scholarly journals Multimodality imaging review of focal renal lesions

Author(s):  
Jonathan Lyske ◽  
Rishi Philip Mathew ◽  
Christopher Hutchinson ◽  
Vimal Patel ◽  
Gavin Low

Abstract Background Focal lesions of the kidney comprise a spectrum of entities that can be broadly classified as malignant tumors, benign tumors, and non-neoplastic lesions. Malignant tumors include renal cell carcinoma subtypes, urothelial carcinoma, lymphoma, post-transplant lymphoproliferative disease, metastases to the kidney, and rare malignant lesions. Benign tumors include angiomyolipoma (fat-rich and fat-poor) and oncocytoma. Non-neoplastic lesions include infective, inflammatory, and vascular entities. Anatomical variants can also mimic focal masses. Main body of the abstract A range of imaging modalities are available to facilitate characterization; ultrasound (US), contrast-enhanced ultrasound (CEUS), computed tomography (CT), magnetic resonance (MR) imaging, and positron emission tomography (PET), each with their own strengths and limitations. Renal lesions are being detected with increasing frequency due to escalating imaging volumes. Accurate diagnosis is central to guiding clinical management and determining prognosis. Certain lesions require intervention, whereas others may be managed conservatively or deemed clinically insignificant. Challenging cases often benefit from a multimodality imaging approach combining the morphology, enhancement and metabolic features. Short conclusion Knowledge of the relevant clinical details and key imaging features is crucial for accurate characterization and differentiation of renal lesions.

2021 ◽  
pp. 26-29
Author(s):  
Shruti Shemawat ◽  
Sakshi Apurva ◽  
D.P Soni ◽  
Saurabh Soni

INTRODUCTION: The skin being largest organ of the body has vast spectrum of disorders which can be difcult to diagnose correctly solely on the basis of clinical features. Hence histopathological examination is necessary to categorise skin lesions. The aim was to study relative frequency of various skin lesions and distribution of these lesions according to age and sex. METHODS: This is a retrospective descriptive hospital based study. The skin biopsies samples which came in the duration of two years from January 2019 to December 2020 at the Department of Pathology, Sardar Patel Medical college and associated group of hospitals, Bikaner, Rajasthan were taken in this study. All skin biopsies that showed denite histopathological diagnosis were included. After proper xing and staining procedures these lesions were examined under light microscopy and categorized as non-neoplastic and neoplastic. Relative frequency of various lesions, distribution of lesions according to age and sex was analyzed. The data collected was tabulated, interpreted and compared with other similar studies. RESULTS: Out of 346 patients, incidence of neoplastic lesions 259 (74.9%) were higher than non-neoplastic lesions 87(25.1%). Males were affected more compared to females with male to female ratio 1.45:1. Non-neoplastic lesions were mostly caused because of infectious etiologies among which leprosy was the most common infection. Keratinocytic tumors 99(52.2%) constituted most common type of neoplastic lesion. Benign tumors 191(73.7%) outnumbered malignant tumors 68(26.3%). The cases of benign tumors were seen more in younger population while that of malignant tumors were seen in older age groups. Among the keratinocytic type of malignant skin tumors squamous cell carcinoma (63.5%) was the most common variant which was followed by basal cell carcinoma 19(36.5%). Male predominance was observed in both squamous cell carcinoma and basal cell carcinoma. CONCLUSION: A wide heterogenesity of skin lesions was observed in the present study . These skin lesions were mostly affecting age group of 10-30 years. Inspite of extensive programmes and research, leprosy and tuberculosis remains a rampant cause of infectious non-neoplastic skin lesions. Sometimes ignorance by patient for a very small appearing skin lesions becomes life threatening. Hence early clinician consultation with proper examination and accurate histopathological diagnosis becomes the mainstay in early treatment and recovery.


2019 ◽  
Vol 104 (12) ◽  
pp. 6129-6138 ◽  
Author(s):  
Mikkel Andreassen ◽  
Emma Ilett ◽  
Dominik Wiese ◽  
Emily P Slater ◽  
Marianne Klose ◽  
...  

