CT Findings of Pulmonary Metastases from Primary Cardiac Angiosarcoma

2021 ◽  
Vol 17 ◽  
Author(s):  
Yan Chen ◽  
Xiang He ◽  
Jianfeng Shang ◽  
Nan Zhang ◽  
Xiaodan Li ◽  
...  
Keyword(s):  
Pulmonary Metastasis ◽  
Pulmonary Metastases ◽  
Mediastinal Lymph Node ◽  
Pulmonary Nodules ◽  
Maximum Diameter ◽  
Imaging Features ◽  
Cardiac Angiosarcoma ◽  
Contrast Enhanced Ct ◽  
Contrast Enhanced ◽  
The Right

Background: Primary cardiac angiosarcoma is a rare malignancy with high predilection to involve surrounding structures such as pulmonary metastases. We analysed the chest computed tomography (CT) imaging features of patients diagnosed with primary cardiac angiosarcoma with pulmonary metastases in this study. Methods: This study retrospectively reviewed 12 patients with confirmed primary cardiac angiosarcoma, out of which eight (all men) with pulmonary metastasis were included in the analysis. The patients’ age ranged from 17 to 74 (mean: 48) years. CT was performed in all patients with unenhanced, contrast-enhanced, and both scans were done in 1, 3 and 4 patients, respectively. Results: Nodular lesions were observed in 7 patients with multiple solid nodules observed in 6 out of 7 patients. A solitary solid nodule was found in the remaining patient in the upper lobe and apical segment of the right lung with a diameter of 11.7 mm. All solid nodules were distributed along with bronchovascular bundles in the lungs, and their maximum diameter ranged from 2.3 to 19.9 mm. Nodules larger than 10 mm in diameter were heterogeneously enhanced on contrast-enhanced CT images (5/8 patients), whereas those smaller than 10 mm were homogeneously enhanced (3/8 patients). Other imaging features, namely the tree-in-bud pattern, emphysema, pleural effusion, and mediastinal lymph node enlargement, were observed in 4, 3, 3, and 2 patients, respectively. Conclusion: CT enhancement features of pulmonary metastasis in patients with primary cardiac angiosarcoma depend on the size of pulmonary nodules, with larger ones being heterogeneous and smaller ones homogeneous. Other signs are less noticed.

scholarly journals Clinical and Imaging Features of Primary Cardiac Angiosarcoma

Diagnostics ◽  
2020 ◽  
Vol 10 (10) ◽  
pp. 776
Author(s):  
Yan Chen ◽  
Yu Li ◽  
Nan Zhang ◽  
Jianfeng Shang ◽  
Xiaodan Li ◽  
...  
Keyword(s):  
Superior Vena ◽  
Vena Cava ◽  
Tumor Location ◽  
Imaging Features ◽  
Enhancement Pattern ◽  
Cardiac Angiosarcoma ◽  
Contrast Enhanced Ct ◽  
Mri Features ◽  
T1 And T2 ◽  
The Right

This study aims to explore computed tomography (CT) and magnetic resonance imaging (MRI) features of patients diagnosed with primary cardiac angiosarcoma. The study involved the analysis of 12 patients diagnosed with primary cardiac angiosarcoma who underwent non-contrast (8/12) or contrast-enhanced CT (10/12) or MRI (4/12). Imaging appearances, including the tumor location and adjacent infiltration, were analyzed. All 12 lesions were located in the right atrium with a broad base. Adjacent invasion including the tricuspid valve and right ventricle (2/12), inferior or superior vena cava (2/12), pericardium (10/12), and right coronary artery (7/12) was common. On unenhanced CT scans, tumors in two patients were homogeneous in density, whereas the others were inhomogeneous. Ten patients showed heterogeneous enhancement. The enhancement pattern showed no direct correlation with the differentiation degree of the tumor. Four lesions manifested as heterogeneous intensity, with hyperintense hemorrhage foci on both T1- and T2-weighted MRI. Three showed rim enhancement and one showed patchy enhancement. Primary cardiac angiosarcoma often involves the right side of the heart with infiltration of peripheral structures. CT features include typical inhomogeneous density on unenhanced scans and heterogeneous centripetal enhancement on enhanced scans. A cauliflower-like appearance on both T1- and T2-weighted MRI is common. The characteristic enhancement pattern of MRI remains to be determined.

scholarly journals Ultrasound and CT imaging features in a patient with salivary duct carcinoma of the parotid gland: a case report with literature review.

