scholarly journals Hematopoietic Islands Mimicking Osteoblastic Metastases in Axial Skeleton

2021 ◽  
Author(s):  
Sophia Samira Goller ◽  
Bernd Erber ◽  
Nicola Fink ◽  
Hans Roland Dürr ◽  
Thomas Knösel ◽  
...  
Keyword(s):  
Correct Diagnosis ◽  
Axial Skeleton ◽  
Appendicular Skeleton ◽  
Imaging Findings ◽  
Ct Guided ◽  
Additional Information ◽  
Ct Guided Biopsy ◽  
Characteristic Imaging ◽  
Important Additional Information

Abstract Background. Hyperplasia of the hematopoietic bone marrow in the appendicular skeleton is common. Focal hematopoietic islands within the axial skeleton is a rare entity and can cause confusion with osteoblastic metastases. The purpose of this study was to describe the characteristic imaging findings in MRI and CT.Methods. We retrospectively analyzed the imaging findings of 14 hematopoietic islands of the axial skeleton in ten patients (nine females, median age= 65.5 years [range, 49-74]), who received both CT and MRI at the time of initial diagnosis between 2006 and 2020. In five cases CT-guided biopsy was performed to confirm the diagnosis, while the other five patients received long term MRI follow-up (median follow-up= 28 months [range, 6-96 months]). Diffusion-weighted imaging was available in three, chemical shift imaging in two, 18F fluorodeoxyglucose PET/CT in two and Technetium 99m skeletal scintigraphy in one of the patients.Results. All lesions were small (mean size=1.72 cm2) and showed moderate hypointense signals on T1- and T2-weighted MRI sequences. They appeared iso- to slightly hyperintense on STIR images and showed slight enhancement after gadolinium administration. To differentiate this entity from osteoblastic metastases, CT provides important additional information, as hematopoietic islands do not show sclerosis. Conclusions. Hematopoietic islands within the axial skeleton can occur and mimic osteoblastic metastases. However, the combination of MRI and CT allows for making the correct diagnosis.

scholarly journals Percutaneous C-Arm Free O-Arm Navigated Biopsy for Spinal Pathologies: A Technical Note

Diagnostics ◽  
2021 ◽  
Vol 11 (4) ◽  
pp. 636
Author(s):  
Masato Tanaka ◽  
Sumeet Sonawane ◽  
Koji Uotani ◽  
Yoshihiro Fujiwara ◽  
Kittipong Sessumpun ◽  
...  
Keyword(s):  
Histopathological Examination ◽  
Correct Diagnosis ◽  
Standard Technique ◽  
Percutaneous Biopsy ◽  
Technical Note ◽  
Spinal Tumors ◽  
Histopathological Diagnosis ◽  
Ct Guided ◽  
Ct Guided Biopsy ◽  
The Right

Background: Percutaneous biopsy under computed tomography (CT) guidance is a standard technique to obtain a definitive diagnosis when spinal tumors, metastases or infections are suspected. However, specimens obtained using a needle are sometimes inadequate for correct diagnosis. This report describes a unique biopsy technique which is C-arm free O-arm navigated using microforceps. This has not been previously described as a biopsy procedure. Case description: A 74-year-old man with T1 vertebra pathology was referred to our hospital with muscle weakness of the right hand, clumsiness and cervicothoracic pain. CT-guided biopsy was performed, but histopathological diagnosis could not be obtained due to insufficient tissue. The patient then underwent biopsy under O-arm navigation, so we could obtain sufficient tissue and small cell carcinoma was diagnosed on histopathological examination. A patient later received chemotherapy and radiation. Conclusions: C-arm free O-arm navigated biopsy is an effective technique for obtaining sufficient material from spine pathologies. Tissue from an exact pathological site can be obtained with 3-D images. This new O-arm navigation biopsy may provide an alternative to repeat CT-guided or open biopsy.

scholarly journals A Case of Radiation Fibrosis Appearing as Mass-Like Consolidation after SBRT with Elevation of Serum CEA