Abstract Introduction Diagnosis and pathological classification of insulinomas are challenging. Aim To characterize localization of tumors, surgery outcomes, and histopathology in patients with insulinoma. Methods Patients with surgically resected sporadic insulinoma were included. Results Eighty patients were included. Seven had a malignant tumor. A total of 312 diagnostic examinations were performed: endoscopic ultrasonography (EUS; n = 59; sensitivity, 70%), MRI (n = 33; sensitivity, 58%), CT (n = 55; sensitivity, 47%), transabdominal ultrasonography (US; n = 45; sensitivity, 40%), somatostatin receptor imaging (n = 17; sensitivity, 29%), 18F-fluorodeoxyglucose positron emission tomography/CT (n = 1; negative), percutaneous transhepatic venous sampling (n = 10; sensitivity, 90%), arterial stimulation venous sampling (n = 20; sensitivity, 65%), and intraoperative US (n = 72; sensitivity, 89%). Fourteen tumors could not be visualized. Invasive methods were used in 7 of these 14 patients and localized the tumor in all cases. Median tumor size was 15 mm (range, 7 to 80 mm). Tumors with malignant vs benign behavior showed less staining for insulin (3 of 7 vs 66 of 73; P = 0.015) and for proinsulin (3 of 6 vs 58 of 59; P < 0.001). Staining for glucagon was seen in 2 of 6 malignant tumors and in no benign tumors (P < 0.001). Forty-three insulinomas stained negative for somatostatin receptor subtype 2a. Conclusion Localization of insulinomas requires many different diagnostic procedures. Most tumors can be localized by conventional imaging, including EUS. For nonvisible tumors, invasive methods may be a useful diagnostic tool. Malignant tumors showed reduced staining for insulin and proinsulin and increased staining for glucagon.


Author(s):  
Sahana N. Naik ◽  
Sunil Kumar K. S. ◽  
Girija B.

Background: Ovarian tumors account for 30% of all cancers of female genital tract which represents the sixth most common cancer and fourth leading cause of death in women. The present study was done with an objective to determine the frequency and distribution of various ovarian tumors and to study their clinical and histopathological presentations.Methods: It is a retrospective observational study of patients with ovarian tumors subjected to surgery in the department of obstetrics and gynecology, SDM College of Medical Sciences and Hospital from January 2005 to December 2015.Results: There were 642 cases comprising of 77.7% of neoplastic lesions and 22.3% of non-neoplastic lesions. Majority of the ovarian tumors (83%) were seen in the age group of 20 to 50 years. Mean age for ovarian tumors was 38 years.  Among the neoplastic lesions 84% were benign, 14.2% were malignant and 1.8% were borderline tumors. Surface epithelial tumors were the commonest tumors (60.9%) followed by germ cell tumors (12.8%).  Serous cystadenoma was the most common benign tumors (47.1%) followed by mucinous cystadenoma (18.4%). Among the ovarian malignant tumors; serous cystadenocarcinoma was the most common (4.5%) followed by mucinous cystadenocarcinoma (2.6%). Chocolate cysts were the most common among the non-neoplastic lesions (36.4%).Conclusions: Ovarian neoplastic lesions were more common than non-neoplastic lesions. Benign ovarian tumors were common in reproductive age group.  The mean age of occurrence for ovarian tumor was 38 years. The most common neoplasm was surface epithelial tumors, of which serous tumors was the commonest. Chocolate cysts were the most frequently encountered histopathological finding among the non-neoplastic lesions.


Author(s):  
Saket Sarswat ◽  
Vimlesh . ◽  
D.P. Soni

Background: Kidney can be involved in various pathological process. Both benign & malignant tumors can occur in the kidney. They arise from different components of renal parenchyma, notably tubular epithelium.1 99 percent of renal neoplasms are malignant, with renal cell carcinoma and wilm’s tumor being the most common2. Men have higher incidence than women (approximately 1.6:1) and vast majority are diagnosed after 65 years of age. Material and methods: Prospective and retrospective study from January 2017 to December 2019 in the Department of Pathology. Results: The study comprised of 67 cases of neoplastic conditions, out of which 63 cases are malignant and only 4 cases were recorded as benign. Conclusion: Malignant tumors far more common than benign lesions. In adults and older individuals, renal cell carcinoma was most common while among paediatric age group, wilms tumor was most common. Benign tumors were uncommon. Keywords: Kidney, renal cell carcinoma, wilms tumor


2017 ◽  
pp. 23-29
Author(s):  
Thi Kim Yen Vo ◽  
Phuoc Bao Quan Nguyen ◽  
Thanh Thao Nguyen

