Clinical findings and imaging features of 67 nasopharyngeal carcinoma patients with postradiation nasopharyngeal necrosis

Abstract Background The aim of this study was to highlight the typical and atypical chest CT imaging features at first presentation in 120 patients who were proved to be COVID-19 by PCR and to correlate these findings with the need for ICU admission, ventilation, and mortality. We retrospectively included 120 patients 71 males (59.2%) and 49 females (40.8%) with a mean age of 47.2 ± 14.4 years. Patients subjected to clinical assessment, CBC, PCR for COVID-19, and non-contrast CT chest at first presentation. Typical and atypical imaging findings were reported and correlated with the clinical findings of the patients, the need for ICU admission, ventilation, and mortality. Results Clinically, fever was seen in 112 patients followed by dry cough in 108 patients and malaise in 35 patients. The final outcome was complete recovery in 113 cases and death in 7 cases. Typical CT findings included bilateral peripheral ground-glass opacities (GGO) in 74.7%, multilobar affection in 92.5% while atypical findings such as homogeneous consolidation, pleural effusion, mediastinal lymphadenopathy, and single lobar affection were found in 13.4, 5, 6.7, and 7.5% respectively. A statistically significant association between the presence of white lung, pleural effusion, peripheral GGO, and the need for ICU admission as well as mechanical ventilation was noted. The death was significantly higher among elderly patients; however, no significance was found between the imaging features and mortality. Conclusion CT features at first presentation can predict the need for ICU admission and the need for ventilation but cannot predict the mortality outcome of the patients.

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A deep-learning-based prognostic nomogram integrating microscopic digital pathology and macroscopic magnetic resonance images in nasopharyngeal carcinoma: a multi-cohort study

Therapeutic Advances in Medical Oncology ◽

10.1177/1758835920971416 ◽

2020 ◽

Vol 12 ◽

pp. 175883592097141

Author(s):

Fan Zhang ◽

Lian-Zhen Zhong ◽

Xun Zhao ◽

Di Dong ◽

Ji-Jin Yao ◽

...

Keyword(s):

Deep Learning ◽

Magnetic Resonance ◽

Nasopharyngeal Carcinoma ◽

Treatment Failure ◽

Digital Pathology ◽

Imaging Features ◽

Multi Scale ◽

External Test ◽

Whole Slide Images ◽

Independent Cohort

Background: To explore the prognostic value of radiomics-based and digital pathology-based imaging biomarkers from macroscopic magnetic resonance imaging (MRI) and microscopic whole-slide images for patients with nasopharyngeal carcinoma (NPC). Methods: We recruited 220 NPC patients and divided them into training ( n = 132), internal test ( n = 44), and external test ( n = 44) cohorts. The primary endpoint was failure-free survival (FFS). Radiomic features were extracted from pretreatment MRI and selected and integrated into a radiomic signature. The histopathological signature was extracted from whole-slide images of biopsy specimens using an end-to-end deep-learning method. Incorporating two signatures and independent clinical factors, a multi-scale nomogram was constructed. We also tested the correlation between the key imaging features and genetic alternations in an independent cohort of 16 patients (biological test cohort). Results: Both radiomic and histopathologic signatures presented significant associations with treatment failure in the three cohorts (C-index: 0.689–0.779, all p < 0.050). The multi-scale nomogram showed a consistent significant improvement for predicting treatment failure compared with the clinical model in the training (C-index: 0.817 versus 0.730, p < 0.050), internal test (C-index: 0.828 versus 0.602, p < 0.050) and external test (C-index: 0.834 versus 0.679, p < 0.050) cohorts. Furthermore, patients were stratified successfully into two groups with distinguishable prognosis (log-rank p < 0.0010) using our nomogram. We also found that two texture features were related to the genetic alternations of chromatin remodeling pathways in another independent cohort. Conclusion: The multi-scale imaging features showed a complementary value in prognostic prediction and may improve individualized treatment in NPC.

