scholarly journals Giant Renal Angiomyolipoma by the Example of Clinical Cases

2021 ◽  
Vol 102 (5) ◽  
pp. 304-310
Author(s):  
S. V. Yadrentseva ◽  
N. V. Nudnov ◽  
Emil’ G. Gasymov
Keyword(s):  
Differential Diagnosis ◽  
Morphological Characteristics ◽  
High Sensitivity ◽  
Renal Angiomyolipoma ◽  
Distinctive Features ◽  
Contrast Enhanced Ct ◽  
Contrast Enhanced ◽  
Enhanced Ct ◽  
Diagnostic Difficulties ◽  
Clinical Cases

The paper presents two clinical cases of patients with giant renal angiomyolipomas (AML), in one of whom its course was complicated by intratumoral hemorrhage. It describes key diagnostic criteria for computed tomography (CT), as well as the distinctive features of other neoplasms that should undergo a differential diagnosis. The similar clinical presentations and morphological characteristics of different renal neoplasms can cause certain diagnostic difficulties; however, the carefully collected historical data and distinctive criteria allow AML to be identified. Due to its high sensitivity and specificity, abdominal contrast-enhanced CT is an effective imaging technique in the detection and differential diagnosis of giant renal AML.

scholarly journals Case Report: Seaweed Bezoar Masquerading as a Malignant Obstruction

2018 ◽  
Vol 2018 ◽  
pp. 1-3
Author(s):  
E. C. Abboud ◽  
B. Babic
Keyword(s):  
Small Bowel ◽  
High Sensitivity ◽  
Bowel Loop ◽  
Asian Woman ◽  
Malignant Obstruction ◽  
Contrast Enhanced Ct ◽  
Contrast Enhanced ◽  
Enhanced Ct ◽  
Risk Patients ◽  
High Index Of Suspicion

Bezoars represent a rare cause of small bowel obstruction (SBO). Nonoperative management of bezoars includes use of endoscopy with mechanical or chemical dissolution methods. When obstruction persists, surgical intervention becomes necessary. Here, we present the case of an Asian woman with a SBO secondary to a phytobezoar masquerading as a malignancy. She presented with two days of acute-on-chronic abdominal pain that started after eating seaweed. Initial computed tomography (CT) scan showed a SBO with a jejunal transition point and ill-defined liver lesions, worrisome for a malignant obstruction with liver metastases. Further imaging, however, showed the resolution of these artifacts. Subsequent laparotomy revealed a small bowel loop with copious obstructing seaweed. A distal stricture was palpated, and the involved segment was resected. Intraoperative liver ultrasound was negative, and final pathology revealed benign small intestine with a mild stricture. Given the rarity of bezoar-related obstructions, the diagnosis is often delayed particularly when confounding factors exist such as our patient’s concomitant hepatic findings. Contrast-enhanced CT has a high sensitivity but a lower specificity in identifying bezoars. A high index of suspicion is therefore necessary especially when managing higher risk patients.

scholarly journals Gastric Bezoar - A Rare Presentation in Infant

2016 ◽  
Vol 6 (1) ◽  
pp. 24-27
Author(s):  
MTH Siddiqui ◽  
Mohammad Mahabubul Alam ◽  
AM Shahinur ◽  
AKM Zahid Hossain ◽  
Gazi Zahirul Hasan
Keyword(s):  
Differential Diagnosis ◽  
Ct Scan ◽  
Contrast Medium ◽  
Medium Study ◽  
Rare Presentation ◽  
Contrast Enhanced Ct ◽  
Gastric Bezoar ◽  
Contrast Enhanced ◽  
Enhanced Ct ◽  
Upper Abdominal

Gastric bezoar in neonate is a rare presentation. Because of rarity of phytobezoar and lactobezoar are not considered as the differential diagnosis of a lump and vomiting commonly. A 7 month female presented with left upper abdominal undifferentiated hard mobile lump and post prandial occasional vomiting. Diagnosis was non-conclusive with USG, contrast medium study of stomach and duodenum and contrast enhanced CT scan. After laparotomy and gastrostomy mass was removed and diagnosed as phytolactobezoar on macroscopic appearance.J. Paediatr. Surg. Bangladesh 6(1): 24-27, 2015 (Jan)

scholarly journals Differentiation of renal angiomyolipoma without visible fat from small clear cell renal cell carcinoma by using specific region of interest on contrast-enhanced CT: a new combination of quantitative tools

