A diagnostic pitfall in hepatic mesenchymal hamartoma mimicking hepatoblastoma: A case report

2020 ◽  
Author(s):  
Zhihong Chen ◽  
Lutong Fang ◽  
Ying Zhang ◽  
Yuanzi Ye ◽  
Wenshu Ji ◽  
...  
Keyword(s):  
Blood Vessels ◽  
Female Child ◽  
Point Of View ◽  
Mesenchymal Hamartoma ◽  
Diagnostic Pitfall ◽  
First Case ◽  
Contrast Enhanced ◽  
Enhanced Ct ◽  
Vascular Channels ◽  
The Right

Abstract Background: Hepatic mesenchymal hamartoma (HMH) is an uncommon benign tumor in children. While mesenchymal hamartomas may be angiomatous and blood vessels may be identified, HMH with a malignant tumor symptom on the contrast-enhanced hepatic computed tomography angiography (CTA) has not been described. Here, we present the first case of HMH mimicking hepatoblastoma on the hepatic CTA from pathological point of view and review the imaging and histological features of this unique lesion. Case presentation: A 2-year-old female child was found a distention in the right abdomen and was admitted to our hospital. The Hepatic CTA showed that the blood vessels were thickened, the tumor blood vessels were clustered in the tumor. According to the hepatic CT findings, the tumor was considered to be malignant, possibly a hepatoblastoma. Microscopic examination showed a tumor arranged in lobules, composed of loose myxoid mesenchyme surrounding ductal structures, with intervening vascular channels. The Immunohistochemical staining revealed positive CK7 and CD34 for the bile duct elements and the lining endothelial cells of the vascular channels. There were abundant blood vessels around the nodules and the margins of remaining hepatocytes, but few in the central region. The blood vessels are small, thin-walled vessels and presented like capillaries and venules. Conclusions: A histological diagnosis of Hepatic Mesenchymal Hamartoma was confirmed by the microscopic examinations. This case adds learning points to radiologists when heterogeneous reinforcement on enhanced CT scan was presented in such a large childhood liver tumor.

Rare pulmonary embolism caused by the combination of bilateral popliteal venous aneurysms and antiphospholipid syndrome

2020 ◽  
Vol 13 (11) ◽  
pp. e236341
Author(s):  
Tomoki Fukui ◽  
Nobuyuki Ogasawara ◽  
Shinji Hasegawa
Keyword(s):  
Pulmonary Embolism ◽  
Antiphospholipid Syndrome ◽  
Venous Aneurysm ◽  
Renal Infarction ◽  
Antiphospholipid Antibody ◽  
First Case ◽  
Contrast Enhanced Ct ◽  
Contrast Enhanced ◽  
Enhanced Ct ◽  
The Right

Popliteal venous aneurysm (PVA) and antiphospholipid syndrome (APS) are under-recognised as potential causes of pulmonary embolism (PE). A 66-year-old woman presented with progressive shortness of breath. A contrast-enhanced CT revealed bilateral PE, a small renal infarction and bilateral PVAs. Direct oral anticoagulant (DOAC) therapy was initiated immediately for venous thrombosis. Given the positivity for serum antiphospholipid antibody (aPL) in an initial blood test, low-dose aspirin was included to prevent further arterial thrombosis. Her symptoms resolved and she was discharged 1 week later. Twelve weeks later, she was diagnosed with APS because of persistent aPL. Surgical resection of the right PVA was performed 1 year later from her hospitalisation. To the best of our knowledge, this is the first case of PE caused by the combination of bilateral PVAs and APS. This report emphasises the importance of careful screening to identify PE causes, and its optimal management.