2015 ◽  
Vol 17 (1) ◽  
pp. 119
Author(s):  
Diana Ioana Fenesan ◽  
Manuela Lenghel ◽  
Grigore Baciut ◽  
Sergiu Vacaras ◽  
Carolina Botar-Jid ◽  
...  
Keyword(s):  
Parotid Gland ◽  
Lymph Nodes ◽  
Ct Imaging ◽  
Salivary Duct Carcinoma ◽  
Imaging Features ◽  
Salivary Duct ◽  
Duct Carcinoma ◽  
Contrast Enhanced Ct ◽  
Contrast Enhanced ◽  
Mass Expansion

The aim of this paper was to present the ultrasound (US) and computed tomography (CT) appearance of a patient with salivary duct carcinoma of the parotid gland. US showed a voluminous mass of the parotid gland, with multiple calcifications. Furthermore, it revealed regional multiple lymph nodes with malignant characters. Sonoelastography of the lesion and lymph nodes detected increased rigidity. Contrast enhanced CT scan of the neck completed the data description regarding the mass expansion and invasion of surrounding tissues. US and CT imaging features played a key role in establishing the malignant character of the mass and lymph nodes.

scholarly journals Pulmonary Nodule in a Patient with Oral and Lung Cancer: Cryptococcus Infection

2019 ◽  
Vol 7 (4) ◽  
pp. 102
Author(s):  
Yamagata ◽  
Hirano ◽  
Kanno ◽  
Uchida ◽  
Fukuzawa ◽  
...  
Keyword(s):  
Lung Cancer ◽  
Mediastinal Lymph Node ◽  
Left Lung ◽  
Pulmonary Nodules ◽  
Pulmonary Cryptococcosis ◽  
Thoracoscopic Resection ◽  
Inferior Lobe ◽  
Primary Lung Tumors ◽  
Oral Cancer Patients ◽  
The Right

Pulmonary nodules are frequently considered to be a metastatic disease or primary lung tumors in oral cancer patients. We present a case of pulmonary cryptococcosis in a 68-year-old man with oral and lung cancer. This lung cancer was treated with thoracoscopic resection of the right inferior lobe and mediastinal lymph node dissection. Lower gingival cancer was treated with a mandibulectomy, neck dissection, and reconstruction after chemoradiotherapy. A 20 mm cavitary nodule appeared at the left lung S6 one-month after surgery, during post-operative computed tomography. Thoracoscopic partial resection of the left inferior lobe was performed under the suspicion of lung metastasis. Pathology results revealed a pseudo-epithelial granuloma with necrosis and many yeast-shaped fungi with capsules. A pathological diagnosis of Cryptococcus infection was made. The patient was prescribed the antifungal agent fosfluconazole, which was administered intravenously for 1 week and intraoral fluconazole for 12 months. No recurrence of the Cryptococcus infection has been noted after 1.5 years.

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 Comparative accuracy and cost-effectiveness of dynamic contrast-enhanced CT and positron emission tomography in the characterisation of solitary pulmonary nodules

Thorax ◽  
2021 ◽  
pp. thoraxjnl-2021-216948
Author(s):  
Fiona J Gilbert ◽  
Scott Harris ◽  
Kenneth A Miles ◽  
Jonathan R Weir-McCall ◽  
Nagmi R Qureshi ◽  
...  
Keyword(s):  
Cost Effectiveness ◽  
Diagnostic Accuracy ◽  
Pulmonary Nodules ◽  
Solitary Pulmonary Nodules ◽  
Contrast Enhanced Ct ◽  
Positron Emission ◽  
Contrast Enhanced ◽  
Pet Ct ◽  
Enhanced Ct ◽  
Sensitivity Specificity

IntroductionDynamic contrast-enhanced CT (DCE-CT) and positron emission tomography/CT (PET/CT) have a high reported accuracy for the diagnosis of malignancy in solitary pulmonary nodules (SPNs). The aim of this study was to compare the accuracy and cost-effectiveness of these.MethodsIn this prospective multicentre trial, 380 participants with an SPN (8–30 mm) and no recent history of malignancy underwent DCE-CT and PET/CT. All patients underwent either biopsy with histological diagnosis or completed CT follow-up. Primary outcome measures were sensitivity, specificity and overall diagnostic accuracy for PET/CT and DCE-CT. Costs and cost-effectiveness were estimated from a healthcare provider perspective using a decision-model.Results312 participants (47% female, 68.1±9.0 years) completed the study, with 61% rate of malignancy at 2 years. The sensitivity, specificity, positive predictive value and negative predictive values for DCE-CT were 95.3% (95% CI 91.3 to 97.5), 29.8% (95% CI 22.3 to 38.4), 68.2% (95% CI 62.4% to 73.5%) and 80.0% (95% CI 66.2 to 89.1), respectively, and for PET/CT were 79.1% (95% CI 72.7 to 84.2), 81.8% (95% CI 74.0 to 87.7), 87.3% (95% CI 81.5 to 91.5) and 71.2% (95% CI 63.2 to 78.1). The area under the receiver operator characteristic curve (AUROC) for DCE-CT and PET/CT was 0.62 (95% CI 0.58 to 0.67) and 0.80 (95% CI 0.76 to 0.85), respectively (p<0.001). Combined results significantly increased diagnostic accuracy over PET/CT alone (AUROC=0.90 (95% CI 0.86 to 0.93), p<0.001). DCE-CT was preferred when the willingness to pay per incremental cost per correctly treated malignancy was below £9000. Above £15 500 a combined approach was preferred.ConclusionsPET/CT has a superior diagnostic accuracy to DCE-CT for the diagnosis of SPNs. Combining both techniques improves the diagnostic accuracy over either test alone and could be cost-effective.Trial registration numberNCT02013063

scholarly journals Clinical Analysis of Video-Assisted Thoracoscopic Surgery for Resection of Solitary Pulmonary Nodules and Influencing Factors in the Diagnosis of Benign and Malignant Nodules