2010 ◽  
Vol 2010 ◽  
pp. 1-4 ◽  
Author(s):  
Kotaro Terashima ◽  
Yoshiyuki Shioyama ◽  
Satoshi Nomoto ◽  
Saiji Ohga ◽  
Takeshi Nonoshita ◽  
...  
Keyword(s):  
Local Recurrence ◽  
Short Interval ◽  
Primary Lung Cancer ◽  
Dorsal Side ◽  
Ct Guided ◽  
Radiation Fibrosis ◽  
Ct Guided Biopsy ◽  
Serum Cea ◽  
The Right

We report a case of radiation fibrosis appearing as mass-like consolidation, which was difficult to distinguish from local recurrence. A 72-year-old woman was diagnosed as having primary lung cancer (cT1N0M0 stage IA) in the right upper lobe and was treated with SBRT of 48 Gy in 4 fractions. After 12 months, mass-like consolidation appeared around the irradiated area, and after 13 months, it had increased in size. FDG-PET revealed high uptake (SUVmax=5.61) for the consolidation. CT-guided biopsy was performed, but we could not confirm the diagnosis. Considering her poor respiratory function and her age, short-interval follow-up was performed. After 15 months, the consolidation enlarged at the dorsal side, and carcinoembryonic antigen (CEA) became elevated (14.6 ng/mL). Serum KL-6 (436 U/mL) and SP-D (204 ng/mL) were also elevated. However, after 16 months, serum CEA slightly decreased. The consolidation gradually retracted on follow-up CT images. CEA, KL-6, and SP-D were also decreased by degrees. After 40 months, there is no evidence of local recurrence.

scholarly journals Multi Slice Computed Tomography in Assessment of Posterior Mediastinal Lesions

2021 ◽  
pp. 1-8
Author(s):  
Nora Mostafa Mohamed El Shalakany ◽  
Samah Ahmed Radwan ◽  
Abdelhady Mohamed Taha ◽  
Mohemed Fathy Dawoud
Keyword(s):  
Multidetector Ct ◽  
Incidental Finding ◽  
Correct Diagnosis ◽  
Malignant Lesion ◽  
Processing Technique ◽  
Ct Guided ◽  
Neurogenic Tumors ◽  
Characteristic Imaging ◽  
Posterior Mediastinal

Background: Posterior Mediastinal lesions are relatively common and represent 23-30% of all mediastinal lesions; 40% of these lesions are an incidental finding. Multidetector CT (MDCT) has shorter imaging time and better spatial resolution than MRI, especially in mediastinum; it is more widely available & less expensive. The additional role of CT is in performing CT guided biopsies if needed. This study aimed to evaluate the role of MSCT in the diagnosis of mediastinal lesions based on the characteristic imaging appearances, which can lead to a correct diagnosis and optimal management. The post-processing technique further improves the diagnosis and surgical planning. Patients and Methods: This study included 30 patients with posterior mediastinal lesions evaluated according to clinical data, diagnostic imaging procedure (MSCT), and histopathological evaluation. Most of the cases in this study had a lesion raised from the LN and vessels by 23.3%. Results: Metastatic lymphadenopathy was the commonest lesion in our study, 13.3%, followed by lymphoma 10.3% and neurogenic tumors 10%. Benign lesions were 60%, while the malignant lesion represents 40% of all cases. Multiple CT features of each posterior mediastinal lesion were used to predict the nearest histological diagnosis. The accuracy of MSCT in our study was 93.3%. Conclusion: MSCT has a practical and significant role in the assessment & evaluation of the posterior mediastinal lesions according to the anatomical origin, the CT feature of the lesion (solid or cystic), density, the effect on the surroundings, the distribution pattern, and extent of the lesion.

scholarly journals Aggressive Vertebral Hemangiomas Causing Compression Fracture with Neurological Deficits: A Retrospective Cohort Study