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Aspergillus pachymeningitis mimicking nasopharyngeal carcinoma

The Journal of Laryngology & Otology ◽

10.1017/s0022215110001623 ◽

2010 ◽

Vol 125 (1) ◽

pp. 103-107 ◽

Cited By ~ 6

Author(s):

H S Chan ◽

H Y Yuen ◽

W K Ng ◽

A C Vlantis ◽

A T Ahuja ◽

...

Keyword(s):

Nasopharyngeal Carcinoma ◽

World Literature ◽

Clinical Course ◽

Rare Condition ◽

Imaging Features ◽

Resonance Imaging ◽

Radiological Findings ◽

Cranial Nerve Palsies ◽

The World ◽

Multiple Cranial Nerve

AbstractObjectives:We report a case of otogenic fungal pachymeningitis in a diabetic patient who presented with multiple cranial nerve palsies and nasopharyngeal swelling.Methods:We present a case report, we describe the investigations, management and clinical course of fungal pachymeningitis, and we present a review of the world literature on fungal and non-fungal pachymeningitis.Results:To our knowledge, this is the first report of fungal pachymeningitis with magnetic resonance imaging features suggestive of nasopharyngeal carcinoma. It is also the first reported case with aspergillus cultured from both a dural biopsy and the ear canal.Conclusion:Fungal pachymeningitis is a rare condition which may present to otorhinolaryngologists. Its clinical and radiological findings can be confused with those of nasopharyngeal carcinoma; fungal pachymeningitis should thus be included in the differential diagnosis of nasopharyngeal carcinoma.

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Abdominal Wall Endometriosis: Clinical Presentation And Imaging Features with Emphasis on Sonography

Bangladesh Journal of Obstetrics & Gynaecology ◽

10.3329/bjog.v29i1.30436 ◽

2016 ◽

Vol 29 (1) ◽

pp. 3-8

Author(s):

Quorrata Eynul Forhad ◽

Ali Akbar Biswas ◽

Sk Monirul Islam ◽

Md Shah Alam

Keyword(s):

Cesarean Section ◽

Abdominal Wall ◽

Power Doppler ◽

Clinical Findings ◽

Imaging Features ◽

Palpable Mass ◽

Scar Endometriosis ◽

Abdominal Wall Endometriosis ◽

Cystic Changes ◽

Pathological Material

Objective(s): The purpose of our study was to evaluate clinical findings and sonographic features of abdominal wall endometriosis and also to report its CT and MRI appearance.Materials and methods: A retrospective study was performed from January 2008 - December 2012, yielding 12 surgically proven cases of abdominal wall endometriosis. All patients had undergone sonography including power Doppler examination. Additional CT was performed in one case and MRI in four. Pathological material was preoperatively obtained by sonographically guided puncture in six patients. The clinical data were analyzed and the imaging studies were reviewed by radiologist working in consensus.Results: All patients had a history of at least one prior cesarean section. All patients C/S was done in this institution and 1500 C/S were performed within a period of 5 years giving a frequency of 0.8% scar endometriosis after C/S. All presented with focal pain near the surgical scar, which was cyclic in three patients. Nine patients presented with a palpable mass near the scar. Sonography detected 11 lesions within the abdominal wall with a mean diameter 25mm and in one case sonography could not identify any lesion. All lesions were hypoechoic, vascular, and solid, with some cystic changes in one. MRI CT scan showed enhancement of the lesions. Finally histopathologically all were proved as endometriosis.Conclusion: Abdominal wall endometriosis frequently presents with noncyclic symptoms. Imaging findings of a solid mass near a cesarean section scar strongly suggest its diagnosis.Bangladesh J Obstet Gynaecol, 2014; Vol. 29(1) : 3-8

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Acute bacterial nephritis. A descriptive study of an underdiagnosed entity

Revista Mexicana de Urología ◽

10.48193/rmu.v80i3.556 ◽

2020 ◽

Vol 80 (3) ◽

pp. 1-10

Author(s):

