scholarly journals Hip pain in children dilemmas in diagnosis and management a case report

2020 ◽  
Vol 8 (8) ◽  
pp. 3098
Author(s):  
Lakshmipriya Baskaran ◽  
Ashok Thudukuchi Ramanathan
Keyword(s):  
Clinical Presentation ◽  
Chronic Osteomyelitis ◽  
Final Diagnosis ◽  
Blood Parameters ◽  
Hip Pain ◽  
Lytic Lesion ◽  
Benign Bone Tumor ◽  
Radiological Imaging ◽  
Ct Guided ◽  
Ct Guided Biopsy

Atraumatic hip pain in growing children is of varied etiology from developmental to infection and tumor. Differential clinical presentation of symptoms and investigation modalities like blood parameters and radiological imaging remains inconclusive at times with differential diagnosis. Biopsy remains the final say in conclusive of establishing final diagnosis unless proved otherwise. Bony lytic lesion of proximal femur in children without systemic illness mimicking benign bone tumor initially (osteiod osteoma) turned out to be chronic osteomyelitis on histopathologically following CT guided biopsy of the lesion which alters the course of management.

scholarly journals Perforated Meckel’s Diverticulitis in a Patient with Unknown Intestinal Malrotation: Clinical Pitfall

2021 ◽  
Vol 2021 ◽  
pp. 1-3
Author(s):  
Marie Burgard ◽  
Floryn Cherbanyk ◽  
François Pugin ◽  
Bernhard Egger
Keyword(s):  
Acute Appendicitis ◽  
Clinical Presentation ◽  
Final Diagnosis ◽  
Intestinal Malrotation ◽  
Radiological Imaging ◽  
Atypical Clinical Presentation ◽  
Lower Abdominal Quadrant ◽  
Meckel’S Diverticulitis ◽  
The Right ◽  
Abdominal Quadrant

Symptomatic Meckel’s diverticulum is rare in adults. The most frequent complications are intestinal obstruction and diverticulitis. Diagnosis of Meckel’s diverticulitis can be challenging due to nonspecific clinical manifestation of pain in the right lower abdominal quadrant, mimicking acute appendicitis. If associated with congenital malformation, such as intestinal malrotation, the anomalous anatomy makes the diagnosis even more challenging. In such cases, radiological imaging is essential to guide further management. We present a case of Meckel’s diverticulitis in which physicians were initially misguided because of the atypical clinical presentation. Yet, anamnestic details directed to a potential underlying malformation, leading to supplementary radiological examination and the final diagnosis.

scholarly journals Spinal pain revealing brucellar spondylodiscitis: a case report

2021 ◽  
Vol 33 (1) ◽  
Author(s):  
Lamia Oulkadi ◽  
Bouchra Amine ◽  
Imane El binoune ◽  
Samira Rostom ◽  
Rachid Bahiri
Keyword(s):  
Mediterranean Basin ◽  
Clinical Presentation ◽  
Spinal Pain ◽  
Endemic Country ◽  
Ct Guided ◽  
Case Presentation ◽  
Delay In Diagnosis ◽  
Ct Guided Biopsy ◽  
Initial Evolution ◽  
The Mediterranean Basin

Abstract Background Brucellosis is an anthropozoonosis. It is an endemic disease in the Mediterranean basin. The clinical presentation is polymorphic. The osteoarticular form is the most frequent of the focal forms affecting mainly the spine. In our endemic context, the diagnosis can lead to confusion with tuberculosis. Case presentation We report a case of brucellar spondylodiscitis treated initially as tubercular spondylodiscitis with a good initial evolution. Then, the diagnosis was rectified towards a Brucella origin, after a clinical and biological relapse. Diagnostic confirmation was based on the isolation of Brucella spp in the disco-vertebral CT-guided biopsy and the positive Brucella serology. Then, the patient was put on three antibacterial treatments with doxycycline, rifampicin, plus streptomycin over a period of 6 months with a good evolution. Conclusion Brucellar spondylodiscitis is still common in the Maghreb. It is generally insidious and leads to a delay in diagnosis. The clinician must always mention it when faced with spondylodiscitis in an endemic country and ask for brucella serology.