Objective: To describe the sonographic characteristics of the focal breasst lesions using Acoustic Radiation Force Impulse Imaging (ARFI), and to evaluate the role of ARFI technique in combination with 2D Ultrasound in diagnosing focal breast lesions. Methods: 2D Ultrasound and ARFI Elastography were caried out in 52 patients who have focal lesions of breast. Images of 2D Ultrasound were classified according to ACR 2013. ARFI Elastography was performed by 2 techniques: “Virtual Touch HD tissue imaging” in order to image of strain distribution and “Virtual Touch HD Tissue quantification imaging” to measure the shear wave velocity (SWV) in the tissue. Strain distribution was classified according to Ako Itoh scale. SWV were measured in 4 positions: internal the lesion (SWVi), boundary zone (SWVb), glandular tissue and fatty tissue next to lesion (SWg and SWf). According to the results of pathology, we determine and compare the value between 2D Ultrasound plus ARFI elastography and 2D Ultrasound alone. Results: 52 patients with breast focal lesions: 22 malignant tumors and 30 benign tumors. Mean Ako Itoh scale of benign tumors were 2.19 ± 1.13 and malignant tumors were 4.72 ± 0.55; the cut-off value was between E3 và E4. SWVi, SWVb, SWVf, SWVg of benign tumors were lower than malignant tumors with cut-off values were 3.32 m/s; 6.01m/s; 1.08m/s; 2.37m/s, respectively. 2D Ultrasound plus ARFI Elastography: Se 100%, Sp 90%, PPV 88%, NPV 100%, Acc 94.2% (p<0.001, K = 0.884). Conclutions: In addition to the morphologic characteristics of breast lesions, ARFI provides information about lesion’s tissue elasticity, which can be a useful tool to differentitate malignant lesions from benign ones. Key words: elastography, focal breast lesions, Acoustic Radiation Force Impulse Imaging


2017 ◽  
Vol 59 (2) ◽  
pp. 236-246 ◽  
Author(s):  
Hee Mang Yoon ◽  
Sun-ju Byeon ◽  
Jae-Yeon Hwang ◽  
Jeong Rye Kim ◽  
Ah Young Jung ◽  
...  

Sacrococcygeal teratomas are the most common solid tumor in newborn infants. The diagnosis is not difficult in many cases; however, there should be additional information on imaging studies in order to manage those infants properly. Details include histology, morphologic classification, complications such as rupture, bleeding, and mass effects on the adjacent structures. Although imaging features cannot accurately predict the histologic subtypes of the tumors, thorough evaluation of the imaging features can help distinguish malignant tumors from benign tumors. In this article, pathogenesis, histological characteristics, clinical considerations, and morphologic characteristics will be discussed.


2020 ◽  
pp. 1-3
Author(s):  
Radhika Mucharla ◽  
Ravikanth Kotagiri

Salivary gland tumours account for 2-6.5% of all the neoplasms of the Head and Neck. Histopathology is most important in diagnosis of salivary gland tumors. AIMS and OBJECTIVES : To study age,sex and site distribution of various salivary gland lesions, to study the histomorphologic (gross &microscopic) aspect of these lesions to correlate clinical diagnosis with that of histopathologic features. MATERIALS AND METHODS: The study is conducted in the RAINBOW CLINICAL LABORATORY AND RESEARCH CENTRE, SIDDIPET during the period of September2018 to September 2020. Formalin fixed ,paraffin embedded sections and stained with hematoxylin and eosin slides were studied. RESULTS: Total number of specimens were 54. Out of these 39 were neoplastic (benign 70%,malignant 30%) and 15 were non neoplastic. Among the benign tumors majority are pleomorphic adenoma.Among the malignant tumors, mucoepidermoid carcinoma is the most common. Among the non neoplastic lesions chronic sialadenitis is most common. CONCLUSION: Histopathological examination of salivary gland lesions stands out to be the most important method in establishing the final diagnosis. It helps in differentiating non neoplastic and neoplastic lesions.


Author(s):  
Yan Song ◽  
Jie Liu ◽  
Lei Cao ◽  
Bao-Hai Yu ◽  
Tao Sun ◽  
...  