2021 ◽  
Vol 2021 ◽  
pp. 1-7
Author(s):  
Hongxu Yue ◽  
Kaijie Fan ◽  
Zhimin Zhang ◽  
Yang Liu
Keyword(s):  
Single Port ◽  
Thoracoscopic Surgery ◽  
Pulmonary Nodules ◽  
Operation Time ◽  
Maximum Diameter ◽  
Imaging Features ◽  
Solitary Pulmonary Nodules ◽  
Serious Adverse Events ◽  
Video Assisted ◽  
Surgical Methods

Purpose. This is a retrospective research comparing the clinical outcomes of single-hole versus multi-hole video-assisted thoracoscopic surgical (VATS) resection for solitary pulmonary nodules (SPN) and examining the factors influencing the diagnosis of benign and malignant pulmonary nodules. Method. We collected the clinical data, surgical status, outcomes, and corresponding imaging features of 317 patients with SPN who were surgically resected by VATS and diagnosed as benign or malignant by pathology in our hospital from January 2019 to December 2021. Result. Among the 317 patients, 124 (39.12%) underwent single-port VATS and 193 (60.88%) underwent multiple-hole VATS. All patients were grouped according to the different surgical methods, and their postoperative indicators were statistically analyzed. The results showed that neither the single-port VATS group nor the multi-port VATS group had any serious adverse events such as death during the perioperative period. The average operation time, intraoperative blood loss, drainage tube indwelling time, and postoperative hospital stay were significantly lower in the two groups. Statistics of postoperative pathological diagnosis showed that 98 cases (30.91%) of all nodules were benign nodules and 219 cases (69.09%) were malignant nodules, and a further single-multivariate analysis showed that age, nodule maximum diameter, lobular sign, burr sign, vascular cluster sign, and pleural depression sign were independent relevant factors for the diagnosis of benign and malignant nodules. Conclusion. VATS is less invasive and has fewer complications and is of great clinical value for both diagnosis and treatment of benign and malignant SPN. Age, maximum nodal diameter, lobar sign, burr sign, vascular set sign, and pleural depression sign were independent correlates affecting the diagnosis of benign and malignant SPN, which reminds that great attention should be paid to patients who are older and have risk factors on imaging, and early and timely active treatment or close follow-up should be carried out.

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.

scholarly journals Intracranial Meningioma with Pulmonary Metastasis in Three Dogs

1992 ◽  
Vol 29 (3) ◽  
pp. 196-202 ◽  
Author(s):  
F. Y. Schulman ◽  
J. L. Ribas ◽  
J. L. Carpenter ◽  
A. F. Sisson ◽  
R. A. LeCouteur
Keyword(s):  
Central Nervous System ◽  
Nervous System ◽  
Pulmonary Metastasis ◽  
Pulmonary Nodules ◽  
Intracranial Meningioma ◽  
German Shepherd ◽  
Central Nervous System Neoplasms ◽  
German Shepherd Dog ◽  
The Right ◽  
Nervous System Neoplasms

Extracranial metastasis of primary central nervous system neoplasms is uncommon and has not been described in the dog. We report the clincopathologic features of intracranial meningioma with pulmonary metastasis in three dogs (case No. 1: 13-year-old castrated male Boxer dog; case No. 2: 14-year-old spayed female Dachshund; case No. 3: 6-year-old spayed female German Shepherd Dog). Case No. 1 presented with ataxia, lethargy, vomiting, and leaning and falling to the right, and had a transient remission following radiation and corticosteroid therapy; case No. 2 had a history of seizures that were unresponsive to primidone, left-sided postural reaction deficits, ataxia, and circling to the right; case No. 3 had only intermittent episodes of vomiting. Computed tomography of case Nos. 1 and 2 revealed peripherally located homogeneous contrast-enhancing intracranial masses. Postmortem examination revealed intracranial masses with single or multiple pulmonary nodules in all three cases. Histologically, the intracranial and pulmonary masses were meningotheliomatous meningiomas with atypical features including brain infiltration, necrosis, nuclear atypia, prominent nucleoli, and moderate cell density. All of the primary meningiomas had low mitotic rates. The current interest in early diagnosis and aggressive clinical/surgical management of canine patients with meningioma and other primary central nervous system neoplasms will likely result in an increased detection of extracranial metastases.

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