Diagnostic yield and safety of percutaneous CT-guided biopsy of retroperitoneal lesions and analysis of imaging features

2021 ◽  
pp. 028418512199028
Author(s):  
Anil Kumar Singh ◽  
Zafar Neyaz ◽  
Ritu Verma ◽  
Anshul Gupta ◽  
Richa Mishra ◽  
...  
Keyword(s):  
Diagnostic Yield ◽  
Final Diagnosis ◽  
Microbiological Analysis ◽  
Imaging Features ◽  
Imaging Findings ◽  
Chi Square ◽  
Tissue Samples ◽  
Ct Guided ◽  
Guided Biopsy ◽  
Ct Guided Biopsy

Background Computed tomography (CT)-guided biopsy is emerging as a preferred method for obtaining tissue samples from retroperitoneal lesions due to clear visualization of needle and vessels. Purpose To assess diagnostic yield and safety of CT-guided biopsy of retroperitoneal lesions and compare CT findings in different disease categories. Material and Methods This retrospective analytical study included 86 patients with retroperitoneal lesions who underwent CT-guided biopsy from December 2010 to March 2020. All procedures were performed with co-axial technique and multiple cores were obtained and subjected to histopathology. Additional tests like immunohistochemistry or microbiological analysis were done depending on clinical suspicion. Diagnostic yield calculation and comparison of imaging findings was done by one-way ANOVA, chi-square, and Fisher’s exact tests. Results CT-guided biopsy was technically successful in all cases with a diagnostic yield of 91.9%. Minor complications in the form of small hematomas were seen in two patients. Major disease categories on final diagnosis were lymphoma, tuberculosis, and metastases. A variety of malignant and benign soft-tissue neoplasms were also noted less commonly. With help of immunohistochemistry, lymphoma subtype was established in 88.8% of cases. Addition of microbiological tests like the GeneXpert assay helped in the diagnosis of tuberculosis in some cases. A mass-like appearance and vascular encasement was common in metastatic group and lymphoma. Conclusion Percutaneous CT-guided biopsy is a safe method for the sampling of retroperitoneal lesions with high diagnostic yield. Imaging findings are mostly overlapping; however, some features are more common in a particular disease condition.

scholarly journals A case series on the role of 18F-FDG PET/CT-guided biopsy of osseous metastases

2021 ◽  
Vol 5 (1) ◽  
Author(s):  
Michael Farrell ◽  
Gina Hyun ◽  
Michael P. Goold ◽  
Pavel Krapiva
Keyword(s):  
Case Series ◽  
Final Diagnosis ◽  
Secondary Malignancy ◽  
Molecular Testing ◽  
Primary Malignancy ◽  
Ct Guided ◽  
Osseous Metastases ◽  
Guided Biopsy ◽  
Pet Ct ◽  
Ct Guided Biopsy

Abstract Purpose This case series explores the utility of positron emission tomography (PET)/computed tomography (CT) guidance for biopsy of 18F-fludeoxyglucose (FDG)-avid osseous lesions that are inconspicuous on CT. Methods PET/CT-guided core biopsies were performed in four patients with suspected malignancies given 18F-FDG-avid osseous lesions that were inconspicuous on CT alone. The final diagnosis for each patient was determined by histopathological and molecular testing. Results PET/CT-guided biopsy yielded accurate sampling via core needle biopsy (CNB) with histopathological confirmation of osseous metastases of the primary malignancy as opposed to a secondary malignancy in three patients and ruled-out metastatic spread in the fourth. Conclusion PET/CT-guided biopsy of hypermetabolic osseous lesions that are inconspicuous on CT alone is an effective and safe diagnostic tool in patients with suspected malignancy.

scholarly journals Metastasis to left scapula with unknown primary: Approach to pathological diagnosis

2013 ◽  
Vol 02 (01) ◽  
pp. 002-002
Author(s):  
Shaista M Vasenwala ◽  
Hena A Ansari ◽  
Nazima Haider ◽  
Amir bin Sabir ◽  
Aseeb Ur Rehman
Keyword(s):  
Clinical Presentation ◽  
Bone Lesion ◽  
Final Diagnosis ◽  
Lytic Lesion ◽  
Unknown Primary ◽  
Metastatic Adenocarcinoma ◽  
Pathological Findings ◽  
Primary Bone ◽  
Left Scapula ◽  
Primary Bone Lesion

AbstractBony metastasis is a frequent occurrence in malignancy. However, the clinical presentation and pathological findings may sometimes be more in favor of a primary bone lesion. In such cases, immunochemistry has a very important role to play in reaching a final diagnosis. We present the case of a 35 year male patient who was investigated for a lytic lesion in the left scapula and was finally diagnosed with metastatic adenocarcinoma with the help of immunostaining.