My Point of View: An Outrageous Affair

2017 ◽  
Keyword(s):  
Criminal Court ◽  
Point Of View ◽  
First Case ◽  
Long Time ◽  
The Right

To the Presiding Judge of the 26th Chamber:Having been informed by Marie Bataille of the situation which, after two years of proceedings, will take her before the criminal court, I wish to convey to you my point of view about this affair.For a long time I have been an activist for voluntary motherhood. I believe that a woman has the right to choose to have or to not have a child, and in the first case, to choose the father of her child. Therefore I welcomed the recent law on abortion and before that, the 1972 law on filiation, which requires that the child be recognized in its biologic and sociologic reality....

scholarly journals Misdiagnosis of Rectus Abdominis Abscess Owing to Delayed Contrast-Enhanced Computed Tomography

2021 ◽  
Author(s):  
Yuichiro Nagase ◽  
Yukinori Harada
Keyword(s):  
Computed Tomography ◽  
Laboratory Tests ◽  
Rectus Abdominis ◽  
Rectus Abdominis Muscle ◽  
Contrast Enhanced Ct ◽  
Contrast Enhanced ◽  
Enhanced Ct ◽  
The Right ◽  
Enhanced Computed Tomography ◽  
Contrast Enhanced Computed Tomography

A 77-year-old man, who was on anticoagulation, presented with a painful lump on the right abdominal wall. Laboratory tests showed slight anaemia and elevated inflammatory markers. Abdominal plain computed tomography (CT) revealed a mass in the right rectus abdominis muscle. He was admitted with a diagnosis of primary rectus abdominis haematoma. However, on the next day, the diagnosis was corrected to primary rectus abdominis abscess, following contrast-enhanced CT of the abdomen. This case illustrates the importance of considering primary rectus abdominis abscess in patients with suspected primary rectus abdominis haematoma, and contrast should be used when performing CT.

scholarly journals Confirmed child patient with covid-19 infection, opperated for associated surgical pathology – first pediatric case in Romania

2020 ◽  
Vol 25 (6) ◽  
pp. 2107-2110
Author(s):  
DANIEL-OVIDIU COSTEA ◽  
◽  
FLORIN-DANIEL ENACHE ◽  
RADU BAZ ◽  
ADRIAN PAUL SUCEVEANU ◽  
...  
Keyword(s):  
Clinical Picture ◽  
Viral Infections ◽  
Female Child ◽  
Point Of View ◽  
Surgical Pathology ◽  
Pediatric Case ◽  
X Ray ◽  
First Case ◽  
Child Patient ◽  
Coronavirus Infection

Background: The year 2020 will remain in history as a challenge for the humanity due to the pandemic situation caused by the Coronavirus – COVID-19 disease. The virus spread rapidly throughout the world, affecting people of all ages including children. Objectives: The purpose of the research was to present the first case in Romania of a child infected with COVID-19, operated for associated surgical pathology. Materials and Methods: The case presented in this paper is a 6 years and 9 months old female child with COVID-19 infection admitted in the Clinic of Pediatric Surgery of Constanta Emergency County Hospital and operated for a peritonitis with appendicular abscess. In the last 7 days she presented transient abdominal pain with episodes of fever that referred to antipyretics. Results: From a surgical point of view, the case is ordinary, without possible redoubtable complications but the clinical picture was atypical due to coronavirus infection. The viral infection did not have a symptomatic history, as in most adult cases, but the lung x-ray showed infectious changes, which is why she was tested for potential COVID-19 infection, with a positive result. Conclusion: The case showed the clinical picture of atypical coronavirus infection in children. Viral infections in children have more abdominal tropism, with mesenteric lymphadenitis, which in some cases can lead to appendicular inflammation with secondary appendicitis. Undiagnosed in time, it can be complicated by peritonitis and any other type of appendicular infectious pathology.

scholarly journals Bony cystic lesion with associated submandibular lymphadenopathy on a background of breast carcinoma: an unexpected case of cervicofacial actinomycosis

2020 ◽  
Vol 13 (4) ◽  
pp. e232850
Author(s):  
Lwazi Sibanda ◽  
Emma Wates ◽  
James Higginson
Keyword(s):  
Breast Carcinoma ◽  
Maxillofacial Surgery ◽  
Oral And Maxillofacial Surgery ◽  
Incision And Drainage ◽  
Contrast Enhanced Ct ◽  
Contrast Enhanced ◽  
Enhanced Ct ◽  
Bony Metastases ◽  
The Right