2020 ◽  
Author(s):  
Hongming Rao ◽  
Guishuang Li ◽  
Limin Liu ◽  
Yuming Huang ◽  
Zhengquan Xu ◽  
...  
Keyword(s):  
Clinical Outcomes ◽  
Body Height ◽  
Compression Fracture ◽  
Neurological Deficits ◽  
Ct Guided ◽  
Guided Biopsy ◽  
Estimated Blood Loss ◽  
Ct Guided Biopsy ◽  
Vertebral Hemangiomas

Abstract Background:In rare instances, aggressive vertebral hemangiomas (VHs) can cause compression fracture, resulting in severe pain and neurological deficits. But the diagnosis and treatment of these aggressive lesions are challenging because of these lesions are rare and atypical. This study aimed to evaluate the safety and efficacy of surgical management for aggressive VHs with vertebral compression fracture by a modified multimodality surgery.Methods:We retrospectively reviewed 6 cases suffering from aggressive VHs with compression fracture and neurological deficits in our department from July 2011 to April 2016. These patients were treated by the multimodality surgery, includingpreoperative embolization, intraoperative injection of gelfoam mixed with cement, and laminectomy decompression.The follow-up period was at least 3 years. Perioperative parameters, clinical outcomes, and radiographical data were collected and analyzed.Results: The 6 patients involved 1 male and 5 females (mean age, 52.3 years).The levels involved were: in thoracic spine (5 cases) and lumbar spine (1 case).Preoperative CT-guided biopsy was conducted in all patients, with 5 patients had definitive pathologic diagnosis. All patients were treated successfully with the multimodal surgery, with no cement leakage and other severe complications. The mean operation time was 182.2 minutes, and the estimated blood loss was 908.3 ml.At an average follow-up of 49.8 months, clinical outcomes assessed by the visual analogue scale and Frankel grade were significantly improved. The vertebral body height and kyphosis angle of the fractured vertebra were also corrected postoperatively. No affected vertebra re-fracture and adjacent vertebral fracture were developed, and none of the patients experienced recurrence of tumor at final follow-up.Conclusions:In cases of aggressive VHs causing compression fracture with neurological deficits, CT-guided biopsy is indicated for the diagnosis. The multimodality surgery (preoperative embolization, intraoperative injection of gelfoam mixed with bone cement combined laminectomy decompression) is effective and safe, and can be considered as an acceptable surgical choice.

Safety and efficacy of ketoconazole (K) in patients (pts) with metastatic castration-resistant prostate cancer (mCRPC): Contemporary experience and prognostic indicators.

2011 ◽  
Vol 29 (7_suppl) ◽  
pp. 145-145
Author(s):  
D. Keizman ◽  
P. Huang ◽  
M. A. Carducci ◽  
S. R. Denmeade ◽  
M. A. Eisenberger
Keyword(s):  
Disease Progression ◽  
Cox Regression ◽  
Axial Skeleton ◽  
Prognostic Indicators ◽  
Appendicular Skeleton ◽  
Castration Resistant Prostate Cancer ◽  
Adrenal Androgens ◽  
Steroid Synthesis ◽  
Safety And Efficacy