Computed Tomography-Guided Biopsy Assisted by 18F-FDG Coincidence Imaging for Solid Tumours

2019 ◽  
Vol 9 (2) ◽  
pp. 366-370
Author(s):  
Feng Chen ◽  
Yunlei Pan ◽  
Tianzeng Lin ◽  
Shan Chen ◽  
Yuan Hong
Keyword(s):  
Computed Tomography ◽  
Solid Tumour ◽  
Final Diagnosis ◽  
Solid Tumours ◽  
Ct Guided ◽  
Guided Biopsy ◽  
Needle Position ◽  
Significant Difference ◽  
Ct Guided Biopsy ◽  
Coincidence Imaging

Objective: Early diagnosis of solid tumour is the key to making treatment plans. The traditional computed tomography (CT)-guided percutaneous biopsy often makes it difficult to determine the puncture point. The aim of this study is to analyze the collaborative application value of CT-guided biopsy assisted by 18F-FDG coincidence imaging for solid tumours. Methods: A retrospective analysis of 15 patients who underwent routine radiological examination can not form a correct diagnosis on body solid tumour. The needle was introduced under CT guidance in a step-by-step technique and correct needle position in the centre of FDG high concentration area in coincidence imaging. The biopsy specimens were examined under light microscopy and immunofluorescence. Result: All the lesions were successfully punctured, and the final diagnosis was malignant in 14 cases and benign in 1 cases. The sensitivity of CT-guided biopsy assisted by coincidence imaging was 92.9% (13/14), and the specificity was 100% (1/1). Compared with clinical final diagnosis, there was no significant difference between the two groups (P >0.05). Two cases of lung biopsy patients had a small amount of blood in sputum after operation. Conclusion: The CT-guided biopsy assisted by 18F-FDG coincidence imaging may improve the diagnostic capability, especially in cases when a definitive diagnosis by imaging alone is difficult to make.

CT-guided core-needle biopsy in omental pathology

1997 ◽  
Vol 38 (6) ◽  
pp. 978-981 ◽  
Author(s):  
F. Pombo ◽  
E. Rodriguez ◽  
R. Martin ◽  
M. Lago
Keyword(s):  
Core Needle Biopsy ◽  
Needle Biopsy ◽  
Percutaneous Biopsy ◽  
Final Diagnosis ◽  
Endoscopic Biopsy ◽  
Ct Guided ◽  
Core Needle ◽  
Laparoscopic Biopsy ◽  
Ct Guided Biopsy ◽  
Sensitivity Specificity

Purpose: to assess the accuracy and clinical usefulness of CT-guided core-needle biopsy in the diagnosis of omental pathology Material and Methods: We retrospectively reviewed the results of CT-guided percutaneous core biopsies in 25 patients with focal (n=2) or diffuse (n=23) omental pathology. These results were compared to the final diagnoses as determined by laparotomy (n=15), laparoscopic biopsy (n=3), endoscopic biopsy (n=1), or by the results of percutaneous biopsy and clinical-radiological and bacteriological modalities (n=6). the final diagnoses showed 4 patients with isolated omental pathology and 21 with widespread peritoneal involvement. the CT-guided biopsies were performed with 1.0–1.8-mm Surecut core-needles Results: in 16 patients, the final diagnosis was metastatic adenocarcinoma - with the primary tumor sites in the ovary (n=3), stomach (n=1), appendix (n=2), and unknown (n=10). in the remaining 9 patients, the final diagnosis was hepatocellular carcinoma, lymphoma, and mesothelioma in 1 patient each; tuberculosis in 5; and actinomycosis in 1. Sufficient histological (n=16) or cytological (n=8) material was obtained by CT biopsy in 24/25 (96%) cases; the specimen was insufficient for diagnosis in 1 case. in differentiating benign from malignant disease, CT-guided biopsy showed a sensitivity, specificity and accuracy of respectively 89.5%, 100% and 92%. It gave a specific diagnosis in 78.9% (15/19) of patients with malignant conditions and in 50% (3/6) of patients with benign disorders. There were no biopsy-related complications Conclusion: CT-guided percutaneous core-needle biopsy of the omentum is a safe, useful and highly accurate procedure for diagnosing malignant omental pathology

