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 Percutaneous CT Guided Vertebral Biopsy: Anatomy and Technical Considerations

2021 ◽  
Author(s):  
Kunal Bharat Gala ◽  
Nitin S. Shetty ◽  
Amit Kumar Janu ◽  
Neeraj Shetty ◽  
Suyash S. Kulkarni
Keyword(s):  
Age Groups ◽  
Percutaneous Biopsy ◽  
Histopathological Analysis ◽  
Histopathological Diagnosis ◽  
Microbiological Analysis ◽  
Ct Guided ◽  
Image Guided ◽  
Multiple Cores ◽  
Ct Guided Biopsy ◽  
Vertebral Biopsy

AbstractIn this review article, the authors discuss the anatomy and technical aspects of CT-guided biopsy of vertebral lesions. CT guidance is highly useful for vertebral biopsies, as the anatomy of the spine is complex and varies widely across the levels. Prebiopsy imaging should be reviewed and later correlated with the final histopathological diagnosis. The majority of the spine biopsies are performed under local anesthesia, except those in critical locations and pediatric age groups. The biopsy sample is sent for histopathological analysis and/or microbiological analysis depending on the indications. It is preferable to use a coaxial system for biopsies, so multiple cores can be obtained with a single needle puncture, thus minimizing the negative yield and complications. Complications after image-guided percutaneous biopsy are rare and can be managed easily.

scholarly journals Percutaneous CT-Guided Biopsy of the Craniovertebral Junction: Safety, Diagnostic Yield, and Technical Notes

Diagnostics ◽  
2022 ◽  
Vol 12 (1) ◽  
pp. 168
Author(s):  
Paolo Spinnato ◽  
Eugenio Rimondi ◽  
Giancarlo Facchini
Keyword(s):  
Diagnostic Yield ◽  
Percutaneous Biopsy ◽  
Craniovertebral Junction ◽  
Vital Statistics ◽  
Bone Lesions ◽  
Histopathological Diagnosis ◽  
Ct Guided ◽  
Guided Biopsy ◽  
Ct Guided Biopsy ◽  
Prostate Cancers

The craniovertebral junction defined as the occiput, the atlas, and the axis is a complex bony region that contains vital neural and vascular structures. We report the experience of a single academic institution regarding CT-guided biopsy of this skeletal region. We reviewed all of the CT-guided biopsies performed in our department, completed in the craniovertebral junction. We collected data in regard to biopsy procedures, patients’ vital statistics, and histopathological diagnosis. In total, 16 patients (8M and 8F; mean age 52; range 16–86 years old) were included in this series. In eight patients, the lesions were located in the atlas vertebra (8/16—50%), in six patients in the axis (37.5%), and in two patients in the occiput (12.5%). No complications were observed during or after the procedures. All of the procedures were technically successful. The biopsy was diagnostic in 13/16 patients (81.3%): four metastatic lesions (25%—three breast and one prostate cancers), four multiple myeloma bone lesions (25%), three aneurismal bone cysts (18.8%), one aggressive hemangioma (6.3%), and one pseudogout (6.3%). Moreover, in two-thirds (66.6%) of non-diagnostic histological reports, malignancies were excluded. CT-guided percutaneous biopsy is a safe tool and allows obtaining a histological diagnosis, in most cases, even in the most delicate site of the human skeleton—the craniovertebral junction.

Ectopic spleen presenting as a slowly enlarging lung nodule in the right lower lobe following gastric pull up operation

2021 ◽  
Vol 14 (2) ◽  
pp. e237912
Author(s):  
Anas Alfahad ◽  
Rima Hussain ◽  
Mamatha Devaraj ◽  
Alexandr Svec
Keyword(s):  
Case Report ◽  
Oesophageal Cancer ◽  
Lung Nodule ◽  
Lower Lobe ◽  
Ct Guided ◽  
Ectopic Spleen ◽  
Guided Biopsy ◽  
Ct Guided Biopsy ◽  
The Right ◽  
Gastric Pull Up

This is a case report of an elderly man who was investigated at our respiratory clinic for slowly enlarging right lower lobe lung nodule on the background of oesophageal cancer diagnosed more than 11 years ago with gastric pull up. CT guided biopsy confirms the diagnosis of intrathoracic ectopic spleen.

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 Sacral Tuberculosis: An Atypical Manifestation

2018 ◽  
Vol 17 (1) ◽  
Author(s):  
Faisal Amir Si Mirah ◽  
Ahmad Faizal Roslan ◽  
Ed Simor Khan Mor Japar Khan ◽  
Rajandra Kumar Karupiah ◽  
Zamzuri Zakaria @ Mohamad
Keyword(s):  
Correct Diagnosis ◽  
Lower Limbs ◽  
Mantoux Test ◽  
Ct Guided ◽  
Walking Aids ◽  
Grade 5 ◽  
History Of ◽  
Prolapsed Intervertebral Disc ◽  
The Right ◽  
High Index Of Suspicion