Background: Scapula is a small irregular-shaped flat bone, which may suffer from a variety of tumors or tumor-like lesions. Because the imaging manifestations are complex and changeable, correct imaging diagnosis is difficult. Introduction: At present, there are few related radiology literatures, and it is necessary to fully analyze the imaging signs of different types of benign and malignant tumors in scapula to guide clinical treatment. This study was to investigate clinical and imaging presentations of tumors and tumor-like lesions in the scapula so as to increase the diagnostic accuracy of diseases in the scapula. Methods: Patients with scapular tumors confirmed by pathology were enrolled. The imaging and clinical data were analyzed. Result: Among 108 patients, benign tumors were in 53 (49.1%) cases, intermediate in seven (6.5%), and malignant in 48 (44.4%) involving 16 diseases. Osteochondroma was the first benign tumors in 45 cases accounting for 84.9% of all benign scapular tumors followed by chondroma in four cases (7.5%). The intermediate tumors were mainly eosinophilic granuloma in four cases. Metastatic tumors were the commonest malignant tumor (27 cases or 56.2% of all malignant tumors), followed by chondrosarcoma (in 13 cases). Except for the one case of chondroblastoma in which the lesion involved the glenoid cavity, all the other cartilaginous tumors were located in the scapular body and processes. The type of lesions in the bony processes is the same as in the scapular body, the common lesions in the central area of body were malignant tumors, and the commonest lesions in the glenoid area were metastasis. Common imaging features of malignant scapular tumors were ill-defined margins, cortical destruction and soft tissue involvement. The imaging features of chondrosarcoma lack specificity except calcification. Benign lesions usually had clear boundary and marginal sclerosis. Conclusion : A wide variety of benign and malignant tumors may occur in the scapula with mostly cartilaginous and metastatic tumors, and the location and distribution of lesions are similar in the scapula to those in the long bones.


2017 ◽  
Vol 2017 ◽  
pp. 1-7 ◽  
Author(s):  
Lele Li ◽  
Guoqing Yang ◽  
Ling Zhao ◽  
Jingtao Dou ◽  
Weijun Gu ◽  
...  

Aim. To investigate the clinical and endocrinological characteristics of patients with adrenal incidentaloma (AI). Materials and Methods. This retrospective study enrolled 1941 AI patients hospitalized at the Department of Endocrinology, Chinese PLA General Hospital, Beijing, China, between January 1997 and December 2016. The patient gender, age at visits, imaging features, functional status, and histological results were analyzed. Results. Of the 1941 patients, 984 (50.70%) were men. The median age was 52 years (interquartile range: 44–69 years). 140 cases had bilateral AI. Endocrine evaluation showed that 1411 (72.69%) patients had nonfunctional tumor, 152 (7.83%) had subclinical Cushing syndrome (SCS), and 82 (4.33%) had primary hyperaldosteronism. A total of 925 patients underwent operation for removal of 496 cortical adenomas (53.62%), 15 adrenal cortical carcinomas (1.62%), and 172 pheochromocytomas (18.59%). The bilateral group had a higher proportion of SCS (18.57% versus 7.10%, P<0.001, P=0.006). A mass size of 46 mm was of great value in distinguishing malignant tumors from the benign tumors, with sensitivity of 88.2% and specificity of 95.5%. Conclusions. We reported the baseline demographic and clinical characteristics of patients with AI in a large series from a single center in China.


2018 ◽  
Vol 64 (4) ◽  
pp. 515-521
Author(s):  
Nikolay Kostenikov ◽  
Olga Mirolyubova ◽  
Violetta Dubrovskaya ◽  
Yuriy Ilyushchenko ◽  
Andrey Stanzhevskiy

Materials and methods. A group of 19 patients with suspected of recurrent growth malignant and benign tumors and postoperative cysts on PET-CT with 13N-ammonium were examined in the postoperative period. The RPH 13N-ammoniа was injected intravenously at the dose of 350-370MBq/m2 of body surface. It is shown, that PET with 13N-ammonia allows to clearly visualize benign and malignant hypervascular tumors, as well as to assess the efficiency of their treatment. The tendency was detected for prevalence of the increased accumulation of 13N-ammonia in benign hypervascular neoplasms of a vascular line as compared to malignant tumors. That is explained by the dependence of the uptake of the drug both upon the degree of tumor vascularization and upon the presence and concentration of glutamine in tumor cells. It is stated in the paper that the level of the uptake of 13N-ammonium in the tumor is in direct ratio to its perfusion and inversely to the degree of its malignancy. In case of effective treatment the level of accumulation of 13N-ammonia in malignant tumors is nonlinearly increased since the rate of metabolic processes is decreased that leads to accumulation of glutamine, however perfusion in the tumor is also nonlinearly decreased. Conclusion. Ultrashort half-life of the radionuclide [13N] (of 9.96 min) and the low radiation exposure that occurs with intravenous introduction of 13N-ammonium create a unique opportunity for diagnosis and assessment of the efficiency of treatment of brain tumors by the method of positron emission tomography.


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