Pedro Antonio Madero-Morales ◽

Rigoberto Pallares-Méndez ◽

Rodrigo Romero-Mata ◽

Guillermo Vizcarra-Mata ◽

Andrés Guillén-Lozoya

Keyword(s):

Acute Pyelonephritis ◽

Clinical Characteristics ◽

Clinical Course ◽

Case Series ◽

Therapy Response ◽

Time Frame ◽

Clinical Findings ◽

Imaging Features ◽

Imaging Studies ◽

Retrospective Case

Background: Acute bacterial nephritis is an infectious process diagnosed through imaging studies. The clinical course of the disease has been shown to be more aggressive than acute pyelonephritis. It continues to be underdiagnosed, thus there are few studies on the entity in the literature. Objective: To describe the clinical characteristics and imaging features of acute bacterial nephritis, as well as its clinical course. Design: A descriptive, retrospective case series was conducted. Materials and methods: Thirty-two cases of acute bacterial nephritis in patients admitted to the hospital within the time frame of 2009 to 2016 were reviewed. The patients’ clinical characteristics upon admission were registered, as well as inpatient clinical progression, culture results, and antibiotic therapy response. The imaging studies were re-evaluated and the diagnostic consistency with either the focal or multifocal disease presentation was confirmed. Results: Cases predominated in women (n=29, 90.62%) and the most frequently associated comorbidities were diabetes (n=16, 50%) and obesity (n=9, 28.25%). The most important clinical findings upon admission were fever (n=15, 46.87%) and leukocytosis (n=27, 84.38%). Escherichia coli was the most commonly isolated bacterium (63.63%). Both acute focal bacterial nephritis and acute multifocal bacterial nephritis were observed in 46.87% (n=15) and 53.13% (n=17) of the patients, respectively. Imaging studies were required for all diagnoses. Conclusion: Fever and leukocytosis are the main findings in acute bacterial nephritis. Imaging studies are necessary for making the diagnosis, given that acute pyelonephritis and acute bacterial nephritis cannot be clinically differentiated.

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Encephalotrigeminal Angiomatosis: A Review with Emphasis on Head and Neck Manifestations

Neurographics ◽

10.3174/ng.2000061 ◽

2021 ◽

Vol 11 (3) ◽

pp. 166-174

Author(s):

B.R. Larsen ◽

M.S. Rosztoczy ◽

D.C. Van Tassel ◽

C.R. Larson ◽

S.A. Avedikian ◽

...

Keyword(s):

Head And Neck ◽

Soft Tissues ◽

Clinical Findings ◽

Imaging Features ◽

Facial Soft Tissue ◽

Vascular Abnormalities ◽

Weber Syndrome ◽

The Face ◽

Sturge Weber Syndrome ◽

Tissue Abnormalities

Encephalotrigeminal angiomatosis, also known as Sturge-Weber syndrome or Sturge-Weber-Dimitri disease, is a sporadic congenital neurocutaneous syndrome characterized by angiomas of the face, eyes, and meninges. The typical clinical findings include seizures, a port-wine facial nevus, hemiparesis, and developmental delay. The classic intracranial imaging features of Sturge-Weber syndrome include cerebral hemispheric atrophy, hypervascularity and/or calcification of the cortex, and ipsilateral choroid plexus enlargement. Extracranial findings primarily include the vascular abnormalities of the ocular and facial soft tissues as well as hypertrophy of the calvarial and maxillofacial osseous structures. Additionally, we report involvement of the extraocular muscles, salivary glands, and lacrimal glands, findings that have not been well described in the literature. While a developmental venous pathology underlying Sturge-Weber syndrome has been proposed resulting in many of the findings, the mechanism behind the facial soft-tissue abnormalities and the clinical sequelae associated with these glandular abnormalities is still uncertain.Learning Objective: To recognize typical clinical and various imaging manifestations of Sturge-Weber syndrome, including head and neck and intracranial imaging findings

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Primary carcinosarcoma of the liver: imaging features and clinical findings in six cases and a review of the literature

Cancer Imaging ◽

10.1186/s40644-018-0141-0 ◽

2018 ◽

Vol 18 (1) ◽

Cited By ~ 6

Author(s):

Jing Li ◽

Pan Liang ◽

Dandan Zhang ◽

Jie Liu ◽

Hongkai Zhang ◽

...

