scholarly journals A Late Presenting Urachal Remnant Tumour: Rare Adenocarcinoma Originated from Developmental Defect

2019 ◽  
pp. 1-8
Author(s):  
Ipsita Dey ◽  
Chhaya Roy ◽  
Tushar Kanti Das
Keyword(s):  
Ct Scan ◽  
Residual Disease ◽  
Histopathological Examination ◽  
Bladder Wall ◽  
Disease Diagnosis ◽  
Urachal Cyst ◽  
Developmental Defect ◽  
Urachal Remnant ◽  
Contrast Enhanced Ct ◽  
Urachal Adenocarcinoma

Occupying only 0.01% of all adult cancer patients, the rare entity urachal adenocarcinoma constitutes 22-35% of adenocarcinomas originating from urinary bladder. Though with the gradual descend of the bladder in the course of development urachus should turn into median umbilical ligament, exceptional persistence of it can give rise to urachal cyst or urachal adenocarcinoma in adulthood. With only 43% of survival rate for 5 years and mean survival between 12 and 24 months urachal carcinoma is a devastating disease. Diagnosis of it is based on the MD Anderson Cancer Centre (MDACC) criteria. Computed Tomography (CT) Scan and/or Magnetic Resonance Imaging (MRI) Scan of abdomen and pelvis are the major imaging modalities to proceed towards diagnosis and staging. Not only histopathological examination but also immune-histochemical expression of both CK7 and CK20 suffice to clinch the diagnosis. Though surgical intervention forms the mainstay of treatment, several regimens of chemotherapy have also been tried to fight against unresectable, residual, extensive urachal carcinomas. This case took place in a 52 years old male patient who was presented with a gradually enhancing infra-umbilical swelling with slow growing urinary symptoms. By dint of Ultrasonography (USG) and Contrast Enhanced CT (CECT) scan of whole abdomen the tumour was detected involving the bladder wall and the anterior abdominal wall. Cystoscopy was followed by upfront cytoreductive surgery. Histopathological examination revealed the diagnosis of an adenocarcinoma which was further confirmed to be an urachal remnant carcinoma with the help of immunohistochemistry. Post-operative CT scan showed residual disease involving bladder wall and was treated with an adjuvant platin based chemotherapy regimen.

Swim bladder mycosis in farmed rainbow trout Oncorhynchus mykiss caused by Phoma herbarum and experimental verification of pathogenicity

2020 ◽  
Vol 138 ◽  
pp. 237-246 ◽  
Author(s):  
J Řehulka ◽  
A Kubátová ◽  
V Hubka
Keyword(s):  
Rainbow Trout ◽  
Histopathological Examination ◽  
Periodic Acid ◽  
Bladder Wall ◽  
Swim Bladder ◽  
Cell Reactivity ◽  
Periodic Acid Schiff ◽  
Posterior Portion ◽  
Hepatic Congestion ◽  
Phoma Herbarum

In this study, spontaneous swim bladder mycosis was documented in a farmed fingerling rainbow trout from a raceway culture system. At necropsy, the gross lesions included a thickened swim bladder wall, and the posterior portion of the swim bladder was enlarged due to massive hyperplasia of muscle. A microscopic wet mount examination of the swim bladder contents revealed abundant septate hyphae, and histopathological examination showed periodic acid-Schiff-positive mycelia in the lumen and wall of the swim bladder. Histopathological examination of the thickened posterior swim bladder revealed muscle hyperplasia with expansion by inflammatory cells. The causative agent was identified as Phoma herbarum through morphological analysis and DNA sequencing. The disease was reproduced in rainbow trout fingerlings using intraperitoneal injection of a spore suspension. Necropsy in dead and moribund fish revealed extensive congestion and haemorrhages in the serosa of visceral organs and in liver and abdominal serosanguinous fluid. Histopathological examination showed severe hepatic congestion, sinusoidal dilatation, Kupffer cell reactivity, leukostasis and degenerative changes. Fungi were disseminated to the liver, pyloric caeca, kidney, spleen and heart. Although infections caused by Phoma spp. have been repeatedly reported in fish, species identification has been hampered by extensive taxonomic changes. The results of this study confirmed the pathogenicity of P. herbarum in salmonids by using a reliably identified strain during experimental fish infection and provides new knowledge regarding the course of infection.

