoglu ◽  
...  
Keyword(s):  
Open Surgery ◽  
Early Stage ◽  
Chronic Cholecystitis ◽  
Pathological Examination ◽  
Wall Thickening ◽  
Xanthogranulomatous Cholecystitis ◽  
Common Procedure ◽  
History Of ◽  
Difficult Cholecystectomy ◽  
Destructive Inflammation

Abstract Xanthogranulomatous cholecystitis is a rare variant of chronic cholecystitis characterized by severe proliferative fibrosis and accumulation of lipid-laden macrophages in regions of destructive inflammation. Xanthogranulomatous cholecystitis clinically and radiologically mimics early-stage gallbladder cancer, with wall thickening on computed tomography. The study included 14 xanthogranulomatous cholecystitis patients that were identified following retrospective analysis of the records of 1248 patients that underwent cholecystectomy between 2005 and 2011. Mean age of the 5 male and 9 female patients was 56.7 years. All 14 patients had gallbladder stones; 10 had a history of acute cholecystitis, 1 had cholangitis, and 2 presented with obstructive jaundice. A right-upper quadrant mass was palpable in 2 patients. All patients underwent cholecystectomy. Open surgery was planned and performed in 6 of the 14 patients, and laparoscopic cholecystectomy was planned in 8 patients, but was converted to open surgery in 1 case. In total, 1 patient developed wound infection, 1 patient had postoperative pneumonia, and 1 patient developed intraabdominal hematoma. None of the patients in the series died. Xanthogranulomatous cholecystitis is difficult to diagnose, both preoperatively and intraoperatively, and definitive diagnosis depends exclusively on pathological examination. Xanthogranulomatous cholecystitis should be a consideration in all difficult cholecystectomy cases.

scholarly journals Postoperative bleeding in a patient with appendiceal mucinous adenocarcinoma and liver dysfunction patient: A case-report

2021 ◽  
Author(s):  
MingKun Sun ◽  
Xiaohua Niu ◽  
Ying Tang ◽  
Wenzhong Mo ◽  
Haiyang Xin ◽  
...  
Keyword(s):  
Hepatitis B ◽  
Liver Dysfunction ◽  
Mucinous Adenocarcinoma ◽  
Malignant Tumors ◽  
Postoperative Bleeding ◽  
Pathological Examination ◽  
Preoperative Imaging ◽  
Intraperitoneal Hyperthermic Chemotherapy ◽  
Hyperthermic Chemotherapy ◽  
Enhanced Computed Tomography

Abstract Background: Appendiceal malignant tumors are rare in the clinic, and the incidence rate of gastrointestinal tumors is only approximately 0.5%. Our aim is to describe our experience with this rare disease and to increase knowledge on the diagnosis and treatment of appendiceal malignant tumors. Case presentation: We report the case of a 69-year-old woman who was admitted to the hospital due to dyspepsia. The patient was a carrier of hepatitis B virus, and liver dysfunction was diagnosed preoperatively. Abdominal enhanced computed tomography and colonoscopy showed that the appendix was significantly enlarged and dilated, and effusion and appendicitis were observed. Mucinous adenocarcinoma and appendiceal abscesses were not excluded because of the lack of specificity, which makes it difficult to diagnose the disease before a surgery. Laparoscopic appendectomy was performed, and a rapid frozen pathological examination showed a mucinous tumor of the appendix. Intraperitoneal hyperthermic chemotherapy with cisplatin was administered. The patient had abdominal hemorrhage on the fifth day after the surgery. After active treatment, she was discharged from the hospital 19 days after the surgery.Conclusions: The diagnosis of appendiceal malignant tumors mainly depends on preoperative imaging and microscopic results,and highly suspected patients, rapid pathological examination is needed during the operation., and so on. Notably, for elderly patients with hepatitis B infection and liver dysfunction, there is a probability of postoperative bleeding.

scholarly journals Ultrasonographic diagnosis, classification, and treatment of cervical lymphatic malformation in paediatric patients: a retrospective study

2020 ◽  
Vol 20 (1) ◽  
Author(s):  
Jiaoling Li ◽  
Wei Zhong ◽  
Xiuping Geng ◽  
Xiaofang Liu ◽  
Xiangxiang Zhang ◽  
...  
Keyword(s):  
Expectant Management ◽  
Interventional Therapy ◽  
Lymphatic Malformation ◽  
Imaging Features ◽  
Contrast Enhanced ◽  
Intracystic Haemorrhage ◽  
First Choice ◽  
Enhanced Computed Tomography ◽  
Contrast Enhanced Computed Tomography ◽  
Classification And Treatment

Abstract Background To explore the imaging features, key diagnostic points, classification, treatment, and prognosis of cervical lymphatic malformation. Methods Overall, 320 patients diagnosed with cervical lymphatic malformation were retrospectively analysed in our hospital between 1 January 2014 and 31 December 2017. Imaging modalities included colour Doppler ultrasound, magnetic resonance imaging, and contrast-enhanced computed tomography. Cervical lymphatic malformations were classified by cyst diameter. Treatments included interventional therapy, surgery, and expectant treatment. Results Cervical lymphatic malformation was identified in 320 of 1192 patients with lymphatic malformation. Four were excluded due to misdiagnosis by ultrasonography. Cervical lymphatic malformation was classified as mixed, macrocystic, and microcystic in 184 (57.5%), 117 (36.56%), and 19 (5.94%) patients, respectively. Sixty-four (20%), ten (3.12%), seven (2.19%), and three (0.94%) patients experienced intracystic haemorrhage, infection, concurrent intracystic haemorrhage and infection, and calcification, respectively. Among 260 (81.25%) patients who underwent interventional sclerotherapy, 163 (50.94%) received it once and 96 (30%) received it two or more times. Twenty-eight (8.75%), five (1.56%), and 27 (8.44%) patients underwent surgical resection, interventional sclerotherapy plus surgery, and expectant management, respectively. Conclusions Ultrasonography is useful for diagnosing definite cervical lymphatic malformation. Interventional therapy is the first choice for children with confirmed cervical lymphatic malformation.

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