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Sample records for intracranial cystic lesions

  1. 内窥镜手术治疗脑积水及颅内囊性占位病灶的临床分析%Endoscopic surgery for cystic lesion hydrocephalus and intracranial lesions

    Institute of Scientific and Technical Information of China (English)

    纪涛; 林恒州; 何毅

    2011-01-01

    目的 探讨神经内窥镜治疗梗阻性脑积水及颅内囊性占位病灶的临床特点.方法 回顾性分析该院2005年2月~2008年2月应用神经内窥镜技术治疗颅内病变患者48例临床资料,其中梗阻性脑积水26例,蛛网膜囊肿12例,透明隔囊肿6例,鞍上巨大囊肿3例,鞍上囊性颅咽管瘤1例.术后随访24个月,观察患者并发症及治疗效果.结果 并发症:发热3例,硬膜下积液2例,脑室出血1例,并发症发生率仅12.5%;疗效:42例有效,有效率高达87.5%,6例无效(脑积水5例,鞍上巨大囊肿1例).结论 神经内窥镜治疗颅内病变具有创伤小、直观、并发症少、有效率高等优点,但要严格掌握手术适应证.%Aim To explore clinical features of endoscopic treatment of obstructive hydrocephalus and nerve intracranial lesions cystic le sion. Methods Retrospective analysis was made in 48 patients with intracranial lesions admitted from February 2005 to February 2008,including obstructive hydrocephalus 26 cases, arachnoid cysts 12 cases, transparent insulation cyst 6 cases, saddle huge cyst 3 cases,saddle cystic cranial pharynx article 1 case. With 24-month follow-up, patients were observed in complications and therapeutic effect. Results The complications included calorific 3 cases, subdural effusion 2 cases, ventricle bleeding 1 case, with a morbidity of only 12.5%. Treatments in 42 patients were effective, efficient rate as high as 87.5% ,6 cases invalid( hydrocephalus in 5 cases, saddle huge cyst in 1 case ). Conclusion Endoscopic treatment of intracranial lesions has small trauma, intuitiveness, fewer complications, and the advantages of high efficiency, but surgical indications should be controlled strictly.

  2. Cystic Lesions in Autoimmune Pancreatitis

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    Macarena Gompertz

    2015-11-01

    Full Text Available Autoimmune pancreatitis (AIP can be chronic or recurrent, but frequently completely reversible after steroid treatment. A cystic lesion in AIP is a rare finding, and it can mimic a pancreatic cystic neoplasm. Difficulties in an exact diagnosis interfere with treatment, and surgery cannot be avoided in some cases. We report the history of a 63-year-old male presenting with jaundice and pruritus. AIP was confirmed by imaging and elevated IgG4 blood levels, and the patient completely recovered after corticosteroid therapy. One year later, he presented with a recurrent episode of AIP with elevated IgG4 levels, accompanied by the appearance of multiple intrapancreatic cystic lesions. All but 1 of these cysts disappeared after steroid treatment, but the remaining cyst in the pancreatic head was even somewhat larger 1 year later. Pancreatoduodenectomy was finally performed. Histology showed the wall of the cystic lesion to be fibrotic; the surrounding pancreatic tissue presented fibrosis, atrophy and lymphoplasmacytic infiltration by IgG4-positive cells, without malignant elements. Our case illustrates the rare possibility that cystic lesions can be part of AIP. These pseudocysts appear in the pancreatic segments involved in the autoimmune disease and can be a consequence of the local inflammation or related to ductal strictures. Steroid treatment should be initiated, after which these cysts can completely disappear with recovery from AIP. Surgical intervention may be necessary in some exceptional cases.

  3. Cystic Lesions of the Mediastinum.

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    Vargas, Daniel; Suby-Long, Thomas; Restrepo, Carlos S

    2016-06-01

    Cystic lesions are commonly seen in the mediastinum, and they may arise from virtually any organ. The vast majority of these lesions are benign and result in no symptoms. When large, cysts may produce symptoms related to compression of adjacent structures. The most common mediastinal cysts are pericardial and foregut duplication cysts. Both computed tomography and magnetic resonance are routinely used to evaluate these lesions. Although computed tomography offers superior spatial resolution, magnetic resonance is useful in differentiating cysts that contain proteinaceous material from solid lesions. Occasionally, cysts arise from solid lesions, such as thymoma or teratoma. Although cysts are alike in appearance, location helps narrowing the differential diagnoses.

  4. Cystic lesions of the pineal region - MRI and pathology

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    Engel, U. [Department of Neuropathology, Benjamin-Franklin-Klinikum, Faculty of Medicine, Freie Universitaet Berlin, Hindenburgdamm 30, 12200 Berlin (Germany); Gottschalk, S.; Niehaus, L.; Lehmann, R. [Department of Neuroradiology, Institute of Radiological Diagnosis, Charite University Hospital, Berlin (Germany); May, C.; Vogel, S. [Neurosurgical Clinic, St. Gertraud' s Hospital, Berlin (Germany); Jaenisch, W. [Department of Neuropathology, Landesklinik Brandenburg (Germany)

    2000-06-01

    Pineal lesions are rare. Tumours in this location comprise 0.4-1% of intracranial tumours. They grow mainly as solid-mass lesions, and cystic tumours are not common. On MRI, a cystic configuration is associated usually with non-neoplastic pineal lesions rather than with a tumour, but analysis does not allow cystic pineal tumours to be distinguished from glial cysts with certainty. We compared neuroradiological and pathological data from 13 cystic pineal lesions, analysing preoperative MRI. Formalin-fixed, paraffin-embedded surgical specimens were stained routinely and immunocytochemically, using the streptavidin-biotin-complex method. Histology revealed six pineocytomas, four glial cysts, an arachnoid cyst, a low-grade astrocytoma and a teratoma. Signal characteristics of pineocytomas were similar in many respects to those of glial pineal cysts. Histomorphological analysis allowed unambiguous discrimination between pineocytomas and glial pineal cysts. (orig.)

  5. Angiomatous lesion and delayed cyst formation after gamma knife surgery for intracranial meningioma: case report and review of literatures.

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    Liu, Zhiyong; He, Min; Chen, Hongxu; Liu, Yi; Li, Qiang; Li, Lin; Li, Jin; Chen, Haifeng; Xu, Jianguo

    2015-01-01

    Gamma Knife has become a major therapeutic method for intracranial meningiomas, vascular malformations and schwannomas with exact effect. In recent years an increasing number of delayed complications after Gamma Knife surgery have been reported, such as secondary tumors, cystic changes or cyst formation. But angiomatous lesion and delayed cyst formation after Gamma Knife for intracranial lesion has rarely been reported. Here we report the first case of angiomatous lesion and delayed cyst formation following Gamma Knife for intracranial meningioma and discuss its pathogenesis.

  6. Diffusion-weighted images of intracranial cyst-like lesions

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    Bergui, M.; Zhong, J.; Sales, S. [Dept. of Neuroradiology, University of Turin (Italy); Bradac, G.B. [Dept. of Neuroradiology, University of Turin (Italy); Neuroradiologia Universitaria, Ospedale S. G. Battista, Turin (Italy)

    2001-10-01

    Magnetic resonance sequences may be designed to evaluate the diffusion movements of the protons (diffusion-weighted images, DWI). In these images, a bright signal identifies a region where the diffusion along a spatial axis is restricted. The contents of a cystic lesion frequently have the signal intensities of a generic homogeneous hyperproteinic fluid (hypointensity in T1-, hyperintensity in T2-weighted images). DWI may give further information about the microscopic organisation of these fluids: a hyperintense signal indicates the presence of a restricted diffusion, due to some kind of microscopic organisation, at the cellular or macromolecular level. This may provide additional information useful for clinical purposes. We obtained DWI in 24 consecutive patients with intracranial cystic lesions, (19 intra-axial: five abscesses, five gliomas, six metastases, two demyelinating lesions, one neurocysticercosis; five extra-axial: two arachnoid cysts, two epidermoid cysts, one cholesteatoma). We found a strongly hyperintense signal, indicating restricted diffusion, in brain abscesses, epidermoid cysts and cholesteatoma; all the remaining lesions were hypointense or mildly hyperintense. We found these data useful in critical diagnoses, such as in differentiating abscesses from tumours, and in identifying elusive tumours such as epidermoid cysts. (orig.)

  7. A residual cystic lesion in acute disseminated encephalomyelitis

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    Go, T. [Otsu Red Cross Hospital, Nagara (Japan). Dept. of Paediatrics; Imai, T. [Kyoto Univ. School of Medicine, Kyoto (Japan). Dept. of Paediatrics

    2000-09-01

    We report a case of acute disseminated encephalomyelitis (ADEM) with a residual cystic lesion on MRI. This seemed to be induced by Japanese encephalitis vaccination. Despite complete clinical improvement with high-dose steroid therapy, the cystic lesion has persisted for 3 years on MRI. There have been no previous reports of residual cystic lesions in ADEM. (orig.)

  8. Cystic lesion around the hip joint

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    Yukata, Kiminori; Nakai, Sho; Goto, Tomohiro; Ikeda, Yuichi; Shimaoka, Yasunori; Yamanaka, Issei; Sairyo, Koichi; Hamawaki, Jun-ichi

    2015-01-01

    This article presents a narrative review of cystic lesions around the hip and primarily consists of 5 sections: Radiological examination, prevalence, pathogenesis, symptoms, and treatment. Cystic lesions around the hip are usually asymptomatic but may be observed incidentally on imaging examinations, such as computed tomography and magnetic resonance imaging. Some cysts may enlarge because of various pathological factors, such as trauma, osteoarthritis, rheumatoid arthritis, or total hip arthroplasty (THA), and may become symptomatic because of compression of surrounding structures, including the femoral, obturator, or sciatic nerves, external iliac or common femoral artery, femoral or external iliac vein, sigmoid colon, cecum, small bowel, ureters, and bladder. Treatment for symptomatic cystic lesions around the hip joint includes rest, nonsteroidal anti-inflammatory drug administration, needle aspiration, and surgical excision. Furthermore, when these cysts are associated with osteoarthritis, rheumatoid arthritis, and THA, primary or revision THA surgery will be necessary concurrent with cyst excision. Knowledge of the characteristic clinical appearance of cystic masses around the hip will be useful for determining specific diagnoses and treatments. PMID:26495246

  9. Sonographic-pathologic correlation of complex cystic breast lesions

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    Saravech Pongrattanaman

    2013-02-01

    Full Text Available Objective: To understand the pathologic basis for sonographic features of complex cystic lesions. Methods: From 2 646 female patients underwent breast sonography at King Chulalongkorn Memorial Hospital from January 2005 through December 2010, 103 cystic lesions were included. Pathologic confirmation was performed by fine-needle aspiration (n=42, core needle biopsy (n=6, excision (n=54 and mastectomy (n=1. Complex cystic breast masses were classified into 3 types as followings; thick outer wall and/or thick internal septa (type I; thick septation and thick wall were defined as equal or more than 0.5 cm, masses containing mixed cystic and solid components (at least 50% of cystic component (type II, predominantly solid with eccentric cystic foci (at least 50% of solid component (type III. Results: In 103 complex cystic masses, there are 27 lesions (26% classified as type I cystic breast masses, 37 lesions (36% as type II cystic breast masses and 39 lesions (38% type III cystic breast masses, 26 lesions (25.2% are proved to be malignant. All of type I cystic breast masses in our study are benign, and 14 (38% of type II cystic breast masses and 12 lesions (31% of type III cystic breast lesions are proved to be malignant. Conclusions: Type II and III lesions should suggest possibility of malignancy and biopsy should be performed in all lesions. All type I lesion in this study are benign. None of other parameters we included in this study (size or margin can effectively differentiate between benign or malignant cystic breast lesions. Also, grading of the malignant lesions by using type of cystic breast mass cannot be applied.

  10. Associated intracranial lesions: meningioma and anterior communicating aneurysm

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    Chiriac A.

    2016-09-01

    Full Text Available Asymptomatic associated intracranial lesions are more frequently diagnosed with the utilization of high-resolution imaging. The occurrence of brain tumors together with intracranial aneurysms are a very rare situation. This coexistence is still a diagnostic and therapeutic challenge as no consensus concerning imaging that may cover both type of intracranial lesion was established. We report a case of a 62 years old patient with a meningioma and aneurysm treated in one session with good outcome.

  11. Associated intracranial lesions: meningioma and anterior communicating aneurysm

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    Chiriac A.; Ion Georgiana; Faiyad Z.; Poeata I.

    2016-01-01

    Asymptomatic associated intracranial lesions are more frequently diagnosed with the utilization of high-resolution imaging. The occurrence of brain tumors together with intracranial aneurysms are a very rare situation. This coexistence is still a diagnostic and therapeutic challenge as no consensus concerning imaging that may cover both type of intracranial lesion was established. We report a case of a 62 years old patient with a meningioma and aneurysm treated in one session with good outcome.

  12. Mediastinal Cystic Lesions; Experience of 77 Patients

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    Koray Aydogdu

    2012-09-01

    Full Text Available Aim: Cystic lesions of the mediastinum are rare. Most of them are congenital lesions and account for 20% to 30 % of all primary masses of the mediastinum. A retrospective study of primary mediastinal cystic lesions (PMCL was conducted to review their clinical, radiological, and pathological features, as well as the early and long-term results of surgical management.Material and Method: From January 1998 through July 2008, 77 patients—47 females and 30 males, aged 4–81 years—with PMCL were treated in our department. All of the patients were analysed acording to the age, gender, symptoms, types of cysts and type of surgery. Results: There were thirty male patients (40 %, aged 4–81 years with a mean age of 39.2, and forty-seven female (60 % patients, aged 16–65 with a mean age of 35.8. Some of the patients’ pathology slides who were diagnosed as benign cysts before are re-examined then reclassified with the new diagnosis. There were thirty-one bronchogenic cysts (44 %; 19 female, 12 males, eighteen  pericardial coelomic cysts (24 %; 7 female, 11 male, five mediastinal hydatid cysts (6 %; 4 female, 1 male, five enterogenous cysts (6 %; 3 female, 2 male,  eight thymic cysts (10 %; 7 female, 1 male, two cystic lymphangiomatosis (4 %; 1 female, 1 male, five teratogenous cysts (6 %;  4 female, 1 male, and three pleural cysts (2 female, 1 male. The main symptoms were pain, fever, dyspnea, and coughing. Twenty-three patients (30 % were asymptomatic. All of the patients underwent surgery. Mean stay in the hospital was 8 days. We did not have any deaths. Discussion: Most of the patients with PMCL were female. Most of the PMCL were foregut lesions. Despite varied location and histology, the clinical presentation of mediastinal cysts was similar. Surgery provides the best chance for cure in all cases of PMCL.

  13. Differential points of mediastinal cystic lesion in chest computed tomography

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    Lee, Seung Jin; Baek, Jang Mi; Song, Jang Hyeon; Seon, Hyun Ju [Dept. of Radiology, Chonnam National University Hospital, Gwangju (Korea, Republic of); Kim, Yun Hyeon [Dept. of Radiology, Chonnam National University Hwasun Hospital, Hwasun (Korea, Republic of)

    2013-10-15

    To find differential diagnostic imaging findings of mediastinal cystic lesions in chest computed tomography. We retrospectively reviewed imaging findings of 70 patients with histopathologically proven mediastinal cystic lesions. They were 33 male and 37 female patients. Among 70 cases, 49 cases were in the anterior mediastinum, 12 cases were in the middle mediastinum, and 9 cases were in the posterior mediastinum. 19 patients had symptoms. Chest discomfort was the most common symptom. When the cystic lesion was located in the anterior mediastinum, and unilocular, the possibility of thymic cyst was the most likely (p < 0.0027). When the cystic lesion was located in the anterior mediastinum and was multilocular with a relatively thick wall, the possibility of a mature cystic teratoma was the most likely (p < 0.001). When the lesion was a high attenuation cystic lesion located around the air-way, the possibility of a bronchogenic cyst was the most likely (p < 0.001). Chest CT gives information about the location, loculation, wall thickness and internal attenuation of mediastinal cystic lesions. And certain details seen on CT imaging can help with the correct diagnosis, especially in the cases of thymic cyst, mature cystic teratoma and bronchogenic cyst.

  14. Diffusion-weighted imaging in characterization of cystic pancreatic lesions

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    Sandrasegaran, K., E-mail: ksandras@iupui.edu [Department of Radiology, Indiana University School of Medicine, Indianapolis, IN (United States); Akisik, F.M.; Patel, A.A.; Rydberg, M. [Department of Radiology, Indiana University School of Medicine, Indianapolis, IN (United States); Cramer, H.M.; Agaram, N.P. [Department of Pathology, Indiana University School of Medicine, Indianapolis, IN (United States); Schmidt, C.M. [Department of Surgery, Indiana University School of Medicine, Indianapolis, IN (United States)

    2011-09-15

    Aim: To evaluate whether apparent diffusion coefficient (ADC) measurements from diffusion-weighted imaging (DWI) can characterize or predict the malignant potential of cystic pancreatic lesions. Materials and methods: Retrospective review of the magnetic resonance imaging (MRI) database over a 2-year period revealed 136 patients with cystic pancreatic lesions. Patients with DWI studies and histological confirmation of cystic mass were included. In patients with known pancreatitis, lesions with amylase content of >1000 IU/l that resolved on subsequent scans were included as pseudocysts. ADC of cystic lesions was measured by two independent reviewers. These values were then compared to categorize these lesions as benign or malignant using conventional MRI sequences. Results: Seventy lesions were analysed: adenocarcinoma (n = 4), intraductal papillary mucinous neoplasm (IPMN; n = 28), mucinous cystic neoplasm (MCN; n = 9), serous cystadenoma (n = 16), and pseudocysts (n = 13). There was no difference between ADC values of malignant and non-malignant lesions (p = 0.06), between mucinous and serous tumours (p = 0.12), or between IPMN and MCN (p = 0.42). ADC values for low-grade IPMN were significantly higher than those for high-grade or invasive IPMN (p = 0.03). Conclusion: ADC values may be helpful in deciding the malignant potential of IPMN. However, they are not useful in differentiating malignant from benign lesions or for characterizing cystic pancreatic lesions.

  15. Radiological Evaluation of Cystic Lesions Presenting as Painful Knee

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    Rajpal Yadav

    2014-06-01

    Conclusion:Painful knee can be a presenting symptom of many cystic lesions of knee. Ultrasound can show the cystic abnormality, but it is only the Magnetic Resonance Imaging which can demonstrate the complete entity. [Cukurova Med J 2014; 39(3.000: 550-558

  16. Brainstem cysticercose simulating cystic tumor lesion: a case report

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    Walter O. Arruda

    1994-09-01

    Full Text Available The authors report the case of a 37 year-old man with a solitary cysticercus cyst in the brainstem (pons successfully removed through a suboccipital craniectomy. Surgery in neurocysticercosis has been indicated in patients with hydrocephalus and/or large cystic lesions. Cystic lesions in the brainstem and spinal cord may have indication for surgery for two reasons: (1 diagnosis; and (2 treatment. Aspects related to differential diagnosis and therapeutic alternatives are discussed.

  17. Increased Intracranial Pressure Following Removal of Intracranial Lesions

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    B. Ramamurthi

    1964-01-01

    Full Text Available Increased intracramal tension may 0 ise some days or ''leeks the problem may ari 1 of lrelUova "nt r a cra nial tumours or . lfter operation. , ""n" . " such increased tensicn raises the pOSS1- In the immed.',iate postoperat1ve perlOd" " f eopenino- Unrelieved tentorial -" d f c the dec1s10n or r O' lility of a clot rormattcn an ore ~ "e"ln .or the so called third day post " f thrombus Into a ma](Ir v .' , herniation. extenslOn 0 a f h raised intracranial pressure,. th common causes 0 sue operative oede~a. are e dematous blockage of ventricular system may When the ventnclc' has been opened. oe have to be tackled by repeated ventricular puncture. the fear of this postoperative oedema is the reason In posterior fossa surgery. '. - ' h many neurosuTgeons leave the dura open. w y " ommoner in posterior fossa " " tracranial presurc1 1S c Late onset of mcreased in f ttbromae or after excision of " b-total removal 0 neuro . operations spec1ally after su ti t the site of surgery or adheslOns block- " cyst forma ion a tubercnlomas. The cause :s Following air studies. a shunt procedure or a ing the cerebrospinal flUld "pa~hWay. tentorial incision would be md1cated.

  18. Adenocarcinoma of the lung presenting with atypical cystic brain lesions

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    Costa, Ricardo; Costa, Rubens B; Bacchi, Carlos; Sarinho, Filipe

    2014-01-01

    Brain metastases occur in up to 10–30% of patients with cancer. Metastatic lesions are usually diagnosed as multiple mass lesions at the junction of the grey and white matter with associated perilesional vasogenic oedema. Cysticercosis is an endemic disease in underdeveloped countries of Africa, Central and South America and is the most common parasitic infection of the central nervous system. The classical radiological finding of neurocysticercosis is cystic lesions showing the scolex in the brain parenchyma. We report a case of metastatic adenocarcinoma of the lung presenting with cystic brain lesions mimicking neurocysticercosis. PMID:24717598

  19. Cystic Lesions of the Gastrointestinal Tract: Multimodality Imaging with Pathologic Correlations

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    Lee, Jong Mee; Park, Cheol Min; Kim, Kyeong Ah; Lee, Chang Hee; Choi, Jae Woong; Shin, Bong Kyung; Lee, Soon Jin; Choi, Dong Il [Korea University College of Medicine Korea University Guro Hospital, Seoul (Korea, Republic of); Jang, Kee Taek [Sungkyunkwan University School of Medicine, Seoul (Korea, Republic of)

    2010-08-15

    The cystic lesions of the gastrointestinal (GI) tract demonstrate the various pathologic findings. Some lesions may present a diagnostic challenge because of non-specific imaging features; however, other lesions are easily diagnosed using characteristic radiologic features and anatomic locations. Cystic masses from the GI tract can be divided into several categories: congenital lesions, neoplastic lesions (cystic neoplasms, cystic degeneration of solid neoplasms), and other miscellaneous lesions. In this pictorial review, we describe the pathologic findings of various cystic lesions of the GI tract as well as the radiologic features of GI cystic lesions from several imaging modalities including a barium study, transabdominal ultrasound (US), computed tomography (CT), and magnetic resonance (MR) imaging

  20. Biopsy results of Bosniak 2F and 3 cystic lesions

    DEFF Research Database (Denmark)

    Rasmussen, René; Hørlyck, Arne; Nielsen, Tommy Kjærgaard

    Purpose: The distinction between benign and malignant complex cystic renal lesions remains a challenge. Bosniak 2F lesions are often followed with repeated CT for a minimum of five years, often entailing a high exposure to radiation. The aim of the present study was to evaluate whether biopsy could...... be helpful in clinical decisions. Material and Methods: From March 2013 - December 2014 a total of 295 percutaneous ultrasound guided biopsies from 287 patients with a suspected malignant renal lesion were performed at our institution. All cases were reviewed in PACS by (RR) and lesions presenting...... with a cystic change were re-evaluated and re-categorized after the Bosniak classification system. The re-evaluation and re-categorization was performed in consensus by a junior radiologist (RR) and an uro-radiological expert (OG). Results: Biopsies from eighteen Bosniak 2F cystic lesions were pathologically...

  1. Advanced endoscopic ultrasound management techniques for preneoplastic pancreatic cystic lesions

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    Arshad, Hafiz Muhammad Sharjeel; Bharmal, Sheila; Duman, Deniz Guney; Liangpunsakul, Suthat; Turner, Brian G

    2017-01-01

    Pancreatic cystic lesions can be benign, premalignant or malignant. The recent increase in detection and tremendous clinical variability of pancreatic cysts has presented a significant therapeutic challenge to physicians. Mucinous cystic neoplasms are of particular interest given their known malignant potential. This review article provides a brief but comprehensive review of premalignant pancreatic cystic lesions with advanced endoscopic ultrasound (EUS) management approaches. A comprehensive literature search was performed using PubMed, Cochrane, OVID and EMBASE databases. Preneoplastic pancreatic cystic lesions include mucinous cystadenoma and intraductal papillary mucinous neoplasm. The 2012 International Sendai Guidelines guide physicians in their management of pancreatic cystic lesions. Some of the advanced EUS management techniques include ethanol ablation, chemotherapeutic (paclitaxel) ablation, radiofrequency ablation and cryotherapy. In future, EUS-guided injections of drug-eluting beads and neodymium:yttrium aluminum agent laser ablation is predicted to be an integral part of EUS-guided management techniques. In summary, International Sendai Consensus Guidelines should be used to make a decision regarding management of pancreatic cystic lesions. Advanced EUS techniques are proving extremely beneficial in management, especially in those patients who are at high surgical risk. PMID:27574295

  2. Role of diffusion-weighted MR imaging in discrimination between the intracranial cystic masses

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    Ahmed Farid Yousef

    2014-09-01

    Results and conclusions: Patients in this study were categorized into three main groups; first group is brain abscesses (36 cases, 91.6% of them showed restricted diffusion, second group is malignant cystic or necrotic brain tumors, 28 cases of high grade necrotic glioma, 60.7% of them are free diffusion, and third group is benign cystic masses, arachnoid and epidermiod cysts (11 cases; all arachnoid cysts are free diffusion. From these results diffusion-weighted imaging is playing an important role in discrimination of cystic intracranial masses.

  3. Intracranial hypertension secondary to abdominal compartment syndrome in a girl with giant ovarian cystic mass.

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    Zavras, Nick; Christianakis, E; Ereikat, K; Mpourikas, D; Velaoras, K; Alexandrou, J

    2012-04-01

    The abdominal compartment syndrome (ACS) is a potentially fatal entity that occurs as a result of an acute increase in intra-abdominal pressure (IAP). The authors report on a girl with a giant ovarian cystic mass, and clinical signs of ACS and intracranial hypertension (ΙΗ). The possible mechanism of IH secondary to ACS is discussed.

  4. OK-432 sclerotherapy for benign cystic head and neck lesions

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    Kim, Chang Hyun; Rho, Myung Ho; Lee, Sang Wook [Masan Samsung Hospital, Masan (Korea, Republic of)

    2003-12-01

    To evaluate the efficacy of OK-432 solution for slerotheraphy of cystic lesions of the head and neck. Nineteen cystic lesions comprising ten plunging ranulas, three simple ranulas, three cystic lymphangiomas, one first branchial cleft cyst and two unknown supraclavicular cysts considered to be lymphangiomas were treated by sucking out as much liquid content as possible and then injecting the same volume of OK-432 solution under ultrasound guidance. Patients were followed up clinically and radiologically. Follow-up sonography or CT- performed after a mean interval of nine months showed total or near-total shrinkage of four plunging ranulas. However, six such lesions recurred in spite of more than one (mean, two) sclerotherapy sessions. In cases involving two simple ranulas at the floor of the mouth, failure resulted from extracystic leakage of OK-432 solution via the puncture site. Two unilocular cystic lymphangiomas completely regressed during the follow-up period (mean, seven months), but the multiocular type showed a 65% volume reduction after 12 months. A first branchial cleft cyst was markedly reduced in size, with only a small cystic portion remaining after eight months, follow-up. Two supraclavicular cysts with straw-color fluid did not respond to sclerotherapy. OK-432 sclerotherapy of macrocystic lymphangiomas is an effective and promising alternative to surgery. For other cysts, however, including plunging ranula, efficacy, varied, and 64% of such lesions recurred.

  5. Cystic lesions accompanying extra-axial tumours

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    Lohle, PNM; Wurzer, HAL; Seelen, PJ; Kingma, LM; Go, KG

    1999-01-01

    We examined the mechanism of cyst formation in extra-axial tumours in the central nervous system (CNS). Cyst fluid, cerebrospinal fluid (CSF) and blood plasma were analysed in eight patients with nine peritumoral cysts: four with meningiomas, two with intracranial and two spinal intradural schwannom

  6. Fetal cystic lung lesions: evaluation with magnetic resonance imaging.

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    Liu, Yu-Peng; Chen, Chih-Ping; Shih, Shin-Lin; Chen, Yi-Fang; Yang, Fei-Shih; Chen, Su-Chiu

    2010-06-01

    To investigate the contribution of magnetic resonance imaging (MRI) to the diagnosis of fetal cystic lung lesions found on routine prenatal ultrasound (US). Experienced radiologists retrospectively reviewed 34 fetal MRI studies performed in 20 fetuses (from 20 to 35 gestational weeks; including 14 repeat studies 10 weeks after the initial MRI), focusing on shape, signal characteristics, feeding artery, volume change, and location of the cystic lesions. Diagnoses were confirmed after birth by postnatal multidetector computed tomography (MDCT) and/or surgery. Bronchopulmonary sequestration (BPS) in the second trimester appeared as a well-defined, homogeneous, hyperintense mass (pure BPS) in eight cases or as a lobulated, inhomogeneous hyperintense mass (BPS mixed with congenital cystic adenomatoid malformation (CCAM)) in three cases. The feeding artery was visible in all 11 cases in the initial MRI, and regression of the mass was seen in 7 cases. As the mass regressed in the third trimester, the signal intensity decreased, becoming inhomogeneous, and the margins became lobulated. The mean initial ratio of the volume of the BPS lesion to the ipsilateral lung in lesions with partial regression was 82%; the mean initial ratio in lesions with nearly complete regression was 61%. CCAM (6) cases also appeared as a hyperintense lobulated mass, and as the lesions regressed, they decreased in size and signal intensity. As with BPS, the larger the lesion on initial MRI, the less likely it was to regress completely. Congenital lobar fluid overload in three cases appeared as a hyperintense, homogeneous lobe with stretched hilar vessels. Prenatal MRI is useful as a diagnostic tool complementary to US for evaluating fetal cystic lung lesions. Smaller lung lesions (<60%) may regress completely.

  7. Surgical pathology of cystic lesions of the mediastinum.

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    Petkar M

    2001-10-01

    Full Text Available BACKGROUND: Mediastinal cysts are uncommonly encountered in a pathologist′s experience. AIMS: To study the incidence, location, clinical presentation and histologic subtypes of cysts in the mediastinum. MATERIALS and METHODS: Cystic lesions of the mediastinum, surgically excised over a period of 22 years were studied after retrieval of relevant clinical data and slides. RESULTS: Thirty-nine mediastinal cysts were encountered in the study period. Most of the patients (81.5 % were symptomatic. Histologically, foregut cysts (19 cases, 50 % were the most common followed by teratomatous cysts (ten cases, 26.3 % and thymic cysts (four cases, 10.5 %. Bronchogenic cysts represented 63 % of the fore-gut cysts. Unusual lesions in the form of cystic mediastinal tuberculous lymphadenitis and cystic schwannoma were seen in three patients. CONCLUSIONS: Despite varied location and histology, clinical presentation of mediastinal cysts are similar. Surgical intervention is the preferred line of management.

  8. Dynamic multislice helical CT of maxillomandibular lesions. Distinction of ameloblastomas from other cystic lesions

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    Tozaki, Mitsuhiro; Hayashi, Katsuhiko; Fukuda, Kunihiko [Jikei Univ., Tokyo (Japan). School of Medicine

    2001-10-01

    The purpose of this study was to evaluate the clinical usefulness of dynamic multislice helical CT in differentiating ameloblastoma from other cystic lesions in cases of maxillomandibular cystic lesions. The study included 32 patients with maxillomandibular cystic lesions (ameloblastoma [n=6], myxofibroma [n=1], odontogenic keratocyst [n=3], dentigerous cyst [n=11], radicular cyst [n=11], and paradental cyst [n=2]). Dynamic study was performed before and 30 sec, and 90 sec after intravenous contrast medium administration. CT density values and percentage of density increase were calculated at 30 and 90 sec. In five cases of ameloblastoma, a rapidly enhancing area was detected within the cystic lesions at 30 sec, while no apparent rapid enhancement was seen in the other cystic lesions. Three cysts showed gradual enhancement in the marginal area at 90 sec. Comparing ameloblastoma and other kinds of cysts, we found significant differences in the percentage of density increase at 30 sec (p<0.01) and 90 sec (p<0.05). Dynamic multislice helical CT is useful in the diagnosis of cystic lesions of the maxillomandibular region, especially in the detection of neovascularities in ameloblastoma. (author)

  9. Purely cystic adrenal lesion in a newborn evolving into a solid neuroblastoma.

    Science.gov (United States)

    Gali, Shapira; Anat, Ilivitzki

    2015-02-01

    Purely cystic neuroblatomas are often discovered prenatally. As the main differential diagnosis is adrenal hemorrhage, follow-up sonography is warranted after birth. Cystic neuroblastomas are expected to evolve into lesions of mixed echogenicity with cystic and solid components. We present a rare case of a purely cystic left-sided adrenal lesion in a newborn, suggesting an adrenal hemorrhage, which on follow-up sonography evolved into a purely solid mass with poor vascularization, diagnosed as a cystic neuroblastoma. We suggest that even purely cystic adrenal masses in the newborn should be closely followed up with sonography, as they may represent purely cystic neuroblastomas. © 2015 Wiley Periodicals, Inc.