145 Background: Intracrine conversion of adrenal androgens to testosterone play an important role in CRPC progression. Treatments (tx) that block adrenal steroid synthesis have shown significant clinical benefits in mCRPC. Aims: To evaluate contemporary data on safety and efficacy associated with K in mCRPC. Methods: All/unselected mCRPC pts progressing on GnRH-a and antiandrogens (AA) treated with K were retrospectively analyzed. Pts were maintained on gonadal suppression, discontinued AA, and received and K 200-400 mg t.i.d. until disease progression or dose-limiting toxicity (DLT). Initial 600mg/d dose was escalated to 1,200mg/d if a PSA decrease was not seen at 3 months (mos) or if a response/subsequent progression to 600/mg/d was observed (optional). Follow up included hematological/chemical profile q 3 mos, scans upon clinical (physical exam/symptoms) or at biochemical progression (PSA increase ≥ 25% and ≥2ng/mL from nadir). A multivariate cox regression model was used to identify variables significantly associated with disease progression. Results: From 1999-2010 (mean follow up 40 mos, range 5-129), 114 m-CRPR pts were treated with K 200mg (n=82, 72%) or 400mg (n=32, 28%) tid. Most common grade 3/4 tox events (n=23) were fatigue, abdominal discomfort, nausea, and dizziness. 9 pts (8%) had DLT (fatigue n=7, hepatotoxicity/thrombocytopenia n=1). 55/114 (48%) had ≥ 50% PSA decline. Overall median time to progression (TTP) was 8 mos (range 1-129). 14 pts remain progression free > 7 mos (range 7-129). Significant prognostic factors (table) were response to prior AA (≥6 vs <6 mos), pre-tx PSADT (≥3 vs <3 mos) and extent of disease (limited-axial skeleton and/or nodal vs extensive- appendicular skeleton and/or visceral). Conclusions: K is effective and safe in m-CRPC. Prior response to AA, PSADT ≥ 3mos and limited metastatic disease is associated with TTP and further supports a therapeutic role for suppressing adrenal androgens in m-CRPC. [Table: see text] No significant financial relationships to disclose.

scholarly journals Tuberculous Spondylitis of the Craniovertebral Junction

2016 ◽  
Vol 1 (1) ◽  
pp. 31-33 ◽  
Author(s):  
Panayiotis D. Megaloikonomos ◽  
Vasilios Igoumenou ◽  
Thekla Antoniadou ◽  
Andreas F. Mavrogenis ◽  
Konstantinos Soultanis
Keyword(s):  
Craniovertebral Junction ◽  
Tuberculous Spondylitis ◽  
Mycobacterium Tuberculosis Infection ◽  
Halo Vest ◽  
Ct Guided ◽  
Antituberculous Treatment ◽  
Ct Guided Biopsy ◽  
Bony Lesions ◽  
Infection Recurrence

Abstract. Craniovertebral junction tuberculosis is rare, accounting for 0.3 to 1% of all tuberculous spondylitis cases. MR imaging is the modality of choice to detect bone involvement, abscess formation and subligamentous spreading of the pus, to differentiate from other lesions affecting the craniovertebral junction, and to determine the efficacy of treatment. Given the fact that surgical treatment of patients with craniovertebral junction tuberculosis has been associated with a high mortality rate ranging up to 10% and recurrence rate ranging up to 20%, conservative is the standard of treatment for most patients.This article presents a patient with craniovertebral junction Mycobacterium tuberculosis infection diagnosed with CT-guided biopsy. A halo vest was applied and antituberculous treatment with rifampicin, isoniazid and ethambutol was initiated. At 6-month follow-up, the patient was asymptomatic; CT of the cervical spine showed healing of the bony lesions. The halo vest was removed and physical therapy was recommended. Antituberculous treatment was continued for a total of 18 months, without any evidence of infection recurrence

scholarly journals Pancreatite Auto-Imune: O Papel da Imagem no Diagnóstico

2015 ◽  
Vol 28 (5) ◽  
pp. 667
Author(s):  
João Ressurreição ◽  
Maria Bali ◽  
Celso Matos
Keyword(s):  
Clinical Picture ◽  
Crucial Role ◽  
Correct Diagnosis ◽  
Diagnostic Process ◽  
Imaging Findings ◽  
Imaging Studies

Auto-immune pancreatitis is an uncommon and underdiagnosed pathology. Its clinical picture is not specific and the diagnosis is therefore difficult. Imaging studies have a crucial role in the diagnostic process and also in the follow-up of treatment. With the objective of emphasizing the importance of imaging in the correct diagnosis of this pathology, the authors report the case of a patient with longterm unspecific abdominal complaints that was diagnosed as auto-immune pancreatitis after laboratorial and imaging investigation. Assuming this diagnosis it was instituted treatment with oral methylprednisolone, which succeeded, with progressive resolution of the clinical, laboratorial and imaging findings.