Keyword(s):

Clinical Findings ◽

Liver Imaging ◽

Imaging Features ◽

Review Of The Literature

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Imaging Features of Intracranial Invasion of Nasopharyngeal Carcinoma via the Carotid Canal

Neurographics ◽

10.3174/ng.41400951 ◽

2014 ◽

Vol 4 (4) ◽

pp. 183-188

Author(s):

G.G. Millare ◽

J. Hamilton ◽

L.E. Ginsberg

Keyword(s):

Nasopharyngeal Carcinoma ◽

Imaging Features ◽

Carotid Canal

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Practical approach to primary retroperitoneal masses in adults

Radiologia Brasileira ◽

10.1590/0100-3984.2017.0179 ◽

2018 ◽

Vol 51 (6) ◽

pp. 391-400 ◽

Cited By ~ 9

Author(s):

Micaela Maciel dos Santos Mota ◽

Regis Otaviano França Bezerra ◽

Marcio Ricardo Taveira Garcia

Keyword(s):

Surgical Planning ◽

Clinical Findings ◽

Practical Approach ◽

Vascular Involvement ◽

Imaging Features ◽

Resonance Imaging ◽

Biopsy Site ◽

Adjacent Structures ◽

Malignant Lesions ◽

Primary Retroperitoneal

Abstract Primary retroperitoneal masses constitute a heterogeneous group of uncommon lesions and represent a challenge due to overlapping imaging findings. Most are malignant lesions. Although they are more prevalent in adults, they can occur at any age. Such lesions are classified as primary when they do not originate from a specific retroperitoneal organ and are divided, according to the image findings, into two major groups: solid and cystic. The clinical findings are nonspecific and vary depending on the location of the lesion in relation to adjacent structures, as well as on its behavior. The main imaging methods used for staging and surgical planning, as well as for selecting the biopsy site and guiding the biopsy procedure, are computed tomography and magnetic resonance imaging. In most cases, the treatment is challenging, because of the size of the lesions, vascular involvement, or involvement of adjacent organs. In this article, we present a review of the retroperitoneal anatomy and a practical approach to the main imaging features to be evaluated, with a view to the differential diagnosis, which can guide the clinical management.

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Multimodality imaging review of complex pelvic lesions in female pelvis

British Journal of Radiology ◽

10.1259/bjr.20200489 ◽

2020 ◽

Vol 93 (1116) ◽

pp. 20200489

Author(s):

Anuradha Chandramohan ◽

Tameem Ahmed Bhat ◽

Reetu John ◽

Betty Simon

Keyword(s):

Multimodality Imaging ◽

Clinical Findings ◽

Imaging Modalities ◽

Imaging Features ◽

Female Pelvis ◽

Diagnostic Dilemma ◽

Multiple Imaging ◽

Wide Range ◽

Risk Of Cancer ◽

Pelvic Lesions

Complex pelvic lesions can originate from various anatomical structures in the pelvis and pose a diagnostic dilemma due to a wide range of possible diagnoses. Accurate characterisation of these lesions would often require an algorithmic approach, which incorporates clinical findings, sequential use of multiple imaging modalities and a multiparametric approach. This approach usually aims at identifying key imaging features, which aid in anatomical localisation, morphology and tissue characterisation. There have been various attempts to standardise the lexicon used for describing adnexal masses in female patients; stratify their risk of cancer and suggest appropriate next steps in the management pathway. Through this review, we extend this approach to complex pelvic masses in female pelvis in general and will focus on optimal use of different imaging modalities to arrive at definitive diagnosis or meaningful differential diagnosis. We will also discuss potential pitfalls of imaging diagnosis and common mimics.

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