  10. Intraductal papillary mucinous neoplasms and other pancreatic cystic lesions

    Institute of Scientific and Technical Information of China (English)

    Hugh James Freeman

    2008-01-01

    Pancreatic cystic neoplasms are being increasingly recognized, even in the absence of symptoms, in large part, due to markedly improved imaging modalities such as magnetic resonance imaging (MRI)/magnetic resonance cholangio pancreatography (MRCP) and computer tomography (CT) scanning. During the past 2 decades, better imaging of these cystic lesions has resulted in definition of different types, including pancreatic intraductal papillary mucinous neoplasms (IPMN). While IPMN represent only a distinct minority of all pancreatic cancers, they appear to be a relatively frequent neoplastic form of pancreatic cystic neoplasm. Moreover, IPMN have a much better outcome and prognosis compared to pancreatic ductal adenocarcinomas. Therefore, recognition of this entity is exceedingly important for the clinician involved in diagnosis and further evaluation of a potentially curable form of pancreatic cancer.

  11. The MRI appearance of cystic lesions around the knee

    Energy Technology Data Exchange (ETDEWEB)

    McCarthy, Catherine L.; McNally, Eugene G. [Department of Radiology, Nuffield Orthopaedic Centre, Windmill Road, OX3 7LD, Headington, Oxford (United Kingdom)

    2004-04-01

    This review presents a comprehensive illustrated overview of the wide variety of cystic lesions around the knee. The aetiology, clinical presentation, MRI appearances and differential diagnosis are discussed. Bursae include those related to the patella as well as pes anserine, tibial collateral ligament, semimembranosus-tibial collateral ligament, iliotibial and fibular collateral ligament-biceps femoris. The anatomical extension, imaging features and clinical significance of meniscal cysts are illustrated. Review of ganglia includes intra-articular, extra-articular, intraosseous and periosteal ganglia, highlighting imaging findings and differential diagnoses. The relationship between proximal tibiofibular joint cysts and intraneural peroneal nerve ganglia is discussed. Intraosseous cystic lesions, including insertional and degenerative cysts, as well as lesions mimicking cysts of the knee are described and illustrated. Knowledge of the location, characteristic appearance and distinguishing features of cystic masses around the knee as well as potential imaging pitfalls such as normal anatomical recesses and atypical cyst contents on MR imaging aids in allowing a specific diagnosis to be made. This will prevent unnecessary additional investigations and determine whether intra-articular surgery or conservative management is appropriate. (orig.)

  12. Diagnosis and Management of Cystic Lesions of the Pancreas

    Directory of Open Access Journals (Sweden)

    Niraj Jani

    2011-01-01

    Full Text Available Pancreatic cysts are challenging lesions to diagnose and to treat. Determining which of the five most common diagnoses—pancreatic pseudocyst, serous cystic neoplasm (SCN, solid pseudopapillary neoplasm (SPN, mucinous cystic neoplasm (MCN, and intraductal mucinous papillary neoplasm (IPMN—is likely the correct one requires the careful integration of many historical, radiographic, laboratory, and other factors, and management is markedly different depending on the type of cystic lesion of the pancreas. Pseudocysts are generally distinguishable based on historical, clinical and radiographic characteristics, and among the others, the most important differentiation is between the mucin-producing MCN and IPMN (high risk for cancer versus the serous SCN and SPN (low risk for cancer. EUS with FNA and cyst-fluid analysis will continue to play an important role in diagnosis. Among mucinous lesions, those that require treatment (resection currently are any MCN, any MD IPMN, and BD IPMN larger than 3 cm, symptomatic, or with an associated mass, with the understanding that SCN or pseudocysts may be removed inadvertently due to diagnostic inaccuracy, and that a certain proportion of SPN will indeed be malignant at the time of removal. The role of ethanol ablation is under investigation as an alternative to resection in selected patients.

  13. Intracranial extension of adenoid cystic carcinoma of the palate: a case report

    Energy Technology Data Exchange (ETDEWEB)

    Oh, Yoon Kyeong; Kee, Keun Hong [College of Medicine, Chosun Univ., Kwangju (Korea, Republic of)

    1999-12-01

    Intracranial involvement by adenoid cystic carcinoma (ACC) is very rare and there is no report of intracranial extension from the palate ACC in Korea. Intracranial involvement can occur in one of three ways: direct extension, perineural spread, and hematogenous spread. A case report of a 35-year-old woman with intracranial ACC is presented. Initially she had ACC of the right palate and was treated by surgery and postoperative radiation therapy. Three years and 10 months later, the paresthesia in the distribution of ophthalmic and maxillary branch of right trigeminal nerve developed without evidence of recurrence in CT scan. Ptosis and total ophthalmoplegia developed sequentially and the second operation was performed. It was suggested that the tumor was spread perineurally along the trigeminal nerve into the Gasserian ganglion and then cavernous sinus and orbit. Seven years and 6 months after the first operation, direct intracranial extension into the right temporal lobe developed via sphenoid bone, sphenoid sinus and temporal bone and the third operation was done. And then Jung metastasis was diagnosed. She is alive for 9 years 5 months after first operation.

  14. Post-traumatic cystic lesion following fracture of the radius

    Energy Technology Data Exchange (ETDEWEB)

    Papadimitriou, Nikolaos G.; Christophorides, John; Beslikas, Theodoros A.; Papadimitriou, Ageliki G. [Aristotle University of Thessaloniki, 2. Orthopaedic University Clinic, Thessaloniki (Greece); Doulianaki, Eleni G. [Aristotle University of Thessaloniki, 1. Pediatric University Clinic, Thessaloniki (Greece)

    2005-07-01

    Post-traumatic cystic lesions are an uncommon complication of fractures in children. They are benign, asymptomatic, non-expansive and tend to resolve spontaneously. Their cause seems to be the invasion of bone-marrow fat by subperiosteal hematoma, which may be visible on radiographs during fracture consolidation of the newly formed subperiosteal bone. The case we present is of cyst formation following a fracture of the distal radius and we evaluate the role of yellow bone marrow in the pathogenesis of the cyst. Its typical features clear differentiation from other lesions, preventing unnecessary and, possibly, invasive examinations. (orig.)

  15. Intracranial alveolar echinococcosis: CT and MRI

    Energy Technology Data Exchange (ETDEWEB)

    Bensaid, A.H. (Dept. of Radiology B, Univ. Hospital, Strasbourg (France)); Dietemann, J.L. (Dept. of Radiology B, Univ. Hospital, Strasbourg (France)); Filippi de la Palavesa, M.M. (Dept. of Radiology B, Univ. Hospital, Strasbourg (France)); Klinkert, A. (Dept. of Radiology B, Univ. Hospital, Strasbourg (France)); Kastler, B. (Dept. of Radiology B, Univ. Hospital, Strasbourg (France)); Gangi, A. (Dept. of Radiology B, Univ. Hospital, Strasbourg (France)); Jacquet, G. (Dept. of Neurosurgery, Univ. Hospital, Besancon (France)); Cattin, F. (Dept. of Radiology, Univ. Hospital, Besancon (France))

    1994-05-01

    Intracranial alveolar echinococcosis is uncommon. We report a patient with right frontal lobe and palpebral lesions secondary to a primary hepatic focus with secondary lesion in the lung. The intracranial and palpebral cystic masses were totally removed and both proved to be alveolar hydatid cysts. An unusual feature in this case is CT and MRI demonstration of dural and bony extension. (orig.)

  16. Mesenteric gastrointestinal stromal tumour presenting as intracranial space occupying lesion

    Science.gov (United States)

    Puri, Tarun; Gunabushanam, Gowthaman; Malik, Monica; Goyal, Shikha; Das, Anup K; Julka, Pramod K; Rath, Goura K

    2006-01-01

    Background Gastrointestinal stromal tumours (GIST) usually present with non-specific gastrointestinal symptoms such as abdominal mass, pain, anorexia and bowel obstruction. Methods We report a case of a 42 year old male who presented with a solitary intracranial space occupying lesion which was established as a metastasis from a mesenteric tumour. Results The patient was initially treated as a metastatic sarcoma, but a lack of response to chemotherapy prompted testing for CD117 which returned positive. A diagnosis of mesenteric GIST presenting as solitary brain metastasis was made, and the patient was treated with imatinib. Conclusion We recommend that all sarcomas with either an intraabdominal or unknown origin be routinely tested for CD117 to rule out GIST. PMID:17105654

  17. A CASE SERIES OF CYSTIC LESIONS OF CONJUNCTIVA

    Directory of Open Access Journals (Sweden)

    Srinivas Rao

    2015-05-01

    Full Text Available INTRODUCTION: Cysticercosis is the most common parasitic disease of the nervous system. The disease occurs when humans become the intermediate host in the life cycle of Taenia solium by ingesting its eggs from contaminated food. The most common sites of involvement of cysticerci are soft tissue , eye and central nervous system. Unusual location of the cysts may result in uncommon manifestations. Ocular cysticercosis can involve both the intraocular and extra ocular muscle. Extra ocular muscle cysticercosis is rare. PRESENTATION OF CAS ES : In the department of ophthalmology , G.S.L medical college , Rajahmundry we are reporting 6 cases of cystic lesions of eye

  18. Functional MRI in Patients with Intracranial Lesions near Language Areas.

    Science.gov (United States)

    Hakyemez, B; Erdogan, C; Yildirim, N; Bora, I; Bekar, A; Parlak, M

    2006-06-30

    We aimed to depict Broca's area and Wernicke's area by word generation and sentence formation paradigms in patients with various intracranial lesions adjacent to language areas using functional MRI technique and to evaluate the ability of functional MRI to lateralize the hemispheric dominance for language. Twenty-three right-handed patients were included in this study. Lesions were classified as low-grade glioma (n=8), high-grade glioma (n=9), metastasis (n=1), meningioma (n=1), arteriovenous malformation (n=2) and mesial temporal sclerosis (n=2). We performed blood-oxygenated-level-dependant functional MRI using a 1.5-T unit. Word generation and sentence formation tasks were used to activate language areas. Language areas were defined as Brodmann 44, 45 (Broca's area) and Brodmann 22 area (Wernicke's area). Laterality index was used to show the dominant hemisphere. Two poorly cooperative patients showed no activation and were excluded from the study. Broca's area was localized in 21 patients (100 %). Wernicke's area, on the other hand, could only be localized in eight of the 21 patients (38 %).The left hemisphere was dominant in 86% of patients while atypical language lateralization (right or bilateral) was demonstrated in 14% of the patients. Bilateral activation areas were shown in 10% of those patients while right cerebral hemisphere was dominant in 4% of the patients. Word generation and sentence formation tasks are especially helpful in localizing Broca's area. Wernicke's area could also be demonstrated in some of the cases. Functional MRI can be used as an important and useful means of demonstrating language areas in patients with lesions adjacent to those areas and depicting the hemispheric dominance.

  19. Multidisciplinary diagnostic and therapeutic approaches to pancreatic cystic lesions

    Directory of Open Access Journals (Sweden)

    Clores MJ

    2014-02-01

    Full Text Available Michael J Clores, Amar Thosani, Jonathan M BuscagliaDivision of Gastroenterology, Department of Medicine, Stony Brook University School of Medicine, Stony Brook, NY, USAAbstract: Pancreatic cystic lesions are commonly encountered today with the routine use of cross-sectional imaging modalities such as computed tomography (CT and magnetic resonance imaging (MRI. The majority of patients discovered to have a pancreatic cyst are completely asymptomatic; yet the presence of such a finding instills fear in the minds of both patient and physician, as the concern for malignant transformation to pancreatic cancer is great despite the relatively low overall likelihood of cyst progression. Not all cysts in the pancreas represent pancreatic cystic neoplasms (PCNs, and not all PCNs have significant malignant potential. Mucinous PCNs are the most concerning, as these lesions have the greatest potential for cancerous transformation to adenocarcinoma. Within the group of mucinous PCNs, intraductal papillary mucinous neoplasms (IPMNs involving the main pancreatic duct are the most worrisome, and surgical resection should be pursued if the patient has appropriate operative risks. IPMN lesions involving the branch ducts, and mucinous cystadenomas, have a lower likelihood for malignancy, and they may be closely followed for the development of any worrisome or high-risk features. Surveillance of known PCNs is performed with a combination of CT, MRI and endoscopic ultrasound (EUS. EUS-guided fine-needle aspiration (EUS-FNA may be used to assess cyst fluid cytology, and also to detect cyst fluid amylase level, carcinoembryonic antigen level, and DNA molecular analysis in certain cases. The presence or absence of specific cyst morphological features, as well as the cyst fluid analysis, is what enables the physician to guide the patient towards continued surveillance, versus the pursuit of surgical resection.Keywords: endoscopic ultrasound, EUS-guided fine

  20. Lymphoepithelial cysts and cystic lymphangiomas: Underrecognized benign cystic lesions of the pancreas

    Institute of Scientific and Technical Information of China (English)

    Ioannis; T; Konstantinidis; Avinash; Kambadakone; Onofrio; A; Catalano; Dushyant; V; Sahani; Vikram; Deshpe; David; G; Forcione; Jennifer; A; Wargo; Carlos; Fernandez-del; Castillo; Keith; D; Lillemoe; Andrew; L; Warshaw; Cristina; R; Ferrone

    2014-01-01

    AIM: To identify their diagnostic and prognostic clinical characteristics in a large series.METHODS: Retrospective review of clinicopathologic and imaging characteristics of patients diagnosed with lymphoepithelial cysts and cystic lymphangiomas of the pancreas at Massachusetts General Hospital.RESULTS: Twelve patients were identified between 1/1/1997 and 8/1/2007. Their median age was 55.5 years(range 19-78 years), and 6 were females. The le-sion was incidentally discovered in half of the patients.Contrast enhanced computed tomography demonstrat-ed that the cysts had thin walls, without calcifications, pancreatic duct dilation or pancreatic parenchyma inva-sion. Endoscopic ultrasound with fine needle aspiration(EUS/FNA) confirmed the diagnosis of a lymphoepithe-lial cyst in 3 patients, one of whom was spared an op-eration and continues to do well after 6 years. Eleven patients had a resection: 3 pancreaticoduodenecto-mies, 7 distal pancreatectomies, and 1 enucleation. The median size of the cysts was 3 cm(range 2-20 cm). At a median follow-up of 57 mo no recurrences or other pancreas-related conditions occurred.CONCLUSION: Lymphoepithelial cysts and cystic lymphangiomas of the pancreas can be diagnosed with a combination of contrast-enhanced computed tomog-raphy scans and EUS/FNA. If the lesion is asymptom-atic, an operation might be avoided.

  1. Ciliated foregut cyst of the pancreas: another differential in the diagnosis of cystic pancreatic lesions.

    Science.gov (United States)

    Vyas, Soumil; Luong, Tu Vinh; Yu, Dominic; Rahman, Sakhanat

    2014-11-28

    With the more frequent use of cross sectional imaging, the detection of cystic pancreatic incidentalomas has become a relatively common entity. The commonest cystic incidentalomas are neoplastic. Pseudocysts are the most single common pathological entity. Foregut cystic lesions as a pathological entity are rare but mostly observed in the mediastinum. Ciliated foregut cysts of the pancreas are very rare and an extremely uncommon cause of a cystic lesion within the pancreas. We present herewith an uncommon case of a large cystic lesion, confirmed as a ciliated foregut cyst on final histology arising from the body and tail of the pancreas. The lesion was very effectively treated with a laparoscopic distal pancreatectomy and splenectomy. The rarity of the lesion makes the case worth reporting.

  2. Isolated cystic lesion of the callosal genu after traumatic brain injury.

    Science.gov (United States)

    Kato, Toru; Okumura, Akihisa; Tsuji, Takeshi; Emi, Misugi; Natsume, Jun

    2012-06-01

    We report the case of a 17-month-old infant who developed an isolated cystic lesion of the callosal genu as a unique lesion of traumatic axonal injury (TAI). Although one of the most common sites of TAI is the corpus callosum, there have been no reports describing the lesion seen in our patient. Brain computed tomography findings were normal on the day of the traffic accident. After 3 months, brain magnetic resonance imaging showed an isolated cystic lesion of the callosal genu that had the appearance of a cystic cavity. This lesion decreased in size 16 months later. The neuroimaging findings of this patient suggest that an isolated cystic lesion of the callosal genu could appear as a unique form of TAI in infants after traumatic brain injury (TBI), but it is nevertheless important to attend to such lesions in children with TBI.

  3. Cystic adrenal lesions: focus on pediatric population (a review).

    Science.gov (United States)

    Carsote, Mara; Ghemigian, Adina; Terzea, Dana; Gheorghisan-Galateanu, Ancuta Augustina; Valea, Ana

    2017-01-01

    The cysts may potentially affect any organ; adrenals cysts are rare. This is a review of the literature regarding adrenal cysts, focusing on children and young adults. Three major types have been described: pure cysts (endothelial, epithelial, and hemorrhagic or pseudocyst), parasitic (as hydatid) cysts and cystic part of a tumour (most frequent are neuroblastoma, ganglioneuroma, pheocromocytoma, and teratoma). The complications are: bleeding, local pressure effects; infection; rupture (including post-traumatic); arterial hypertension due to renal vessels compression. Adrenal hemorrhage represents a particular condition associating precipitating factors such as: coagulation defects as Factor IX or X deficiency, von Willebrand disease, thrombocytopenia; antiphospholipid syndrome; previous therapy with clopidogrel or corticosteroids; the rupture of a prior tumour. At birth, the most suggestive features are abdominal palpable mass, anemia, and persistent jaundice. Adrenal insufficiency may be found especially in premature delivery. The hemorrhage is mostly self-limiting. Antenatal ultrasound diagnosis of a cyst does not always predict the exact pathology result. The most important differential diagnosis of adrenal hemorrhage/hemorrhagic cyst is cystic neuroblastoma which is highly suggestive in the presence of distant metastases and abnormal catecholamine profile. The major clue to differentiate the two conditions is the fact that the tumor is stable or increases over time while the adrenal hemorrhage is expected to remit within one to two weeks. Pediatric adrenal cysts vary from simple cysts with a benign behavior to neoplasia- related lesions displaying severe prognosis as seen in cystic neuroblastoma. A multidisciplinary team is required for their management which is conservative as close follow-up or it makes necessary different surgical procedures in cases with large masses or if a malignancy suspicion is presented. Recently, laparoscopic approach is regarded as

  4. Cystic adrenal lesions: focus on pediatric population (a review)

    Science.gov (United States)

    CARSOTE, MARA; GHEMIGIAN, ADINA; TERZEA, DANA; GHEORGHISAN-GALATEANU, ANCUTA AUGUSTINA; VALEA, ANA

    2017-01-01

    Background and aim The cysts may potentially affect any organ; adrenals cysts are rare. This is a review of the literature regarding adrenal cysts, focusing on children and young adults. General data Three major types have been described: pure cysts (endothelial, epithelial, and hemorrhagic or pseudocyst), parasitic (as hydatid) cysts and cystic part of a tumour (most frequent are neuroblastoma, ganglioneuroma, pheocromocytoma, and teratoma). The complications are: bleeding, local pressure effects; infection; rupture (including post-traumatic); arterial hypertension due to renal vessels compression. Adrenal hemorrhage represents a particular condition associating precipitating factors such as: coagulation defects as Factor IX or X deficiency, von Willebrand disease, thrombocytopenia; antiphospholipid syndrome; previous therapy with clopidogrel or corticosteroids; the rupture of a prior tumour. At birth, the most suggestive features are abdominal palpable mass, anemia, and persistent jaundice. Adrenal insufficiency may be found especially in premature delivery. The hemorrhage is mostly self-limiting. Antenatal ultrasound diagnosis of a cyst does not always predict the exact pathology result. The most important differential diagnosis of adrenal hemorrhage/hemorrhagic cyst is cystic neuroblastoma which is highly suggestive in the presence of distant metastases and abnormal catecholamine profile. The major clue to differentiate the two conditions is the fact that the tumor is stable or increases over time while the adrenal hemorrhage is expected to remit within one to two weeks. Conclusion Pediatric adrenal cysts vary from simple cysts with a benign behavior to neoplasia- related lesions displaying severe prognosis as seen in cystic neuroblastoma. A multidisciplinary team is required for their management which is conservative as close follow-up or it makes necessary different surgical procedures in cases with large masses or if a malignancy suspicion is presented

  5. Magnetic Resonance Imaging in the Assessment of Cystic Pancreatic Lesions: Differentiation of Benign and Malignant Lesion Status

    Energy Technology Data Exchange (ETDEWEB)

    Haenninen, E. Lopez; Pech, M.; Ricke, J.; Denecke, T.; Amthauer, H.; Lehmkuhl, L.; Boehmig, M.; Roettgen, R.; Pinkernelle, J.; Felix, R.; Langrehr, J. [Charite Medical Univ. Center, Campus Virchow Clinic, Berlin (Germany). Depts. of Radiology, Visceral and Transplant Surgery, Gastroenterology and Hepatology

    2006-03-15

    Purpose: To characterize cystic pancreatic lesions and tumors with magnetic resonance imaging (MRI), and to assess the value of morphological criteria in differentiating pseudocysts versus cystic tumors and benign versus malignant cystic tumors. Material and Methods: Twenty-three patients with cystic pancreatic tumors or lesions underwent plain and contrast-material-enhanced MRI, including magnetic resonance cholangiopancreatography (MRCP). The MR findings were characterized and analyzed by two readers, and the role of various imaging criteria and combinations thereof for final lesion assignment were assessed. Final diagnoses were obtained from the results of open surgery (n = 19) and/or biopsy (n = 4). Results: Final diagnoses included cystic tumors (n = 11) and pseudocysts (n = 12). The lesions were located in the head (56%) and body or tail (44%). Lesion diameters ranged from 7 to 50 mm. Various lesion contrast enhancement patterns were observed for both benign and malignant lesions. Serous cystadenomas were located in the head, they were lobulated, and had wall diameters >2 mm; with the combination of these characteristics all patients with serous cystadenoma could be identified, whereas in no other patient was this constellation observed. Conclusion: MRI facilitated the diagnosis of serous cystadenomas, although no definite morphologic criterion for the differentiation between pseudocysts and mucinous cystadenomas was identified. In consideration of the substantial therapeutic consequences, either diagnostics in unclear cystic pancreatic lesions should comprise cyst fluid analysis if necessary, or eligible patients should be referred for surgical resection.

  6. Stereotactic radiosurgery for intracranial lesions using a linear accelerator

    Energy Technology Data Exchange (ETDEWEB)

    Shoji, Kazufusa [Mie Univ., Tsu (Japan). School of Medicine; Toyota, Shun; Seta, Hidetoshi [and others

    1996-09-01

    Experiences in 47 cases of stereotactic radiosurgery were reported. The surgery was carried out using stereotactic radiosurgery system of Fisher STP system (Leibinger Co.). The accelerator was Clinac 2100c (Varian Co., 10 mV X ray) or EXL-15 SP (Mitsubishi Co., 6 mV) equipped with collimator. CT and MRI imaging data were firstly transported to the working station to determine the target volume, target coordinates and radiation dose. Irradiation from 90deg to -90deg directions from isocenter of the linac was done within an error of 1 mm after the actual measurement of the target on the port film. The treatment was necessary for 6-8 hr and and irradiation was essentially complete for it. The dose was 20 Gy for metastatic brain tumors (31 patients), 14-16 Gy for acoustic neuroma (1) and 16 Gy for arteriovenous malformation (1). The local control rate of the brain tumors was as high as 90%. The complication was cerebral necrosis (1 case) and exacerbation of neurological symptoms (1), which exhibited remission with steroid treatment. Thus stereotactic radiosurgery with linac made it possible to treat intracranial lesions without invasion effectively and safely. (K.H.)

  7. Cysts and cystic-appearing lesions of the knee: A pictorial essay

    Directory of Open Access Journals (Sweden)

    Nicholas A Telischak

    2014-01-01

    Full Text Available Cysts and cystic-appearing lesions around the knee are common and can be divided into true cysts (synovial cysts, bursae, ganglia, and meniscal cysts and lesions that mimic cysts (hematomas, seromas, abscesses, vascular lesions, and neoplasms. The specific anatomic location of the cystic lesion often permits the correct diagnosis. In difficult cases, identifying a cystic mass in an atypical location and/or visualizing internal solid contrast enhancement on magnetic resonance imaging (MRI should raise concern for a neoplasm and the need for further evaluation and intervention.

  8. Application of Contrast-Enhanced Ultrasound in Cystic Pancreatic Lesions Using a Simplified Classification Diagnostic Criterion

    Directory of Open Access Journals (Sweden)

    Zhihui Fan

    2015-01-01

    Full Text Available Objective. Classification diagnosis was performed for cystic pancreatic lesions using ultrasound (US and contrast-enhanced ultrasound (CEUS to explore the diagnostic value of CEUS by comparison with enhanced CT. Methods. Sixty-four cases with cystic pancreatic lesions were included in this study. The cystic lesions of pancreas were classified into four types by US, CEUS, and CT: type I unilocular cysts; type II microcystic lesions; type III macrocystic lesions; and type IV cystic lesions with solid components or irregular thickening of the cystic wall or septa. Results. Eighteen type I, 7 type II, 10 type III, and 29 type IV cases were diagnosed by CT. The classification results by US were as follows: 6 type I; 5 type II; 4 type III; and 49 type IV cases. Compared with the results by enhanced CT, the kappa value was 0.36. Using CEUS, 15, 6, 12, and 31 cases were diagnosed as types I–IV, respectively. The kappa value was 0.77. Conclusion. CEUS has obvious superiority over US in the classification diagnostic accuracy in cystic pancreatic lesions and CEUS results showed substantial agreement with enhanced CT. CEUS could contribute to the differential diagnosis of cystic pancreatic diseases.

  9. Brain involvement by leprosy presenting as a frontal cystic lesion.

    Science.gov (United States)

    Lee, Kyung-Hwa; Moon, Kyung-Sub; Yun, Sook Jung; Won, Young Ho; Lee, Jae-Hyuk; Lee, Min-Cheol; Jung, Shin

    2014-07-01

    Leprosy has a predilection for peripheral nerves and is not considered to involve the CNS. The idea that the CNS is exempt from Mycobacterium leprae bacilli has been suspected from a clinical perspective or CSF study in leprosy patients. However, there has been no direct evidence for CNS involvement by leprosy in a living patient. To the best of the authors' knowledge, the present case is the first report providing histopathological and molecular evidence for CNS involvement by leprosy in a living patient. Brain MRI revealed a 2-cm cystic lesion in the right frontal lobe of the patient. The medical history revealed that the patient had been receiving multidrug therapy for borderline lepromatous leprosy. Neuronavigation-guided craniotomy and lesion removal were performed due to a presumptive diagnosis of low-grade glioma. The brain specimen demonstrated variably thickened blood vessels and densely scattered foamy macrophages in the perivascular spaces and parenchymal stroma. Fite acid-fast stain displayed red granular inclusions that were suggestive for fragmented M. leprae. M. leprae-specific nested polymerase chain reaction amplification showed positive bands, and DNA sequencing also demonstrated homology with the M. leprae genome. This case supports the notion that M. leprae can involve the cerebral cortex regardless of cranial nerve engagement.

  10. Diagnostic and radiological management of cystic pancreatic lesions: Important features for radiologists

    Energy Technology Data Exchange (ETDEWEB)

    Buerke, B., E-mail: buerkeb@uni-muenster.de [Department of Clinical Radiology, University of Muenster, Muenster (Germany); Domagk, D. [Department of Medicine B, University of Muenster, Muenster (Germany); Heindel, W.; Wessling, J. [Department of Clinical Radiology, University of Muenster, Muenster (Germany)

    2012-08-15

    Cystic pancreatic neoplasms are often an incidental finding, the frequency of which is increasing. The understanding of such lesions has increased in recent years, but the numerous types of lesions involved can hinder differential diagnosis. They include, in particular, intraductal papillary mucinous neoplasms (IPMN), serous cystic neoplasms (SCN), and mucinous cystic neoplasms (MCN). Knowledge of their histological and radiological structure, as well as distribution in terms of localization, age, and sex, helps to differentiate such tumours from common pancreatic pseudocysts. Several types of cystic pancreatic neoplasms can undergo malignant transformation and, therefore, require differentiated radiological management. This review aims to develop a broader understanding of the pathological and radiological characteristics of cystic pancreatic neoplasms, and provide a guideline for everyday practice based on current concepts in the radiological management of the given lesions.

  11. Intracranial subdural osteoma: a rare benign tumor that can be differentiated from other calcified intracranial lesions utilizing MR imaging.

    Science.gov (United States)

    Barajas, Ramon F; Perry, Arie; Sughrue, Michael; Aghi, Manish; Cha, Soonmee

    2012-10-01

    We report the magnetic resonance (MR) imaging characteristics of subdural osteoma and other benign calcified intracranial lesions to highlight imaging features that differentiate between these disease entities. A 63-year-old woman presented with progressively altered mental status. Non-contrast CT demonstrated a densely calcified right middle cranial fossa extra-axial mass. MR imaging of the lesion demonstrated T1 and T2 hypointensity without evidence of contrast enhancement, parenchymal abnormality, or connection to adjacent venous structures. Diffusion weighted imaging demonstrated markedly decreased signal intensity and artificially reduced diffusion on apparent diffusion coefficient map. Histologically, the tumor was predominantly composed of lamellar bone and small fragments of residual dura consistent with subdural osteoma. This case demonstrates that radiological examination can provide additional insight into the origin of intracranial osteomas (extradural versus subdural versus sinonasal) and help distinguish from other diagnostic considerations including benign meningeal ossification and calcified meningioma prior to surgical resection.

  12. A paradoxical decline: intracranial lesions in two HIV-positive patients recovering from cryptococcal meningitis.

    Science.gov (United States)

    Pettersen, Kenneth D; Pappas, Peter G; Chin-Hong, Peter; Baxi, Sanjiv M

    2015-10-16

    Cryptococcal immune reconstitution inflammatory syndrome (C-IRIS) is an increasingly important manifestation among patients with HIV/AIDS, especially as the use of antiretroviral therapy (ART) is expanding worldwide. Cryptococcus and associated C-IRIS are common causes of meningitis. While intracranial lesions are common in HIV/AIDS, they are rarely due to cryptococcosis or C-IRIS. We describe two cases of paradoxical C-IRIS associated with the development of intracranial cryptococcomas in HIV/AIDS. Both patients had an initial episode of cryptococcal meningitis treated with antifungal therapy. At the time, they had initiated or modified ART with subsequent evidence of immune reconstitution. Two months later, they developed aseptic meningitis with intracranial lesions. After exhaustive work ups, both patients were diagnosed with paradoxical C-IRIS and biopsy confirmed intracranial cryptococcomas. We review the important clinical, diagnostic and therapeutic features of cryptococcomas associated with C-IRIS in HIV/AIDS.

  13. Fluid collections and juxta-articular cystic lesions of the shoulder: spectrum of MRI findings

    Energy Technology Data Exchange (ETDEWEB)

    Mellado, J.M.; Salvado, E.; Camins, A.; Ramos, A.; Sauri, A. [Institut de Diagnostic per la Imatge, Hospital Joan XXIII, Tarragona (Spain); Merino, X. [Institut de Diagnostic per la Imatge, Hospital Vall' Ebron, Barcelona (Spain); Calmet, J. [Orthopaedic Surgery, Hospital Joan XXIII, Carrer Doctor Mallafre Guasch, Tarragona (Spain)

    2002-03-01

    The MR imaging features of fluid collections and juxta-articular cystic lesions of the shoulder are discussed, with special focus on those related to subacromial impingement and rotator cuff tears. Other more unusual fluid collections and cystic lesions are described, including rice-bodies bursitis, idiopathic synovial osteochondromatosis, dialysis-related amyloid arthropathy, hemophilic arthropathy, infectious conditions, non-infectious inflammatory arthritis, and paralabral cysts. (orig.)

  14. Epidemiology, Diagnosis, and Management of Cystic Lesions of the Pancreas

    Directory of Open Access Journals (Sweden)

    Koen de Jong

    2012-01-01

    Full Text Available Although little is known on the true prevalence of pancreatic cysts, physicians are currently more frequently confronted with pancreatic cysts because of the increasing use of sophisticated cross-sectional abdominal imaging. Cystic lesions of the pancreas comprise of a heterogeneous group of diagnostic entities, some of which are benign such as inflammatory pseudocysts or serous cystadenomas and do not require resection when asymptomatic. Others like mucinous cysts or intraductal papillary mucinous neoplasms (IPMN have a malignant potential and in these cases surgical resection is often indicated. For this reason an adequate distinction between the various cysts is crucial to optimize management strategy. Different diagnostic methods that could be of value in the differentiation include radiologic imaging techniques such as CT, MR, and endosonography. In addition, fluid aspiration for cytopathology, tumormarkers or molecular analysis is widely used. Different guidelines are available but so far no optimal diagnostic algorithm exists. We summarize the epidemiology, classification, clinical presentation, diagnostics, management, and future perspectives.