Sacral tuberculosis (TB) is extremely rare and its unusual entity might delay the diagnosis and treatment of this treatable disease. A 38-year-old lady presented with a 1 year history of lower back pain with radiculopathy more to right lower limb. The patient was initially treated as Prolapsed Intervertebral Disc (PID), but showed no improvement despite regular physiotherapy and medication. Subsequently, the pain was confined to the right gluteal area and became more severe. Quality of life was impaired in which patient started using walking aids and stopped working. There was a weight loss of 20kg. No other symptom of TB infection or history of contact with TB patient. Bowel and urinary functions were normal. Examination showed localized tenderness at the right gluteal area. Neurological assessment of both lower limbs were MRC grade 5. Blood investigations were normal including the ESR level (17mm/hour). Mantoux test was positive with 18mm induration. MRI revealed a large rim enhancing paravertebral collection at pre-sacral space which extended into bilateral piriformis and gluteal muscles. The patient underwent CT-guided drainage of both gluteals and specimens taken to confirm the diagnosis of TB. Patient showed significant improvement clinically within 1 week after the drainage procedure and initiation of antituberculous chemotherapy. The initial presentation of this patient mimics PID due to irritation of sciatic nerve at piriformis level. However a change in the presentation and failure of conservative treatment should raise a high index of suspicion and necessitates further investigation to establish correct diagnosis hence proper treatment can be initiated.

scholarly journals Laryngeal gout mimicking chondrosarcoma with concurrent longus colli tendinitis

2019 ◽  
Vol 12 (10) ◽  
pp. e231070
Author(s):  
Si Ying Chrisanda Lee ◽  
Yijin Jereme Gan ◽  
Julian Park Nam Goh ◽  
Yong Howe Ho ◽  
Ming Yann Lim
Keyword(s):  
Ct Scan ◽  
Thyroid Cartilage ◽  
Open Biopsy ◽  
Mri Scan ◽  
Ct Guided ◽  
Standardised Uptake Value ◽  
Positron Emission ◽  
Longus Colli ◽  
Ct Guided Biopsy ◽  
The Right

A 42-year-old man with multiple comorbidities, including gout, presented to the emergency department with severe odynophagia for 4 days with intermittent dysphagia for 1–2 months. A CT scan of the neck showed right longus colli tendinitis and partially calcified excrescences from the right thyroid cartilage which raised suspicion of a cartilaginous tumour. He underwent an MRI scan of the neck to better evaluate the thyroid cartilage findings, which showed a heterogeneous mass suspicious for a chondroid tumour. He then underwent a positron-emission tomography-CT scan which showed a fluorodeoxyglucose-avid mass containing foci of calcification involving the right thyroid cartilage and adjacent strap muscle, with high standardised uptake value of 7.7. He subsequently underwent a CT-guided biopsy and an open biopsy of the right thyroid cartilage, and the results revealed gouty tophi. To our knowledge, this is the first reported case of laryngeal gout with longus coli tendinitis, both of which are rare conditions.

Extraordinarily Large Malignant Extra Gastro Intestinal Stromal Tumor Presenting as an Abdominal Mass

2019 ◽  
Vol 2 (2) ◽  
pp. 84-87
Author(s):  
P Paudyal ◽  
TN Subba ◽  
A Pradhan ◽  
S Dhakal ◽  
S Karki ◽  
...  
Keyword(s):  
Gastrointestinal Stromal Tumors ◽  
Histopathological Examination ◽  
Abdominal Mass ◽  
Correct Diagnosis ◽  
Standard Technique ◽  
Gastrointestinal Neoplasms ◽  
Epithelial Tumor ◽  
Stromal Tumors ◽  
Cut Surface ◽  
Histology And Immunohistochemistry

Background: Gastrointestinal stromal tumors (GIST) are rare of all gastrointestinal neoplasms with histology and immunohistochemistry similar to gastrointestinal stromal tumors. They occur outside the gastrointestinal tract rarely and are, hence, called the extra gastrointestinal stromal tumors (EGIST). Herein, we report a rare case of malignant extra intestinal gastrointestinal tumor. Case report: A 39 yr old female presented to the surgical OPD with a lump in the abdomen since 4 months. We received a lobulated tumor which measured 40x25x20 cm3 and showed capsule. Cut surface was predominantly solid, grey white with areas of hemorrhage and necrosis along with cystic areas. Histopathology and immunohisto chemistry revealed it to be a malignant EGIST of mesentery because of no continuity of the tumor with the small intestine microscopically. Conclusion: EGIST is a rare no epithelial tumor of mesentery. Omentum histopathological examination is a standard technique to diagnose the tumor and to differentiate it immunohistochemically from other tumors having similar morphology. Correct diagnosis plays valuable role in the treatment.

Cryptogenic organising pneumonia: an unusual cause of pleuritic chest pain

2021 ◽  
Vol 14 (1) ◽  
pp. e238514
Author(s):  
Rebecca Ceci Bonello ◽  
Etienne Ceci Bonello ◽  
Christian Vassallo ◽  
Edward Giles Bellia
Keyword(s):  
Chest Pain ◽  
Inflammatory Markers ◽  
White Cell Count ◽  
Clinical Status ◽  
Lower Lobe ◽  
Pleuritic Chest Pain ◽  
Ct Guided ◽  
Atypical Pathogens ◽  
Ct Guided Biopsy ◽  
The Right

A 76-year-old woman presented with a 2-hour history of pleuritic chest pain with no other associated symptoms. Blood investigations revealed raised inflammatory markers and an elevated white cell count. On chest radiograph, an airspace shadow indicative of a consolidation was prominent. This was followed by a CT scan of her thorax which showed a spiculated lesion in the right upper lobe, a lesion in the posterior segment of the left lower lobe and mildly enlarged right hilar lymph nodes. She was started on dual antibiotic therapy; however, the patient’s clinical status and inflammatory markers did not improve. A bronchoscopy was performed which excluded malignancy and atypical pathogens. CT-guided biopsy confirmed the presence of cryptogenic organising pneumonia. Prednisolone 50 mg daily was prescribed with quick resolution of symptoms.

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.

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