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Xu Wang ◽  
Ge Song ◽  
Haitao Jiang
Keyword(s):  
Quantitative Data ◽  
Prediction Models ◽  
Clear Cell ◽  
Demographic Data ◽  
Region Of Interest ◽  
Renal Angiomyolipoma ◽  
Cell Renal Cell Carcinoma ◽  
Contrast Enhanced Ct ◽  
Contrast Enhanced ◽  
Enhanced Ct

Abstract Background To investigate the value of using specific region of interest (ROI) on contrast-enhanced CT for differentiating renal angiomyolipoma without visible fat (AML.wovf) from small clear cell renal cell carcinoma (ccRCC). Methods Four-phase (pre-contrast phase [PCP], corticomedullary phase [CMP], nephrographic phase [NP], and excretory phase [EP]) contrast-enhanced CT images of AML.wovf (n = 31) and ccRCC (n = 74) confirmed by histopathology were retrospectively analyzed. The CT attenuation value of tumor (AVT), net enhancement value (NEV), relative enhancement ratio (RER), heterogeneous degree of tumor (HDT) and standardized heterogeneous ratio (SHR) were obtained by using different ROIs [small: ROI (1), smaller: ROI (2), large: ROI (3)], and the differences of these quantitative data between AML.wovf and ccRCC were statistically analyzed. Multivariate regression was used to screen the main factors for differentiation in each scanning phase, and the prediction models were established and evaluated. Results Among the quantitative parameters determined by different ROIs, the degree of enhancement measured by ROI (2) and the enhanced heterogeneity measured by ROI (3) performed better than ROI (1) in distinguishing AML.wovf from ccRCC. The receiver operating characteristic (ROC) curves showed that the area under the curve (AUC) of RER_CMP (2), RER_NP (2) measured by ROI (2) and HDT_CMP and SHR_CMP measured by ROI (3) were higher (AUC = 0.876, 0.849, 0.837 and 0.800). Prediction models that incorporated demographic data, morphological features and quantitative data derived from the enhanced phase were superior to quantitative data derived from the pre-contrast phase in differentiating between AML.wovf and ccRCC. Among them, the model in CMP was the best prediction model with the highest AUC (AUC = 0.986). Conclusion The combination of quantitative data obtained by specific ROI in CMP can be used as a simple quantitative tool to distinguish AML.wovf from ccRCC, which has a high diagnostic value after combining demographic data and morphological features.

scholarly journals CONTRAST-ENHANCED COMPUTED TOMOGRAPHIC CHOLANGIOGRAPHY IN DIFFERENTIAL DIAGNOSIS OF THE MALIGNANT AND BENIGN CAUSES OF BILIARY OBSTRUCTION

2021 ◽  
Vol 20 (4) ◽  
pp. 39-48
Author(s):  
V. V. Zarubin ◽  
A. P. Kurazhov ◽  
V. D. Zavadovskaja ◽  
O. V. Rodionova ◽  
O. S. Tonkikh ◽  
...  
Keyword(s):  
Differential Diagnosis ◽  
Obstructive Jaundice ◽  
Biliary Obstruction ◽  
Imaging Techniques ◽  
Endoscopic Retrograde ◽  
Diagnostic Efficacy ◽  
Contrast Enhanced Ct ◽  
Contrast Enhanced ◽  
Enhanced Ct ◽  
Diagnostic Imaging Techniques