  15. Incidence of Radiographic Cystic Lesions Associated With Unerupted Teeth in Dogs.

    Science.gov (United States)

    Babbitt, Sam G; Krakowski Volker, Mary; Luskin, Ira R

    2016-12-01

    Medical records and radiographs were retrospectively reviewed over a 3-year period (2012-2015) from dogs presented to a private dental referral practice. Medical records were evaluated for the diagnosis of impacted or embedded teeth. The identified dogs' radiographs were reviewed for the presence of radiographically significant cystic lesions that were associated with the impacted or embedded teeth. Radiographic criteria were established by the authors for the purposes of identifying cystic lesions in dogs of different breeds and sizes, using established indices from human dental pathology as a basis. When histopathology results were available, they were reviewed and reported. In this study, 136 dogs ranging in age from 3 months to 17 years were diagnosed with 213 unerupted teeth during the study period. There were 62 (29.1%) of the 213 radiographically apparent cystic lesions identified based on the criteria proposed in this study. In this study, 146 (68.5%) of the 213 unerupted teeth were identified as mandibular first premolar teeth. Histopathology was obtained on 28 (45.1%) of the 62 diagnosed cystic lesions. Dentigerous cysts accounted for 20 (71.4%) of the 28 cystic lesions. Brachycephalic breeds were overrepresented in this study. Boxer, pug, Shih Tzu, and Boston terrier dogs were most likely to present with cystic lesions associated with unerupted teeth. Seventeen (85%) of the 20 cases with a histopathologic diagnosis of dentigerous cyst were found within these 4 brachycephalic breeds.

  16. Characteristics of bony changes and tooth displacement in the mandibular cystic lesion involving the impacted third molar

    OpenAIRE

    2014-01-01

    Objectives The purpose of this retrospective study is to find the differentiating characteristics of cystic and cystic-appearing lesions that involve the impacted mandibular third molar by analyzing panoramic radiographs and computed tomography images, and to aid the preoperative diagnosis. Materials and Methods Eighty-one patients who had a mandibular cystic or cystic-appearing lesion that involved impacted mandibular third molar and underwent cyst enucleation were included in the study. The...

  17. Endoscopic Ultrasound for the Evaluation of Cystic Lesions of the Pancreas

    Directory of Open Access Journals (Sweden)

    Mohammad Al-Haddad

    2010-07-01

    Full Text Available Although the exact prevalence of cystic pancreatic lesions is unknown, it is estimated to be around 1% of the general population based on large scale observational imaging studies [1]. While cystic pancreatic lesions are increasingly diagnosed due to the widespread use of cross-sectional imaging modalities like computed tomography (CT and magnetic resonance imaging (MRI, it is not known if this reflects a true increase in incidence [1]. Inflammatory pseudocysts constitute about 75% of pancreatic cysts but are not classified as true cystic pancreatic lesions since they are non-epithelial inflammatory fluid collections associated with acute or chronic pancreatitis [2]. About 15% of cystic pancreatic lesions can be classified as cystic neoplasms that require further evaluation and monitoring due to risk of progression to malignancy [1, 3]. Based on surgical pathology, cystic pancreatic lesions are classified by the type of epithelium lining the cyst. These include serous cystadenomas, intraductal papillary mucinous neoplasms (IPMN, mucinous cystadenomas, mucinous cystadenocarcinomas, solid pseudopapillary tumors and few other rare types [4].

  18. Acoustic radiation force impulse (ARFI) ultrasound imaging of pancreatic cystic lesions

    Energy Technology Data Exchange (ETDEWEB)

    D' Onofrio, M., E-mail: mirko.donofrio@univr.it [Department of Radiology, University Hospital G.B. Rossi, Piazzale L.A. Scuro 10, University of Verona, 37134 Verona (Italy); Gallotti, A. [Department of Radiology, University Hospital G.B. Rossi, Piazzale L.A. Scuro 10, University of Verona, 37134 Verona (Italy); Salvia, R. [Department of Surgery, University Hospital G.B. Rossi, Piazzale L.A. Scuro 10, University of Verona, 37134 Verona (Italy); Capelli, P. [Department of Pathology, University Hospital G.B. Rossi, Piazzale L.A. Scuro 10, University of Verona, 37134 Verona (Italy); Mucelli, R. Pozzi [Department of Radiology, University Hospital G.B. Rossi, Piazzale L.A. Scuro 10, University of Verona, 37134 Verona (Italy)

    2011-11-15

    Purpose: To evaluate the ARFI ultrasound imaging with Virtual Touch tissue quantification in studying pancreatic cystic lesions, compared with phantom fluid models. Materials and methods: Different phantom fluids at different viscosity or density (water, iodinate contrast agent, and oil) were evaluated by two independent operators. From September to December 2008, 23 pancreatic cystic lesions were prospectively studied. All lesions were pathologically confirmed. Results: Non-numerical values on water and numerical values on other phantoms were obtained. Inter-observer evaluation revealed a perfect correlation (rs = 1.00; p < 0.0001) between all measurements achieved by both operators per each balloon and fluid. Among the pancreatic cystic lesions, 14 mucinous cystadenomas, 4 pseudocysts, 3 intraductal papillary-mucinous neoplasms and 2 serous cystadenomas were studied. The values obtained ranged from XXXX/0-4,85 m/s in mucinous cystadenomas, from XXXX/0-3,11 m/s in pseudocysts, from XXXX/0-4,57 m/s in intraductal papillary-mucinous neoplasms. In serous cystadenomas all values measured were XXXX/0 m/s. Diagnostic accuracy in benign and non-benign differentiation of pancreatic cystic lesions was 78%. Conclusions: Virtual Touch tissue quantification can be applied in the analysis of fluids and is potentially able to differentiate more complex (mucinous) from simple (serous) content in studying pancreatic cystic lesions.

  19. Decompression Device Using a Stainless Steel Tube and Wire for Treatment of Odontogenic Cystic Lesions: A Technical Report.

    Science.gov (United States)

    Jung, Eun-Joo; Baek, Jin-A; Leem, Dae-Ho

    2014-11-01

    Decompression is considered an effective treatment for odontogenic cystic lesions in the jaw. A variety of decompression devices are successfully used for the treatment of keratocystic odontogenic tumors, radicular cysts, dentigerous cysts, and ameloblastoma. The purpose of these devices is to keep an opening between the cystic lesion and the oral environment during treatment. The aim of this report is to describe an effective decompression tube using a stainless steel tube and wire for treatment of jaw cystic lesions.

  20. Concurrent or sequential tibial subchondral cystic lesions in 4 horses with medial femoral condyle subchondral cystic lesions.

    Science.gov (United States)

    Bonilla, Alvaro G; Bertone, Alicia L; Brokken, Matthew T; Santschi, Elizabeth M

    2016-12-01

    CASE DESCRIPTION 4 horses were examined because of signs of chronic hind limb lameness. CLINICAL FINDINGS 3 horses had a history of lameness for > 6 months; specific duration was unknown for 1 horse. On initial evaluation, grade 3 to 4 (on a scale from 1 to 5) hind limb lameness was present in all 4 horses. Radiography of the stifle joint of the affected limb revealed medial femoral condyle subchondral lucencies or subchondral cystic lesions (SCLs) in all 4 horses, medial femorotibial osteoarthritis in 3 horses, and medial tibial condyle SCLs in 3 horses. TREATMENT AND OUTCOME 2 horses were treated medically (stall rest and oral NSAID administration), and 2 horses were treated surgically by means of medial femoral transcondylar lag screw placement through the medial femoral condyle SCLs. The 2 horses treated medically did not improve and were euthanized. Necropsy confirmed the presence of medial femoral condyle and medial tibial condyle SCLs. Surgical treatment did not resolve the lameness in 1 horse with SCLs in the medial tibial condyle and medial femoral condyle, and euthanasia was performed 150 days after surgery. In the second horse, a medial tibial condyle SCL was evident on radiographs obtained 3 months after surgery; however, this was not addressed surgically, and signs of lameness resolved 11 months after surgery. CLINICAL RELEVANCE Results of this small case series suggested that SCLs in the medial tibial condyle can occur in association with SCLs of the medial femoral condyle, with a poor prognosis for return to athletic function in affected horses. Further investigation is indicated.

  1. 3D-CT angiography. Intracranial arterial lesions

    Energy Technology Data Exchange (ETDEWEB)

    Asato, Mikio; Tong, X.Q.; Tamura, Shozo [Miyazaki Medical Coll., Kiyotake (Japan)] [and others

    1997-06-01

    Since its introduction, three dimensional CT angiography (3D-CTA) on spiral (helical) CT has played an important role in clinical imaging. Initially it was reported to be useful in depicting aortic abnormalities, afterwards the merit in detecting intracranial aneurysm by 3D-CTA was also described. We have investigated the usefullness of 3D-CTA in detecting patients of intracranial aneurysm as well as arterio-venous malformation (AVM), Moyamoya disease and stenosis of middle cerebral artery, meanwhile the MR angiography (MRA) and digital subtraction angiography (DSA) examination of these patients were also studied as comparison to the 3D-CTA results. The sensitivity and specificity on investigating intracranial aneurysm were similar with other reports so far. 3D-CTA was possible to identify the feeding artery, nidus and draining vein of AVM, although DSA showed higher detectability. Occlusion of internal carotid artery and post-operative anastomosis in Moyamoya disease were all demonstrated by 3D-CTA, however the Moyamoya collaterals were shown better on MRA. 3D-CTA revealed the site of stenosis of middle cerebral artery in all of our cases, but in general maximum intensity projection (MIP) images can provide more exact information about the degree of stenosis. Five years has passed since the emergence of spiral CT and utilizing of 3D-CTA in clinical applications. With the development of hard and soft ware in the near future, it is possible to delineate more small vessels by 3D-CTA. We predict that 3D-CTA would be widely used for detecting vasculature of the whole body, and may take the place of conventional angiography in many cases. (author)

  2. Groove Pancreatitis with Several Cystic Lesions around the Pancreatic Head Treated Conservatively: Report of a Case

    Directory of Open Access Journals (Sweden)

    Ryusuke Ito

    2008-11-01

    Full Text Available A 61-year-old man was admitted to our hospital with epigastric pain and vomiting. Enhanced abdominal computed tomography revealed inflammatory change of the pancreatic groove and focal wall thickening of the second portion of the duodenum with several cystic lesions around the head of the pancreas. We diagnosed atypical type of groove pancreatitis. The patient made a satisfactory recovery by conservative medication treatment for acute on chronic pancreatitis and cystic lesions disappeared in parallel with pancreatitis. Groove pancreatitis is a rare form of chronic pancreatitis, and to the best of our knowledge, our patient is the first case in the English literature of groove pancreatitis with cystic lesions around the head of the pancreas, which disappeared after conservative treatment for pancreatitis.

  3. A Study on Role of Magnetic Resonance Imaging (MRI in Intracranial Space Occupying Lesions

    Directory of Open Access Journals (Sweden)

    Bhavesh Ramjibhai Goyani

    2015-03-01

    Full Text Available Background: The high morbidity and mortality associated with Intracranial Space Occupying Lesions necessitates their early diagnosis so as to plan the intervention that is required. In the present study cases of either clinically suspected brain space occupying lesions or already diagnosed cases of brain space occupying lesions were studied by cross sectional imaging of MRI. Methodology: The present cross-sectional study was conducted presented with symptoms of raised ICT of sub acute onset and had lateralizing sign. A semi-structured questionnaire was prepared and demographic and clinical data like age, sex, symptoms and various morphological characters of Supratentorial SOLs were studied. A clinico-radiological correlation and confirmation of Radiological diagnosis was done by biopsy/surgery/MRI whenever possible to minimize patient follow up. Results: Majority of the patients were in the fourth decade (28.5%. Metastases were the most common single group of intracranial space occupying lesion (27%, Gliomas were the most common brain tumors (31.4%. Of the Gliomas, astrocytomas accounted for (81.8%. Most common hemisphere to be involved was the parietal lobe (31.4%. Intra-axial involvement (78.58 % was most common localization in present study. Edema was the most common associated MRI finding (74.3%. Conclusion: The diagnostic accuracy of MRI in evaluation of intracranial space occupying lesion was 98.57 %. MRI remains the first line investigation for diagnosing and evaluation Intracranial space occupying lesion with a reasonable degree of diagnostic accuracy and with the advent of newer modifications of MRI such as MR Spectroscopy, 3-Tesla MRI, and newer techniques like MR Perfusion. [Natl J Med Res 2015; 5(1.000: 18-21

  4. Comparative diagnostic performance of multidetector computed tomography and MRI for characterization of pancreatic cystic lesions

    Energy Technology Data Exchange (ETDEWEB)

    Moon, Sung Min; Shin, Sang Soo; Park, Jin Gyoon [Dept. of Radiology, Chonnam National University Hospital, Gwangju (Korea, Republic of); Jeong, Yong Yeon [Dept. of Radiology, Chonnam National University Hwasun Hospital, Hwasun (Korea, Republic of)

    2015-06-15

    To compare the diagnostic performance of multidetector computed tomography (MDCT) and magnetic resonance imaging (MRI) in characterization of pancreatic cystic lesions. We conducted a retrospective study on 34 patients with histopathologically proven cystic pancreatic lesions who underwent both preoperative MDCT and MRI. CT and MRI were independently evaluated for differentiating mucinous vs. non-mucinous lesions, differentiating aggressive vs. non-aggressive lesion, analyzing morphological features, and evaluating specific leading diagnoses. Sensitivity, specificity, and accuracy were determined. Competency assessment of lesional morphology analysis was performed using the kappa values of the 2 tests. The sensitivity, specificity, and accuracy of MRI for differentiating mucinous vs. non-mucinous lesions were higher than CT (p = 0.03). For differentiating aggressiveness, the sensitivity of MRI was better than CT, but the specificity of CT was better than MRI. In evaluation of morphologic features, MRI showed better performance in characterization of septa and wall. Otherwise, the 2 modalities showed similarly good performance. MRI was better than CT in determining a specific diagnosis (58.8% vs. 47.2%, respectively). CT and MRI are reasonable diagnostic methods for characterization of pancreatic cystic lesions. However, MRI enables more confident assessment than CT in differentiating mucinous vs. non-mucinous lesions and characterization of the septa and wall.

  5. CYSTIC LESIONS OF THE BRAIN - A CLASSIFICATION BASED ON PATHOGENESIS, WITH CONSIDERATION OF HISTOLOGICAL AND RADIOLOGICAL FEATURES

    NARCIS (Netherlands)

    GO, KG; HEW, JM; KAMMAN, RL; MOLENAAR, WM; PRUIM, J; BLAAUW, EH

    1993-01-01

    A classification of the existing multitude of cystic lesions of the brain is proposed, which allows an understanding of their genesis and consequent therapeutic implications, as well as their diagnostic characteristics. Essentially, cerebral cystic lesions may be classified into the following catego

  6. Contrast Enhanced Transabdominal Ultrasound in the Characterisation of Pancreatic Lesions with Cystic Appearance

    Directory of Open Access Journals (Sweden)

    Stefan A Beyer-Enke

    2010-09-01

    Full Text Available Context Contrast enhanced ultrasound (CEUS has been established for detection and characterisation of liver tumours and differential diagnosis of solid pancreatic lesions. The role of transabdominal CEUS in cystic pancreatic disease is less obvious. Objective We prospectively evaluated CEUS for characterization of undetermined cystic pancreatic lesions with respect to the differential diagnosis of pseudocysts and cystic neoplasia and differentiation between benign and malignant disease (gold standard: histology or cytology. Patients One-hundred and fourteen patients (63 males, 51 females; median age: 62 years, range: 33-87 years were prospectively examined. Investigations Conventional B-mode and transabdominal CEUS. Main outcome measures Conventional B-mode (criteria: solid nodules, septae, and contrast enhancing features of cystic pancreatic lesions (microperfusion of solid nodules were analysed. Final diagnoses were made by surgery (47 patients or histology/cytology and follow-up of at least one year (67 patients. Results Fifty patients proved to have neoplastic lesions (37 malignant, 13 of benign origin. Sixty-four patients had pseudocysts caused by acute (27 patients or chronic pancreatitis (37 patients. Conventional B-mode had a sensitivity of 94% and a low specificity of 44% in the differentiation of pseudocysts versus neoplasia. CEUS had a higher specificity of 77% with the same sensitivity of conventional B-mode ultrasound. The combination of conventional ultrasound and CEUS improved the specificity even more to 97% with an unchanged sensitivity. CEUS was not reliable in the differentiation of benign and malignant neoplasia. Conclusion CEUS improves the differentiation between pseudocysts and pancreatic neoplasia in comparison to the conventional B-mode imaging. The microvascularisation visualised using CEUS even in small nodules (with or without septae associated with cystic lesions is an indicator for cystic pancreatic neoplasia.

  7. Pulmonary cystic keratinizing squamous cell lesions of rats after inhalation/instillation of different particles.

    Science.gov (United States)

    Rittinghausen, S; Mohr, U; Dungworth, D L

    1997-12-01

    Cystic keratinizing squamous cell lesions from three inhalation studies (Study A, B, C) and one intratracheal instillation study (Study D) in rats were reclassified and a certain number of lesions examined immunohistochemically for PCNA (proliferating cell nuclear antigen) as a marker of cellular proliferation. The following classification was used: squamous cell metaplasia with marked keratinization, keratinizing cyst, cystic keratinizing epithelioma, cystic keratinizing squamous cell carcinoma, keratinizing squamous cell carcinoma and non-keratinizing squamous cell carcinoma. In study A (inhalation of coal oven exhaust and subcutaneous injection of a high dose of DB (ah)A) 49.3% of rats developed cystic keratinizing squamous cell carcinomas. Inhalation of coal oven exhaust gas together with intratracheal instillation of crocidolite or subcutaneous injection of a low dose DB(ah)A (dibenz(ah)anthracene) resulted in cystic keratinizing squamous cell carcinomas in 23% to 24% of the rats. High incidences of cystic squamous cell carcinomas in the range of 31.9% to 76.4% were observed in rats of Study B1 after a 10-months exposure to tar/pitch condensation aerosol (different B(a)P (benzo(a)pyrene) concentrations) with added carbon black in some groups. After a 20-months exposure period to the same inhalation atmospheres (Study B2) the incidence of squamous cell carcinomas was increased up to 95.8%. Exposure of rats to various concentrations of unfiltered diesel exhaust (Study C) resulted in incidences of cystic keratinizing epitheliomas ranging from 2.5% (2.5 mg/m3) to 10.7% (7.5 mg/m3). Epitheliomas were also observed in 16.2% of carbon black and 16.0% of titanium dioxide exposed rats. Only a few cystic keratinizing squamous cell carcinomas occurred. In the intratrachel instillation study (Study D) increased incidences of cystic keratinizing epitheliomas occurred in rats exposed to native diesel exhaust particles (16.7%), high dose of extracted diesel exhaust particles

  8. Role of dynamic CT perfusion study in evaluating various intracranial space-occupying lesions

    Directory of Open Access Journals (Sweden)

    Ravindra B Kamble

    2015-01-01

    Full Text Available Aims: Differentiating intracranial mass lesions on CT scan is challenging. The purpose of our study was to determine the perfusion parameters in various intracranial space-occupying lesions (ICSOL, differentiate benign and malignant lesions, and differentiate between grades of gliomas. Materials and Methods: We performed CT perfusion (CTP in 64 patients, with age ranging from 17 to 68 years, having space-occupying lesions in brain and calculated relative cerebral blood flow (rCBF and relative cerebral blood volume (rCBV. Results: We found significantly lower perfusion in low-grade gliomas as compared to high-grade tumors, lymphoma, and metastases. Similarly in infective lesions, TWT and abscesses showed significantly lower perfusion compared to TOT. In ring enhancing lesions, capsule of TWT showed significantly lower perfusion as compared to abscesses, TOT, and metastases. Conclusion: Thus, in conclusion, infective lesions can be differentiated from tumors like lymphomas, high-grade gliomas, or metastases based on perfusion parameters. The cut off value of rCBV 1.64 can be used to differentiate between low grade and high grade gliomas. However, depending only on perfusion parameters, differentiation between the tumors like lymphomas, high-grade gliomas, and metastases may not be possible.

  9. Cystic lesions of the jaws. Study of a three-year period.

    Directory of Open Access Journals (Sweden)

    Dimosthenis IGOUMENAKIS

    2014-04-01

    Full Text Available Cystic lesions of the jaws are common pathologic entity. Aim: The analysis of a case series of cystic lesions of the jaws. Material and Method: Retrospective study of the cases of cystic lesions, which were managed in our department during the years 2010 - 2012 was conducted. The following inclusion criteria of a case in the study were defined: maximum diameter of the lesion at least 2cm, surgical treatment of the lesion under general anesthesia and postoperative follow-up of the patient for at least one year. Results: 56 cases were analyzed. Average age of the patients was 48.2 years and the average maximum diameter of the lesions was 3.86cm. Almost all cases were managed by enucleation (49/56– 87.5%. Decompression was implemented in 5 cases (8.9%. In all cases, except for one where recurrence was observed, the result was cure of the lesion. The use of bone graft was correlated in statistically significant degree with seemingly quicker bone regeneration, but also with an increased risk of immediate postoperative wound dehiscence. Conclusions: Enucleation as well as decompression were proven to be good methods, as their use provided satisfactory results in all cases. The results of bone allograft application were controversial and therefore its use must be studied more thoroughly.

  10. Cystic Lesions in the Greater Tuberosity of the Humerus: The Relation to Rotator Cuff Tears and Age

    Energy Technology Data Exchange (ETDEWEB)

    Kim, Gang Deuk; Oh, Jung Taek [Wonkwang University Hospital, Iksan (Korea, Republic of)

    2008-12-15

    This study was designed to investigate the location of cystic lesions in the greater tuberosity of the humerus and the relationship to rotator cuff tears and age. A total of 78 patients (age range, 19-82 years; mean age, 51 years) who underwent arthroscopy or open surgery after MR arthrography (MRA) for a painful shoulder were enrolled in the study. The location of the cystic lesions were classified as 'A' for a supraspinatus insertion site, as 'C' for an infraspinatus insertion site, as 'B' for both a supraspinatus and infraspinatus insertion site, as 'BG' for a site posterior to the bicipital groove and as 'P' for a site at the bare area of the humeral head. The location of cystic lesions and supraspinatus and infraspinatus tears were evaluated on MRA. Statistical analyses used the chi-squared test and logistic regression. 'BG' and 'A' cystic lesions were related to the presence of a supraspinatus tear, 'C' cystic lesions were related to the presence of an infraspinatus tear and 'B' cystic lesions were related to the presence of both supraspinatus and infraspinatus tears (p < 0.05). 'P' cystic lesions were not related to the presence of rotator cuff tears. The incidence of cystic lesions increased with age, but with no statistical correlation. Cystic lesions at the supraspinatus and infraspinatus insertion sites are useful to predict the presence of a rotator cuff tear, but cystic lesions were not age related

  11. Cystic fibrohistiocytic tumor of the lung presenting as a solitary lesion

    Directory of Open Access Journals (Sweden)

    gGiorgio Sgarbi

    2010-03-01

    Full Text Available Cystic fibrohistiocytic tumor of the lung is a rare neoplasm. In many cases it represents a metastasis from a benign or low-grade fibrohistiocytic tumor of the skin, but occasionally it may be primary. Radiologically it usually occurs as a cystic change of multiple pulmonary nodules, and pneumothorax is the most frequent presenting symptom. We present here a 16-year-old man with recurrent right pneumothorax. The patient had no his-tory of cutaneous fibrohistiocytic lesions. He underwent videothoracoscopic right apical segmentectomy, right lower lobe nodulectomy, and pleuroabrasion. Microscopy of the apical segmentectomy showed a cystic fibrohistio-cytic tumor, whereas the nodule of the lower lobe was an intraparenchymal lymph node. The patient is alive with no tumor recurrence. The differential diagnosis includes Langerhans cell histiocytosis, lymphangioleiomyomatosis, pleuropulmonary blastoma, and metastatic endometrial stromal sarcoma. This disease usually occurs with multiple pulmonary cysts and cavitation. This case is the first reported presenting as a single lesion.

  12. Intracranial lesions in the acquired immunodeficiency syndrome: radiological (computed tomographic) features

    Energy Technology Data Exchange (ETDEWEB)

    Elkin, C.M.; Leon, E.; Grenell, S.L.; Leeds, N.E.

    1985-01-18

    Computed tomography (CT) delineates the presence or absence of intracerebral focal lesions in most instances. The presence of contrast enhancement, cerebral atrophy, and an intracranial mass are important in consideration of the differential diagnosis and in establishing the diagnosis. Initially the authors utilized a double dose of contrast medium in all patients after single-dose study, but little additional information was obtained. A second dose of contrast medium is now administered only to evaluate further a suspected lesion. Angiography can confirm the location of the lesion(s) and the cortical veins before biopsy. Of one hundred patients with AIDS examined, 33% had neurological symptoms excluding headache and herpes zoster. All patients with neurological symptoms were studied with noncontrast and contrast CT scanning. Twenty-seven patients in the group had abnormal scans. In 13, the abnormality was limited to a diffuse atrophic appearance, while in 14, focal lesions were identified. Representative cases are discussed and illustrated.

  13. Lithium-induced Nephrotoxicity: A Case Report of Renal Cystic Disease Presenting as a Mass Lesion

    Directory of Open Access Journals (Sweden)

    Yvonne McCartney

    2014-11-01

    Full Text Available Lithium is an effective therapeutic agent used in the management of bipolar disorder. However, lithium is also associated with several side effects, including renal toxicity. We present a case of a symptomatic cystic mass lesion in the kidney of a patient who had a history of lithium therapy for the management of bipolar disorder.

  14. Diffusion-weighted MR imaging of cystic lesions of neurocysticercosis: a preliminary study

    Energy Technology Data Exchange (ETDEWEB)

    Raffin, Luciana S.; Bacheschi, Luiz A.; Machado, Luis R.; Nobrega, Jose P.S.; Coelho, Christina; Leite, Claudia C. [Sao Paulo Univ., SP (Brazil). Faculdade de Medicina. Dept. de Neurologia]. E-mail: bacheschi@henet.usp.br

    2001-12-01

    Neurocysticercosis is an endemic disease in some developing countries. It has pleomorfic clinical and imaging findings, which are variable from patient to patient. In this preliminary note, we studied the magnetic resonance diffusion-weighted images of sixteen patients presenting with cystic lesions of this disease diagnosed by clinical and laboratorial findings. All the lesions had hypointense signal and the similar apparent diffusion coefficient values as the cerebrospinal fluid. (author)

  15. Complex cystic lesions of the breast on ultrasonography: Feature analysis and BI-RADS assessment

    Energy Technology Data Exchange (ETDEWEB)

    Hsu, Hsian-He, E-mail: hsianhe@yahoo.com.tw [Department of Radiology, Tri-Service General Hospital, National Defense Medical Center, Taiwan (China); Yu, Jyh-Cherng [Department of Surgery, Division of General Surgery, Tri-Service General Hospital, National Defense Medical Center, Taiwan (China); Lee, Herng-Sheng [Department of Pathology, Tri-Service General Hospital, National Defense Medical Center, Taiwan (China); Lin, Wen-Chiung; Chang, Wei-Chou [Department of Radiology, Tri-Service General Hospital, National Defense Medical Center, Taiwan (China); Tung, Ho-Jui [Department of Healthcare Administration, Asia University, Taiwan (China); Huang, Guo-Shu; Hsu, Giu-Cheng [Department of Radiology, Tri-Service General Hospital, National Defense Medical Center, Taiwan (China)

    2011-07-15

    Purpose: To analyze the features of breast complex cystic lesions at ultrasonography (US) and to determine appropriate Breast Imaging Reporting and Data System (BI-RADS) categories and management recommendations for these lesions based on US findings with pathologic correlation. Materials and methods: From July 2001 to June 2007, 152 consecutive pathologically proven complex cystic lesions on US were retrospectively reviewed. All lesions at US were evaluated for size, lesion characteristics, margins, and presence of abnormal axillary nodes. US features of lesions were classified into four types, and positive predictive values (PPVs) were calculated for each type. Clinical, imaging, and histopathological findings were reviewed. Results: Of the 152 lesions based on US appearance, 36 (24%) were classified as type I, 49 (32%) as type II, 28 (18%) as type III, and 39 (26%) as type IV. The PPVs for malignancy in each type were 14% for type I, 16% for type II, 14% for type III, and 41% for type IV. There was a significantly higher frequency of malignancy among lesions of type IV compared with the other three types (16/39 = 41% vs 5/36 = 14%, p = 0.0089; 16/39 = 41% vs 8/49 = 16%, p = 0.0098; and 16/39 = 41% vs 4/28 = 14%, p = 0.018 [Chi-squared test]). Lesions with maximum diameter equal to or larger than 20 mm, not circumscribed margins, or a mammographic finding of suspected malignancy had a high probability of malignancy (p < 0.05 for each). Conclusion: US is useful in evaluating the complex cystic lesions and in clarifying the indication for biopsy of these lesions. The four types of US classifications used in our study establish accepted benchmarks for these breast abnormalities when stratified according to BI-RADS categories.

  16. Ring enhancing intracranial lesion responding to antituberculous treatment in an HIV-infected patient

    OpenAIRE

    Daniela Pellegrino; Juliana Gerhardt; Porfírio,Fátima M.V.; Edgar Bortholi Santos; Dauar,Rafi F.; Augusto C. Penalva de Oliveira; José E. Vidal

    2010-01-01

    Cerebral tuberculomas constitute a major differential diagnosis of cerebral toxoplasmosis in human immunodeficiency virus (HIV)-infected patients in developing countries. We report the case of a 34-year old woman co-infected with HIV and possible disseminated tuberculosis (hepatitis, lymphadenopathy, and pleural effusion) who presented a large and solitary intracranial mass lesion. Despite extensive diagnostic efforts, including brain, ganglionar, and liver biopsies, no definitive diagnosis w...

  17. Role of tissue harmonic imaging in characterization of cystic renal lesions.

    Science.gov (United States)

    Mohammed, Asmi; Sandhu, Manavjit S; Lal, Anupam; Sodhi, Kushaljit S; Sud, Kamal; Kohli, Harbir S

    2008-12-01

    To determine the utility of tissue harmonic imaging in evaluating cystic renal lesions and to compare these findings with conventional ultrasound guidance (USG) and CT. Thirty patients, detected with cystic renal lesions on routine USG (over a period of 18 months from July 2004 to December 2005 at the Postgraduate Institute of Medical Education and Research Chandigarh, Chandigarh, India) were included in this study. All patients underwent a conventional gray scale ultrasound study (GSI), followed by tissue harmonic imaging (THI) sonography on the same machine (advance technology limited high definition imaging 5000). Computed tomography of abdomen was carried out within one week of the ultrasound examinations. All images were evaluated for size, number, and location of lesions. The findings of THI sonography, conventional USG and CT of abdomen were recorded in their respective proformas. The images obtained by GSI, THI, and contrast enhanced CT were also evaluated for image quality, lesion conspicuity, and fluid-solid differentiation. Tissue harmonic imaging showed better image quality in 27 of 34 lesions, improvement in lesion conspicuity was found in 27 of 34 cystic lesions, and an improved solid-fluid differentiation in 30 of 34 lesions when compared to GSI. The THI provided additional information as compared to GSI in 8 patients. The grading of CT scan was significantly higher in overall image quality (p=0.007) and lesion conspicuity (p=0.004), but was non-significant for fluid-solid differentiation (p=0.23). Tissue harmonic imaging provides better image quality, lesion delineation, and superior characterization than conventional gray scale sonography.

  18. Intracranial lesions with high signal intensity on T1-weighted MR images – review of pathologies

    Science.gov (United States)

    Zimny, Anna; Zińska, Lidia; Bladowska, Joanna; Neska-Matuszewska, Małgorzata; Sąsiadek, Marek

    2013-01-01

    Summary In the article we present pathological intracranial substances and lesions, which produce high signal intensity on T1-weighted MR images. Six groups of substances are discussed: 1. Gadolinium – based contrast agents, 2.hemoglobin degradation products (intra- and extra-cellular methemoglobin), 3. lipid-containing lesions (lipoma, dermoid cyst, implanted fatty materials, laminar cortical necrosis), 4. substances with high concentration of proteins (colloid cyst, craniopharyngioma, Rathke’s cleft cyst, ectopic posterior pituitary gland), 5. melanin (metastatic melanoma), 6. lesions containing mineral substances such as: calcium (calcifications, Fahr’s disease), copper (Wilson’s disease) and manganese (hepatic encephalopathy, manganese intoxication in intravenous drug abusers). Appropriate interpretation of signal intensity as well as analysis of location of lesions and clinical symptoms enables planning of further diagnostics and, in many cases, establishing the final diagnosis based on MR examination. PMID:24505222

  19. Role of shear-wave elastography (SWE) in complex cystic and solid breast lesions in comparison with conventional ultrasound

    Energy Technology Data Exchange (ETDEWEB)

    Lee, Bo Eun; Chung, Jin, E-mail: aqua0724@ewha.ac.kr; Cha, Eun-Suk; Lee, Jee Eun; Kim, Jeoung Hyun

    2015-07-15

    Highlights: • Complex cystic lesions have a broad spectrum of malignancy rate. • SWE is useful to evaluate cystic breast lesions. • Cutoff value of Emax was 108.5 kPa, for predicting malignancy. • Using this cutoff value, sensitivity of 86.7% and specificity of 97.3%. • SWE could reduce unnecessary biopsies in complex cystic and solid breast lesions. - Abstract: Objective: To evaluate the additional role of shear-wave elastography (SWE) in differential diagnosis of complex cystic and solid breast lesions. Materials and methods: From January 2013 to November 2013, 140 complex cystic and solid breast lesions from 139 consecutive patients were performed ultrasound and SWE prior to biopsy. BI-RADS ultrasound final assessment and SWE parameters were recorded for each lesion. Histopathologic diagnosis was used as the reference standard. Results: Among the 140 lesions, 30 lesions (21.4%) were malignant. The mean maximum elasticity (Emax) of malignant lesions (184.3 kPa) was significantly higher than that of benign lesions (45.5 kPa) (P < 0.001). Homogeneity of elasticity and color pattern were significantly different from malignancy and benign lesions (P < 0.05). Emax with cutoff value at 108.5 kPa showed Az value of 0.968 (95% CI, 0.932–0.985) with sensitivity of 86.7% and specificity of 97.3%. Using this cutoff value, false-positive rate was 2.7% and false-negative rate was 13.3%. By applying an Emax value of 108.5 kPa or less as a criterion for downgrading BI-RADS category 4a lesions to category 3 lesions, 103/123 (83.7%) lesions could be downgraded to category 3 lesions. Conclusion: Additional use of SWE could reduce unnecessary benign biopsies in complex cystic and solid breast lesions.

