scholarly journals CERVICOFACIAL ACTINOMYCOSIS: A DIFFERENTIAL DIAGNOSIS OF MALIGNANT LESIONS

2019 ◽  
Author(s):  
DIVINO FRANÇA ◽  
ANA LUISA GARCIA GIAMBERARDINO ◽  
PATRICIA ARENAS ROCHA ◽  
VALERIA MIDORI GUTOSKI YUKI ◽  
LAURA PICCOLI SILVA GRANERO ◽  
...  
2021 ◽  
Vol 22 (Supplement_1) ◽  
Author(s):  
EC D"angelo ◽  
P Paolisso ◽  
L Bergamaschi ◽  
A Foa ◽  
I Magnani ◽  
...  

Abstract Funding Acknowledgements Type of funding sources: Public hospital(s). Main funding source(s): S. Orsola Hospital Background  Differential diagnosis of cardiac masses represents a challenging issue with important implications for therapeutic management and patient’s prognosis. Cardiac Magnetic Resonance (CMR) is a non-invasive imaging technique used to characterize morphologic and functional features of masses. Integration of these information can lead an accurate diagnosis. Purpose  To evaluate the diagnostic role of CMR in defining the nature of cardiac masses. Methods : Ninety-three patients with cardiac masses evaluated with CMR were enrolled. All masses had histological certainty. CMR sequences allowed a qualitative morphologic description as well as tissue characterization. Evaluation of masses morphology included localization, size and borders assessment, detection of potential multiple lesions and pericardial effusion. Tissue characterization resulted from an estimation of contrast enhancement - early gadolinium enhancement (EGE) and late gadolinium enhancement (LGE) sequences - and tissue homogeneity in T1 and T2 weighted acquisitions. The descriptive analysis was carried out by comparing benign vs malignant lesions as well as dividing patients into 4 subgroups: primitive benign tumours, primitive malignant tumours, metastatic tumours and pseudotumours.  Results  The descriptive analysis of the morphologic features showed that diameter > 50mm, invasion of surrounding planes, irregular margins and presence of pericardial effusion were able to predict malignancy (p < 0.001). As for tissue characteristics, heterogeneous signal intensity - independently from T1 and T2 weighted acquisitions - and EGE were more common in malignant lesions (p <0.001). When analysing the four subgroups, CMR features did not discriminate between primitive malignant masses and metastasis. Conversely, hyperintensity signal and EGE were able to distinguish benign primitive lesions from pseudotumors (p = 0.002).  Furthermore, using classification and regression tree (CART) analysis, we developed an algorithm to differentiate masses: invasion of surrounding planes was a common characteristic of malignancy and identifies itself malignant tumors. In the absence of invasive features, gadolinium enhancement was evaluated: the lack of contrast uptake was able to exclude a pseudotumor diagnosis and reduced the probability of a primary benign tumor.  Conclusions Cardiac magnetic resonance is a very powerful diagnostic tool for differential diagnosis of cardiac masses as it correctly addresses malignancy. Furthermore, an accurate evaluation of the several CMR features, may discriminate primary benign masses and pseudotumours. Abstract Figure. Benign and malignant cardiac masses


BMC Cancer ◽  
2020 ◽  
Vol 20 (1) ◽  
Author(s):  
Sihua Niu ◽  
Jianhua Huang ◽  
Jia Li ◽  
Xueling Liu ◽  
Dan Wang ◽  
...  