Actinomycosis is an uncommon, chronic suppurative granulomatous infection and needs to be considered as a differential diagnosis. A 56-year-old woman with a background of type 2 diabetes mellitus and breast carcinoma was referred to the Oral and Maxillofacial Surgery 2-week wait clinic, regarding a tender sublingual mass and firm erythematous swelling in the right submandibular and submental region. This was slowly progressive and had not responded to oral co-amoxiclav. An orthopantomogram showed a well-defined radiolucency and smaller radiolucent lesions throughout the edentulous right body of the mandible. A contrast-enhanced CT confirmed a right submandibular abscess communicating with cavitating lesions. The differentials included osteomyelitis, bony metastases, multiple myeloma or other cystic lesions. The patient underwent incision and drainage of the abscess, alongside biopsies, and intravenous co-amoxiclav was given. Microbiology cultures confirmed the presence of Actinomyces israelii and a diagnosis of cervicofacial actinomycosis with mandibular osteomyelitis. The patient was successfully treated with prolonged antibiotics.

scholarly journals Resolution of grade IV hypertensive retinopathy in an adult with pheochromocytoma: post-tumor resection

2020 ◽  
Vol 13 (2) ◽  
pp. e231245
Author(s):  
Aparajita Banerjee ◽  
Bhagabat Nayak ◽  
Gargi Verma ◽  
Sucheta Parija
Keyword(s):  
Blood Pressure ◽  
Tumor Resection ◽  
Hypertensive Retinopathy ◽  
Corrected Visual Acuity ◽  
Contrast Enhanced Ct ◽  
Contrast Enhanced ◽  
Enhanced Ct ◽  
Hypertensive Woman ◽  
Systemic Examination ◽  
The Right

A 64-year-old hypertensive woman presented with complaints of a painless, progressive decrease in vision, headache, dizziness for the last month. She was a known case of diabetes mellitus on insulin therapy. On examination, best-corrected visual acuity was 6/12 in the right eye and 6/18 in the left eye. The fundus examination in both eyes revealed features of grade IV hypertensive retinopathy. Systemic examination revealed the raised blood pressure of 200/110 mm Hg. Diagnosis of pheochromocytoma was made on the basis of increased urinary norepinephrine (892.8 mg/dL) and mass in the left adrenal gland (measuring 31×28 mm) at contrast-enhanced CT. Medical management to control hypertension was done and ultimately, she underwent left laparoscopic adrenalectomy. After 10 months of surgery, the patient was asymptomatic, blood pressure was within normal limit and her vision improved to 6/6 in both the eyes. The retinal features of hypertensive retinopathy had completely disappeared.

Unique levoatriocardinal veins in neonates with hypoplastic left heart syndrome and intact atrial septum

2017 ◽  
Vol 28 (1) ◽  
pp. 150-152 ◽  
Author(s):  
Chiaki Iida ◽  
Jun Muneuchi ◽  
Mamie Watanabe
Keyword(s):  
Hypoplastic Left Heart Syndrome ◽  
Atrial Septum ◽  
Left Heart ◽  
Hypoplastic Left Heart ◽  
Intact Atrial Septum ◽  
Contrast Enhanced Ct ◽  
Contrast Enhanced ◽  
Enhanced Ct ◽  
The Right ◽  
Left Heart Syndrome

AbstractWe had two cases of neonates with hypoplastic left heart syndrome and intact atrial septum who had unique levoatriocardinal veins. Contrast-enhanced CT and angiography revealed that previously unknown communicating vessels ran from the top of the left atrium and drained into the right atrium. We emphasise that transcatheter atrial septostomy should be performed not through these communicating vessels but using the trans-septal approach in neonates with hypoplastic left heart syndrome and an intact atrial septum.

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