  20. Different information by MRI compare to ultrasound in fetal intracranial space occupying lesions.

    Science.gov (United States)

    Xia, Wei; Kasprian, Gregor; Hu, Daoyu; Xiao, Peng; Yang, Wenzhong; Chen, Xinlin

    2017-07-10

    The purpose of this study was to evaluate the value of prenatal magnetic resonance imaging (MRI) in characterizing fetal intracranial space occupying lesions in comparison to prenatal ultrasound. This retrospective study included 50 fetuses (mean age 26 years, mean gestational weeks 31 + 1 GW) with intracranial space occupying lesions, suspected by prenatal screening ultrasound. T2-weighted, T1-weighted, SSFP, and diffusion-weighted sequences of the fetal brain were obtained on a 1.5 T unit. Pathology (n = 5), postmortem MRI (n = 3), or postnatal US (n = 42) was available as standard of reference. The fetal MRI provided correct diagnosis in 49 cases (98%), while 35 (70%) by ultrasound, and MRI failed in 1 case (2%), while ultrasound failed in 15 cases (30%). Fetal MR and ultrasound were concordant in 35 of 50 cases (70%), completely discordant in 4 (8%), and partially discordant in 11 (22%) cases. MRI could provide detailed information about the minor lesions, such as focal hemorrhage and periventricular nodules. Meanwhile, it could provide whole view of the lesion in order to delineate the surrounding anatomical structure. But there are still some limitations of its soft-tissue resolution in a case with teratoma; more effort is needed to improve the sequences.

  1. Radiographic features of large cystic lesions of the jaws in children

    Energy Technology Data Exchange (ETDEWEB)

    Bodner, Lipa; Woldenberg, Yitzhak [Department of Oral and Maxillofacial Surgery, Soroka Medical Center, P.O. Box 151, Beer-Sheva 84101 (Israel); Bar-Ziv, Jacob [Department of Radiology, Hebrew University and Hadassab School of Medicine, Jerusalem (Israel)

    2003-01-01

    The surgical approach to cystic lesions of the jaws is either marsupialisation or enucleation. The treatment of choice is dependent on the size of the lesion, the bony integrity of the cyst and its proximity to anatomical structures.Objectives. To assess large (>2.0 cm) cystic lesions of the jaws using plain film radiography (PFR), CT, multiplanar reconstruction program (MPR) and three-dimensional CT (3D-CT).Patients and methods. Twelve children aged 7-14 years.Results. The classic radiological feature was a unilocular radiolucent area surrounded by a well-defined radio-opaque margin adjacent to the root of a non-viable tooth or associated with the crown of an unerupted tooth. Malposition of teeth and root resorption were more common in dentigerous cysts. The features seen on CT were clear and more precise than those seen on PFR. MPR, by the three-dimensional visualisation of the jaw (axial, panoramic, and bucco-lingual), provided useful information for determining the outline of the cyst and its proximity to adjacent anatomical structures, such as teeth, nerves or maxillary sinus. 3-D CT further and more clearly demonstrated discontinuity in the buccal or palatal/lingual cortices of the jaw bone. PFR was very accurate in determining root resorption.Conclusions. CT with MPR and, ideally, 3-D CT should be used for the comprehensive diagnostic work-up and meticulous surgical management of large cystic lesions of the jaws in children. (orig.)

  2. Cross-sectional prevalence of pancreatic cystic lesions in patients with acromegaly, a single-center experience.

    Science.gov (United States)

    Odake, Yukiko; Fukuoka, Hidenori; Yamamoto, Masaaki; Arisaka, Yoshifumi; Konishi, Junya; Yoshida, Kenichi; Matsumoto, Ryusaku; Bando, Hironori; Suda, Kentaro; Nishizawa, Hitoshi; Iguchi, Genzo; Yamada, Shozo; Ogawa, Wataru; Takahashi, Yutaka

    2017-05-24

    Acromegaly is a disease associated with an increased risk for several kinds of neoplasms including colon and thyroid cancer. Although the association between acromegaly and pancreatic neoplasms has not been elucidated, it has recently been reported that GNAS gene mutations were found in 58% of intraductal papillary mucinous neoplasms (IPMNs), which are representative pancreatic cystic lesions, suggesting a link between IPMNs and acromegaly. To assess the prevalence of pancreatic cystic lesions in patients with acromegaly, we performed a retrospective cross-sectional single institute study. Thirty consecutive acromegalic patients (20 females and 10 males; mean age, 60.9 ± 11.9 years) who underwent abdominal contrast-enhanced computed tomography or magnetic resonance imaging between 2007 and 2015 at Kobe University Hospital were recruited. We also analyzed the relationship between presence of pancreatic cystic lesions and somatic GNAS mutations in pituitary tumors. Seventeen of 30 (56.7%) patients studied had pancreatic cystic lesions. Nine of 17 patients (52.9%) were diagnosed with IPMNs based on imaging findings. These results suggest that the prevalence of IPMNs may be higher in acromegalic patients in acromegalic patients than historically observed in control patients (up to 13.5%). In patients with pancreatic cystic lesions, the mean patient age was higher and the duration of disease was longer than in those without pancreatic cystic lesions (67.0 ± 2.3 vs. 53.0 ± 2.7 years, p lesions. These data demonstrate that old or long-suffering patients with acromegaly have a higher prevalence of pancreatic cystic lesions. Moreover, the prevalence of pancreatic cystic lesions may be increased in acromegalic patients.

  3. Modern diagnostics of cystic liver lesions and hemangiomas; Moderne Diagnostik zystischer Leberlaesionen und Haemangiome

    Energy Technology Data Exchange (ETDEWEB)

    Poetter-Lang, S.; Bastati-Huber, N.; Ba-Ssalamah, A. [Medical University of Vienna, Department of Biomedical Imaging and Image-guided Therapy, Wien (Austria); Brancatelli, G. [Universitaetsklinikum Palermo, Abteilung Radiologie, Palermo (Italy)

    2015-01-01

    Cystic liver lesions incorporate a broad heterogeneous group of mostly benign but also malignant abnormalities. The radiological aim is the non-invasive diagnosis with the use of different imaging modalities to determine the type of lesion. The common generally asymptomatic incidental findings of cystic lesions on ultrasound, computed tomography (CT) and magnetic resonance imaging (MRI) must be classified on the basis of specific imaging features. Such a differentiation is essential because the clinical consequences and the appropriate therapy can vary depending on the underlying pathology. Due to the morphological overlap of many cystic lesions, conventional radiological methods are often insufficient. The huge advances in cross-sectional imaging (multidetector CT, MRI with special sequences and different contrast agents and MR cholangiopancreatography) in combination with the clinical history usually enable a non-invasive diagnosis. Pathognomonic morphological and hemodynamic lesion features, as well as a knowledge of the pathomechanisms, help to differentiate this broad spectrum of entities. In this article the different entities of cystic liver lesions, together with the appropriate diagnostic method for detection and distinction and including their strengths and limitations, are demonstrated. A well-founded knowledge about the development of various cystic liver lesions and the suitable choice of imaging method facilitate a non-invasive diagnosis. (orig.) [German] Die zystischen Leberlaesionen umfassen eine grosse heterogene Gruppe meist benigner, jedoch auch maligner Veraenderungen. Das radiologische Ziel ist die nichtinvasive Artdiagnose mithilfe verschiedener bildgebender Verfahren. Die haeufigen, meist asymptomatischen Zufallsbefunde in Ultraschall, CT und MRT muessen anhand spezieller bildgebender Kriterien klassifiziert werden. Eine Differenzierung ist hierbei essenziell, da die klinischen Konsequenzen und weiterfuehrenden Therapien je nach zugrunde

  4. Simulated cystic renal lesions: quantitative X-ray phase-contrast CT--an in vitro phantom study

    National Research Council Canada - National Science Library

    Fingerle, Alexander A; Willner, Marian; Herzen, Julia; Münzel, Daniela; Hahn, Dieter; Rummeny, Ernst J; Noël, Peter B; Pfeiffer, Franz

    2014-01-01

    To determine if grating-based x-ray phase-contrast computed tomography (CT) can allow differentiation of simulated simple, protein-rich, hemorrhagic, and enhancing cystic renal lesions in an in vitro phantom...

  5. STUDY OF INTRAOPERATIVE SQUASH CYTOLOGY OF INTRACRANIAL AND SPINAL CORD LESIONS WITH HISTOPATHOLOGICAL AND IHC STUDY

    Directory of Open Access Journals (Sweden)

    Naval Kishore Bajaj

    2016-07-01

    Full Text Available BACKGROUND The causes of discordant diagnoses achieved at squash cytology of intracranial and spinal cord tumours were ascertained. Lesions having the advantage of diagnostic accuracy by squash cytology of intracranial and spinal cord lesions was also determined. METHODS Squash preparations of 72 patients suspected to have neoplasia were made and stained with rapid haematoxylin and eosin stain and toluidine blue stain. The smears were classified according to the cytomorphological criteria and the squash cytodiagnoses were compared. RESULTS Total 72 cases were studied, 93.9% were neoplastic and 6.1% non-neoplastic on histopathology. Amongst neoplasms, Astrocytic tumours constituted 26.3% of cases followed by Meningiomas comprising 20.8%. Amongst the benign lesions, Tuberculoma was seen most frequently (6.95%. Overall diagnostic accuracy of squash was 98.65%. On statistical analysis, Sensitivity, Specificity, Positive Predictive value (PPV and Negative Predictive Value (NPV of squash cytology were 98.6%, 100%, 100% and 80% respectively. CONCLUSION Intraoperative Squash is reliable, accurate, cost effective diagnostic modality when combined with histopathological and immunohistochemical techniques.

  6. Combined monitoring of evoked potentials during microsurgery for lesions adjacent to the brainstem and intracranial aneurysms

    Institute of Scientific and Technical Information of China (English)

    KANG De-zhi; WU Zan-yi; LAN Qing; YU Liang-hong; LIN Zhang-ya; WANG Chen-yang; LIN Yuan-xiang

    2007-01-01

    Background Neurophysiologic monitoring during surgery is to prevent permanent neurological injury resulting from surgical manipulation. To improve the accuracy and sensitivity of intraoperative neuromonitoring, combined monitoring of transcranial electrical stimulation motor evoked potentials (TES-MEPs), somatosensory evoked potentials (SSEPs) and brainstem auditory evoked potentials (BAEPs) was attempted in microsurgery for lesions adjacent to the brainstem and intracranial aneurysms.Methods Monitoring of combined TES-MEPs with SSEPs was attempted in 68 consecutive patients with lesions adjacent to the brainstem as well as intracranial aneurysms. Among them, 31 patients (31 operations, 28 of posterior cranial fossa tumors, 3 of posterior circulation aneurysms) were also subjected to monitoring of BAEPs. The correlation of monitoring results and clinical outcome was studied prospectively.Results Combined monitoring of evoked potentials (EPs) was done in 64 (94.1%) of the 68 patients. MEPs monitoring was impossible for 4 patients (5.9%). No complication was observed during the combined monitoring in all the patients. In 45 (66.2%) of the 68 patients, EPs were stable, and they were neurologically intact. Motor dysfunction was detected by MEPs in 8 patients, SSEPs in 5, and BAEPs in 4, respectively.Conclusions A close relationship exists between postoperative motor function and the results of TES-MEPs monitoring.TES-MEPs are superior to SSEPs and BAEPs in detecting motor dysfunction, but combined EPs serve as a safe,effective and invasive method for intraoperative monitoring of the function of the motor nervous system. Monitoring of combined EPs during microsurgery for lesions adjacent to the brainstem and intracranial aneurysms may detect potentially hazardous maneuvers and improve the safety of subsequent procedures.

  7. Bosniak classification of renal cystic lesions according to multidetector computed tomography findings*

    Science.gov (United States)

    de Miranda, Christiana Maia Nobre Rocha; Maranhão, Carol Pontes de Miranda; dos Santos, Carla Jotta Justo; Padilha, Igor Gomes; de Farias, Lucas de Pádua Gomes; da Rocha, Milzi Sarmento

    2014-01-01

    Renal cystic lesions are usually diagnosed in the radiologists’ practice and therefore their characterization is crucial to determine the clinical approach to be adopted and prognosis. The Bosniak classification based on computed tomography findings has allowed for standardization and categorization of lesions in increasing order of malignancy (I, II, IIF, III and IV) in a simple and accurate way. The present iconographic essay developed with multidetector computed tomography images of selected cases from the archives of the authors’ institution, is aimed at describing imaging findings that can help in the diagnosis of renal cysts. PMID:25741060

  8. Lesion stability characteristics outperform degree of stenosis in predicting outcomes following stenting for symptomatic intracranial atherosclerosis.

    Science.gov (United States)

    Alexander, M D; Cooke, D L; Meyers, P M; Amans, M R; Dowd, C F; Halbach, V V; Higashida, R T; Hetts, S W

    2016-01-01

    Intracranial atherosclerotic disease (ICAD) causes substantial morbidity and mortality. Treatment decisions have most commonly been driven by the degree of luminal stenosis. This study compares ICAD lesion stability features with percentage stenosis for associations with adverse outcomes following treatment with stents. Retrospective analysis was performed of prospectively maintained procedure logs. Lesions were classified by symptom type as hypoperfusion, non-hypoperfusion, or indeterminate, and pretreatment asymptomatic intervals were noted. Hypoperfusion lesions and indeterminate or non-hypoperfusion lesions with ≥14 days of asymptomatic interval were classified as stable. Percentage stenosis was calculated and compared against these other symptom features for value in predicting technical complication, ischemic stroke, disability, or death at 90 days and 2 years using univariate and multivariate analysis. 130 lesions were treated in 124 patients. The only statistically significant percent stenosis finding was lesions with 60-99% stenosis were less likely to have technical complications. In univariate analysis, stroke at 2 years was less common with hypoperfusion and stable lesions. In multivariate analysis, only hypoperfusion status was associated with lower stroke rates at 2 years. Lesion stability features, particularly non-hypoperfusion symptomatology, outperform percentage stenosis in predicting outcomes following treatment of ICAD with stents. Further examination is needed to better classify the natural history of ICAD and more precisely classify lesion stability. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/

  9. Magnetic resonance diffusion-weighted imaging in the characterization of pancreatic mucinous cystic lesions

    Energy Technology Data Exchange (ETDEWEB)

    Fatima, Z. [Department of Radiology, University of Yamanashi, 1110 Shimokato, Chuo-shi, Yamanashi 409-3898 (Japan); Ichikawa, T., E-mail: ichikawa@yamanashi.ac.j [Department of Radiology, University of Yamanashi, 1110 Shimokato, Chuo-shi, Yamanashi 409-3898 (Japan); Motosugi, U.; Muhi, A.; Sano, K.; Sou, H. [Department of Radiology, University of Yamanashi, 1110 Shimokato, Chuo-shi, Yamanashi 409-3898 (Japan); Haradome, H. [Department of Radiology, Kyorin University School of Medicine, Tokyo (Japan); Kiryu, S. [Department of Radiology, Institute of Medical Science, University of Tokyo (Japan); Araki, T. [Department of Radiology, University of Yamanashi, 1110 Shimokato, Chuo-shi, Yamanashi 409-3898 (Japan)

    2011-02-15

    Aim: The aim of the study was to evaluate the utility of diffusion-weighted imaging (DWI), including apparent diffusion coefficient (ADC) measurement, in order to differentiate mucinous cystic neoplasms (MCNs) from intraductal papillary mucinous neoplasms (IPMNs) of the pancreas. Materials and methods: Fifty cases of IPMN with a total of 62 lesions, and eight cases of MCN, were retrospectively selected for the study. The cases of IPMN were selected using multimodality clinical or histopathological criteria, while all MCN lesions were histopathologically proven. DWI was carried out using b values of 500 and 1000 s/mm{sup 2}. Visual assessment was performed by two radiologists who used two categories (low-iso or high signal intensity). ADC values of the lesions were also calculated. Fisher's exact test and the Mann-Whitney U test were used for statistical analysis. Results: All IPMN lesions demonstrated low-iso signal intensities compared with the pancreatic parenchyma on DWI. Two of the MCN lesions demonstrated low-iso signal intensities, and six lesions demonstrated high signal intensities. The ADC values for IPMNs (mean 2.9 {+-} 0.024 x 10{sup -3} mm{sup 2}/s) were significantly higher than those for MCNs (mean 2.1 {+-} 0.30 x 10{sup -3} mm{sup 2}/s). ROC analysis showed an optimal cut-off value of 2.4 x 10{sup -3} mm{sup 2}/s for differentiating between the two types of lesions, providing a sensitivity of 98% and a specificity of 88%. Conclusion: The results of the present study suggest that ADC values in mucinous cystic lesions of the pancreas can be advantageous for their characterization into IPMN and MCN.

  10. Can miRNA Biomarkers Be Utilized to Improve the Evaluation and Management of Pancreatic Cystic Lesions?

    Directory of Open Access Journals (Sweden)

    Lee Linda S.

    2014-01-01

    Full Text Available This article reviews the current strategies and challenges of diagnosing pancreatic cystic lesions, and presents an overview of molecular tools that are available to enhance diagnostic accuracy. Specifically, we highlight the emergence of microRNAs (miRNAs as diagnostic markers. miRNA signatures have been reported for both solid tissue and biofluid specimens, including cyst fluid, collected from patients with solid and cystic pancreatic lesions. These miRNA signatures offer the opportunity to improve molecular characterization of pancreatic lesions, to help guide clinical management through early diagnosis and informed prognosis, and to provide novel therapeutic targets for pancreatic cancer.

  11. Bilateral Cystic Lesions Associated to Maxillary Erupted Dilated Odontomas: A Case Report

    Directory of Open Access Journals (Sweden)

    Mahmoodi A.

    2012-06-01

    Full Text Available The term ‘Dilated Odontoma’ is a malformation which most frequently occurs in the deciduous, permanent or supernumerary teeth. It can be diagnosed with deep invagination of the enamel inside the crown or root. In other words, the most extreme form of dens in the dente is known as “dilated odontoma”.Although dilated odontomas are usually asymptomatic, their eruption into the mouth can give rise to pain, inflammation, and infection.This report is an attempt to describe the case of a 22-year-old female presenting with bilateral cystic lesions associated with erupted dilated odontomas of the maxilla.The patient had no history of pain but she complained about a recurrent swelling which she was suffering from for about two years. Conventional radiographs showed bilateral cystic lesions associated with dilated odontomas. The findings were also confirmed by Dent Scan. The treatment plan consisted of surgical removal of the lesions, followed by histopathologic study in order to confirm the initial diagnosis.

  12. Imaging presentation of pancreatic cystic lesions%胰腺囊性病变的影像学表现

    Institute of Scientific and Technical Information of China (English)

    李震; 胡道予

    2013-01-01

    Pancreatic cystic lesions are being recognized increasingly due to the development of computed tomography and magnetic resonance imaging.Differential diagnosis between pseudocysts and cystic tumors is the key point for pancreatic cystic lesions.Patients with pancreatic pseudocysts generally have a history of acute or chronic pancreatitis,whereas patients with cystic tumors did not have such a history.Some pancreatic cystic lesions did not have typical imaging presentations,and they were difficult to be diagnosed.Pancreatic cystic lesions could be divided into unilocular cysts,microcystic lesions,macrocystic lesions and cysts with a solid component according to the presentations under computed tomography and magnetic resonance imaging.This typing system is helpful for the diagnosis and differential diagnosis of pancreatic cystic tumors,as well as for the guidance of therapy.%随着CT和MRI检查新技术的发展,胰腺囊性病变逐渐被临床医师认识和了解.胰腺囊性肿瘤和假性囊肿的鉴别是诊断的重点.胰腺假性囊肿患者一般具有急慢性胰腺炎病史,而胰腺囊性肿瘤没有胰腺炎病史.部分胰腺囊性肿瘤缺乏影像学特征性,在临床上常常难以鉴别.胰腺囊性病变按照CT和MRI检查的特点分为单囊性病变、微囊性病变、大囊性病变和囊实性病变.这一分型系统有助于诊断和鉴别诊断,并可以指导治疗方案和判断预后,具有重要的临床价值.

  13. Differential diagnosis and radiological management of cystic pancreatic lesions; Differenzialdiagnose und radiologisches Management von zystischen Tumoren des Pankreas

    Energy Technology Data Exchange (ETDEWEB)

    Buerke, B.; Heindel, W.; Wessling, J. [Universitaetsklinikum Muenster (Germany). Inst. fuer Klinische Radiologie

    2010-10-15

    Cystic pancreatic lesions are often discovered incidentally as an asymptomatic finding, at a rate which is increasing considerably. In recent years the understanding of such tumors has become clearly differentiated. The spectrum of relevant lesions includes in particular the intraductal papillary mucinous neoplasm (IPMN), serous cystic neoplasm (SCN) and mucinous cystic neoplasm (MCN). With certain knowledge of their histological and radiomorphological structure as well as their distribution in terms of location, age and sex, such tumors are easy to differentiate and demarcate from common pancreatic pseudocysts. This also implies the fundamental understanding of complementary endoscopic procedures such as endosonography, which enables aspiration of the content of the cyst. A number of cystic pancreatic lesions have the potential to undergo malignant transformation along the adenoma-carcinoma sequence and therefore necessitate a differentiated approach to their radiological management. This review aims to develop a broad understanding of the pathological and radiomorphological characteristics of cystic pancreatic lesions and provides advice regarding procedures, particularly with respect to incidentally detected lesions. (orig.)

  14. [Congenital cystic lung lesions--review of the literature with three clinical cases].

    Science.gov (United States)

    Slancheva, B; Hitrova, S; Markov, D; Vakrilova, L; Pramatarova, T; Yarukova, N; Brankov, O

    2013-01-01

    Congenital cystic lung lesions are rare. Mainly affects the lower respiratory patishta.i are congenital cystic malformation and adematozna bronchopulmonary sequestration (BPS). The pathogenesis of the occurrence of these malformations is not clear but they have a common clinical course. In most cases, the anomaly is asymptomatic and occurs with infections of the lung during the first year of life. Currently congenital lung lesions were classified into five types and is considered by most authors. The anomaly is due to the abnormal proliferation of terminal bronchioles accompanied by inhibition of alveolar development between 7-17 weeks, obstructed airway dysplasia and metaplasia of normal lung tissue. Early diagnosis is vital in making a medical decision on how to treat CCAM. Associated with abnormalities of the urinary tract, cardiovascular system, gastrointestinal atresia, diaphragmatic hernia skeletal abnormalities. In pregnancies in which prenatal lung lesions weighs registered necessary series of ultrasound examinations to track finding and using the Doppler to assess how the blood supply of the fault. The clinical presentation of malformations is respiratory distress, respiratory infection, and dyspnea. The use of CT and MRA allows better visualization of the pulmonary lesions. With its combination with arteriography and bronchoscopy are used to differentiate CCAM and pulmonary sequestration. We present three cases with lung lesions were born in Neonatologia clinic at the University Hospital of Obstetrics and Gynecology "Maternity" Sofia for the period 2010-2012 three cases CCAMs type 1, operated by 5 meters after birth with a good final outcome without complications in the postoperative period and lack of pulmonary symptoms up to 1 year after birth.

  15. Frontal dermoid cyst coexisting with suprasellar craniopharyngioma: a spectrum of ectodermally derived epithelial-lined cystic lesions?

    Science.gov (United States)

    Abou-Al-Shaar, Hussam; Abd-El-Barr, Muhammad M; Zaidi, Hasan A; Russell-Goldman, Eleanor; Folkerth, Rebecca D; Laws, Edward R; Antonio Chiocca, E

    2016-12-01

    There is a wide group of lesions that may exist in the sellar and suprasellar regions. Embryologically, there is varying evidence that many of these entities may in fact represent a continuum of pathology deriving from a common ectodermal origin. The authors report a case of a concomitant suprasellar craniopharyngioma invading the third ventricle with a concurrent frontal lobe cystic dermoid tumor. A 21-year-old man presented to the authors' service with a 3-day history of worsening headache, nausea, vomiting, and blurry vision. Magnetic resonance imaging depicted a right frontal lobe lesion associated with a separate suprasellar cystic lesion invading the third ventricle. The patient underwent a right pterional craniotomy for resection of both lesions. Gross-total resection of the right frontal lesion was achieved, and subtotal resection of the suprasellar lesion was accomplished with some residual tumor adherent to the walls of the third ventricle. Histopathological examination of the resected right frontal lesion documented a diagnosis of dermoid cyst and, for the suprasellar lesion, a diagnosis of adamantinomatous craniopharyngioma. The occurrence of craniopharyngioma with dermoid cyst has not been reported in the literature before. Such an association might indeed suggest the previously reported hypothesis that these lesions represent a spectrum of ectodermally derived epithelial-lined cystic lesions.

  16. Biplane CT of intraorbital and intracranial complicated lesions of nasal origin

    Energy Technology Data Exchange (ETDEWEB)

    Sadamoto, K.; Sadamoto, M. (Sadamoto Hospital of the Washo-Kai Medical Foundation, Ehime (Japan)); Koike, S.

    1981-12-01

    Thirty-three patients with intraorbital and intracranial complicated lesions of nasal origin were examined by means of the biplane CT (combination of axial and coronal CT) technique. The cases were comprised of 1 case of orbital cellulitis, 1 case of a postoperative maxillary cyst, 6 cases of mucocele (or pyocele), 2 cases of progressive gangrenous rhinitis (including Wegener's granulomatosis), and 23 cases of maxillary cancer. In the case of orbital cellulitis, a markedly dilated superior ophthalmic vein was observed by biplane CT for the first time. A remarkable swelling of the superior rectus and levator palpebral superior muscles was confirmed precisely by coronal CT. In the 6 cases of mucocele (or pyocele), coronal CT scans confirmed the original lesions from the frontal sinus or from the ethmoid sinus. In the 23 cases of maxillary cancer, coronal CT was especially useful for the observation of the precise infiltration in the intraorbit, base of the skull, intracranium, and subtemporal fossa. It is concluded that this technique, i.e., biplane CT, is reliable for the diagnosis of these lesions of nasal origin and is useful for the TNM-classification of UICC.

  17. Clinical, Radiological, Cytological and Biochemical Analysis of Pancreatic Cystic Lesions are Necessary prior to Definitive Therapeutic Planning

    Directory of Open Access Journals (Sweden)

    Mallikarjuna Uppara

    2015-11-01

    Full Text Available Objective To retrospectively study the correlation between pre-operative morphological and biochemical features of resected pancreatic cystic lesions and predictive power of these features in relation to biological behaviour and final histology. Methods We reviewed the literature systematically to identify relevant variables that are in use to predict the biological nature of pancreatic cystic lesions and aid therapeutic planning. We designed a template encompassing all used variables to collate the available data of resected pancreatic cystic lesions from two centres. The collated data included clinico-pathological and biochemical data, pre-operative computed tomography, magnetic resonance imaging, Endoscopic ultrasound, positron emission tomography–computed tomography, Fine-needle aspiration analysis whenever available and correlated with the final post-operative histology. Pooled data was analysed using statistics and data 14 statistical software. Results Sixty-four patients with pre-operative diagnosis of pancreatic cystic lesions were identified. Twenty seven cases underwent endoscopic ultra sound - fine-needle aspiration as an adjunct to the radiological assessment to evaluate the nature of these noted PCLs and both cytological and biochemical analysis were carried out on the intra-cystic aspirate. The intra cystic carcinoembryonic antigen levels recorded a mean of 667.97 in the tested group with a standard deviation of 1934.38. Conclusion No single test is able to predict the nature or behaviour of pancreatic cystic lesions. The differences noted on specialist imaging can be very subtle and demand specialist interpretive skills and hence a panel of pre-operative testing with review at specialist multidisciplinary meeting is mandatory for all such cases.

  18. Association between renal cystic lesions and bilateral Wilms' tumours

    Energy Technology Data Exchange (ETDEWEB)

    Simanovsky, Natalia; Hiller, Nurith [Hadassah-Hebrew University Medical Center at Mt Scopus, Department of Medical Imaging, POB 12000, Jerusalem (Israel); Revel-Vilk, Shoshana; Weintraub, Michael [Hadassah-Hebrew University Medical Center, Department of Pediatric Hematology/ Oncology, Jerusalem (Israel)

    2016-06-15

    Evaluate a potential association between Wilms' tumour (WT) and renal cystic lesions. Digital records and imaging files of consecutive patients diagnosed with WT between 2004 and 2014 were retrospectively reviewed under an Institutional Review Board waiver of informed consent. The locations of renal cysts seen on US, CT, and/or MRI were recorded and compared with the locations of newly developed WT. A total of 48 patients (mean age 3 years 9 months) presented with newly diagnosed WT in the study period. Mean follow-up was 4.5 (range 1-10) years. WT was unilateral in 40 children, bilateral in 8. Renal cysts were identified in only one of the forty patients (2.5 %) with unilateral disease - in the contralateral kidney. In contrast, renal cysts were found in seven of eight patients with bilateral WT (87.5 %), in two of whom, new tumours developed in the same location where cysts had been seen on previous imaging studies. Renal cystic lesions in patients with Wilms' tumour should be regarded as potential tumour precursors, and followed with frequent imaging. (orig.)

  19. Mucocele-like tumors of the breast as cystic lesions: sonographic-pathologic correlation.

    Science.gov (United States)

    Kim, Sun Mi; Kim, Hak Hee; Kang, Doo Kyung; Shin, Hee Jung; Cho, Nariya; Park, Jeong Mi; Cha, Joo Hee

    2011-06-01

    The purpose of this study was to evaluate the differential radiologic findings of pure mucocele-like tumor and mucocele-like tumor associated with atypical ductal hyperplasia (ADH) or malignancy of the breast according to BI-RADS and sonographic cystic mass classification. During a 10-year period, 72 mucocele-like tumors in 68 women were diagnosed histologically at three institutions. We retrospectively reviewed the mammographic (n = 69) and ultrasound (n = 72) findings of the 72 lesions according to the BI-RADS lexicon. The radiologic findings were correlated with the pathologic results. Mammography showed 53 lesions had calcifications without (n = 39) or with (n = 14) a mass. Calcifications of intermediate concern or associated with higher probability of malignancy were found more frequently in mucocele-like tumors associated with ADH or malignancy than in pure mucocele-like tumors (92.3% vs 62.9%, p = 0.019). At ultrasound, 69 of the mucocele-like tumors (95.8%) were seen as a cystic mass. Cysts with thick septations, clustered cysts, and complex masses were more frequently seen in mucocele-like tumors associated with ADH or malignancy (89.7% vs 32.5%, p Mucocele-like tumors associated with ADH or malignancy were more frequently seen as clustered cysts, cysts with thick septations, and complex masses associated with calcifications of intermediate concern or higher probability of malignancy. BI-RADS can be used in the management of mucocele-like tumors.

  20. Cystic Lesions of the Jaws - A Clinicopathological Study of 322 Cases and Review of the Literature

    Directory of Open Access Journals (Sweden)

    Esther Manor, Leonid Kachko, Max B. Puterman, George Szabo, Lipa Bodner

    2012-01-01

    Full Text Available Three hundred and twenty-two patients (192 male and 130 female with cystic lesions of the jaw were successfully diagnosed and treated. One hundred and fifty-five (48% were radicular cysts, 80 (25% were dentigerous cysts, 23 (7% were odontogenic keratocyst (=keratocystic odontogenic tumor, 19 (6% were eruption cysts, 16 (5% were traumatic bone cysts, and 29 (9% were non-odontogenic cysts.There were 95 in the pediatric age group (1 month to 16 years and 227 in the adult age group (17 years and older. Male to female ratio was 1 in the pediatric age group and 1.7 in the adult age group. The treatment modalities were: marsupialization, enucleation, enucleation with bone grafting, or resection. The distribution and characteristics of jaw cysts in children are different from those in adults. In children there is a relatively high rate of developmental cysts, whereas in adults the inflammatory cysts are more common. Following enucleation of a cystic jaw lesion, the entire surgical specimen and not only a biopsy specimen, should be examined histopathologically to prevent any possibility of an intramural squamous cell carcinoma that may be overlooked. The differences in prevalence of each type of jaw cyst during a lifetime may point toward a multifactorial polygenic pattern rather than a monogenic pattern.