The contrast-enhanced CT scan in the diagnosis of isodense subdural hematoma

1979 ◽  
Vol 50 (1) ◽  
pp. 64-69 ◽  
Author(s):  
Fong Y. Tsai ◽  
James E. Huprich ◽  
Hervey D. Segall ◽  
James S. Teal
Keyword(s):  
Cerebral Cortex ◽  
Ct Scan ◽  
Subdural Hematoma ◽  
Correct Diagnosis ◽  
Content Type ◽  
Subdural Hematomas ◽  
Contrast Enhanced Ct ◽  
Contrast Enhanced ◽  
Enhanced Ct ◽  
Fine Print

✓ The authors review 29 cases of surgically-proven isodense subdural hematomas examined by non-contrast and contrast-enhanced computerized tomography scans. Three types of isodense collections were noted: homogeneous isodense collections, mixed-density collections, and gravitational layering within subdural collections. Contrast enhancement within the cerebral cortex, cortical vessels, and subdural membranes led to the correct diagnosis in each case. Contrast-enhanced scans are essential for the evaluation of isodense subdural hematomas.

scholarly journals Modified radical retropubic prostatectomy: Personal technical variation “tension free continuum-urethral anastomosis (T.F.C.U.A)” with optical magnification in the preservation of the bladder neck, and estimation of the urinary continence

2013 ◽  
Vol 85 (4) ◽  
pp. 170 ◽  
Author(s):  
Alberto Roggia ◽  
Emilio Pozzi ◽  
Guglielmo Mantica ◽  
Maurizio Salvadore ◽  
Dimitrios Choussos ◽  
...  
Keyword(s):  
Histopathological Examination ◽  
Bladder Wall ◽  
Muscle Layer ◽  
Radical Retropubic Prostatectomy ◽  
Optical Systems ◽  
Urinary Continence ◽  
Tension Free ◽  
Optical Magnification ◽  
Retropubic Radical Prostatectomy

Objective: To reassess the double continence technique for open retropubic radical prostatectomy, proposed by Malizia and employed by Pagano et al., with the “tension free continuum-urethral anastomosis” (T.F.C.U.A.) personal modification and the use of image magnification optical systems and appropriate and delicate surgical tools. Materials and methods: A total of 173 radical retropubic prostatectomies, performed by the same surgeon, were evaluated in terms of early and late continence. Results: The presence of residual prostate cancer cells within the muscle layer was always excluded by the histopathological examination that also demonstrated that the muscle layer was well represented; satisfactory outcomes were obtained in terms of both early urinary continence (60%) and urinary continence at 6-12 month follow-up (92.4% for the whole series and 97.2% for the last series of patients). Conclusions: The “tension free” anastomosis obtained by the suspension of the anterior bladder wall to the the pubis along the median line allowed to achieve satisfactory outcomes in terms of urinary continence, even if these data obviously need to be confirmed by other series and comparative trials.

Utility of PET/CT for therapy response assessment in non-Hodgkin's lymphoma

QJM ◽  
2021 ◽  
Vol 114 (Supplement_1) ◽  
Author(s):  
Sally Mahmoud Abdel-Aziz Abdel-Aziz ◽  
Safaa Kamal Mohamed BadrElden ◽  
Asmaa Magdy Mohamed Salama
Keyword(s):  
Ct Scan ◽  
Hodgkin’S Lymphoma ◽  
B Cell Lymphoma ◽  
Hodgkin's Lymphoma ◽  
Whole Body ◽  
Non Hodgkin’S Lymphoma ◽  
Contrast Enhanced Ct ◽  
Pet Ct ◽  
Non Hodgkin's Lymphoma ◽  
Enhanced Ct