scholarly journals Atypical Presentation of Spindle Cell Carcinoma

2021 ◽  
Author(s):  
Harshika Singh ◽  
Sachin Khanduri ◽  
Anvit Krishnam ◽  
Poonam Yadav ◽  
Harleen Chawla
Keyword(s):  
Cell Carcinoma ◽  
Spindle Cell ◽  
Final Diagnosis ◽  
Spindle Cell Carcinoma ◽  
Ct Guided ◽  
Contrast Enhanced Ct ◽  
Contrast Enhanced ◽  
Enhanced Ct ◽  
Ct Guided Biopsy ◽  
Clinically Significant

Spindle Cell Carcinoma (SCC) of the lung is a rare entity. Computed Tomography (CT) and histopathology forms the basis of diagnosis. Here, authors presented a case of a 30-year-old male patient who reported with complaints of painless abdominal swelling associated with shortness of breath and fever. The patient underwent Contrast Enhanced CT (CECT) of chest, abdomen and pelvis with percutaneous CT guided biopsy. The final diagnosis was SCC of lung with transdiaphragmatic spread to abdomen. This case is clinically significant as it depicts unusual spread of SCC presenting as thoracoabdominal mass.

scholarly journals Clinical Value of CT-Guided Fine Needle Aspiration and Tissue-Core Biopsy of Thoracic Masses in the Dog and Cat

Animals ◽  
2021 ◽  
Vol 11 (3) ◽  
pp. 883
Author(s):  
Massimo Vignoli ◽  
Roberto Tamburro ◽  
Andrea Felici ◽  
Francesca Del Signore ◽  
Annalisa Dettori ◽  
...  
Keyword(s):  
Fine Needle Aspiration ◽  
Core Biopsy ◽  
Needle Aspiration ◽  
Clinical Value ◽  
Reliable Technique ◽  
Ct Guided ◽  
Fine Needle ◽  
Tissue Core ◽  
Histopathologic Diagnosis ◽  
Ct Guided Biopsy

Diagnosis of thoracic lesions on the basis of history and physical examination is often challenging. Diagnostic imaging is therefore of paramount importance in this field. Radiology has traditionally been considered the diagnostic procedure of choice for these diseases. Nevertheless, it is often not possible to differentiate inflammatory/infectious lesions from neoplastic diseases. A correct cytological and histopathologic diagnosis is therefore needed for an accurate diagnosis and subsequent prognostic and therapeutic approach. In human medicine, Computed Tomography (CT) and CT-guided biopsy are used in the presence of lesions which are not adequately diagnosed with other procedures. In the present study, thoracic lesions from 52 dogs and 10 cats of different sex, breed and size underwent both CT-guided fine-needle aspiration (FNAB) and tissue-core biopsy (TCB). Clinical examination, hematobiochemical analysis and chest radiography were performed on all animals. In this study, 59 of 62 histopathological samples were diagnostic (95.2%). Cytology was diagnostic in 43 of 62 samples (69.4%). General sensitivity, accuracy and PPV for FNAB and TCB were 67.7%, 67.7% and 100% and 96.7%, 95.2% and 98.3%, respectively. Combining the two techniques, the overall mean accuracy for diagnosis was 98.4%. Nineteen of 62 cases showed complications (30.6%). Mild pneumothorax was seen in 16 cases, whereas mild hemorrhage occurred in three cases. No major complications were encountered. CT-guided FNAB cytology can be considered a useful and reliable technique, especially for small lesions or lesions located close to vital organs and therefore dangerous to biopsy in other way.

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