  1. Cystic lesions of the jaws - a clinicopathological study of 322 cases and review of the literature.

    Science.gov (United States)

    Manor, Esther; Kachko, Leonid; Puterman, Max B; Szabo, George; Bodner, Lipa

    2012-01-01

    Three hundred and twenty-two patients (192 male and 130 female) with cystic lesions of the jaw were successfully diagnosed and treated. One hundred and fifty-five (48%) were radicular cysts, 80 (25%) were dentigerous cysts, 23 (7%) were odontogenic keratocyst (=keratocystic odontogenic tumor), 19 (6%) were eruption cysts, 16 (5%) were traumatic bone cysts, and 29 (9%) were non-odontogenic cysts. There were 95 in the pediatric age group (1 month to 16 years) and 227 in the adult age group (17 years and older). Male to female ratio was 1 in the pediatric age group and 1.7 in the adult age group. The treatment modalities were: marsupialization, enucleation, enucleation with bone grafting, or resection. The distribution and characteristics of jaw cysts in children are different from those in adults. In children there is a relatively high rate of developmental cysts, whereas in adults the inflammatory cysts are more common. Following enucleation of a cystic jaw lesion, the entire surgical specimen and not only a biopsy specimen, should be examined histopathologically to prevent any possibility of an intramural squamous cell carcinoma that may be overlooked. The differences in prevalence of each type of jaw cyst during a lifetime may point toward a multifactorial polygenic pattern rather than a monogenic pattern.

  2. Cystic Lesions of the Jaws - A Clinicopathological Study of 322 Cases and Review of the Literature

    Science.gov (United States)

    Manor, Esther; Kachko, Leonid; Puterman, Max B.; Szabo, George; Bodner, Lipa

    2012-01-01

    Three hundred and twenty-two patients (192 male and 130 female) with cystic lesions of the jaw were successfully diagnosed and treated. One hundred and fifty-five (48%) were radicular cysts, 80 (25%) were dentigerous cysts, 23 (7%) were odontogenic keratocyst (=keratocystic odontogenic tumor), 19 (6%) were eruption cysts, 16 (5%) were traumatic bone cysts, and 29 (9%) were non-odontogenic cysts. There were 95 in the pediatric age group (1 month to 16 years) and 227 in the adult age group (17 years and older). Male to female ratio was 1 in the pediatric age group and 1.7 in the adult age group. The treatment modalities were: marsupialization, enucleation, enucleation with bone grafting, or resection. The distribution and characteristics of jaw cysts in children are different from those in adults. In children there is a relatively high rate of developmental cysts, whereas in adults the inflammatory cysts are more common. Following enucleation of a cystic jaw lesion, the entire surgical specimen and not only a biopsy specimen, should be examined histopathologically to prevent any possibility of an intramural squamous cell carcinoma that may be overlooked. The differences in prevalence of each type of jaw cyst during a lifetime may point toward a multifactorial polygenic pattern rather than a monogenic pattern. PMID:22211085

  3. A Low-Cost iPhone-Assisted Augmented Reality Solution for the Localization of Intracranial Lesions.

    Directory of Open Access Journals (Sweden)

    YuanZheng Hou

    Full Text Available Precise location of intracranial lesions before surgery is important, but occasionally difficult. Modern navigation systems are very helpful, but expensive. A low-cost solution that could locate brain lesions and their surface projections in augmented reality would be beneficial. We used an iPhone to partially achieve this goal, and evaluated its accuracy and feasibility in a clinical neurosurgery setting.We located brain lesions in 35 patients, and using an iPhone, we depicted the lesion's surface projection onto the skin of the head. To assess the accuracy of this method, we pasted computed tomography (CT markers surrounding the depicted lesion boundaries on the skin onto 15 patients. CT scans were then performed with or without contrast enhancement. The deviations (D between the CT markers and the actual lesion boundaries were measured. We found that 97.7% of the markers displayed a high accuracy level (D ≤ 5mm. In the remaining 20 patients, we compared our iPhone-based method with a frameless neuronavigation system. Four check points were chosen on the skin surrounding the depicted lesion boundaries, to assess the deviations between the two methods. The integrated offset was calculated according to the deviations at the four check points. We found that for the supratentorial lesions, the medial offset between these two methods was 2.90 mm and the maximum offset was 4.2 mm.This low-cost, image-based, iPhone-assisted, augmented reality solution is technically feasible, and helpful for the localization of some intracranial lesions, especially shallow supratentorial intracranial lesions of moderate size.

  4. Can radiological characteristics of preoperative cerebral lesions predict postoperative intracranial haemorrhage in endocarditis patients?

    Science.gov (United States)

    Diab, Mahmoud; Guenther, Albrecht; Scheffel, Philipp; Sponholz, Christoph; Lehmann, Thomas; Hedderich, Johannes; Faerber, Gloria; Brunkhorst, Frank; Pletz, Mathias W; Doenst, Torsten

    2016-05-01

    Infective endocarditis (IE) is associated with high mortality (20-40%) and neurological complications (20-50%). Postoperative intracranial haemorrhage (ICH) is a feared complication especially in patients with preoperative cerebral infarcts. The aim of this study was to determine the radiological characteristics of cerebral lesions that could predict the occurrence of postoperative ICH in IE patients. We retrospectively reviewed all charts, brain imaging and follow-up data from patients operated for left-sided endocarditis between January 2007 and April 2013. A total of 308 patients (age 62.0 ± 13.9) underwent surgery for IE. Preoperative cerebrovascular complications were present in 122 patients (39.6%), representing stroke in 87, silent cerebral infarctions in 31 patients and transient ischaemic attacks in 4 patients. Among 118 patients with cerebral lesions, the aetiological classification of the lesions was ischaemic in 63.6%, ischaemic with haemorrhagic transformation (HT) in 17.8%, ischaemic with concomitant microbleeds in 16.1% and intracerebral bleeding in 2.5%. Postoperative ICH occurred in 17 patients and its incidence was slightly higher in patients with preoperative cerebral infarcts compared with those without preoperative cerebral infarcts [7.6 vs 4.2%, respectively, odds ratio (OR) 1.88, 95% confidence interval (CI) 0.70-5.02, P = 0.21]. However, the difference was not statistically significant. Similarly, the incidence of postoperative ICH was higher in cases of HT of ischaemic infarcts than in cases of ischaemic infarcts not complicated with HT (19.0 vs 5.3%). However, the difference was not statistically significant (P = 0.24). The radiological pattern of preoperative cerebral lesions was single in 35.6% and multiple in 60.0% of cases. Multiple cerebral lesions were associated with a non-significantly lower incidence of postoperative ICH than single lesions (5.6 vs 11.9%, respectively, OR: 0.44, CI: 0.11-1.73, P = 0.29). The results suggest that

  5. Photochemically induced cystic lesion in the rat spinal cord. I. Behavioral and morphological analysis

    Energy Technology Data Exchange (ETDEWEB)

    Cameron, T.; Prado, R.; Watson, B.D.; Gonzalez-Carvajal, M.; Holets, V.R. (Univ. of Miami, FL (USA))

    1990-08-01

    The present study describes the production of a spinal cord lesion which is initiated by vascular occlusion resulting from the interaction between the photosensitizing dye erythrosin B and an argon laser beam. The lesion has characteristics similar to those of the central cavity thought to lead to the production of post-traumatic syringomyelia (PTS) in humans. The present study examines the behavioral and morphological characteristics of this injury over a 28-day period. Histological analysis revealed a cavity extending from the dorsal horns to lamina VIII, with some lateral and ventral pathways being spared. The cavity volume reached a maximum 7 days after lesion induction. Behavioral changes were assessed using six different tests of motor and reflex function (motor function, climbing, waterbath, inclined plane, withdrawal to pain, and withdrawal to extension). Lesioned animals exhibited flaccid paralysis for 3-5 days, which resolved afterward. The photochemically induced cavity should provide a reproducible model for examining the effects of cystic spinal cord injury on locomotor and reflex function.

  6. Transendoscopic Nd:YAG ablation of cystic lesions in 27 large animals: 1986-1995

    Science.gov (United States)

    Tate, Lloyd P.

    1997-05-01

    Hospital medical surgery records and laser logs were examined to determine the population of large animals presented to the College of Veterinary Medicine treated by laser and conventional means for cystic lesions. Cystic lesions were most frequently found in 2 anatomical locations: endometrial cysts and upper respiratory cysts. The majority of endometrial cysts were considered to be acquired, whereas the most frequently encountered upper respiratory cysts were believed to be congenital due to the fact they were most frequently seen in young animals. Nine mares, totaling 42 endometrial cysts, were presented to the Veterinary Teaching Hospital (VTH), all of which had been treated by transendoscopic Nd:YAG laser ablation. Eighteen of the respiratory cysts in the same time period were presented to the VTH, of which 10 received conventional surgery and 8 were laser photoablated. Respiratory cysts treated by conventional surgery were generally found in locations inaccessible to visualization by transendoscopic technique, and thus required a surgical approach under general anesthesia. All mares with endometrial cysts were presented with a history of conception failure. After laser ablation, a majority of the mares were able to carry a foal to term and none represented with recurrence of endometrial cysts. Horses that presented with upper respiratory cysts also did not experience recurrence of cysts; although several horses, 1 treated by laser ablation and 4 treated by conventional surgery for frontal and/or maxillary sinus cysts, had transitory sinusitis. Transendoscopic Nd:YAG photoablation of cysts appears to be a very satisfactory means of treating this particular form of lesion in large animals with minimal complications and it can be performed with the animal in a standing position as an outpatient.

  7. Tumores quísticos pancreáticos y lesiones pseudotumorales Cystic pancreatic tumours and pseudo-tumoural lesions

    Directory of Open Access Journals (Sweden)

    F.J. Jiménez Mendióroz

    2003-08-01

    Full Text Available Las lesiones quísticas de páncreas son infrecuentes, estimándose en sólo un 1% de todos los tumores pancreáticos y en un 10% de todos los quistes pancreáticos. El diagnóstico preoperatorio es importante para un adecuado tratamiento, existiendo en la actualidad valiosas técnicas radiológicas como son los ultrasonidos, la tomografía computarizada y la resonancia magnética. A pesar de todo tenemos que aceptar que nos encontramos ante un grupo de tumores de difícil diagnóstico, debido a la gran variedad de tipos celulares que existen en los mismos.Cystic lesions of the pancreas are infrequent, estimated at only some 1% of all pancreatic tumours and at some 10% of all pancreatic cysts. The pre-operational diagnosis is important for a suitable treatment, with valuable radiological techniques available today such as ultrasound, computerised tomography and magnetic resonance. In spite of this we have to accept that we are facing a group of tumours whose diagnosis is difficult, due to the great variety of cellular types existing within them.

  8. SU-E-J-123: Targeting Accuracy of Image-Guided Radiosurgery for Intracranial Lesions

    Energy Technology Data Exchange (ETDEWEB)

    Huang, Y; Wen, N; Zhao, B; Kim, J; Gordon, J; Chetty, I [Henry Ford Health System, Detroit, MI (United States)

    2014-06-01

    Purpose: To evaluate the setup accuracies of image-guided intracranial radiosurgery across several different linear accelerator platforms. Methods: A CT scan with a slice thickness of 1.0 mm was acquired of a Rando head phantom (The Phantom Laboratory) in a U-frame mask (BrainLAB AG). The phantom had three embedded BBs, simulating a central, left, and anterior lesion. The phantom was setup with each BB placed at the radiation isocenter under image guidance. Four different setup procedures were investigated: (1) NTX-ExacTrac: 6 degree-of-freedom (6D) correction on a Novalis Tx (BrainLAB AG) with ExacTrac localization (BrainLAB AG); (2) NTX-CBCT: 4D correction on the Novalis Tx with cone-beam computed tomography (CBCT); (3) TrueBeam-CBCT: 4D correction on a TrueBeam (Varian) with CBCT; (4) Edge-CBCT: 6D correction on an Edge (Varian) with CBCT. The experiment was repeated 5 times with different initial setup error at each BB location on each platform, and the mean (μ) and one standard deviation (σ) of the residual error was compared.The congruence between radiation and imaging isocenters on each platform was evaluated by acquiring Winston Lutz (WL) images of a WL jig followed by imaging using ExacTrac or CBCT. The difference in coordinates of the jig relative to radiation and imaging isocenters was then recorded. Results: Averaged over all three BB locations, the residual vector setup errors (μ±σ) of the phantom in mm were 0.6±0.2, 1.0±0.5, 0.2±0.1, and 0.3±0.1 on NTX-ExacTrac, NTX-CBCT, TrueBeam-CBCT, and Edge-CBCT, with their ranges in mm being 0.4∼1.1, 0.4∼1.9, 0.1∼0.5, and 0.2∼0.6, respectively. And imaging isocenter was found stable relative to radiation isocenter, with the congruence to radiation isocenter in mm being 0.6±0.1, 0.7±0.1, 0.3±0.1, 0.2±0.1, respectively, on the four systems in the same order. Conclusion: Millimeter accuracy can be achieved with image-guided radiosurgery for intracranial lesions based on this set of experiments.

  9. Carbonic Anhydrase Inhibitors for the Treatment of Cystic Macular Lesions in Children With X-Linked Juvenile Retinoschisis

    NARCIS (Netherlands)

    Verbakel, S.K.; Ven, J.P.H. van de; Blanc, L.M.P. le; Groenewoud, J.M.M.; Jong, E.K.; Klevering, B.J.; Hoyng, C.B.

    2016-01-01

    Purpose: Little is known regarding the therapeutic effect of carbonic anhydrase inhibitors (CAIs) in the management of cystic macular lesions in children with X-linked juvenile retinoschisis (XLRS) despite the fact that this disease often manifests during childhood. Therefore, our goal was to determ

  10. Distribution and natural course of intracranial vessel wall lesions in patients with ischemic stroke or TIA at 7.0 tesla MRI

    Energy Technology Data Exchange (ETDEWEB)

    Kolk, Anja G. van der; Luijten, Peter R.; Hendrikse, Jeroen [University Medical Center Utrecht, Department of Radiology, Postbox 85500, Utrecht (Netherlands); Zwanenburg, Jaco J.M. [University Medical Center Utrecht, Department of Radiology, Postbox 85500, Utrecht (Netherlands); University Medical Center Utrecht, Image Sciences Institute, Utrecht (Netherlands); Brundel, Manon; Biessels, Geert Jan [University Medical Center Utrecht, Department of Neurology, Utrecht (Netherlands); Visser, Fredy [University Medical Center Utrecht, Department of Radiology, Postbox 85500, Utrecht (Netherlands); Philips Healthcare, Best (Netherlands)

    2015-06-01

    Previous studies using intracranial vessel wall MRI techniques showed that over 50 % of patients with ischemic stroke or TIA had one or more intracranial vessel wall lesions. In the current study, we assessed the preferential location of these lesions within the intracranial arterial tree and their potential changes over time in these patient groups. Forty-nine patients with ischemic stroke (n = 25) or TIA (n = 24) of the anterior cerebral circulation underwent 7.0 T MRI, including a T{sub 1}-weighted magnetization-preparation inversion recovery turbo-spin-echo (MPIR-TSE) sequence within one week and approximately one month after symptom onset. Intracranial vessel wall lesions were scored for multiple locations within the arterial tree and differences between one-week and one-month images. At baseline, 132 intracranial vessel wall lesions were found in 41 patients (84 %), located primarily in the anterior cerebral circulation (74 %), with a preferential location in the distal internal carotid artery and M1 and M2 segments of the middle cerebral artery. During follow-up, presence or enhancement patterns changed in 14 lesions (17 %). A large burden of intracranial vessel wall lesions was found in both the anterior and posterior cerebral circulation. Most lesions were found to be relatively stable, possibly indicating a more generalized atherosclerotic process. (orig.)

  11. Neonatal Acute Megakaryoblastic Leukemia Presenting with Leukemia Cutis and Multiple Intracranial Lesions Successfully Treated with Unrelated Cord Blood Transplantation

    Directory of Open Access Journals (Sweden)

    Hiroshi Tsujimoto

    2015-01-01

    Full Text Available Neonatal acute megakaryoblastic leukemia (AMKL without Down syndrome (DS is an extremely rare disorder. We report of a one-day-old male infant without DS who developed AMKL with leukemia cutis and right facial nerve palsy. Magnetic resonance imaging of the patient’s brain revealed multiple intracranial tumors. A biopsy specimen of the skin lesion was suggestive of AMKL, but the bone marrow leukemic cells were less than 5% of the marrow nucleated cells. The skin and intracranial lesions had spontaneously regressed within one and a half months, but the patient’s anemia and thrombocytopenia gradually worsened and the leukemic cells in the bone marrow gradually increased to more than 20% of the nucleated cells. In addition, multiple intracranial lesions reappeared at 72 days of life. We diagnosed the patient with AMKL, and chemotherapy followed by unrelated cord blood transplantation after a reduced-intensity conditioning regimen resulted in sustained complete remission. At present, the patient is well, and he has demonstrated normal development for five years.

  12. 鞍区囊性病变的CT、MRI诊断%CT, MRI diagnosis of cystic lesions in sella region

    Institute of Scientific and Technical Information of China (English)

    李红英; 渐楠

    2014-01-01

    Objective:Analysis of sellar cystic lesions of the CT, MRI, to evaluate the value of CT and MRI in the diagnosis of. sellar cystic lesions. Materials and Methods:A retrospective analysis of 46 cases of cystic lesions in sella region image and clinical operation and pathological data. Results:Cystic pituitary tumor 22 cases, 17 cases of craniopharyngioma, 3 cases of Rathke cyst, 1 cases of dermoid cyst, 3 cases of epidermoid cyst. Conclusions:CT can accurately show the damage degree of sellar region tumor calciifcation and osteoporosis, MRI can show the lesions size, shape and adjacent anatomic relationship between the lesions of sellar region, is the preferred method of examination.%目的:分析鞍区囊性占位病变的CT、MRI表现,探讨CT及MRI诊断价值。材料与方法回顾性分析46例鞍区囊性病变的影像及临床手术病理资料。结果囊实性垂体瘤22例、颅咽管瘤17例、Rathke囊肿3例、皮样囊肿3例、表皮样囊肿1例。结论 CT能准确显示鞍区肿瘤钙化和骨质破坏程度,MRI能很好显示病变大小,形态及邻近解剖关系,是鞍区病变首选检查方法。

  13. Image analysis of intracranial high perfusion lesion by whole brain one-stop imaging technique with 320 detector rows CT

    Directory of Open Access Journals (Sweden)

    Fei-zhou DU

    2014-03-01

    Full Text Available Objective  The perfusion and vascular architecture features were investigated and evaluated by use of one-stop imaging technique with 320 rows CT for exploring the clinical value of one-stop imaging technique in the diagnosis of intracranial lesions. Methods  The perfusion parameters and vascular architecture of intracranial high perfusion lesions of 52 patients were collected in General Hospital of Chengdu Command from Oct. 2010 to Apr. 2013, who were examined by one-stop imaging technique with 320 rows CT, were retrospectively analyzed. The perfusion values of normal contralateral cerebral tissue were used as control to analyze the perfusion and vascular architecture features of injured parts. Results  Of the 52 patients, there were 16 cases of subacute cerebral infarction, 9 cases of arteriovenous malformation, 7 cases of hemangioma, 12 cases of meningioma, and 8 cases of glioma. All the patients showed elevated CBV and/or CBF and different changes in mean transit time (MTT, time to peak (TTP and delay time (Delay. In the cases of subacute cerebral infarction, the parameters of MTT, TTP and Delay increased. In the cases of arteriovenous malformation, all the parameters decreased. In the cases of hemangioma, the MTT decreased, while TTP and Delay increased. In the cases of glioma, the TTP and Delay increased, while the change of MTT varied. Meanwhile, abnormality of vascular structures was found in all the cases by CT angiography. Conclusion  With whole brain perfusion and one-stop vascular imaging with 320 rows CT, the perfusion characteristics of intracranial lesions can be revealed completely, including blood supply and microcirculation changes in the lesions, and it may be of benefit in guiding the clinical diagnosis and treatment. DOI: 10.11855/j.issn.0577-7402.2014.03.10

  14. Accelerated detection of intracranial space-occupying lesions with CUDA based on statistical texture atlas in brain HRCT.

    Science.gov (United States)

    Liu, Wei; Feng, Huanqing; Li, Chuanfu; Huang, Yufeng; Wu, Dehuang; Tong, Tong

    2009-01-01

    In this paper, we present a method that detects intracranial space-occupying lesions in two-dimensional (2D) brain high-resolution CT images. Use of statistical texture atlas technique localizes anatomy variation in the gray level distribution of brain images, and in turn, identifies the regions with lesions. The statistical texture atlas involves 147 HRCT slices of normal individuals and its construction is extremely time-consuming. To improve the performance of atlas construction, we have implemented the pixel-wise texture extraction procedure on Nvidia 8800GTX GPU with Compute Unified Device Architecture (CUDA) platform. Experimental results indicate that the extracted texture feature is distinctive and robust enough, and is suitable for detecting uniform and mixed density space-occupying lesions. In addition, a significant speedup against straight forward CPU version was achieved with CUDA.

  15. Immunohistochemical study of ki-67 and bcl-2 expression in some odontogenic cystic lesions with different clinical behaviors

    Directory of Open Access Journals (Sweden)

    Seyed Hossein Tabatabaei

    2016-11-01

    Full Text Available Background: Cystic lesions with odontogenic epithelial origin and similar clinicoradiographic appearance, show different clinical behaviors. Objective: To compare some factors related to cell proliferation and escape from apoptosis in epithelium covering two groups of odontogenic cystic lesions with different clinical behaviors. Methods: In this cross-sectional study 11 paraffin-embedded samples were selected of each lesions radicular cyst, dentigerous cyst, odontogenic keratocyst, and unicystic ameloblastoma. The sample underwent immunohistochemical staining for investigating the expression of ki-67 antigen and bcl-2 protein. Data analyzed with SPSS17 software and Kruskal–Wallis and chi-square statistical tests. Findings: Most of ki-67 positive cells were observed in parabasal layer of odontogenic keratocyst [35.50±26.29%; P=0.001]. The average of ki-67-LI was more in parabasal layer of aggressive group (26.80±37.79% compared to non-aggressive group (4.04±3.38%, was not being statistically significant. The highest average of bcl-2-LI was 95±6.70% in basal layer of odontogenic keratocyst (P=0.001. In all layers, the average of bcl-2-LI was more in aggressive lesions compared to non-aggressive ones and the highest amount was found in basal layer (72.45±3.94×10% which was statistically significant (P=0.001. Conclusion: According to the results of this study, more expression of the markers related to escape from apoptosis in aggressive lesions group compared to non-aggressive group, suggests that escape from apoptosis had a more critical role in aggressive behavior of odontogenic cystic lesions.

  16. Spinal level of myelomeningocele lesion as a contributing factor in posterior fossa volume, intracranial cerebellar volume, and cerebellar ectopia.

    LENUS (Irish Health Repository)

    Sweeney, Kieron J

    2013-02-01

    McLone and Knepper\\'s unified theory of Chiari malformation Type II (CM-II) describes how the loss of CSF via the open posterior neuropore fails to create adequate distending pressure for the developing rhomboencephalic vesicle. The authors of the present article describe the relationship between the posterior fossa volume and intracranial cerebellar volume as being related to the distance from the obex of the fourth ventricle to the myelomeningocele lesion using a common mathematical model, the Hagen-Poiseuille law.

  17. Association of White Matter Lesions, Cerebral Atrophy, Intracranial Extravascular Calcifications, and Ventricular-Communicating Hydrocephalus with Delirium Among Veterans.

    Science.gov (United States)

    Detweiler, Mark B; Sherigar, Rathnakara M; Bader, Geoffrey; Sullivan, Kelly; Kenneth, Arline; Kalafat, Naciye; Reddy, Pavan; Lutgens, Brian

    2017-06-01

    The literature regarding the underlying neuropathogenesis of delirium on head computed tomography (CT) is limited. The aim of this research was to investigate, using case-control retrospective chart review, the association of white matter lesions (WML), cerebral atrophy, intracranial extravascular calcifications, and ventricular-communicating hydrocephalus in older adult military veterans with and without delirium hospitalized in a Veterans Affairs Medical Center. Head CT scans were examined for WML, atrophy, and intracranial extravascular calcifications globally in the cortex, subcortex (frontal, temporal, parietal, occipital lobes), basal ganglia (globus pallidus, caudate, putamen), and internal capsule, in addition to the presence of ventricular-communicating hydrocephalus. WML were graded as not present, 2 cm. Atrophy, cerebral atrophy, intracranial extravascular calcifications, and ventricular-communicating hydrocephalus were graded as present or not present. There was a significant association of WML in the temporal lobe periventricular cortical and subcortical brain and a significant association of atrophy in the parietal lobes and the cerebellum in hospitalized older adult military veterans with delirium compared with hospitalized older adult military veterans without delirium. There were no differences between the delirium and nondelirium groups for intracranial extravascular calcifications and ventricular-communicating hydrocephalus. The results suggest that atrophy in the parietal lobes and the cerebellum of hospitalized older adult military veterans may be associated with an elevated risk of delirium when compared with age, race, and sex-matched control veterans. Continuing efforts are needed to clarify the role of atrophy during delirium in the veteran and nonveteran older adult population to reduce progressive frailty and decreased quality of life secondary to hospital and posthospital-discharge delirium.

  18. Frontal sinus mucocele with intracranial extension associated with osteoma in the anterior cranial fossa.

    Science.gov (United States)

    Sakamoto, Hiroki; Tanaka, Toshihide; Kato, Naoki; Arai, Takao; Hasegawa, Yuzuru; Abe, Toshiaki

    2011-01-01

    A 70-year-old man presented with a rare case of paranasal osteoma with secondary mucocele extending intracranially, manifesting as a generalized convulsion. Computed tomography showed a large calcified tumor adjacent to the cystic mass in the left frontal lobe. He underwent left frontal craniotomy, and the cystic lesion was totally removed. Histological examination confirmed the diagnosis of osteoma and mucocele. The giant paranasal sinus osteoma prevented growth of the mucocele into orbital recess and extension into the orbital space and paranasal sinus. The mucocele disrupted the dura in the anterior cranial fossa, resulting in a giant cystic intracranial lesion. Frontal osteoplastic craniotomy was effective for exposing both lesions and plastic repair of the dural perforation to prevent cerebrospinal fluid leakage and secondary infection.

  19. Perpetual dilemma: Pleural or parenchymal/congenital or acquired solitary cystic lesion with fluid level.

    Science.gov (United States)

    Talwar, Deepak; Jha, Onkar; Sharma, Rahul Kumar; Saxena, Rajat

    2017-01-01

    Congenital cystic adenomatoid malformations (CCAMs) are rare congenital, nonhereditary developmental anomalies of the lung with unknown etiology. CCAM is predominantly a disorder of infancy with the majority of the cases being diagnosed within the first 2 years of life. When CCAM presents in adults, it represents a diagnostic dilemma and requires careful evaluation. We here report a case of large solitary congenital pulmonary cystic adenomatoid malformation with infection and hemorrhage, which was diagnosed as encysted hydropneumothorax on computerized tomography scans but turned out to be infected pulmonary cystic adenomatoid malformation after surgical excision.

  20. Mucus Containing Cystic Lesions “Mucocele” of the Appendix: The Unresolved Issues

    Science.gov (United States)

    Rabie, Mohammad Ezzedien; Al Skaini, Mohammad Saad; Alqahtani, Saad; El Hakeem, Ismail; Al Qahtani, Abdulla Saad; Malatani, Tarek; Hummadi, Abduelah

    2015-01-01

    the appendix should be considered in the differential diagnosis of cystic lesions in the right lower abdomen. Owing to its rarity, it continues to intrigue the surgeon as well as the radiologist and pathologist alike. For mucinous cystadenocarcinoma, right hemicolectomy is usually needed, whereas for hyperplasia and cystadenoma, appendectomy usually suffices if the resection margins are free. For mucinous tumours of uncertain malignant potential and low grade mucinous tumours as well as pseudomyxoma peritonei, the decision is not as simple. As for laparoscopic surgery, no solid proof exists with or against its safety. Although not yet standardized, perioperative colonoscopy and regular follow-up to detect early recurrences should probably be part of the management plan. PMID:25878899

  1. Mucus containing cystic lesions "mucocele" of the appendix: the unresolved issues.

    Science.gov (United States)

    Rabie, Mohammad Ezzedien; Al Shraim, Mubarak; Al Skaini, Mohammad Saad; Alqahtani, Saad; El Hakeem, Ismail; Al Qahtani, Abdulla Saad; Malatani, Tarek; Hummadi, Abduelah

    2015-01-01

    diagnosis of cystic lesions in the right lower abdomen. Owing to its rarity, it continues to intrigue the surgeon as well as the radiologist and pathologist alike. For mucinous cystadenocarcinoma, right hemicolectomy is usually needed, whereas for hyperplasia and cystadenoma, appendectomy usually suffices if the resection margins are free. For mucinous tumours of uncertain malignant potential and low grade mucinous tumours as well as pseudomyxoma peritonei, the decision is not as simple. As for laparoscopic surgery, no solid proof exists with or against its safety. Although not yet standardized, perioperative colonoscopy and regular follow-up to detect early recurrences should probably be part of the management plan.

  2. Mucus Containing Cystic Lesions “Mucocele” of the Appendix: The Unresolved Issues

    Directory of Open Access Journals (Sweden)

    Mohammad Ezzedien Rabie

    2015-01-01

    . Conclusion. Mucocele of the appendix should be considered in the differential diagnosis of cystic lesions in the right lower abdomen. Owing to its rarity, it continues to intrigue the surgeon as well as the radiologist and pathologist alike. For mucinous cystadenocarcinoma, right hemicolectomy is usually needed, whereas for hyperplasia and cystadenoma, appendectomy usually suffices if the resection margins are free. For mucinous tumours of uncertain malignant potential and low grade mucinous tumours as well as pseudomyxoma peritonei, the decision is not as simple. As for laparoscopic surgery, no solid proof exists with or against its safety. Although not yet standardized, perioperative colonoscopy and regular follow-up to detect early recurrences should probably be part of the management plan.

  3. Omega-3 polyunsaturated Fatty acids suppress the cystic lesion formation of peritoneal endometriosis in transgenic mouse models.

    Directory of Open Access Journals (Sweden)

    Kensuke Tomio

    Full Text Available Omega-3 polyunsaturated fatty acids (omega-3 PUFAs play a role in controlling pathological inflammatory reactions. Endometriosis is characterized by the presence of endometrial tissue on the peritoneum and an exaggerated inflammatory environment around ectopic tissues. Here peritoneal endometriosis was reproduced using a mouse model in which murine endometrial fragments were inoculated into the peritoneal cavity of mice. Fat-1 mice, in which omega-6 can be converted to omega-3 PUFAs, or wild type mice, in which it cannot, were used for the endometriosis model to address the actions of omega-3 PUFAs on the development of endometriotic lesions. The number and weight of cystic endometriotic lesions in fat-1 mice two weeks after inoculation were significantly less than half to those of controls. Mediator lipidomics revealed that cystic endometriotic lesions and peritoneal fluids were abundant in 12/15-hydroxyeicosapentaenoic acid (12/15-HEPE, derived from eicosapentaenoic acid (EPA, and their amount in fat-1 mice was significantly larger than that in controls. 12/15-Lipoxygenase (12/15-LOX-knockout (KO and control mice with or without EPA administration were assessed for the endometriosis model. EPA administration decreased the number of lesions in controls but not in 12/15-LOX-KO mice. The peritoneal fluids in EPA-fed 12/15-LOX-KO mice contained reduced levels of EPA metabolites such as 12/15-HEPE and EPA-derived resolvin E3 even after EPA administration. cDNA microarrays of endometriotic lesions revealed that Interleukin-6 (IL-6 expression in fat-1 mice was significantly lower than that in controls. These results suggest that both endogenous and exogenous EPA-derived PUFAs protect against the development of endometriosis through their anti-inflammatory effects and, in particular, the 12/15-LOX-pathway products of EPA may be key mediators to suppress endometriosis.

  4. Intracranial tumour-like lesions in children and young adults with multiple sclerosis. Intrakranielle tumoraehnliche Laesionen bei Kindern und jungen Erwachsenen mit multipler Sklerose

    Energy Technology Data Exchange (ETDEWEB)

    Einig, M.; Ernst, J.P. (Staedtisches Klinikum der Landeshauptstadt Wiesbaden, Kinderklinik (Germany)); Higer, H.P.; Mauz, M. (Deutsche Klinik fuer Diagnostik, Wiesbaden, Fachbereich Kernspintomographie (Germany))

    1992-10-01

    Atypical early manifestations of multiple sclerosis (MS) are common in children and young adults, 6 patients (aged 5 to 33 years) were examined by MR because of confusing neurological manifestations. In addition to small MS lesions there were also large intracerebral lesions which, however, did not occupy additional space but which looked more like tumours or abscesses. The lesions were sharply demarcated cystic formations with margins that enhanced with contrast. The diagnosis of these lesions presents difficulties, the differential diagnosis including MS and its variants, neoplastic, infectious and vascular processes. MR can provide valuable diagnostic information. (orig.).

  5. [Diagnostic value of cyst fluid analysis in cystic lesions of the pancreas: current data, limitations, and perspectives].