Abstract Aim of the study to evaluate the role of PET/CT in initial diagnosis and staging of lymphoma, and to determine the predictive value of 18F-FDG PET by monitoring the early response and final response after completion of chemotherapy in patients with non-Hodgkin's lymphoma. Patient and Methods our prospective study included 25 patients with pathologically confirmed nonHodgkin Lymphoma diffuse large B cell lymphoma selected from Department of Radiology at Ain Shams University Hospital from January 2019 to March 2020. The patients included in this study performed the followings: Initial PET/CT for staging, interim PET/CT and end of the treatment PET/CT. We performed low dose non enhanced CT scan first, then a whole body PET study followed by diagnostic enhanced whole body CT scan. The whole study took approximately 20-30 minutes. Results PET/CT has greater sensitivity 100% and specificity 68.8% than CT alone for detecting sites of nodal and extra-nodal involvement and for assessment of therapeutic response in non-Hodgkin lymphoma. Conclusion PET / CT is an accurate method for evaluating tumor viability in the post-therapy setting of Non-Hodgkin lymphomas. PET / CT has a significant advantage for the diagnosis of diffusely infiltrating organs without mass lesions or contrast enhancement compared to contrast enhanced CT.

A Case of Incidentally Detected Bladder Lipoma and a Review of the Literature

2021 ◽  
Vol 17 ◽  
Author(s):  
Emre Emekli ◽  
Elif Gündoğdu
Keyword(s):  
Histopathological Examination ◽  
Adrenal Adenoma ◽  
Bladder Wall ◽  
Benign Tumors ◽  
Imaging Features ◽  
Multiplanar Reconstructions ◽  
Clinical Presentations ◽  
Pelvic Lipomatosis ◽  
One Year

Background: Lipomas are benign fatty tumors made of fat tissue. Bladder lipomas are extremely rare. For this reason, it is necessary to be aware of the imaging features when incidentally detected in imaging. Case Report: In the abdominal computed tomography (CT) performed as part of the follow-up examination of a 43-year-old patient, who had undergone surgery for adrenal adenoma five years earlier, a 14x9x8 mm smoothly marginated, ovoid-shaped, hypodense mass lesion with a homogeneous internal structure was detected in the anterior bladder wall. The pre-contrast density of the lesion was measured as -105 HU. The magnetic resonance imaging performed one year after the CT examination revealed a 14x9x8 intramural mass in the bladder wall, showing protrusion toward the lumen. The group was observed to be markedly hypointense on fat-suppressed T1 and T2-weighted images and considered consistent with a bladder lipoma. Discussion: Bladder lipomas are benign lesions that can vary in clinical presentations but usually cause hematuria. The differential diagnosis of bladder lipomas includes other mesenchymal rare benign tumors that can arise from the urinary bladder submucosal layer, including leiomyoma, hemangioma, plasmacytoma, fibroma, and neurofibroma, in imaging bladder lipomas present as homogeneous lesions containing macroscopic fat. Only the liposarcoma and pelvic lipomatosis could also show similar features. The less differentiated liposarcomas tend to present more heterogeneous enhancement, irregular-shaped margins, and infiltrative behavior. Also, appropriate multiplanar reconstructions may allow the radiologist to determine it is an extravesical pelvic lipomatosis. Conclusion: Using CT and MRI, these lesions rich in adipose tissue can be distinguished from other lesions, and their diagnosis can be made to a great extent. However, a histopathological examination is required for a definitive diagnosis.

scholarly journals Cysticercosis: Hooked by a Hooklet on Fine Needle Aspiration Cytology—A Case Report