Intracranial infections: clinical and imaging characteristics

2007 ◽  
Vol 48 (8) ◽  
pp. 875-893 ◽  
Author(s):  
B. R. Foerster ◽  
M. M. Thurnher ◽  
P. N. Malani ◽  
M. Petrou ◽  
F. Carets-Zumelzu ◽  
...  
Keyword(s):  
Correct Diagnosis ◽  
Clinical Information ◽  
Hiv Positive ◽  
Resonance Spectroscopy ◽  
Imaging Findings ◽  
Imaging Characteristics ◽  
Immunodeficiency Virus ◽  
Characteristic Imaging ◽  
The Brain ◽  
Intracranial Infections

The radiologist plays a crucial role in identifying and narrowing the differential diagnosis of intracranial infections. A thorough understanding of the intracranial compartment anatomy and characteristic imaging findings of specific pathogens, as well incorporation of the clinical information, is essential to establish correct diagnosis. Specific types of infections have certain propensities for different anatomical regions within the brain. In addition, the imaging findings must be placed in the context of the clinical setting, particularly in immunocompromised and human immunodeficiency virus (HIV)-positive patients. This paper describes and depicts infections within the different compartments of the brain. Pathology-proven infectious cases are presented in both immunocompetent and immunocompromised patients, with a discussion of the characteristic findings of each pathogen. Magnetic resonance spectroscopy (MRS) characteristics for several infections are also discussed.

The skull and skeleton of Eogyrinus attheyi Watson (Amphibia: Labyrinthodontia)

1972 ◽  
Vol 263 (851) ◽  
pp. 279-326 ◽  
Keyword(s):  
Semicircular Canals ◽  
Axial Skeleton ◽  
Significant Feature ◽  
Appendicular Skeleton ◽  
Living Animal ◽  
Allometric Growth ◽  
Left Femur ◽  
Additional Information ◽  
Size Groups ◽  
Coal Measures

As a preliminary to the redescription of the anatomy of Eogyrinus attheyi Watson, an account is given of the problems of nomenclature of British members of the anthracosaur family Eogyrinidae to which it belongs. There is no evidence to show that the four named genera of British eogyrinids differ from one another in any significant feature not explicable by allometric growth. Reconstruction of a series of allometric curves based on known skull specimens allows estimation of the dimensions of incomplete specimens. The skulls then fall into four size groups which correspond, with some stratigraphical backing, to the four named genera. The lectotype skull of Eogyrinus , from the Low Main Seam, Newsham, Northumberland, has been cleaned using an ‘ Airbrasive’ unit and is used as the basis of a new description of the skull. Additional information is provided by other Newsham specimens and two skulls from the Middle Coal Measures of Lanarkshire. The skull is completely known and is typical of anthracosaurs. The skull roof is closely similar to that of the eogyrinid Palaeoherpeton ( 'Palaeogyrinus’ )but no anterior tectal bone is present above the naris in Eogyrinu s. The nature of the dermal ornament is fully described. The palate is typically anthracosaur, with toothless vomers, a ‘ tusk-pair ’ on each palatine and ectopterygoid, and additional small ectopterygoid teeth. The pterygoids descend below the level of the jaw line posteriorly as in Palaeoherpeton . The braincase is reconstructed from an isolated Newsham specimen, originally attributed by Watson, from the lectotype and from one of the Scottish skulls. The isolated specimen shows the course of the semicircular canals as well as the fenestra ovalis. Most of the cranial nerve foramina are present. A complete reconstruction of the lower jaws is possible both as single rami and in articulation. Description of the jaw articulation allows a reconstruction of the relative movements of the rami in opening and closure. The only associated material of the appendicular skeleton is the lectotype left femur, but an interclavicle from Newsham is certainly eogyrinid and probably pertains to Eogyrinus . Isolated ventral scales are described and their pattern of articulation reconstructed. The material described in this paper is combined with that used in an earlier account of the axial skeleton to give a reconstruction of the whole skeleton of Eogyrinus in articulation, together with a restoration of the appearance of the living animal.

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.

Sign in / Sign up

Export Citation Format

Share Document