    Science.gov (United States)

    Hammel, P

    2000-05-01

    Diagnostic assessment and therapeutic indications in patients with cystic lesions of the pancreas are often difficult, especially since incidental detection of such lesions is increasing due to improvements in imaging techniques. Some lesions are benign (pseudocyst, serous cystadenoma) requiring conservative management and follow-up, whereas others are premalignant (mucinous cystadenoma, intraductal papillary mucinous tumor.) or frankly malignant (cystadenocarcinoma) and require surgical resection when possible. In about a third of cases, imaging findings are not sufficiently accurate in establishing the diagnosis, especially in cases of unilocular lesions. Fine needle aspiration can be considered as a second line method in uncertain cases. Aspiration should be performed in specialized services as the procedure requires careful consideration in some patients. Complications are usually rare and minor. The most accurate markers in this field are the carcinoembryonic antigen and the Ca 72.4. They allow to distinguish between a pseudocyst or a serous cystadenoma and a mucinous tumor (benign or malignant) with a 60% sensitivity and a specificity of nearly 100%. Cytological or histological analysis can provide valuable information but their accuracy seems to depend on tumor type. Genetic studies (Ki-ras.) may be possible in the future, including lesions with low cellular cyst fluid content. In conclusion, cyst fluid analysis after fine needle aspiration is a useful diagnostic tool but should always be interpreted in combination with clinical data and imaging findings.

  6. Clinical applications of MR digital subtraction angiography for the evaluation of intracranial vascular and tumorous lesions

    Energy Technology Data Exchange (ETDEWEB)

    Katase, Shichiro; Tsuchiya, Kazuhiro; Hachiya, Junichi [Kyorin Univ., Mitaka, Tokyo (Japan). School of Medicine

    2001-07-01

    MR digital subtraction angiography (MR DSA), which is performed by a rapid two-dimensional T1-weighted sequence in combination with bolus injection of gadolinium-based contrast agent was applied to the evaluation of cerebral arteriovenous malformations (AVMs), brain tumors (intraaxial and extraaxial tumors), and other vascular lesions. This study was performed to evaluate the clinical usefulness of the method in the diagnosis of these lesions. We studied 19 cases of cerebral AVM, 36 cases of intraaxial tumor (metastatic brain tumors in 14, glioblastomas in five, astrocytomas in eight, malignant lymphomas in four, pineal tumors in two, and other tumors, in three), 34 cases of extraaxial tumor (meningiomas in 29, and pituitary adenomas in five), and 10 cases of other vascular lesions (cerebral aneurysms in five, venous thrombosis in two, and other lesion in three). For cerebral AVMs, the feeder, nidus, and drainer were evaluated on a 4 - point grading scale (0=poor, 1=fair, 2=good, 3=excellent), and the results obtained were compared with those of conventional cerebral angiography or MR angiography using the postcontrast three-dimensional time-of-flight method. Brain tumors were classified into six enhancement patterns, and were compared with the findings of conventional cerebral angiography. Other vascular lesions were assessed visually. All cases were evaluated independently by two radiologists, and inter-observer agreement was assessed using the {kappa}-test. In all cerebral AVM cases, the hemodynamics of the feeder, nidus, and drainer could be observed. In all but five brain tumor cases, tumor stain could be confirmed in MR DSA images. The findings of tumor stain corresponded to those of cerebral angiographic images. For other vascular lesions, results of lesion detection and lesion morphology were almost in congruence with other methods. MR DSA provides information on the hemodynamics of vascular and tumorous lesions. When used in conjunction with routine MR

  7. Cystic metastasis versus brain abscess: Role of MR imaging in accurate diagnosis and implications on treatment

    Directory of Open Access Journals (Sweden)

    Shetty Prakash

    2010-01-01

    Full Text Available Intracranial cystic metastases are difficult to differentiate from non neoplastic lesions like a cystic abscess on routine magnetic resonance imaging (MRI sequences in patients with a known primary cancer. Diffusion weighted MRI sequences can help in differentiating between the two. This carries significant implications on the intent and nature of treatment. We present a case of a forty five-year- old patient of squamous cell carcinoma of larynx who developed an intracranial cystic ring enhancing lesion following chemotherapy. Though routine MRI was equivocal, MR diffusion was highly suggestive of an abscess and this led to surgical excision which confirmed the diagnosis. We discuss this case and review the literature regarding the role of newer MRI sequences and the ramifications on patient treatment.

  8. Intracranial non-Langerhans cell histiocytosis presenting as an isolated intraparenchymal lesion

    Energy Technology Data Exchange (ETDEWEB)

    Rajaram, Smitha; Shackley, Fiona; Raghavan, Ashok [Western Bank, Sheffield Children' s Hospital, Sheffield (United Kingdom); Wharton, Stephen B. [University of Sheffield, Department of Neurosciences, Sheffield (United Kingdom); Connolly, Daniel J.A. [Western Bank, Sheffield Children' s Hospital, Sheffield (United Kingdom); University of Sheffield, Academic Radiology, Sheffield (United Kingdom)

    2010-12-15

    Non-Langerhans cell histiocytosis in the absence of cutaneous or other organ involvement is very rare. A Caucasian boy age 3 years 11 months presented with episodes of recurrent right-side seizures over 2 weeks. Brain CT and MR imaging showed a single enhancing left frontal lobe lesion. Stereotactic biopsy was performed and histological examination showed diffuse infiltrate of macrophages with foamy cytoplasm. Four months later there was recurrence of seizure activity despite anti-epileptic medication and a repeat MR scan showed a persistent enhancing lesion in the left frontal lobe. Histological examination of the resection specimen resembled juvenile xanthogranuloma (JXG) involving the central nervous system. In the absence of skin lesions a diagnosis of non-Langerhans cell histiocytosis was made. The child made a full recovery following surgery with resolution of his symptoms. (orig.)

  9. Unusual presentation of neurobrucellosis: a solitary intracranial mass lesion mimicking a cerebral tumor : a case of encephalitis caused by Brucella melitensis.

    Science.gov (United States)

    Erdem, Mehtap; Namiduru, Mustafa; Karaoglan, Ilkay; Kecik, Vuslat Bosnak; Aydin, Abdullah; Tanriverdi, Mustafa

    2012-10-01

    Among the diverse presentations of neurobrucellosis, solitary intracranial mass lesions are extremely rare. To the best of our knowledge, we describe here the second case of neurobrucellosis mimicking a cerebral tumor caused by Brucella melitensis. The mass lesion was clinically and radiologically indistinguishable from a brain tumor. The diagnosis was established by isolating Brucella melitensis in a blood culture and a positive Wright's agglutination test on the cerebrospinal fluid at 1:320 titers. Paraffin sections of the cerebral mass showed nongranulomatous encephalitis. We suggest that patients with an isolated intraparenchymal mass lesion with nongranulomatous encephalitis should also be studied for brucellosis in endemic areas.

  10. MRI Technique in the Diagnosis of Cervical Cystic Lesions%上颈部囊性病变的MRI分析

    Institute of Scientific and Technical Information of China (English)

    杨宁; 刘丽辉

    2014-01-01

    目的:探讨MRI检查在上颈部囊性病变中的诊断价值。方法:36例上颈部囊性肿物,术前行穿刺检查和MRI检查以明确囊液性质、嚢肿范围、来源及信号强度。根据囊液性质及MRI检查特点,决定手术方法,术后病理确诊。结果:穿刺囊液为蛋清样黏液23例,为淡黄色水样液体6例,为灰色脓汁样液体5例。另有2例患者不配合未能行穿刺检查。MRI检查T1低信号、T2高信号且囊肿有“尾状征”与口底关系密切者25例,诊断为潜突型舌下腺囊肿,采用口内入路摘除舌下腺,其余11例采用颈部入路。术后病理证实潜突型舌下腺囊肿25例,淋巴管瘤6例,鳃裂囊肿5例。所有术后病理确诊与术前诊断相符,随访3~36月,未见有患者复发。结论:上颈部囊性病变术前MRI检查,有助于术前明确诊断,以正确指导手术,避免盲目颈部探查手术。%Objective: To explore the diagnostic value of MRI technique applied for cervical cystic lesions. Method: 36 cases with cervical cystic lesions were checked preoperatively by puncture examination and/or MRI. Results: There were 23 cases with the cystic fluid like egg white, 6 cases with pale yellow watery fluid and 5 cases with gray pus-like fluid. Another 2 patients didn't complete puncture examination because of poor cooperation. 25 MRI images clearly showed the cystic wall was originated from the ipsilateral sublingual gland, 11 patients without correct preoperative diagnosis by MRI. The patients with low signal T1 and hyperintensity signal T2 and "tail syndrome" in MRI were subject to using intraoral approach to remove the sublingual gland. There was no patient of recurrence within 3 to 36 months follow-up. The postop-erative pathology confirmed the preoperative diagnosis. Conclusion:MRI examination can clearly show the travel and ori-gin sites of cystic lesions of the neck and contribute to get correct diagnosis preoperatively.

  11. Endoscopic ultrasound-guided fine needle aspiration and biopsy using a 22-gauge needle with side fenestration in pancreatic cystic lesions.

    Science.gov (United States)

    Barresi, Luca; Tarantino, Ilaria; Traina, Mario; Granata, Antonino; Curcio, Gabriele; Azzopardi, Neville; Baccarini, Paola; Liotta, Rosa; Fornelli, Adele; Maimone, Antonella; Jovine, Elio; Cennamo, Vincenzo; Fabbri, Carlo

    2014-01-01

    Cytologic diagnosis by endoscopic ultrasound-guided fine needle aspiration is associated with low sensitivity and adequacy. A newly designed endoscopic ultrasound-guided fine needle biopsy device, endowed with a side fenestration, is now available. We carried out a study with the aim of evaluating the feasibility, safety, and diagnostic yield of the 22-gauge needle with side fenestration for endoscopic ultrasound fine needle aspiration and biopsy of pancreatic cystic lesions. 58 patients with 60 pancreatic cystic lesions consecutively referred for endoscopic ultrasound guided-fine needle aspiration were enrolled in a prospective, dual centre study, and underwent fine needle aspiration and biopsy with the 22-gauge needle with side fenestration. Fine needle aspiration and biopsy was technically feasible in all cases. In 39/60 (65%) pancreatic cystic lesions, the specimens were adequate for cyto-histologic assessment. In lesions with solid components, and in malignant lesions, adequacy was 94.4% (p = 0.0149) and 100% (p = 0.0069), respectively. Samples were adequate for histologic evaluation in 18/39 (46.1%) cases. There were only 2 (3.3%) mild complications. Fine needle aspiration and biopsy with the 22-gauge needle with side fenestration is feasible, and superior to conventional endoscopic ultrasound-guided fine needle aspiration cytology from cystic fluid, particularly in pancreatic cystic lesions with solid component or malignancy, with a higher diagnostic yield and with no increase in complication rate. Copyright © 2013 Editrice Gastroenterologica Italiana S.r.l. Published by Elsevier Ltd. All rights reserved.

  12. Contrast enhancement of intracranial lesions at 1.5 T: comparison among 2D spin echo, black-blood (BB) Cube, and BB Cube-FLAIR sequences

    Energy Technology Data Exchange (ETDEWEB)

    Im, SungWoon; Ashikaga, Ryuichiro; Yagyu, Yukinobu; Hyodo, Tomoko; Imaoka, Izumi; Kumano, Seishi; Ishii, Kazunari; Murakami, Takamichi [Kinki University Faculty of Medicine, Department of Radiology, Osaka-Sayama, Osaka (Japan); Wakayama, Tetsuya; Miyoshi, Mitsuharu [GE Healthcare Japan, MR Applications and Workflow, Asia Pacific, Hino, Tokyo (Japan)

    2015-11-15

    The purpose of this study was to investigate the usefulness of T1W black-blood Cube (BB Cube) and T1W BB Cube fluid-attenuated inversion recovery (BB Cube-FLAIR) sequences for contrast-enhanced brain imaging, by evaluating flow-related artefacts, detectability, and contrast ratio (CR) of intracranial lesions among these sequences and T1W-SE. Phantom studies were performed to determine the optimal parameters of BB Cube and BB Cube-FLAIR. A clinical study in 23 patients with intracranial lesions was performed to evaluate the usefulness of these two sequences for the diagnosis of intracranial lesions compared with the conventional 2D T1W-SE sequence. The phantom study revealed that the optimal parameters for contrast-enhanced T1W imaging were TR/TE = 500 ms/minimum in BB Cube and TR/TE/TI = 600 ms/minimum/300 ms in BB Cube-FLAIR imaging. In the clinical study, the degree of flow-related artefacts was significantly lower in BB Cube and BB Cube-FLAIR than in T1W-SE. Regarding tumour detection, BB Cube showed the best detectability; however, there were no significant differences in CR among the sequences. At 1.5 T, contrast-enhanced BB Cube was a better imaging sequence for detecting brain lesions than T1W-SE or BB Cube-FLAIR. (orig.)

  13. Herniation pits and cystic-appearing lesions at the anterior femoral neck: an anatomical study by MSCT and {mu}CT

    Energy Technology Data Exchange (ETDEWEB)

    Panzer, Stephanie; Esch, Ulrich [Trauma Center Murnau, Department of Radiology, Murnau (Germany); Abdulazim, Ahmed Nabil; Augat, Peter [Paracelsus University Salzburg and Trauma Center Murnau, Biomechanics Laboratory, Murnau (Germany)

    2010-07-15

    To determine distinguishing features between herniation pits (HPs) and other cystic-appearing lesions at the anterior femoral neck in multi-slice computed tomography (MSCT) and micro-computed tomography (microCT) examinations. Institutional review board approval was obtained to examine 37 proximal femora of 23 cadaveric specimens (mean age available in 19 cadavers, 83 years; range 68-100 years; 9 female, 8 male, 6 unknown). All 37 femora were investigated by MSCT. 23 femora, which revealed cystic-appearing lesions at the anterior femoral neck in MSCT examinations, were additionally examined by microCT. Cystic-appearing lesions were categorized by their location, sclerotic margin, demarcation and shape in MSCT with assessment of inter-observer agreement. Detailed cortical and trabecular properties were evaluated in microCT examinations. There were seven HPs in three femora. There were a number of abnormalities potentially imitating HPs, including focal osteoporosis (13 in 13 femora), degenerative changes (5 in 4 femora) and trabecular restructuring (5 in 4 femora) at the anterior femoral neck. HPs were differentiated on the basis of their subchondral/subcortical location, completely surrounding sclerosis, clear demarcation and round-to-oval shape in MSCT. Because of their location and their microscopic appearance, HPs seem to resemble intra-osseous ganglia at the anterior femoral neck. HPs have to be differentiated from other cystic appearing lesions at the anterior femoral neck to avoid overestimation of their incidence in the context of diagnosis of femoroacetabular impingement. (orig.)

  14. Peripheral doses in patients undergoing Cyberknife treatment for intracranial lesions. A single centre experience

    Directory of Open Access Journals (Sweden)

    Vlachopoulou Vassiliki

    2011-11-01

    Full Text Available Abstract Background Stereotactic radiosurgery/radiotherapy procedures are known to deliver a very high dose per fraction, and thus, the corresponding peripheral dose could be a limiting factor for the long term surviving patients. The aim of this clinical study was to measure the peripheral dose delivered to patients undergoing intracranial Cyberknife treatment, using the MOSFET dosimeters. The influence of the supplemental shielding, the number of monitor units and the collimator size to the peripheral dose were investigated. Methods MOSFET dosimeters were placed in preselected anatomical regions of the patient undergoing Cyberknife treatment, namely the thyroid gland, the nipple, the umbilicus and the pubic symphysis. Results The mean peripheral doses before the supplemental shielding was added to the Cyberknife unit were 51.79 cGy, 13.31 cGy and 10.07 cGy while after the shielding upgrade they were 38.40 cGy, 10.94 cGy, and 8.69 cGy, in the thyroid gland, the umbilicus and the pubic symphysis, respectively. The increase of the collimator size corresponds to an increase of the PD and becomes less significant at larger distances, indicating that at these distances the PD is predominate due to the head leakage and collimator scatter. Conclusion Weighting the effect of the number of monitor units and the collimator size can be effectively used during the optimization procedure in order to choose the most suitable treatment plan that will deliver the maximum dose to the tumor, while being compatible with the dose constraints for the surrounding organs at risk. Attention is required in defining the thyroid gland as a structure of avoidance in the treatment plan especially in patients with benign diseases.

  15. A novel conservative approach combining “SealBio” and “Surgical Fenestration” for healing of large periapical cystic lesions of endodontic origin: A pilot study

    Directory of Open Access Journals (Sweden)

    Naseem Shah

    2017-01-01

    Full Text Available Objectives: To evaluate the treatment outcome of large periapical cystic lesions treated by combining two novel, conservative approaches, “SealBio” and “Surgical Fenestration”. Materials and Methods: Five cases (4M:1F, age range 14-38 years, mean age 24.5 years of large periapical cystic lesions, diagnosed on clinical and radiographic examination, were included in the study. After informed consent, endodontic treatment was initiated; chemo-mechanical preparation and intra-canal dressing of calcium hydroxide was given. At the next sitting after one week, further disinfection root canals was done by “apical clearing”, “apical foramen widening” and irrigation. A cotton pellet was kept in the access cavity. After local anaesthesia, full thickness muco-periosteal flap was reflected and the thinned out bone was removed with bone rongers, a small piece of cystic lining was excised and the cystic cavity was copiously flushed with Betadine solution. The remaining cystic lining was gently curetted and the flap was sutured back. “SealBio” was performed after gentle irrigation with saline and intentional over instrumentation. A calcium sulphate based cement was pushed in the cervical third of the canal and the access opening was sealed with glass ionomer cement. Patient was prescribed antibiotics and anti-inflammatory drugs for 5 days and sutures were removed after 7 days. Patients were followed up clinically and radiographically at regular intervals. Conclusions: In this pilot study, treatment outcome after combined technique of “SealBio” and “Surgical fenestration” was found to be highly effective in healing of large periapical cystic lesions. It was simple to perform and very conservative treatment; it required minimal bone removal, obviated the need for complete cyst enucleation, apicectomy and retrograde filling.

  16. Nonsurgical endodontic therapy along with minimal invasive treatment utilizing Bhasker's hypothesis for the management of infected radicular cystic lesion: A rare case report

    Directory of Open Access Journals (Sweden)

    Sanjeev Kumar Salaria

    2016-01-01

    Full Text Available Radicular cyst (RC is the most common odontogenic cyst of inflammatory origin affecting the jaws; involves the roots of the carious or traumatic non-vital tooth. Different therapeutic modalities, such as nonsurgical endodontic therapy or surgical enucleation with primary closure, decompression etc., were proposed for the management of such lesions. Presenting a case of a 28-year-old otherwise healthy male patient who reported with pain and swelling with respect to tooth #41, 31. Diagnosis of infected RC at a rare location was established on the basis of clinical, radiographical and fine needle aspiration cytological examination. Looking after the clinical characteristics, origin, extension, size of cystic lesion and patient cooperation; nonsurgical endodontic therapy utilizing Bhasker's hypothesis was opted. One year post-operative result suggested that nonsurgical endodontic therapy along with minimally invasive treatment utilizing Bhasker's hypothesis is an effective tool to transform infected radicular cystic lesion to healthy periapical periodontal tissue.

  17. Treatment of intracranial hydatid cysts

    Institute of Scientific and Technical Information of China (English)

    Sailike Duishanbai; WEN Hao; GENG Dangmurenjiafu; LIU Chen; GUO Huai-rong; HAO Yu-jun; LIU Bo; WANG Yong-xin; LUO Kun; ZHOU Kai

    2011-01-01

    Background Echinococcosis is still endemic in many countries, including China, where it is especially prevalent in the northwest. The aim of this study was to enrich the international literature about the treatment of intracranial hydatid cysts.Methods We retrospectively reviewed the clinical features, radiological manifestations, and surgical outcome of 97 patients with intracranial hydatid cysts, who received surgical treatment at the Neurosurgical Department of First Affiliated Hospital of Xinjiang Medical University from 1985 to 2010 and followed up the patient via sending a questionnaire or telephone contact. Clinical outcome was evaluated using the Karnofsky Performance Scale Index.Results Headache and vomiting were the most common initial symptoms in our patients. Neurological deficits caused by the mass effect of the cysts were seen in 82 cases. On the X-ray, significant bone erosion was seen in only two cases with epidural hydatid cysts. Round-shaped and thin-walled homogeneous low-density cystic lesions without surrounding edema and enhancement were the main findings on computerized tomography (CT) in 95 patients with intraparenchymal hydatid cysts, while two cases with epidural hydatid cysts presented as a heterodensity lesions. On magnetic resonance imaging (MRI), hydatid cyst presented as a round-shaped low signal lesion in T1-weighted images and high signal lesion in T2-weighted images, without enhancement after contrast media injection, while the two cases with epidural cysts presented as mixed signal masses. Surgical removal of cyst was performed in all cases. Total removal was achieved in 93 cases without rupturing the cyst wall. Only two cysts ruptured during the dissection, resulting in two surgery-related mortalities. There was no other additional neurological deficit caused directly by surgery. In 97.2% of the patients, the Karnofsky Performance Scale score was 80 to 90 at the last follow-up.Conclusions Intracranial hydatid cyst is still a

  18. Investigation of intracranial peripheral dose arising from the treatment of large lesions with Leksell GammaKnife Perfexion.

    Science.gov (United States)

    Ruschin, Mark; Nordström, Håkan; Kjäll, Per; Cho, Young-Bin; Jaffray, David

    2009-06-01

    This investigation involves quantifying the extent of intracranial peripheral dose arising from simulated targets situated in the skull-base or upper-spine region using the Leksell GammaKnife Perfexion treatment unit. For each of three spherical target volumes--denoted as Vs (4 cm3), VM (18 cm3), and VL (60 cm3)--three treatment plans were manually generated, one for each of the three collimator sizes--4, 8, and 16 mm. Each of the plans was delivered to a spherical dosimetry phantom with an insert containing EBT Gafchromic film. The total dose at 70 mm from the targets' edges, %D(70 mm), was measured as a function of elevation angle and expressed as a percentage of the prescription dose. The film insert was placed centered in the median sagittal plane (Leksell X = 100) and %D(70 mm) was measured for the angular range from 0 degree (superior/along Z axis) to 90 degrees (anterior/along Y axis). For a given collimator i, the irradiation time ti to treat a spherical target of volume V using the 50% isodose line was observed to follow a power-law relationship of the form ti = Ai(V/ Vi)n where Ai was the maximum dose divided by collimator dose rate and Vi was the volume encompassed by the 50% isodose line for a single shot. The mean value of n was 0.61 (range: 0.61-0.62). Along the superior (Z) direction (angle=0 degree) and up to angles of around 30 degrees, the %D(70 mm) was always highest for the 4 mm plans, followed by the 8 mm, followed by the 16 mm. In this angular range, the maximum measured %D(70 mm) was 1.7% of the prescription dose. The intracranial peripheral dose along the superior direction (combined scatter and leakage dose) resulting from irradiation of upper-spine or base-of-skull lesions is measured to be less than 2% of the prescription dose, even for very large (60 cm3) targets. The results of this study indicate that, for a given target volume, treatment plans consisting of only 4 mm shots yield larger peripheral dose in the superior direction than 8

  19. De novo cystic brain lesions mimicking neurocysticercosis in ALK-positive lung cancer.

    Science.gov (United States)

    Kim, Su-Hyun; Hyun, Jae-Won; Kim, Ho Jin; Gwak, Ho-Shin; Lee, Sang Hyun; Hong, Eun-Kyung; Lee, Youngjoo

    2017-08-01

    Cystic brain metastases (CBM) have been recently reported in a minority of patients with anaplastic lymphoma kinase (ALK)-positive non-small cell lung cancer (NSCLC). All previously reported ALK-positive CBM developed during crizotinib treatment and were often asymptomatic and indolent, even without CNS-directed therapy. Thus, crizotinib was suggested as an etiologic agent for the development of CBM. Here, we report a case of de novo CBM in a patient with ALK-positive NSCLC prior to crizotinib treatment; the ALK-positive NSCLC had initially been misdiagnosed as neurocysticercosis because of the atypical radiological presentation of brain metastases. Copyright © 2017 Elsevier B.V. All rights reserved.

  20. Risk factors for cervical carotid and intracranial cerebrovascular lesions in patients undergoing coronary artery bypass grafting. Preoperative evaluation using magnetic resonance imaging and angiography

    Energy Technology Data Exchange (ETDEWEB)

    Makino, Masahiro [Kyoto Prefectural Univ. of Medicine (Japan). Research Inst. for Neurological Diseases and Geriatrics

    2001-12-01

    Recently neurologic complications after coronary artery bypass grafting (CABG) have received increasing attention. There is no detailed report about the risk factors for these complications, although stenosis in the cervical and intracranial arteries, especially in Japanese patients, latent ischemic brain lesions and preoperative neurological conditions are related to these events. In this prospective study, we evaluated occlusive lesions in the cervical carotid and intracranial arteries, silent brain infarction and cerebral deep white matter lesion with MRA and MRI in patients scheduled to undergo CABG to determine the prevalence of occlusive diseases in cervical carotid and intracranial arteries, latent ischemic change in the brain in this population and to identify preoperative risk factors for these patients. The subjects were 144 consecutive patients (103 men and 41 women, mean age 65.9{+-}9.2 years old) who were scheduled for CABG under elective conditions and who were examined by the same MRI apparatus using the same protocol between November 1998 and March 2001. After routine neurological examination and Mini-Mental State Examination (MMSE) were completed, MRI and MRA were obtained, then the prevalence of abnormalities on MRI and MRA studies and risk factors were evaluated. Cervical carotid artery stenosis with {>=}50% luminal narrowing was detected in 29.2% of the subjects, and that with {>=}75% luminal narrowing was detected in 16.0% of the subjects. Intracranial arterial stenosis showing {>=}50% luminal narrowing was detected in 38.2% of subjects, and that showing {>=}75% luminal narrowing was detected in 19.4% of subjects. Brain infarction was observed in 74.3% of subjects, cerebral deep white matter lesion showing grade 2 or higher on Fazekas classification was observed in 17.4% of the subjects. The characteristics, including possible risk factors of subjects with and without these abnormal findings, were compared. Patients with cervical carotid

  1. Prevalence of Pancreatic Cystic Lesions Is Associated With Diabetes Mellitus and Obesity: An Analysis of 5296 Individuals Who Underwent a Preventive Medical Examination.

    Science.gov (United States)

    Mizuno, Suguru; Isayama, Hiroyuki; Nakai, Yousuke; Yoshikawa, Takeharu; Ishigaki, Kazunaga; Matsubara, Saburo; Yamamoto, Natsuyo; Ijichi, Hideaki; Tateishi, Keisuke; Tada, Minoru; Hayashi, Naoto; Koike, Kazuhiko

    2017-07-01

    Pancreatic cystic lesions (PCLs) are considered precursors of pancreatic cancer. Diabetes mellitus (DM) and obesity are known as risk factors for pancreatic cancer. We investigated the prevalence of PCLs in the general population and the relationship between PCLs and DM/obesity. This cross-sectional analysis included 5296 individuals who underwent a preventive medical examination between October 2006 and June 2013 at our institution. Magnetic resonance imaging, including magnetic resonance cholangiopancreatography, was performed using a 3.0-T system as part of a comprehensive health screening program. We investigated the prevalence and risk factors of PCLs. The prevalence of PCLs was 13.7%, which was increased according to age. Individuals with PCLs were more prone to obesity (body mass index, 24.0 vs 23.7 kg/m [P = 0.015]; waist circumference, 87.4 vs 85.5 cm [P Pancreatic cystic lesions were significantly associated with DM and obesity.

  2. Management of acute ischemic stroke due to tandem occlusion: should endovascular recanalization of the extracranial or intracranial occlusive lesion be done first?

    Science.gov (United States)

    Rangel-Castilla, Leonardo; Rajah, Gary B; Shakir, Hakeem J; Shallwani, Hussain; Gandhi, Sirin; Davies, Jason M; Snyder, Kenneth V; Levy, Elad I; Siddiqui, Adnan H

    2017-04-01

    OBJECTIVE Acute tandem occlusions of the cervical internal carotid artery and an intracranial large vessel present treatment challenges. Controversy exists regarding which lesion should be addressed first. The authors sought to evaluate the endovascular approach for revascularization of these lesions at Gates Vascular Institute. METHODS The authors performed a retrospective review of a prospectively maintained, single-institution database. They analyzed demographic, procedural, radiological, and clinical outcome data for patients who underwent endovascular treatment for tandem occlusions. A modified Rankin Scale (mRS) score ≤ 2 was defined as a favorable clinical outcome. RESULTS Forty-five patients were identified for inclusion in the study. The average age of these patients was 64 years; the mean National Institutes of Health Stroke Scale score at presentation was 14.4. Fifteen patients received intravenous thrombolysis before undergoing endovascular treatment. Thirty-seven (82%) of the 45 proximal cervical internal carotid artery occlusions were atherothrombotic in nature. Thirty-eight patients underwent a proximal-to-distal approach with carotid artery stenting first, followed by intracranial thrombectomy, whereas 7 patients underwent a distal-to-proximal approach (that is, intracranial thrombectomy was performed first). Thirty-seven (82%) procedures were completed with local anesthesia. For intracranial thrombectomy procedures, aspiration alone was used in 15 cases, stent retrieval alone was used in 5, and a combination of aspiration and stent-retriever thrombectomy was used in the remaining 25. The average time to revascularization was 81 minutes. Successful recanalization (thrombolysis in cerebral infarction Grade 2b/3) was achieved in 39 (87%) patients. Mean National Institutes of Health Stroke Scale scores were 9.3 immediately postprocedure (p acute carotid artery stenting and mechanical thrombectomy concurrently. Proximal-to-distal and aspiration

  3. Cystic lesions of the jaws: a retrospective clinicopathologic study of 2030 cases.

    Science.gov (United States)

    Lo Muzio, Lorenzo; Mascitti, Marco; Santarelli, Andrea; Rubini, Corrado; Bambini, Fabrizio; Procaccini, Maurizio; Bertossi, Dario; Albanese, Massimo; Bondì, Vincenzo; Nocini, Pier Francesco

    2017-08-01

    The aim of this study was to perform an epidemiologic analysis of cases of jaw cysts treated from 1973 to 2012 at the Dentistry and Maxillofacial Surgery Unit of the Verona Hospital, Italy, and to compare the data obtained with those published in the literature. A retrospective survey of 2030 patients treated for jaw cysts from 1973 to 2012 was performed. The lesions were classified according to the 2005 World Health Organization histologic classification, and the following variables were analyzed: age, gender, histopathologic diagnosis, and site of onset. Of 2030 total lesions, there were 1970 odontogenic cysts (97.04%), 50 nonodontogenic cysts (2.46%), and 10 pseudocysts (0.49%). Of the patients, 314 were children (15.47%), and 1716 were adults (84.53%). Mean age was 37.24 years, with a male/female ratio of 1.71:1. There is a wide variety of cysts, some of which are subject to variations according to gender, localization, and age. Copyright © 2017 Elsevier Inc. All rights reserved.

  4. Bosniak classification of renal cystic lesions according to multidetector computed tomography findings; Classificacao de Bosniak das lesoes cisticas renais segundo achados na tomografia computadorizada multidetectores

    Energy Technology Data Exchange (ETDEWEB)

    Miranda, Christiana Maia Nobre Rocha de; Padilha, Igor Gomes; Farias, Lucas de Padua Gomes de; Rocha, Milzi Sarmento da, E-mail: maiachristiana@globo.com [Universidade Federal de Alagoas (UFAL), Maceio, AL (Brazil); Maranhao, Carol Pontes de Miranda; Santos, Carla Jotta Justo dos [Clinica de Medicina Nuclear e Radiologia de Maceio (MedRadiUS), Maceio, AL (Brazil)

    2014-03-15

    Renal cystic lesions are usually diagnosed in the radiologists' practice and therefore their characterization is crucial to determine the clinical approach to be adopted and prognosis. The Bosniak classification based on computed tomography findings has allowed for standardization and categorization of lesions in increasing order of malignancy (I, II, IIF, III and IV) in a simple and accurate way. The present iconographic essay developed with multidetector computed tomography images of selected cases from the archives of the authors' institution, is aimed at describing imaging findings that can help in the diagnosis of renal cysts. (author)

  5. Ultrasound Imaging of Cystic Nephroma

    Directory of Open Access Journals (Sweden)

    Federico Greco

    2017-07-01

    Full Text Available Cystic nephroma is a rare, benign multicystic lesion of the kidney. This tumor occurs both in children and in adults. In children, it is highly prevalent in males; in adults, it is more frequent in women. The term “cystic nephroma” represents two apparently different entities: pediatric cystic nephroma, a benign form thought to originate from metanephric tissue, and adult cystic nephroma, considered as a lesion of mixed epithelial stromal tumor. The clinical presentation may be a palpable mass or nonspecific symptoms such as abdominal pain, hematuria, and urinary tract infections. In this review, we summarize the ultrasound imaging features of cystic nephroma and describe the characteristics of the most common renal cystic lesions and the differential diagnosis of cystic nephroma with other renal cystic lesions.