2013 ◽  
Vol 2013 ◽  
pp. 1-2 ◽  
Author(s):  
Manav Sawhney ◽  
Shubhra Agarwal
Keyword(s):  
Fine Needle Aspiration ◽  
Fine Needle Aspiration Cytology ◽  
Histopathological Examination ◽  
Bladder Wall ◽  
Clinical Manifestations ◽  
Needle Aspiration ◽  
Aspiration Cytology ◽  
Muscle Involvement ◽  
Fine Needle ◽  
Needle Aspiration Cytology

Cysticercosis is a systemic parasitic disease caused by the larval form of cestodeT. solium. It has a worldwide distribution and is potentially harmful with variable clinical manifestations. The patient most commonly presents with subcutaneous and muscle involvement in the form of nodular lesions. The other most commonly involved sites include eye, brain, bladder wall, and heart. Cysticercosis can be diagnosed on serology, and radiologically but confirmatory diagnosis is based on histopathological examination of the involved tissue biopsy specimen. Fine needle aspiration cytology is a useful low-cost outpatient procedure tool for preoperative diagnosis of cysticercosis and is absolutely essential for diagnosis of the parasitic lesions in a peripheral hospital, one like ours.

scholarly journals Is CT Angiogram of the Abdominal Vessels Needed following the Diagnosis of Ischemic Colitis? A Multicenter Community Study

2014 ◽  
Vol 2014 ◽  
pp. 1-8 ◽  
Author(s):  
Muhammed Sherid ◽  
Salih Samo ◽  
Samian Sulaiman ◽  
Husein Husein ◽  
Sankara N. Sethuraman ◽  
...  
Keyword(s):  
Ct Scan ◽  
Ischemic Colitis ◽  
Celiac Trunk ◽  
Ct Angiogram ◽  
Contrast Enhanced Ct ◽  
Contrast Enhanced ◽  
Enhanced Ct ◽  
Group 3 ◽  
Group 5 ◽  
Atherosclerotic Changes

Background. CT angiogram is frequently obtained after diagnosis of ischemic colitis (IC). Aims. To investigate the vascular findings of CT angiogram as compared to contrast-enhanced CT scan and whether this modality changes the management or prognosis of IC. Methods. We conducted a retrospective analysis of patients with IC from 2007 to 2013. Results. CT angiogram was performed in 34 patients (28.81%), whereas contrast-enhanced CT scan was performed in 54 patients (45.76%). In CT angiogram group, 8 patients (23.5%) had atherosclerotic changes. Stenosis was found in 12 patients (35.3%) (9: celiac trunk, 3: SMA). Among this group, one patient underwent colectomy and another underwent angioplasty of the celiac trunk who died within 30 days. Among contrast-enhanced CT scan group, 5 patients (9.3%) had atherosclerotic changes. Stenosis was found in 5 patients (9.3%) (3: celiac trunk, 1: SMA, and 1: IMA). Among this group, 3 patients had colectomy and one died within 30 days. There was no statistical difference between both groups in all vascular findings except the stenosis which was higher in CT angiogram group (P=0.0025). Neither the need for surgery nor all-cause mortality was different between both groups. Conclusion. CT angiogram did not provide any useful findings that altered the management or the prognosis of IC.

scholarly journals Limited benefit of additional contrast-enhanced CT to end-of-treatment PET/CT evaluation in patients with follicular lymphoma

2021 ◽  
Vol 11 (1) ◽  
Author(s):  
Gaetano Paone ◽  
Mariana Raditchkova-Sarnelli ◽  
Teresa Ruberto-Macchi ◽  
Marco Cuzzocrea ◽  
Emanuele Zucca ◽  
...  
Keyword(s):  
Follicular Lymphoma ◽  
Metabolic Response ◽  
Residual Disease ◽  
Response Assessment ◽  
Complete Response ◽  
Moderate Increase ◽  
Comparable Rate ◽  
Contrast Enhanced Ct ◽  
End Of Treatment ◽  
Pet Ct