Abstract Background The classification of Breast Imaging Reporting and Data System 4A (BI-RADS 4A) lesions is mostly based on the personal experience of doctors and lacks specific and clear classification standards. The development of artificial intelligence (AI) provides a new method for BI-RADS categorisation. We analysed the ultrasonic morphological and texture characteristics of BI-RADS 4A benign and malignant lesions using AI, and these ultrasonic characteristics of BI-RADS 4A benign and malignant lesions were compared to examine the value of AI in the differential diagnosis of BI-RADS 4A benign and malignant lesions. Methods A total of 206 lesions of BI-RADS 4A examined using ultrasonography were analysed retrospectively, including 174 benign lesions and 32 malignant lesions. All of the lesions were contoured manually, and the ultrasonic morphological and texture features of the lesions, such as circularity, height-to-width ratio, margin spicules, margin coarseness, margin indistinctness, margin lobulation, energy, entropy, grey mean, internal calcification and angle between the long axis of the lesion and skin, were calculated using grey level gradient co-occurrence matrix analysis. Differences between benign and malignant lesions of BI-RADS 4A were analysed. Results Significant differences in margin lobulation, entropy, internal calcification and ALS were noted between the benign group and malignant group (P = 0.013, 0.045, 0.045, and 0.002, respectively). The malignant group had more margin lobulations and lower entropy compared with the benign group, and the benign group had more internal calcifications and a greater angle between the long axis of the lesion and skin compared with the malignant group. No significant differences in circularity, height-to-width ratio, margin spicules, margin coarseness, margin indistinctness, energy, and grey mean were noted between benign and malignant lesions. Conclusions Compared with the naked eye, AI can reveal more subtle differences between benign and malignant BI-RADS 4A lesions. These results remind us carefully observation of the margin and the internal echo is of great significance. With the help of morphological and texture information provided by AI, doctors can make a more accurate judgment on such atypical benign and malignant lesions.


2021 ◽  
Vol 2021 ◽  
pp. 1-4
Author(s):  
Ashwag Yagoub Aloyouny

Introduction. Palatine tonsils are part of the mucosa-associated lymphoid tissue, located in the oropharyngeal region. Although these tissues protect the body from foreign intruders, they are more prone to infections due to their anatomical structure and location. For instance, the differential diagnosis of a white lesion on the palatine tonsil can range from benign to malignant lesions. Oral lymphoepithelial cysts commonly arise as painless, yellowish nodules on the floor of the mouth and the ventral or lateral surface of the tongue. Case Presentation. This paper presents a rare case of an unusual site of a lymphoepithelial cyst (LEC) in the oral cavity. The lesion was located in the tonsil of a 20-year-old woman with a chief complaint of a painless, white lump in the back of the mouth for nine months. Discussion. The differential diagnosis of a white lesion on the palatine tonsil is caused by several factors, such as bacterial, viral, and fungal infections; trauma; stones; cysts; abscess; or cancer. In this case, both the clinical presentation and extra- and intraoral examinations were highly associated with LEC. Oral LEC etiopathogenesis is uncertain, and several theories have been proposed to discuss the causes of LEC. In addition, oral LEC could be monitored without surgical intervention if the nodule is asymptomatic. Conclusion. We emphasize the importance of a thorough clinical examination of oral and oropharyngeal lesions, which are usually neglected.


2015 ◽  
Vol 43 (01) ◽  
pp. 45-49
Author(s):  
F. Del Chicca ◽  
M. Ruetten ◽  
B. Gerber ◽  
P. Baloi

SummaryA 13-year-old domestic shorthair cat was presented with weight loss and azotemia. Abdominal ultrasound revealed a large cystic spaceoccupying lesion with multiple septae in the left kidney. A core needle biopsy yielded a renal cystadenoma originating from the epithelial cells. This report describes the clinical, ultrasonographic and computed tomographic features and the growth progression of a renal cystadenoma. We describe the first attempt to apply the human Bosniak classification to a cat with renal cystic neoplasia to differentiate between benign and malignant lesions. Cystadenoma should be a differential diagnosis in cases of renal cystic space-occupying lesions. Other differentials, imaging features to differentiate benign and malignant lesions and the risk of malignant transformation will be discussed.


Author(s):  
Liva Andrejeva ◽  
Jaime L. Geisel ◽  
Malini Harigopal

A spiculated mass is a centrally dense lesion seen on mammography with sharp lines radiating from its margin. The spicules can vary greatly in length, from a few millimeters to several centimeters. In malignant lesions, spicules represent a mixture of tumor cells and fibrosis invading the normal tissue surrounding the lesion. Although a spiculated mass is thought of as a classic finding of malignancy on mammography, ultrasound, and MRI, its differential diagnosis includes benign lesions. However, unless clinical history strongly supports a benign diagnosis, a spiculated mass on any modality typically will require additional workup and biopsy. This chapter reviews the key imaging and clinical features, imaging protocols and pitfalls, differential diagnoses, radiology–pathology correlations, and clinical management recommendations for a spiculated mass. Topics discussed include both malignant and benign masses.