  6. Remote multiple intracranial hemorrhage in multiple metastatic lung adenocarcinoma following decompression of posterior fossa lesion: Unknown cause

    Directory of Open Access Journals (Sweden)

    Subhas Konar

    2015-01-01

    Full Text Available Cerebral metastasis can present with hemorrhage. However, multiple hemorrhages in metastatic lesions following surgical decompression of a single lesion are never reported. We report a case of cerebral metastasis from lung cancer that developed multiple hemorrhages in supratentorial metastatic lesions following surgical resection of an infratentorial lesion.

  7. Subdural intracranial pressure, cerebral perfusion pressure, and degree of cerebral swelling in supra- and infratentorial space-occupying lesions in children

    DEFF Research Database (Denmark)

    Stilling, M; Karatasi, E; Rasmussen, Mads

    2005-01-01

    UNLABELLED: To our knowledge comparative studies of intracranial pressure (ICP) and degree of cerebral swelling during craniotomy for supratentorial or infratentorial space occupying lesion in children are not available. In this prospective study subdural ICP, cerebral perfusion pressure (CPP......), dural tension, and the degree of cerebral swelling were analysed in supine and prone positioned children subjected to craniotomy for space occupying lesions. MATERIAL AND METHOD: 48 children with space occupying tumours were subjected to either isoflurane/nitrous oxide 50%/fentanyl (n = 22) or propofol....../fentanyl/air/oxygen (n = 26). 25 children were operated supratentorially in supine position, while 23 patients were operated infratentorially in the prone position. Subdural ICP, mean arterial blood pressure (MABP), and CPP were measured just before opening of the dura. Dural tension was estimated before opening of dura...

  8. Malignancy rates and diagnostic performance of the Bosniak classification for the diagnosis of cystic renal lesions in computed tomography - a systematic review and meta-analysis

    Energy Technology Data Exchange (ETDEWEB)

    Sevcenco, Sabina; Shariat, Shahrokh F. [Medical University of Vienna, Department of Urology, Vienna (Austria); Spick, Claudio; Helbich, Thomas H.; Baltzer, Pascal A. [Medical University of Vienna, Department of Biomedical Imaging and Image-guided Therapy, General Hospital Vienna, Vienna (Austria); Heinz, Gertraud [University Hospital of Sankt-Poelten, Department of Radiology, Poelten (Austria); Klingler, Hans C. [Wilhelminenspital, Department of Urology, Vienna (Austria); Rauchenwald, Michael [Donauspital, Department of Urology, Vienna (Austria)

    2017-06-15

    To systematically review the literature on the Bosniak classification system in CT to determine its diagnostic performance to diagnose malignant cystic lesions and the prevalence of malignancy in Bosniak categories. A predefined database search was performed from 1 January 1986 to 18 January 2016. Two independent reviewers extracted data on malignancy rates in Bosniak categories and several covariates using predefined criteria. Study quality was assessed using QUADAS-2. Meta-analysis included data pooling, subgroup analyses, meta-regression and investigation of publication bias. A total of 35 studies, which included 2,578 lesions, were investigated. Data on observer experience, inter-observer variation and technical CT standards were insufficiently reported. The pooled rate of malignancy increased from Bosniak I (3.2 %, 95 % CI 0-6.8, I{sup 2} = 5 %) to Bosniak II (6 %, 95 % CI 2.7-9.3, I{sup 2} = 32 %), IIF (6.7 %, 95 % CI 5-8.4, I{sup 2} = 0 %), III (55.1 %, 95 % CI 45.7-64.5, I{sup 2} = 89 %) and IV (91 %, 95 % CI 87.7-94.2, I{sup 2} = 36). Several study design-related influences on malignancy rates and subsequent diagnostic performance indices were identified. The Bosniak classification is an accurate tool with which to stratify the risk of malignancy in renal cystic lesions. (orig.)

  9. Intracranial endoscopy.

    Science.gov (United States)

    Schroeder, H W; Gaab, M R

    1999-04-15

    The authors' intention is to reduce the invasiveness of intracranial procedures while avoiding traumatization of brain tissue, to decrease the risk of neurological and mental deficits. Intracranial endoscopy is a minimally invasive technique that provides rapid access to the target via small burr holes without the need for brain retraction. Craniotomy as well as microsurgical brain splitting and dissection can often be avoided. Furthermore, because obstructed cerebrospinal fluid pathways can be physiologically restored, the need for shunt placement is eliminated. The ventricular system and subarachnoid spaces provide ideal conditions for the use of an endoscope. Therefore, a variety of disorders, such as hydrocephalus, small intraventricular lesions, and arachnoid and parenchymal cysts can be effectively treated using endoscopic techniques. With the aid of special instruments, laser fibers, and bipolar diathermy, even highly vascularized lesions such as cavernomas may be treated. Moreover, during standard microsurgical procedures, the endoscopic view may provide valuable additional information ("looking around a corner") about the individual anatomy that is not visible with the microscope. In transsphenoidal pituitary surgery, transseptal dissection can be avoided if an endonasal approach is taken. In the depth of the intrasellar space, the extent of tumor removal can be more accurately controlled, especially in larger tumors with para- and suprasellar growth. The combined use of endoscopes and computerized neuronavigation systems increases the accuracy of the approach and provides real-time control of the endoscope tip position and approach trajectory. In the future, the indications for neuroendoscopy will certainly expand with improved technical equipment.

  10. Catastrophic complication following injection and extracorporeal shock wave therapy of a medial femoral condyle subchondral cystic lesion in a 14 year old Arabian mare

    Directory of Open Access Journals (Sweden)

    Darla K. Moser

    2017-05-01

    Full Text Available This report describes fibrous cyst lining injection and extracorporeal shock wave therapy (ESWT of a medial femoral condyle (MFC subchondral cystic lesion (SCL resulting in catastrophic MFC fracture in an Arabian mare. The mare was presented for evaluation of a severe hind limb lameness of approximately 4 months duration. On presentation, a non-weight bearing lameness of the left hind limb with severe effusion and soft tissue swelling of the stifle region was noted. Radiographic evaluation of the stifle revealed a large SCL of the MFC with associated osteoarthritis. Arthroscopic guided intra-lesional injection of the SCL with corticosteroids and autologous bone marrow concentrate was performed followed by ESWT of the MFC. The mare was discharged walking comfortably 48-hours post-operatively. An acute increase in lameness was noted 14 days post-operatively. Imaging revealed catastrophic fracture of the left MFC. Possible mechanisms leading to failure of the MFC secondary to the described treatment are discussed.

  11. Diagnóstico diferencial inmunomorfológico de las lesiones quísticas maxilares con queratinización Immunomorphological differential diagnosis of maxillary cystic lesions with keratinization

    Directory of Open Access Journals (Sweden)

    Beatriz Vera-Sirera

    2011-12-01

    Full Text Available Objetivos: Los quistes maxilares con queratinización son formas lesionales de carácter controvertido y de relevancia clínica, dada la implicación clínico-evolutiva del llamado tumor odontogénico queratoquístico (TOQ. En el presente estudio nos planteamos valorar la utilidad de las técnicas inmunohistoquímicas en la identificación de estas lesiones. Material y métodos: Se analizan de forma retrospectiva las lesiones quísticas maxilares dotadas de fenómenos de queratinización interna, diagnosticadas en un mismo centro hospitalario, a lo largo de un periodo de 4 años, realizando un estudio inmunohistoquímico mediante la aplicación de un panel de cinco anticuerpos (Ki67, Bcl-2, p53, CK19, D2-40. Resultados: De un total de 410 lesiones quísticas maxilares, se seleccionaron 22 casos (5,36% en los que existían rasgos morfológicos de queratinización interna. Aplicando los criterios morfológicos de la clasificación histológica de la OMS (2005 se diagnosticaron 15 TOQ y 4 quistes odontogénicos ortoqueratósicos (QOO, existiendo 3 observaciones con rasgos morfológicos híbridos de TOQ y de QOO. El estudio inmunohistoquímico llevado a cabo permitió realizar un certero diagnóstico diferencial entre el TOQ y el QOO, y además su empleo posibilitó adscribir de forma correcta las formas híbridas a cada uno de estos dos tipos lesionales. Conclusiones: El análisis inmunohistoquímico, con la aplicación de un panel de cinco anticuerpos, permite un diagnóstico certero de las lesiones quisticas maxilares con queratinización, permitiendo la diferenciación del TOQ frente al QOO, así como la correcta identificación de las lesiones de carácter morfológico híbrido.Objectives: Maxillary cystic lesions with keratinization are controversial lesions that are clinically relevant due to the prognostic implication of the so-called keratocystic odontogenic tumor (KOT. The aim of this study was to assess the usefulness of

  12. Does secretin stimulation add to magnetic resonance cholangiopancreatography in characterising pancreatic cystic lesions as side-branch intraductal papillary mucinous neoplasm?

    Energy Technology Data Exchange (ETDEWEB)

    Purysko, Andrei S.; Gandhi, Namita S.; Veniero, Joseph C. [Cleveland Clinic, From the Abdominal Imaging Section, Imaging Institute, Cleveland, OH (United States); Walsh, R.M. [Cleveland Clinic, Department of General Surgery, Digestive Disease Institute, Cleveland, OH (United States); Obuchowski, Nancy A. [Cleveland Clinic, Department of Quantitative Health Sciences, Cleveland, OH (United States)

    2014-12-15

    To assess the value of secretin during magnetic resonance cholangiopancreatography (MRCP) in demonstrating communication between cystic lesions and the pancreatic duct to help determine the diagnosis of side-branch intraductal papillary mucinous neoplasm (SB-IPMN). This is an IRB-approved, HIPAA-compliant retrospective study of 29 SB-IPMN patients and 13 non-IPMN subjects (control) who underwent secretin-enhanced MRCP (s-MRCP). Two readers blinded to the final diagnosis reviewed three randomised image sets: (1) pre-secretin HASTE, (2) dynamic s-MRCP and (3) post-secretin HASTE. Logistic regression, generalised linear models and ROC analyses were used to compare pre- and post-secretin results. There was no significant difference in median scores for the pre-secretin [reader 1: 1; reader 2: 2 (range -2 to 2)] and post-secretin HASTE [reader 1: 1; reader 2: 1 (range -2 to 2)] in the SB-IPMN group (P = 0.14), while the scores were lower for s-MRCP [reader 1: 0.5 (range -2 to 2); reader 2: 0 (range -1 to 2); P = 0.016]. There was no significant difference in mean maximum diameter of SB-IPMN on pre- and post-secretin HASTE, and s-MRCP (P > 0.05). Secretin stimulation did not add to MRCP in characterising pancreatic cystic lesions as SB-IPMN. (orig.)

  13. Different optical spectral characteristics in a necrotic transmissible venereal tumor and a cystic lesion in the same canine prostate observed by triple-band trans-rectal optical tomography under trans-rectal ultrasound guidance

    Science.gov (United States)

    Jiang, Zhen; Holyoak, G. Reed; Ritchey, Jerry W.; Bartels, Kenneth E.; Rock, Kendra; Ownby, Charlotte L.; Slobodov, Gennady; Bunting, Charles F.; Piao, Daqing

    2011-03-01

    Different optical spectral characteristics were observed in a necrotic transmissible venereal tumor (TVT) and a cystic lesion in the same canine prostate by triple-wavelength trans-rectal optical tomography under trans-rectal ultrasound (TRUS) guidance. The NIR imager acquiring at 705nm, 785nm and 808nm was used to quantify both the total hemoglobin concentration (HbT) and oxygen saturation (StO2) in the prostate. The TVT tumor in the canine prostate as a model of prostate cancer was induced in a 7-year old, 27 kg dog. A 2 mL suspension of 2.5x106 cells/mL of homogenized TVT cells recovered from an in vivo subcutaneously propagated TVT tumor in an NOD/SCID mouse were injected in the cranial aspect of the right lobe of the canine prostate. The left lobe of the prostate had a cystic lesion present before TVT inoculation. After the TVT homogenate injection, the prostate was monitored weekly over a 9-week period, using trans-rectal NIR and TRUS in grey-scale and Doppler. A TVT mass within the right lobe developed a necrotic center during the later stages of this study, as the mass presented with substantially increased [HbT] in the periphery, with an area of reduced StO2 less than the area of the mass itself shown on ultrasonography. Conversely, the cystic lesion presented with slightly increased [HbT] in the periphery of the lesion shown on ultrasound with oxygen-reduction inside and in the periphery of the lesion. There was no detectable change of blood flow on Doppler US in the periphery of the cystic lesion. The slightly increased [HbT] in the periphery of the cystic lesion was correlated with intra-lesional hemorrhage upon histopathologic examination.

  14. Intracranial tuberculoma: MR imaging

    Energy Technology Data Exchange (ETDEWEB)

    Salgado, P.; Zenteno, M.A.; Rodriguez-Carbajal, J.; Brutto, O.H. del; Talamas, O.

    1989-09-01

    MR studies of 6 patients with intracranial tuberculoma are reviewed. All patients also underwent CT scans which showed hypo- or isodense lesions with abnormal enhancement following contrast administration. MR showed lesions with prolongation of the T1 relaxation time in every case. On the T2-weighted sequences, the signal properties of the tuberculoma varied according to the stage of evolution of the lesion. Incipient tuberculomas appeared as scattered areas of hypointensity surrounded by edema. Mature tuberculomas were composed of a dark necrotic center surrounded by an isointense capsule which was, in turn, surrounded by edema. In one patient, the center of the lesion was hyperintense probably because of liquefaction and pus formation (tuberculous abscess). While both, CT and MR, were equally sensitive in visualizing the intracranial tuberculoma in every patient, MR was slightly superior in demonstrating the extent of the lesion, especially for brainstem tuberculomas. Nevertheless, the potential role for MR diagnosis of intracranial tuberculoma is limited by the fact that other infectious or neoplasic diseases may present similar findings. The diagnosis of intracranial tuberculoma should rest on a proper integration of data from clinical manifestations, cerebrospinal fluid analysis, and neuroimaging studies. (orig.).

  15. 神经内镜造瘘术治疗颅内病变372例%Neuroendoscopic treatment for 372 cases of intracranial lesions

    Institute of Scientific and Technical Information of China (English)

    詹升全; 李炎稳; 郭文龙; 毛承亮; 李昭杰; 周东; 林志俊; 唐凯; 林晓风; 王鹏; 舒航; 周德祥

    2011-01-01

    Objective To explore the application of neuroendoscopic treatment for intracranial lesions. Methods The clinic data of 372 patients with intracranial lesions, who underwent neuroendoscopic treatment at our department from May 1998 to May 2010, were reviewed retrospectively. Representative endoscopic treatments included endoscopic third ventriculostomy (ETV) (n=198), ETV & endoscopic biopsy (n=69) , neuroendoscopic ostomy for septum pellucidum fenestration (n=55) (for septum pellucidum cysts, n=37) and endoscopic cystoventriculostomy for ventricular cysts (n=50). Their surgical indications and clinical outcomes were summarized for analysis. Results ETV was performed successfully in 369 cases. Among them, 2 failed cases underwent other operations and endoscopic biopsy failed in 1case. Within a short post-operative period, the symptoms were resolved in 347 cases (93.3%) , showed no improvement in 23 cases (6.2%) and 2 died (0.5%). At Month 6 post-operation, a failure of ETV was detected in 22 cases (9.5%), a failure of neuroendoscopic ostomy for septum pellucidum cysts in 23(69.7%) and for ventricular cysts in 12 cases (26.7%). Conclusion ETV is effective in the treatment of obstructive hydrocephlus, but its indication should be strictly controlled for children. Effective rate of neuroendoscopic treatment for intracranial septum pellucidum cysts remains unsatisfactory so that its operative indication should be strictly controlled.%目的 探讨神经内镜造瘘术在治疗颅内病变中的作用.方法 回顾性分析广东省人民医院神经外科1998年5月至2010年5月使用神经内镜造瘘术治疗的颅内病变的临床资料.选取具有代表性手术方式的病例共372例,手术包括神经内镜下第三脑室底造瘘术198例、神经内镜下第三脑室底造瘘加病变活检或切除术69例、透明隔造瘘术55例、脑室囊肿造瘘术50例.总结并分析其手术适应证的把握及手术效果.结果 成功行造瘘术369例,2例改

  16. Intestinal lesions are associated with altered intestinal microbiome and are more frequent in children and young adults with cystic fibrosis and cirrhosis.

    Science.gov (United States)

    Flass, Thomas; Tong, Suhong; Frank, Daniel N; Wagner, Brandie D; Robertson, Charles E; Kotter, Cassandra Vogel; Sokol, Ronald J; Zemanick, Edith; Accurso, Frank; Hoffenberg, Edward J; Narkewicz, Michael R

    2015-01-01

    Cirrhosis (CIR) occurs in 5-7% of cystic fibrosis (CF) patients. We hypothesized that alterations in intestinal function in CF contribute to the development of CIR. Determine the frequency of macroscopic intestinal lesions, intestinal inflammation, intestinal permeability and characterize fecal microbiome in CF CIR subjects and CF subjects with no liver disease (CFnoLIV). 11 subjects with CFCIR (6 M, 12.8 yrs ± 3.8) and 19 matched with CFnoLIV (10 M, 12.6 yrs ± 3.4) underwent small bowel capsule endoscopy, intestinal permeability testing by urinary lactulose: mannitol excretion ratio, fecal calprotectin determination and fecal microbiome characterization. CFCIR and CFnoLIV did not differ in key demographics or CF complications. CFCIR had higher GGT (59±51 U/L vs 17±4 p = 0.02) and lower platelet count (187±126 vs 283±60 p = 0.04) and weight (-0.86 ± 1.0 vs 0.30 ± 0.9 p = 0.002) z scores. CFCIR had more severe intestinal mucosal lesions on capsule endoscopy (score ≥4, 4/11 vs 0/19 p = 0.01). Fecal calprotectin was similar between CFCIR and CFnoLIV (166 μg/g ±175 vs 136 ± 193 p = 0.58, nl Bacteroides were decreased in relative abundance in CFCIR and were associated with lower capsule endoscopy score whereas Clostridium were more abundant in CFCIR and associated with higher capsule endoscopy score. CFCIR is associated with increased intestinal mucosal lesions, slower small bowel transit time and alterations in fecal microbiome. Abnormal intestinal permeability and elevated fecal calprotectin are common in all CF subjects. Disturbances in intestinal function in CF combined with changes in the microbiome may contribute to the development of hepatic fibrosis and intestinal lesions.

  17. CT Diagnosis and differential diagnosis of type of ovarian cystic lesions%卵巢囊性类病变的CT诊断和鉴别诊断

    Institute of Scientific and Technical Information of China (English)

    徐恒昀; 曾亚琴; 唐立华

    2011-01-01

    目的 分析女性卵巢区域囊性类病变的CT表现,旨在进一步提高其CT诊断和鉴别诊断的准确率.方法 对经抗炎复查、手术及病理证实的48例60个卵巢囊性类病变患者的CT及临床资料进行回顾性分析.结果 卵巢囊肿17例,囊腺瘤10例,巧克力囊肿7例,囊性畸胎瘤3例,卵巢性索间质肿瘤、颗粒细胞瘤和卵泡膜细胞瘤各1例,浆膜外子宫肌瘤液化1例,卵巢癌5例,转移瘤1例.经抗炎复查证实子宫附件区脓肿2例.结论 CT能直观清楚地显示女性盆腔病变及其与周围的关系,在卵巢区域囊性类病变的诊断及鉴别诊断中具有重要价值.%Objective To analyze female regional cystic ovarian lesions CT manifestations. CT is to further improve its diagnosis and differential diagnosis of accuracy. Methods 60 lesions of 48 cases were analyzed including CT and clinical information. Results By surgery and pathology, there were 17 with ovarian cysts, 10 cases with cystadenoma; 7 cases with chocolate cysts; 3 cases with cystic teratoma and 1 case with ovarian sex cord stromal tumor, granular cell tumor, metastatic tumors and theca cell tumor each and serosa outside hysteromyoma, and 5 cases with ovarian cancer. Conclusion CT can clearly show the intuitive female pelvic lesions and their the peripheral relations.

  18. Research on CT and MRI in Diagnosis of Benign Pelvic Cystic Lesion%盆腔良性多囊性病变的CT、MRI诊断研究

    Institute of Scientific and Technical Information of China (English)

    孙跃

    2016-01-01

    目的:总结MRI技术、CT技术应用于盆腔良性多囊性病变患者中的意义。方法随机筛选2014年2月-2016年1月因患盆腔良性多囊性病变进入该院接受专业诊疗的46例患者,所有入选对象均接受病理诊断,且已证实。在46例患者中施行MRI技术、CT技术检查,并对两种技术应用价值进行评定。结果该次入选的46例研究对象中,其疾病类型以内膜异位为主,而其病灶征象常见于多囊样、巧克力型囊肿,经检查后,MRI技术的检出率89.13%(41/46),CT技术的检出率69.57%(32/46),两种技术对照差异有统计学意义(P<0.05)。结论 MRI技术、CT技术应用于盆腔良性多囊性病变患者中,均可对患者疾病类型、疾病特征等进行判断,且两种技术各有优势,因此在展开临床诊断工作时,建议有机结合两种技术,以提升诊断工作质量。%Objective To summarize the significance of MRI technology and CT technology in the application of patients with benign pelvic cystic lesion. Methods 46 cases of patients receiving specialized treatment and diagnosis in our hospital from February 2014 to January 2016 due to benign pelvic cystic lesion were randomly screened, all the selected objects re-ceived pathologic diagnosis and were confirmed, and examined by MRI technology and CT technology, and the application value of the two technologies was evaluated. Results In the 46 cases, the disease type was mainly endometriosis, but the le-sion sign was common in multiple follicular cysts and chocolate cysts, after examination, the detection rate of MRI technolo-gy and CT technology were respectively 89.13%(41/46) and 69.57%(32/46), and the difference was obvious by comparison, (P<0.05). Conclusion The application of MRI technology and CT technology in patients with benign pelvic cystic lesion can determine the disease type and features of patients, and both technologies have advantages, therefore, the two technologies are suggested to

  19. In vivo proton magnetic resonance spectroscopy in a known case of intracranial hydatid cyst

    Directory of Open Access Journals (Sweden)

    Chand K

    2005-01-01

    Full Text Available We are presenting magnetic resonance spectroscopy (MRS findings of a known case of hydatid cyst operated twice in the past. A 22-years-old male patient had presented with recurrent symptoms of generalized seizures and raised intracranial tension. MRI with MRS of the lesion was performed that showed a recurrent loculated cystic lesion in right parieto-occipital lobe. MRS through the lesion was performed using repetition time (TR of 1500 ms and time to echo (TE of 135 ms using 2 x 2 x 2 cm voxel, from the margin of the lesion. MRS showed mildly elevated choline (Cho, depressed creatine (Cr and N-acetyl aspartate (NAA, a large peak of lactate, pyruvate and acetate peaks.

  20. Rapid growth of an infectious intracranial aneurysm with catastrophic intracranial hemorrhage.

    Science.gov (United States)

    Koffie, Robert M; Stapleton, Christopher J; Torok, Collin M; Yoo, Albert J; Leslie-Mazwi, Thabele M; Codd, Patrick J

    2015-03-01

    Infectious intracranial aneurysms are rare vascular lesions that classically occur in patients with infective endocarditis. We present a 49-year-old man with altered mental status and headache with rapid growth and rupture of an infectious intracranial aneurysm with catastrophic intracranial hemorrhage, and review issues related to open neurosurgical and endovascular interventions.

  1. Rapidly Evoluting Congenital Cystic Neuroblastoma in a Neonate

    Energy Technology Data Exchange (ETDEWEB)

    Yun, Tae Jun; Kim, Myung Jun; Han, Seok Joo; Lee, Mi Jung [Severance Children' s Hospital, Yonsei University, College of Medicine, Seoul(Korea, Republic of)

    2012-08-15

    Perinatal detection of neonatal suprarenal masses has increased. Here, we report an unusual case of an adrenal cystic neuroblastoma that presented as a purely cystic lesion upon initial postnatal ultrasonography (US) and showed rapid evolution to a mixed cystic and solid mass during follow-up US and MRI. We suggest a short-term (two weeks) follow-up US for neonatal adrenal cystic lesions, even if they appear as purely cystic.

  2. Intracranial metastases: spectrum of MR imaging findings

    Energy Technology Data Exchange (ETDEWEB)

    Lee, Eun Kyoung; Lee, Eun Ja; Lee, Yong Seok [Department of Radiology, Dongguk University Ilsan Hospital, Goyang-shi (Korea, Republic of)], E-mail: ejl1048@hanmail.net; Kim, Mi Sung; Park, No Hyuck [Department of Radiology, Kwandong University, College of Medicine, Myongji Hospital, Goyang-shi (Korea, Republic of); Park, Hee-Jin [Department of Radiology, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, Seoul (Korea, Republic of); II, Sung Park [Department of Diagnostic Radiology, Soonchunhyang University Bucheon Hospital, Bucheon (Korea, Republic of)

    2012-12-15

    Intracranial metastatic lesions arise through a number of routes. Therefore, they can involve any part of the central nervous system and their imaging appearances vary. Magnetic resonance imaging (MRI) plays a key role in lesion detection, lesion delineation, and differentiation of metastases from other intracranial disease processes. This article is a reasoned pictorial review illustrating the many faces of intracranial metastatic lesions based on the location - intra-axial metastases, calvarial metastases, dural metastases, leptomeningeal metastases, secondary invasion of the meninges by metastatic disease involving the calvarium and skull base, direct or perineural intracranial extension of head and neck neoplasm, and other unusual manifestations of intracranial metastases. We also review the role of advanced MRI to distinguish metastases from high-grade gliomas, tumor-mimicking lesions such as brain abscesses, and delayed post-radiation changes in radiosurgically treated patients.

  3. Serum tumor markers not useful in screening patients with pancreatic mucinous cystic lesions associated with malignant changes

    Institute of Scientific and Technical Information of China (English)

    Raffaele Pezzilli; Lucia Calculli; Gianvico Melzi d’Eril; Alessandra Barassi

    2016-01-01

    BACKGROUND: Serum cancer antigen 19-9 (CA19-9) pro-vides additional information about mucinous cystic pancre-atic neoplasm (MPN). This study was undertaken to assess both CA19-9 and carcinoembryonic antigen (CEA) serum concentrations in consecutive patients affected by MPNs and other chronic benign and malignant pancreatic diseases. We also evaluated whether serum CA19-9 and CEA determina-tions provide additional information such as the presence of invasive carcinoma in MPN patients. METHODS: Serum CA19-9 and CEA from 91 patients with pancreatic diseases were tested by commercially available kits at the time of diagnosis. The upper reference limit of serum CA19-9 was 37 U/mL and that of serum CEA was 3 ng/mL. RESULTS: Thirty-ifve patients was diagnosed with chronic pancreatitis (CP), 32 with MPN, and 24 with pancreatic ductal adenocarcinoma (PDAC) conifrmed histologically. Surgery was carried out in 5 CP patients, in 10 MPN patients (7 of them had severe dysplasia), and 9 PDAC patients. Serum CA19-9 activity was high in 12 (34.3%) CP patients, in 7 (21.9%) MPN patients, and in 12 (50.0%) PDAC patients (P=0.089). High se-rum CEA concentrations were noted in 6 (17.1%) CP patients, in 6 (18.8%) MPN patients, and in 12 (50.0%) PDAC patients (P=0.010). In the 7 MPN patients associated with histological-ly conifrmed severe dysplasia, 3 (42.9%) patients had elevated serum activity of serum CA19-9, and 2 (28.6%) patients had high levels of CEA. CONCLUSION: Serum determination of oncological markers is not useful in selecting MPN patients with malignant changes.

  4. Epidural Cystic Spinal Meningioma

    Science.gov (United States)

    Zhang, Ji; Chen, Zheng-he; Wang, Zi-feng; Sun, Peng; Jin, Jie-tian; Zhang, Xiang-heng; Zhao, Yi-ying; Wang, Jian; Mou, Yong-gao; Chen, Zhong-ping

    2016-01-01

    Abstract Cystic spinal meningioma (CSM) is an uncommon meningioma variant. Extradural CSMs are particularly rare and difficult to distinguish from other intraaxial tumors. This study presents a case of a 36-year-old woman with intraspinal extradual CSM at the thoracolumbar spine. She experienced persistent weakness, progressive numbness, and sensory disturbance in the right lower limb. Magnetic resonance imaging (MRI) of the patient revealed an irregular cystic mass at the thoracic 11 to lumbar 3 levels dorsally. This case was misdiagnosed as other neoplasms prior to surgery because of the atypical radiographic features and location of the tumor. Extradural CSMs should be considered in the differential diagnosis of intraspinal extradural cystic neoplasms. Complete removal of cystic wall provides an optimal outcome, rendering the lesion curable. PMID:26986119

  5. Intestinal lesions are associated with altered intestinal microbiome and are more frequent in children and young adults with cystic fibrosis and cirrhosis.

    Directory of Open Access Journals (Sweden)

    Thomas Flass

    Full Text Available Cirrhosis (CIR occurs in 5-7% of cystic fibrosis (CF patients. We hypothesized that alterations in intestinal function in CF contribute to the development of CIR.Determine the frequency of macroscopic intestinal lesions, intestinal inflammation, intestinal permeability and characterize fecal microbiome in CF CIR subjects and CF subjects with no liver disease (CFnoLIV.11 subjects with CFCIR (6 M, 12.8 yrs ± 3.8 and 19 matched with CFnoLIV (10 M, 12.6 yrs ± 3.4 underwent small bowel capsule endoscopy, intestinal permeability testing by urinary lactulose: mannitol excretion ratio, fecal calprotectin determination and fecal microbiome characterization.CFCIR and CFnoLIV did not differ in key demographics or CF complications. CFCIR had higher GGT (59±51 U/L vs 17±4 p = 0.02 and lower platelet count (187±126 vs 283±60 p = 0.04 and weight (-0.86 ± 1.0 vs 0.30 ± 0.9 p = 0.002 z scores. CFCIR had more severe intestinal mucosal lesions on capsule endoscopy (score ≥4, 4/11 vs 0/19 p = 0.01. Fecal calprotectin was similar between CFCIR and CFnoLIV (166 μg/g ±175 vs 136 ± 193 p = 0.58, nl <120. Lactulose:mannitol ratio was elevated in 27/28 subjects and was slightly lower in CFCIR vs CFnoLIV (0.08±0.02 vs 0.11±0.05, p = 0.04, nl ≤0.03. Small bowel transit time was longer in CFCIR vs CFnoLIV (195±42 min vs 167±68 p<0.001, nl 274 ± 41. Bacteroides were decreased in relative abundance in CFCIR and were associated with lower capsule endoscopy score whereas Clostridium were more abundant in CFCIR and associated with higher capsule endoscopy score.CFCIR is associated with increased intestinal mucosal lesions, slower small bowel transit time and alterations in fecal microbiome. Abnormal intestinal permeability and elevated fecal calprotectin are common in all CF subjects. Disturbances in intestinal function in CF combined with changes in the microbiome may contribute to the development of hepatic fibrosis and intestinal lesions.