Introduction. Determination of the cause of cholestasis and treatment of patients with obstructive jaundice syndrome remains challenging owing to the steady rise in diseases of the hepatopancreatoduodenal zone and the high frequency of diagnostic errors. In the differential diagnosis of the causes of obstructive jaundice, diagnostic imaging techniques are of the greatest importance. In the world literature, there are few reports on the assessment of the diagnostic potential of multispiral computed tomography under conditions of direct contrasting of the biliary tree using endoscopic retrograde cholangiopancreatography, percutaneous transhepatic cholangiography, or through pre-installed palliative drainage in the bile ducts. There is no generally accepted algorithm for determining the causes of biliary obstruction. It leads to ineffective use of various diagnostic imaging techniques, complicating the diagnostic process.The purpose of the study was to evaluate the diagnostic efficacy of contrast-enhanced ct cholangiography (ct-cg) in the differential diagnosis of causes of malignant and benign biliary obstruction in cases with obstructive jaundice syndrome.Material and methods. The study included 55 patients with obstructive jaundice, who were treated in a surgical hospital from july 2016 to july 2019.Results. It was found that contrast ct-cg in diagnosing the causes of biliary obstruction of both malignant and benign genesis is more informative than x-ray endoscopic retrograde cholangiopancreatography. The diagnostic efficacy of ct-cg in detecting causes of malignant biliary obstruction was: 93.3% sensitivity, 92.9% specificity, and 93.1% accuracy. The diagnostic efficacy of ct-cg in detecting causes of benign biliary obstruction was: 92.9%, 93.3% and 93.1%, respectively.Conclusion. Based on the high accuracy, contrast-enhanced ct-cg is a promising imaging technique in cases with bile duct obstruction.

Gastric perforation secondary to Rapunzel syndrome

2021 ◽  
Vol 14 (2) ◽  
pp. e240100
Author(s):  
Jamaall Jackman ◽  
Gael R Nana ◽  
James Catton ◽  
Ioannis Christakis
Keyword(s):  
Emergency Department ◽  
Differential Diagnosis ◽  
Gastric Perforation ◽  
Uneventful Recovery ◽  
Free Fluid ◽  
Rapunzel Syndrome ◽  
Contrast Enhanced Ct ◽  
Contrast Enhanced ◽  
Enhanced Ct

Rapunzel syndrome is rare and describes a trichobezoar that extends through the pylorus into the jejunum, ileum or even the colon. Due to the large intraluminal size and weight they can attain, acute presentations of obstruction or perforation may occur. We report a case of a 17-year-old girl who presented to the emergency department following a syncopal episode. On examination, a left upper quadrant mass was appreciated with no signs of peritonism. Contrast-enhanced CT demonstrated a giant trichobezoar with resulting gastric perforation and intra-abdominal free fluid. Laparotomy and gastrotomy were performed and the patient had an uneventful recovery with psychiatric review prior to discharge. Though uncommon, bezoars should be included in our differential diagnosis as they can present in various ways owing to their size and weight. This case illustrates the risk of gastric perforation with large gastric bezoars.

scholarly journals Upper Tract Transitional Carcinoma: An Array of Imaging Conundrum

2020 ◽  
Vol 18 (2) ◽  
Author(s):  
Raihanah Haroon ◽  
Siti Kamariah Che Mohamed ◽  
Khairunisa Ahmad Affandi
Keyword(s):  
Urothelial Carcinoma ◽  
Histopathological Analysis ◽  
Distinctive Features ◽  
Upper Tract ◽  
Contrast Enhanced Ct ◽  
Contrast Enhanced ◽  
Enhanced Ct ◽  
Carcinoma Of The Bladder ◽  
The Right

Case report: We report a 38-year-old gentleman who presented with painless haematuria for 6-months duration. Contrast-enhanced CT renal revealed a large, calcified intrapelvic mass with calyceal extension confined within the right kidney with moderate pelvicalyceal dilatation but no evidence of synchronous lesion elsewhere. Histopathological analysis showed high grade urothelial carcinoma of the renal pelvis with invasion of the renal parenchyma. Upper tract urothelial carcinoma (UTUC) which was once thought similar to urothelial carcinoma of the bladder (UCB), is increasingly being recognized as a different entity. However, heterogenous array of imaging manifestations of UTUC is also increasingly being encountered and pose diagnostic challenges though UTUC is not as prevalent as UCB which is easier to diagnose. Despite distinctive features against renal cell carcinoma (RCC), UTUC may mimic numerous other renal pathology especially the benign ones hence imaging plays a pivotal role to ascertain the diagnosis. This disease is usually treated with radical nephroureterectomy with superadded neoadjuvant chemotherapy for high risk cases. Less invasive endoscopic resection is also offered in certain cases but stringent surveillance of the whole urinary tract as well as post-operative follow-up are mandatory.

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