AbstractDespite follicular lymphoma (FL) is frequently characterized by a moderate increase of glucose metabolism, PET/CT examinations provides valuable information for staging and response assessment of the disease. The aim of the study was to assess and compare the diagnostic performance of PET/ldCT and PET/ceCT, respectively, in evaluating FL patients at the end of treatment. Fifty FL consecutive patients who underwent end-of-therapy PET/CT with both ldCT and ceCT were analyzed. Two blinded observers independently assessed PET/ldCT and PET/ceCT applying the Deauville score (DS) and Lugano classification criteria. PET imaging obtained after the end-of-treatment (EoT) was classified as showing PET and ce-CT matched response (concordant imaging group, CIG) or PET and ce-CT unmatched response (discordant imaging group, DIG). Relapse rate and Event-Free Survival (EFS) were compared between CIG and DIG patients. Overall, no differences in metabolic response classification were observed between PET/ldCT and PET/ceCT. In 13 (26%) patients PET/ceCT identified additional FDG-negative nodal lesions in mesenteric, retroperitoneal and iliac regions. However, in all cases, final DS remained unchanged and the additional results did not modify the following therapeutic decision. Among patients, who obtained complete metabolic response a comparable rate of relapse was registered in DIG 3/13 (23%) and CIG subgroups 5/20 (25%) [p = 0.899]. In all 3 DIG cohort patients who relapsed the recurrent disease involved also, but not exclusively, PET negative lymph nodes detected by ceCT. In overall population metabolic response defined by PET/ldCT predicted EFS [76% (group of patients with metabolic response) vs 35% (group of patients with residual disease), p = 0.0013] significantly better than ceCT-Based response assessment [75% (group of patients with complete response) vs 53% (group of patients with residual disease), p = 0.06]. Our study demonstrates a negligible diagnostic and predictive value of ceCT performed in addition to standard 18FDG PET/ldCT for EoT response evaluation in FLs. PET/ldCT should be performed as first-line imaging procedure, also in patients with prevalent abdominal and pelvic involvement, limiting the acquisition of ceCT in selected cases. This tailored approach would contribute to avoid useless radiation exposure and preserve renal function of patients.

scholarly journals Doughnut bother! Histopathological examination of anastomotic doughnuts following colorectal anastomosis does not change patient management

2020 ◽  
Vol 3 (1) ◽  
Author(s):  
Steven Dixon ◽  
Hannah Barrow ◽  
Jane Hughes
Keyword(s):  
Patient Management ◽  
Residual Disease ◽  
Histopathological Examination ◽  
Colorectal Anastomosis ◽  
Complete Response ◽  
Patient Treatment ◽  
Histopathological Analysis ◽  
Retrospective Case ◽  
Female Ratio ◽  
Stapling Device

Abstract Introduction The use of a circular stapling device to create an anastomosis following colonic or rectal resection is common practice in the United Kingdom. Histopathological analysis of the anastomotic doughnuts produced takes time and resources, but does it ever change patient management? The aim of this study was to review the examination of doughnuts and whether patient treatment was altered by the findings. Method A retrospective case note review of all cases involving anastomotic doughnuts in a single trust between December 2010 and January 2018, was performed. Results There were 435 cases identified, male to female ratio was 2.0:1, age range 20–86 years and a median age of 66 years. 376 Doughnut samples were received by the pathology department (86.4%) and 354 were examined (81.4%). The disease processes involved were adenocarcinoma (n = 352, 80.9%), diverticular disease (n = 47, 10.8%), no residual disease/complete response (n = 22, 5.1%), adenoma (n = 7, 1.6%), mucinous (n = 5, 1.1%), Crohn’s disease (n = 1, 0.2%) and neuroendocrine (n = 1, 0.2%). Benign adenomatous change was identified in 4 cases (0.9%). No doughnuts examined contained dysplastic or malignant changes. Conclusion The histological examination of anastomotic doughnuts is extremely unlikely to identify malignant change and subsequently does not change patient management. Pathology departments could save time and resources by not routinely examining doughnuts.

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