2013 ◽  
Vol 2013 ◽  
pp. 1-20 ◽  
Author(s):  
Luigi Grazioli ◽  
Lucio Olivetti ◽  
Giancarlo Mazza ◽  
Maria Pia Bondioni

Hepatocellular adenomas (HCAs) are currently categorized into distinct genetic and pathologic subtypes as follows: inflammatory hepatocellular adenoma, hepatocyte-nuclear-factor-1-alpha (HNF-1α-mutated) hepatocellular adenoma, andβ-catenin-mutated hepatocellular adenomas; the fourth, defined as unclassified subtype, encompasses HCAs without any genetic abnormalities. This classification has accepted management implications due to different risks of haemorrhage and malignant transformation of the four subtypes. Imaging guided biopsy and/or surgical resection very important in obtaining definitive characterization; nevertheless, MRI with intra-extravascular and hepatobiliary (dual phase) agents, is an important tool not only in differential subtypes definition but even in surveillance with early identification of complications and discovery of some signs of HCA malignant degeneration. Inflammation, abnormal rich vascularisation, peliotic areas, and abundant fatty infiltration are pathologic findings differently present in the HCA subtypes and they may be detected by multiparametric MRI approach. Lesion enlargement and heterogeneity of signal intensity and of contrast enhancement are signs to be considered in malignant transformation. The purpose of this paper is to present the state of the art of MRI in the diagnosis of HCA and subtype characterization, with particular regard to morphologic and functional information available with dual phase contrast agents, and to discuss differential diagnosis with the most common benign and malignant lesions mimicking HCAs.


2013 ◽  
Vol 2013 ◽  
pp. 1-7 ◽  
Author(s):  
Tomasz Gorycki ◽  
Michał Studniarek

The aim of the study was to assess how realiable is differential diagnosis and prognosis for endoscopic treatment with MR signal characteristics as the qualitative parameter and magnetic resonance cholangiopancreatography (MRCP) images in cases of bile duct obstructions caused by solid masses.Material and Methods. Retrospective study of MR and MRCP images in 80 patients (mean age 58 ys) was conducted. Mean signal intensity ratio (SIR) from planar MR images and MRCP linear measurements were compared between benign and malignant lesions and in groups including the size and number of stents placed during ERCP (< 10 F <) in 51 cases in which ERCP was performed.Results. Significantly higher SIR values were encountered in malignant lesions in T2W images () and STIR T2W images (). Malignant lesions were characterised by longer strictures () and greater proximal biliary duct dilatation (). High significance for predicting ERCP conditions was found with mean SIR in STIR T2W images and stricture length.Conclusion. Probability of malignancy of solid lesions obstructing biliary duct increased with higher SIR in T2W images and with longer strictures. Passing the stricture during ERCP treatment was easier and more probable in cases of shorter strictures caused by lesions with higher SIR in STIR T2W images.


2020 ◽  
Vol 25 (1) ◽  
pp. 34-39
Author(s):  
Young Koog Cheon

Although most gallbladder (GB) polyps are benign, some early carcinomas of the GB share the same appearance as benign polyps. Currently, GB polyps larger than 1 cm should be surgically removed because of the increased risk of malignancy. Distinguishing between nonneoplastic, neoplastic, and potentially malignant lesions is a major diagnostic dilemma, and the therapeutic options for these lesions remain controversial. Endoscopic ultrasonography (EUS) is considered to be superior to conventional US for imaging GB lesions, because EUS can provide highresolution images of small lesions with higher ultrasound frequencies. However, differential diagnosis remains difficult, especially for small GB polyps. Thus, various diagnostic methods using EUS have been introduced to overcome difficulty for differential diagnosis between neoplastic and non-neoplastic polyps. Contrastenhanced harmonic EUS is useful for observing microvascular patterns and additional enhancement images of GB polyps. This is needed a post-recording analysis due to a short enhancement time. Real-time color Doppler-EUS provides the Doppler flow of vessels without a time limit.


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