  6. Diagnostic strategy and differential therapeutic approach for cystic lesions of the pancreas; Diagnostische Strategie und differenzialtherapeutisches Vorgehen bei zystischen Laesionen des Pankreas

    Energy Technology Data Exchange (ETDEWEB)

    Mayer, P.; Klauss, M. [Universitaetsklinikum Heidelberg, Diagnostische und Interventionelle Radiologie, Heidelberg (Germany); Tjaden, C. [Universitaetsklinikum Heidelberg, Chirurgie, Heidelberg (Germany)

    2016-04-15

    Cystic pancreatic lesions (CPL) are diagnosed with increasing frequency. Because up to 60 % of CPL are classified as malignant or premalignant, every CPL should be fully investigated and clarified. Serous CPL with low risk of malignancy must be differentiated from mucinous CPL with relevant potential malignancy (intraductal papillary mucinous neoplasm IPMN) and mucinous cystic neoplasm (MCN) as well as from harmless pseudocysts. Cross-sectional imaging with computed tomography (CT) and magnetic resonance imaging (MRI) plays a crucial role in the diagnostics of CPL. An algorithm for the differential diagnostic classification of CPL is presented. The connection to the pancreatic duct is the key diagnostic criterion to differentiate IPMN from all other CPL. An exception to this rule is that pseudocysts can also show a connection to the pancreatic duct. A further classification of CPL with no connection to the pancreatic duct can be made by morphological criteria and correlation of the radiological findings with patient age, sex, history and symptoms. Depending on the diagnosis and hence the malignant potential the indications for surgery or watch and wait have to be discussed in an interdisciplinary cooperation. Due to its higher soft tissue contrast MRI is often superior to CT for depiction of CPL morphology. (orig.) [German] Zystische Pankreaslaesionen (ZPL) werden zunehmend haeufiger diagnostiziert. Da bis zu 60 % der ZPL als praemaligne oder maligne einzustufen sind, sollte jede ZPL diagnostisch abgeklaert werden. Seroese ZPL mit geringem Entartungsrisiko (seroes zystische Neoplasien, SZN) muessen von muzinoesen ZPL mit relevantem Malignitaetspotenzial (intraduktale papillaer-muzinoese Neoplasien [IPMN] und muzinoes zystische Neoplasie [MZN]) und harmlosen Pseudozysten unterschieden werden. Die Schnittbildgebung mithilfe der CT und MRT spielt bei der Diagnostik von ZPL eine entscheidende Rolle. Vorgestellt wird ein Algorithmus zur differenzialdiagnostischen

  7. Therapeutic effect of staged treatment for huge mandibular cystic lesions%巨大下颌骨囊性病变分期治疗效果评价

    Institute of Scientific and Technical Information of China (English)

    张青; 方利华; 周平秀; 鞠铎

    2011-01-01

    PURPOSE: To investigate the therapeutic effect of staged treatment for huge mandibular cystic lesions. METHODS: The study enrolled 18 cases of huge cystic lesions whose extent in X-ray film exceeded 5 cm from 2005 to 2009 in our hospital, 6 of them presented mal-aligned dentition. Decompression was first given under local anesthesia to make the entire extent gradually reduced to half of its primary extent, then the cysts were enucleated secondarily combined with simultaneous Bio-oss insertion under general anesthesia, followed by X-ray examination monthly to observe the density of bone, and normal orthodontic treatment was given to 6 cases with malocclusion. RESULTS: The lesions reduced to around half of the primary extent in 4 to 6 months after decompression, the density of bone substitute became almost similar to adjacent bone 6 to 12 months after secondary operation, no case had recurrence within 2 to 3 years. 6 cases with malocclusion were corrected after 2 to 3 years of orthodontic therapy. CONCLUSIONS: The staged treatment can retain the whole mandible and teeth at the same time of enucleation of the cyst, and achieve excellent aesthetic result combined with orthodontic therapy. Supported by Research Fund of Medical Science of Zhejiang Province (2006B125) and Research Fund of Huzhou City(2007YS28).%目的:探讨对巨大下颌骨囊性病变进行分期治疗的效果.方法:选择2005-2009年在本院收治的下颌骨范围大于5cm的囊性病变18例,其中伴牙列不齐者6例,一期局麻下行减压术,待范围减小至小于原来的1/2后,行二期全麻下囊性病变摘除术,即刻Bio-oss骨粉植入,术后每月定期拍摄口腔全景片观察骨密度变化,伴牙列不齐的6例患者手术后2个月开始以常规正畸加力牵引.结果:一期术后4~6个月,病变减小至原来的1/2左右,二期术后6~12个月,骨粉与周围正常骨密度基本一致,2~3a后无一例复发.6例牙列不齐的患者,经1~2a正畸治疗后,

  8. Intracranial Large Artery Occlusive Disease

    Institute of Scientific and Technical Information of China (English)

    Wong KS; Li H; Kay R

    2000-01-01

    @@Intracranial large artery stenosis is the most commonly found vascular lesion in stroke patient of Chinese, Hispanic and African ancestry. There .have been few studies on the epidemiology, pathophysiology, treatment and prognosis of this important disease. Recent advances in technology provide safe and reliable investigation for studying large number of patients. Transcranial Doppler is an easily accessible, cheap and reliable method to diagnose intracranial stenosis. It is suitable for screening for and monitoring the progress of intracranial stenosis. Magnetic resonance angiography and CT angiography provide the morphology of lumenal stenosis but are less accessible.

  9. Pregnancy-like (pseudolactational) hyperplasia: a primary diagnosis in mammographically detected lesions of the breast and its relationship to cystic hypersecretory hyperplasia.

    Science.gov (United States)

    Shin, S J; Rosen, P P

    2000-12-01

    Pregnancy-like (pseudolactational) hyperplasia (PLH) has long been recognized as an incidental finding in breast biopsies performed for various clinically detected benign and malignant conditions. The histologic features of PLH have been well described, including some instances exhibiting cytologic and structural atypia. The presence of calcifications in these lesions was rarely mentioned and was considered to be of little consequence. More recently, however, calcifications in PLH have become the target of needle localization and needle core biopsies. The authors report 12 instances in which PLH was the primary diagnosis in biopsy specimens obtained for radiographic abnormalities, usually calcifications. Six of 12 procedures (50.0%) were performed for mammographically detected calcifications, four cases for a mass, one for an "abnormal mammogram," and one for galactorrhea. Calcifications were present in PLH in 10 biopsies, in benign terminal ducts in one specimen, and were not identified histologically in the remaining specimen. In most instances, calcifications associated with PLH had smooth round or lobulated contours and distinctive, internal, unevenly spaced laminations. Cystic hypersecretory hyperplasia (CHH) was present in five specimens. In four of the five specimens, CHH merged with PLH (PLH/CHH). Four of 12 specimens (33.3%) showed atypia within foci of PLH/CHH. PLH should be recognized as a primary diagnosis in breast biopsies for mammographically detected abnormalities such as calcifications. Some calcifications associated with PLH have a distinctive histologic appearance, and their recognition can aid in the diagnosis of PLH. Additional cases of PLH/CHH must be studied to ascertain the clinical significance, if any, of this previously undescribed entity. The precancerous significance of PLH/CHH and of PLH with atypia has not been determined. In most instances, surgical excision would be prudent if PLH/ CHH or PLH with atypia is present in a needle core

  10. Intracranial, intradural aneurysmal bone cyst.

    Science.gov (United States)

    Afnan, Jalil; Snuderl, Matija; Small, Juan

    2015-01-01

    Aneurysmal bone cysts (ABCs) are benign, expansile, blood-filled, osteolytic lesions with internal septations that may be intraosseous or extraosseous. The cysts may cause local mass effect, and changes in the regional vascular supply necessitating intervention. A case of an intracranial, intradural ABC in a young male patient with progressively severe headaches is presented. This is only the third recorded intradural case, the majority of these rare lesions being extracranial and only a minute fraction intracranial. Copyright © 2015 Elsevier Inc. All rights reserved.

  11. Diffuse idiopathic intracranial fusiform aneurysm development. Case report and literature review

    Directory of Open Access Journals (Sweden)

    Eric S Nussbaum

    2014-01-01

    Full Text Available Background: Fusiform intracranial aneurysms (FIAs are uncommon lesions representing less than 15% of all intracranial aneurysms in most large series. Their etiology has been linked to a variety of causes including atherosclerosis, fibromuscular dysplasia, cystic medial necrosis, connective tissue disease, hypertension, diabetes, hyperlipidemia, infection, cardiac myxoma, oral contraceptive use, vasculitis, and lymphoproliferative disorders. The finding of numerous lesions in a single patient is distinctly uncommon. Case Description: We describe the unique case of a 47-year-old female who developed multiple FIAs over a 6-year period without an obvious underlying pathology. The patient′s medical history was significant for obesity, migraine headaches, insomnia, breast cancer, and chronic skin rash. Various diagnoses were explored including infectious etiologies, autoimmune vasculopathies, malignancy-related causes, connective tissue disorders, and underlying genetic conditions. However, all investigations, including aneurysm wall and skin biopsies were negative or deemed noncontributory toward making a definitive diagnosis. Conclusion: We report an unusual case of a patient with a normal cerebral angiogram developing numerous, FIAs without obvious underlying etiology over a 6-year period. Close clinical and radiological follow-up is recommended in this case because the natural history of the disease is unclear at this point. The literature regarding potential causes of multiple fusiform intracranial aneuryms is reviewed.

  12. Retroperitoneal Cystic Lymphangioma

    Directory of Open Access Journals (Sweden)

    Ş.Sevil Altunrende

    2010-03-01

    Full Text Available Abdominal cystic lymphangioma is a rare, benign, congenital tumor. It is an developmental abnormality of the lymphatic system. Males are relatively more affected and 90% of the cases are under 5 years of age. Multilocular cystic lesion with septations is seen on abdominal ultrasonography. As echogenicity can vary depending on the content of the cyst like cellular debris, hemorrhage or chylous, liquid-liquid or fat-liquid levels can be observed. Definitive treatment is total excision. Cyst aspiration is not an effective method and nearly always ends with recurrence. Computerized tomography and magnetic resonance imaging findings of sonographically detected retroperitoneal cystic lymphangioma in a newborn girl with abdominal distention are discussed in this paper. (The Medical Bulletin of Haseki 2010; 48: 47-9

  13. Windowing decompression in the application of large jaw cystic lesion treatment%开窗减压术在颌骨大型囊性病变治疗中的应用

    Institute of Scientific and Technical Information of China (English)

    郭建; 李伟

    2015-01-01

    Objective Explore the windowing decompression in the treatment of jaw cystic lesion. methods 39 cases of oral maxillofacial large cystic lesion with windowing decompression treatment, postoperative 3 months to 2 years, periodic review by clinical and radiographic examination evaluation of curative effect.Results Heal in 5 cases (12.82%); Improvement in 30 cases (76.92%), jaw cysts shrink by more than 50%; Invalid 4 cases (10.26%).Conclusion Windowing decompression can maximize the protection of jaw morphology and function, in the treatment of large jaw cystic lesion is of great signiifcance.%目的:探讨开窗减压术在颌骨囊性病变治疗中的意义。方法39例颌骨大型囊性病变采用开窗减压术治疗,术后定期复查3个月~2年,通过临床和影像学检查评估疗效。结果手术后治愈5例(12.82%);好转30例(76.92%),颌骨囊腔缩小50%以上;无效4例(10.26%)。结论开窗减压术能最大程度地保护颌骨的形态及功能,在颌骨大型囊性病变的治疗中具有重要意义。

  14. Cystic thymic diseases: CT manifestations

    Energy Technology Data Exchange (ETDEWEB)

    Song, Soon Young; Choi, Yo Won; Jeon, Eui Yong; Jeon, Seok Chol; Seo, Heung Suk; Hahm, Chang Kok [School of Medicine, Hanyang University, Seoul (Korea, Republic of)

    1995-09-15

    To describe CT findings and differential points of cystic thymic lesions. We evaluated retrospectively total 19 masses with well marginated cystic lesions at thymic area on CT scans. They were 10 teratomas, 3 congenital thymic cysts, 2 multilocular thymic cysts(associated with thymoma and myasthenia gravis in each), 2 cysts Assciated with thymic Hodgkin's lymphomas an ectopic parathyroid cyst, and an infected thymic cyst. The radiological abnormalities evaluated were thickness of the wall, presence or abscene of septa, mural nodule, solid component, calcification and fat component. All three cases of congenital thymic cysts and an ectopic parathyroid cyst appeared as thin-walled unilocular cyst with homogeneous internal density and without identifiable solid component. In multilocular thymic cyst, there were thick wall and solid components(n =2), thick internal septa and calcifications(n = 1). The cysts of teratomas manifested thick walls(n = 9), internal septa(n = 4), calcifications(n = 6), fat components(n = 4), and solid components(n = 4). Cysts in Hodgkin's diseases appeared as multilocular or unilocular and had thick wall and septa without calcification. Infected thymic cyst presented with multilocular cystic mass with identifiable wall and septa, calcification, and solid components. The thymic diseases with cystic lesion include teratomas, congenital thymic cysts, multilocular thymic cysts, parathyroid cyst, and Hodgkin's disease. Congenital thymic cyst and ectopic parathyroid cyst are thin-walled unilocular cystic lesions. Cystic lesions associated with teratoma, Hodgkin's disease, and multilocular thymic cyst are thick-walled cystic lesions with or without solid component.

  15. 开窗减压术治疗颌骨囊性病变的临床研究%Clinic Research of Fenestrating Decompression in the Treatment of Jaw Cystic Lesion

    Institute of Scientific and Technical Information of China (English)

    王郸; 张桂荣

    2015-01-01

    Objective To research the treatment effect and reliability of fenestrating decompression in the treatment of Jaw cystic lesion. Methods To systematic review the clinical data of using fenestrating decompression in the treatment of Jaw cystic lesion.from June 2011 to June 2013. Results In patients with jaw cystic lesion,there were 87cases for cure,31 cases for improvement,6 cases for invalid ,the total effective rate was 95.2%. 124 cases of patients with postoperative follow-up of 1 year The 10 cases of recurrence, the recurrence rate was 8.06%, Patients were restored to normal jaw shape, Not nerve damage and damage to the surrounding structures. Conclusion The fenestrating decompression in the treatment of jaw cystic lesion can make jaw shape back to normal and make the function of the jaw gets maximum retention. It was a simple and efficient, safe and reliable, low recurrence rate of therapy for the treatment of jaw cysts. It has wide application prospect.%目的:研究开窗减压术治疗颌骨囊性病变的治疗效果和可靠性。方法系统性的回顾分析2011年6月~2013年6月我院124例开窗减压术治疗颌骨囊性病变患者的临床资料。结果颌骨囊性病变患者中治愈87例、好转31例、无效6例,治疗后总有效率为95.2%。124例患者术后随访1年,其中出现复发10例、复发率8.06%,患者均恢复正常的颌骨外形、未发生神经损伤和周围结构的损伤。结论开窗减压术治疗颌骨囊性病变能够使颌骨的形态恢复正常,使颌骨的功能得到最大限度的保留,是一种简单高效、安全可靠、复发率低的治疗颌骨囊性病的治疗方法,具有广泛的应用前景。

  16. Intraosseous calcifying cystic odontogenic tumor

    Directory of Open Access Journals (Sweden)

    Kler Shikha

    2009-01-01

    Full Text Available The calcifying odontogenic cyst was first reported by Gorlin et al . in 1962. It had been classified as a neoplasm related to the odontogenic apparatus because of its histological complexity and morphological diversity until it was renamed as a calcifying cystic odontogenic tumor by the WHO, in 2005. Here we describe a case of mandibular calcifying cystic odontogenic tumor in a 75-year-old male, which was present since five years, with a history of occurrence after the extraction of teeth in the involved region. The lesion was surgically removed and a histopathological examination revealed a cystic tumor with predominance of ghost cells and some amount of dentinoid tissue.

  17. Intracranial haemorrhage

    African Journals Online (AJOL)

    His interests include vascular neurosurgery and spinal deformities. ... he returned to specialise in neurosurgery after time spent working abroad. ... at Groote Schuur Hospital, where his major interests are skull base surgery and ... intracranial bleed is hypertension – this is an ... cerebellar signs and symptoms or with raised.

  18. Drainage therapy for gigantic cystic lesions of the jaw%开窗减压术治疗颌骨巨大囊性病变的临床研究

    Institute of Scientific and Technical Information of China (English)

    辛俊彤; 袁荣涛; 卜令学; 贾暮云; 李宁毅

    2011-01-01

    Objective To study the drainage therapy for giganlic cyslic lesions of the jaw. Methods Seven palienls with giganlic cyslic lesions of the jaw in the Deplarlmenl of Oral and Maxillofacial Surgery of the Affiliated Hospital of Medical College in Qingdao U niversily were examnined wilh drainage iherapy from August,2006 to April,2009. They were evaluated wilh a preoperalive panoramic photography and CT. Second operation was taken while the cavity became narrow and small. The left cystic lesion tissue was obtained for pathological examination. Results Six cases with gigantic cystic lesions of the jaw were cured with drainage therapy in an average peri od of 15. 7 months,from five months to twenty-six months. There was no recurrence after one year's follow-up. One case with dentigerous cyst failed with drainage therapy,and then was taken curettage. The cyst wall was found thicker than other cases. Conclusions Drain age therapy was an ideal minimally invasive surgery therapy for gigantic cystic lesions of the jaw. The mechanisms need more studies.%目的 研究开窗减压术治疗颌骨巨大囊性病变.方法 选取7例颌骨巨大囊性病变病例,术前均行X线和CT检查,行开窗减压术治疗.对其治疗前后影像学表现、组织病理学变化进行研究.结果 6例颌骨巨大囊性病变病例,经开窗减压治疗后,囊腔消退,二期手术刮除残余囊壁,随诊1年无复发,平均病程15.7月.另1例含牙囊肿治疗无效,行刮除术.结论 开窗减压术是一种理想的颌骨巨大囊性病变的微创功能治疗方法,其内在的机制尚需进一步研究.

  19. 彩超在新生儿早期小病灶颅内出血的诊断价值%Diagnostic value of ultrasonography on the early neonatal intracranial hemorrhage of small lesions

    Institute of Scientific and Technical Information of China (English)

    黄智勇; 魏达友; 巫朝君

    2015-01-01

    目的 探讨彩超在新生儿早期小病灶颅内出血诊断中的应用价值.方法 选取茂名市人民医院收治的80例早期小病灶颅内出血新生儿作为研究对象,所有患儿均接受颅脑CT和彩色多普勒超声检查,对比两种检查方式的诊断结果.结果 彩超检查检出率为82.3%,漏诊率为17.7%,CT扫描颅脑出血诊断率为92.5%,漏诊率为7.5%,CT检查的诊断符合率略高于彩超检查,但差异无统计学意义(P>0.05).结论 在新生儿颅内出血的早期诊断中,彩色多普勒超声检查为重要的辅助手段,其能有效满足新生儿颅内出血定位诊断需求,为早期诊断和治疗提供依据.%Objective To investigate the application value of color Doppler ultrasound on the diagnosis of intracranial hemorrhage in early newborns small lesion.Methods Eighty cases of early small foci of neonatal intracranial hemorrhage in our hospital were selected as the objects of the study.All of the children underwent brain CT and color Doppler ultrasound,and the diagnosis results of two kinds of examination method were compared.Results The detection rate by ultrasound was 82.3%,the rate of missed diagnosis was 17.7%.The brain hemorrhage diagnosis rate by CT scan was 92.5%,the rate of missed diagnosis was 7.5%.The diagnostic accordance rate of CT examination was slightly higher than that of color Doppler ultrasound,but the difference was not significant(P > 0.05).Conclusions Color Doppler ultrasound is an important auxiliary means in the early diagnosis of neonatal intracranial hemorrhage,which can effectively meet the needs of localization diagnosis of neonatal intracranial hemorrhage,and provide evidence for early diagnosis and treatment.

  20. Epilepsy patients with localized lateral temporal lobe lesion: intracranial EEG study and surgery-making%颞叶新皮层癫痫的颅内电极研究

    Institute of Scientific and Technical Information of China (English)

    孙朝晖; 周文静; 石岩芳; 左焕琮

    2013-01-01

    Objective For patients with lesional lateral temporal lobe epilepsy,whether or not to resection the hippocampal is difficult to decide.We analyzed the intracranial EEG of patients with localized lesion in the lateral temporal cortex.Methods We studied 8 patients who satisfied the following criteria:MRI showed a lesion localized at the lateral temporal lobe.Postoperative follow-up was more than Ⅰ year.Results A total of 65 complex partial seizures and 16 subclinical seizures were recorded,among them,24 clinical seizures and 7 subclinical seizures arising from hippocampal.7 patients had ictal discharges originating from the hippocampal.Conclusions Intracranial EEG analysis revealed that independent ictal discharges from the hippocampal in patients with localized lesion in the lateral cortex,hippocampal maybe an independent epilepticgenic onset zone.%目的 对于颞叶新皮层存在局灶性损害的癫痫患者,应用颅内电极记录新皮层病灶部位及海马的发作期电活动,以判断海马是否是独立的致痫灶.方法 总结8例患者,入选标准:MRI显示一侧颞叶新皮层存在局灶性的损害,双侧海马形态基本正常,无萎缩及肿胀等变化;术后随访1年以上.分析颅内脑电图临床发作及电发作的起源部位.结果 颅内脑电图共记录到临床发作65次,电发作16次,其中起源于颞叶内侧的临床发作24次,电发作7次.仅1例患者所有发作均起源于新皮层,其余7例均有独立起源于海马的临床发作或电发作.结论 颅内脑电图记录显示在颞叶新皮层存在局灶性损害的癫痫患者,海马是重要的独立致痫区,MRI不能提供确切的证据,颅内电极记录是确定致痫灶的可靠方法.

  1. Percutaneous puncture of spinal cysts in the diagnosis and therapy of syringomyelia and cystic tumors

    Energy Technology Data Exchange (ETDEWEB)

    Dietemann, J.L.; Babin, E.; Wackenheim, A.; Maitrot, D.; Bonneville, J.F.

    1982-10-01

    The experience with percutaneous puncture of intraspinal cystic lesions is reported in cases: an extradural cyst demonstrated with air, a spinal cord tumor with lipiodol and two cases of syringomyelia with metrizamide. Percutaneous puncture of cystic lesions makes possible an accurate delineation of the lesion and a histological approach through biochemical and cytological analysis of the aspirated cystic fluid, while aspiration of the fluid of cystic tumors decompresses the spinal cord and thus plays a therapeutic role.

  2. Multiple intracranial lipoma

    Directory of Open Access Journals (Sweden)

    B P Venkatesh

    2014-01-01

    Full Text Available Intracranial lipomas are rare congenital, non-neoplastic lesions discovered incidentally on computerised tomography (CT or magnetic resonance imaging (MRI with an incidence rate of less than 0.1% of all intracranial tumours. Most lipomas are asymptomatic pericallosal lesions sometimes presenting with seizures or headache. Corpus callosum agenesis and defects of midline structures differentiation may be present. Callosal lipomas are of two types: Anterior bulky tubulonodular variety associated with forebrain and rostral callosal anomalies, and posterior ribbon-like curvilinear lipoma generally seen with a normal or near normal corpus callosum. Corpus callosal hypogenesis/agenesis is seen in up to 90% of anterior and 30% of posterior pericallosal lipomas. The association of corpus callosal lipoma with choroid plexus lipoma is variable with its reported incidence rate being 20-50%. A 50-year-old patient was referred to our department for CT scan of brain with history of recent onset of headache and one episode of seizure. We present the imaging findings in this rare case of callosal tubulonodular lipoma having prominent intralesional vessels and extensive calcification with a concomitant intraventricular lipoma in a patient with dysgenetic corpus callosum.

  3. 开窗减压术治疗上颌骨大型囊性病变的临床研究%Clinical study of large maxillary cystic lesions treated by decompression

    Institute of Scientific and Technical Information of China (English)

    李伯友; 苏铭扬; 李阳; 林璇; 吴熙凤; 高永波

    2016-01-01

    目的:探讨开窗减压术在上颌骨大型囊性病变治疗中的临床应用效果。方法回顾2007年10月—2014年10月治疗的25例上颌骨大型囊性病变开窗减压术治疗病例,观察上颌窦形态、囊腔大小及周围骨质变化。结果25例患者中,8例患者开窗减压术后3个月上颌窦骨壁厚度增加,上颌窦形态完全恢复,囊肿消失,未行囊肿刮治术;17例患者术后9~12个月上颌窦形态完全恢复或基本恢复,二期行囊肿刮治术。术后随访1~5年,无复发。结论上颌骨大型囊性病变开窗减压术具有能恢复上颌窦的形态和功能、创伤小、并发症少等优点。%Objective To evaluate the effects of decompression in treating large maxillary cystic lesions. Meth⁃ods 25 cases of large maxillary cystic lesions were performed decompression during Oct. 2007⁃Oct. 2014. According to the clinical and radiological examination, morphology of maxillary sinus and cyst cavity were observed. Results 12 cases of radicular cysts, 10 cases of dentigerous cysts, and 3 cases of keratocystic odontogenic tumor were diagnosed ac⁃cording to pathological examination. The appearance of the maxillary sinus were completely restored and the cyst disap⁃peared totally in 7 cases after the first 3 months, and then after the next 9⁃12 months, the other 18 cases had the appear⁃ance of maxillary sinus completely or basically restored with a following enucleation of cysts. All patients were followed up for 1⁃5 years, and no recurrence was observed. Conclusion To treat large maxillary cystic lesions by decompres⁃sion is effective to conserve the morphology and function of maxillary sinus, and it is a simple surgical approach with less damage and complications.

  4. Cystic Pheochromocytoma Presenting as Adrenal Cyst

    Science.gov (United States)

    Abdulsalam, Mohammed Shafi; Satish, Priyanka; Janakiraman, Raghunath Keddy; Singh, Shivshankar

    2016-01-01

    Pheochromocytomas are usually solid tumours. But it can present as cystic lesions in the adrenal gland. Cystic lesions in adrenal gland with hypertension needs attention to rule out pheochromocytoma. If ignored, it may lead to hypertensive emergency, multisystem crisis and death. Early diagnosis with biochemistry, Computed Tomography (CT) or Magnetic Resonance Imaging (MRI) of abdomen, proper functional imaging like Meta Iodo Benzyl Guanidine (MIBG) scan is essential. Proper preoperative preparation is important to prevent hypertensive crisis during and after surgery. We are reporting a case of cystic pheochromocytoma in a young male. PMID:28050427

  5. Role of diffusion weighted imaging in differentiation of intracranial tuberculoma and tuberculous abscess from cysticercus granulomas-a report of more than 100 lesions

    Energy Technology Data Exchange (ETDEWEB)

    Gupta, Rakesh K. [Department of Radiology, Sanjay Gandhi Postgraduate Institute of Medical Sciences, MR Section, Lucknow 226014 (India)]. E-mail: rgupta@sgpgi.ac.in; Prakash, Mahesh [Department of Radiology, Sanjay Gandhi Postgraduate Institute of Medical Sciences, MR Section, Lucknow 226014 (India); Mishra, Asht M. [Department of Radiology, Sanjay Gandhi Postgraduate Institute of Medical Sciences, MR Section, Lucknow 226014 (India); Husain, Mazhar [Department of Neurosurgery, King George' s Medical University, Lucknow (India); Prasad, Kashi N. [Department of Microbiology, Sanjay Gandhi Postgraduate Institute of Medical Sciences, Lucknow (India); Husain, Nuzhat [Department of Neuropathology, King George' s Medical University, Lucknow (India)

    2005-09-01

    Restricted diffusion is noted in a large number of non-stroke conditions including tuberculoma. The purpose of this study was to demonstrate spectrum of diffusion weighted imaging (DWI) abnormalities in tuberculomas and tuberculous abscess and to distinguish these from degenerating neurocysticercosis. Seventy tuberculomas and tuberculous abscesses in 30 patients were categorized in three groups depending on the intensity in the core of the lesion on T2 weighted images. Mean apparent diffusion coefficient (ADC) was calculated from the core as well as from the wall of the lesions. Forty-five lesions of neurocysticercosis in different stage of evolution in 12 patients were also included for comparison. The mean ADC value from the core of the T2 hypointense lesions was significantly higher compared to the wall ((1.24 {+-} 0.32) x 10{sup -3} and (1.06 {+-} 0.15) x 10{sup -3} mm{sup 2}/s, respectively), while mean ADC value from the core of mildly T2 hyperintense lesions was significantly lower compared to the wall ((0.80 {+-} 0.08) x 10{sup -3} and (1.08 {+-} 0.13) x 10{sup -3} mm{sup 2}/s, respectively). Truly T2 hyperintense lesions were divided into two subgroups, tuberculomas and tuberculous abscesses; ADC values from the core and the wall of these lesions were (0.74 {+-} 0.13) x 10{sup -3} (0.61 {+-} 0.08) x 10{sup -3} and (1.03 {+-} 0.14) x 10{sup -3} (1.08 {+-} 0.14) x 10{sup -3} mm{sup 2}/s, respectively, and was significantly lower in core as compared to the wall. However, there was no significant difference between ADC values of the tuberculous abscess and the hyperintense tuberculomas. Vesicular and degenerating stages of cysticercus cysts from the core showed ADC values of (1.66 {+-} 0.29) x 10{sup -3} and (1.51 {+-} 0.23) x 10{sup -3} mm{sup 2}/s, respectively, and were significantly higher than the core of all groups of tuberculomas and tuberculous abscess. We conclude that addition of DWI to routine imaging protocol may help in differentiation of

  6. Malignant Transformation Six Months after Removal of Intracranial Epidermoid Cyst: A Case Report

    Directory of Open Access Journals (Sweden)

    Fayçal Lakhdar

    2011-01-01

    Full Text Available Intracranial epidermoid cysts are uncommon benign tumors of developmental origin; malignant transformation of benign epidermoid cysts is rare, and their prognosis remains poor. We report a case of squamous cell carcinoma arising in the cerebellopontine angle. A 52-year-old man presented with left facial paralysis and cerebellar ataxia. He had undergone total removal of a benign epidermoid cyst six months previously. Postoperative magnetic resonance imaging of the brain revealed a heterogeneous and cystic lesion in the left cerebellopontine angle with hydrocephalus. The cyst wall was enhanced by gadolinium. He underwent ventricle-peritoneal shunt and removal again; the histopathological examination revealed a squamous cell carcinoma possibly arising from an underlying epidermoid cyst. This entity is being reported for its rarity. The presence of contrast enhancement at the site of an epidermoid cyst combined with an acute, progressive neurological deficit should alert the neurosurgeon to the possibility of a malignant transformation.

  7. Radiological description of cystic pancreatic tumors.

    Science.gov (United States)

    Rodríguez Torres, C; Larrosa López, R

    2016-01-01

    Although most cystic pancreatic lesions are pseudocysts, it is important to do a thorough differential diagnosis with true cystic tumors because cystic tumors are potentially malignant. Sometimes computed tomography and magnetic resonance imaging cannot establish the definitive diagnosis, making it necessary to perform other imaging tests such as endoscopic ultrasound, which in addition to morphological information, can also enable cytologic and biochemical analysis of the lesion through puncture and aspiration of its contents. Combining all these findings nearly always provides enough diagnostic information to allow the appropriate approach in each case. This article describes the specific morphological characteristics for each cystic pancreatic tumor on computed tomography, magnetic resonance imaging, and endoscopic ultrasound and reviews the guidelines for managing these types of lesions. Copyright © 2016 SERAM. Publicado por Elsevier España, S.L.U. All rights reserved.

  8. Ring enhancing intracranial lesion responding to antituberculous treatment in an HIV-infected patient Lesão intracraniana que respondeu ao tratamento anti-tuberculoso em paciente infectado pelo HIV

    Directory of Open Access Journals (Sweden)

    Daniela Pellegrino

    2010-10-01

    Full Text Available Cerebral tuberculomas constitute a major differential diagnosis of cerebral toxoplasmosis in human immunodeficiency virus (HIV-infected patients in developing countries. We report the case of a 34-year old woman co-infected with HIV and possible disseminated tuberculosis (hepatitis, lymphadenopathy, and pleural effusion who presented a large and solitary intracranial mass lesion. Despite extensive diagnostic efforts, including brain, ganglionar, and liver biopsies, no definitive diagnosis was reached. However, a trial with first-line antituberculous drugs led to a significant clinical and radiological improvement. Atypical presentations of cerebral tuberculomas should always be considered in the differential diagnosis of intracranial mass lesions in HIV-infected patients and a trial with antituberculous drugs is a valuable strategy to infer the diagnosis in a subset of patients.Os tuberculomas cerebrais constituem diagnóstico diferencial importante da toxoplasmose cerebral em pacientes infectados pelo vírus da imunodeficiência humana (HIV de países em desenvolvimento. Os autores relatam o caso de uma mulher HIV positiva de 34 anos de idade, que apresentou provável tuberculose disseminada (hepatite, adenomegalia, e derrame pleural associada à lesão expansiva cerebral única e gigante. Apesar dos esforços diagnósticos realizados, incluindo biópsia cerebral, ganglionar e hepática, o diagnóstico etiológico não foi confirmado. Porém, a resposta clínico-radiológica ao tratamento tuberculostático permitiu definir o diagnóstico de tuberculoma cerebral e a paciente teve alta hospitalar. Apresentações atípicas de tuberculomas cerebrais devem ser sempre consideradas no diagnóstico diferencial das lesões expansivas cerebrais em pacientes infectados pelo HIV e o uso do tratamento tuberculostático constitui ferramenta útil na definição diagnóstica em um sub-grupo de pacientes

  9. Mucins in the diagnosis and differential diagnosis of pancreatic cystic neoplasms: report of 40 cases

    Institute of Scientific and Technical Information of China (English)

    JI Yuan; TAN Yun-shan; XU Jian-fang; QI Wei-dong; LI Xiao-ping; SU-JIE Ake-su; ZHU Xiong-zeng

    2006-01-01

    @@ Cystic neoplasms of the pancreas account for 10% to 15% of all cystic pancreatic lesions.The majority (85% to 90%) of cystic lesions of the pancreas are pseudocysts. Although cystic neoplasms of the pancreas are rare, they range from benign to malignant neoplasms. The clinical challenge is the differential diagnosis and management of the cystic neoplasms, which represent 10% to 25% of primary pancreatic neoplasms. Pancreatic neoplasms and tumour like lesions with cystic features have been recently reviewed. The incidence of pancreatic cystic neoplasms reported is variable. Because there is no large, systematic study on tne cases from China comparing the incidence and biology of cystic neoplasms of pancreas to that of Western series, we reviewed all the cases of cystic neoplasms from Zhongshan Hospital over 6 years. Most of the neoplasms in our series were classified according to the recent World Health Organization (WHO)classification.1,2

  10. INTRACRANIAL PRESSURE MONITORING

    Directory of Open Access Journals (Sweden)

    Retno Widiyanthi

    2013-07-01

    Full Text Available Normal 0 false false false EN-US X-NONE X-NONE Intracranial pressure is total of pressure that is produced by brain, blood, and cerebrospinal fluid/CSF in the tight cranial space. As a respon to intracranial pressure increasing, compensation begin by movement of CSF from ventricle to cerebral subarachnoidal space, and increase the absorption of CSF. Increasing of ICP usually caused by increasing of brain volume (cerebral oedem, blood (intracranial bleeding, space occupying lesion, or CSF (hidrocephalus. Indication in ICP monitoring can be seen from : neurological criteria, abnormal CT-scan result when admission, normal CT-scan result, but had more two risk factors. According to the procedure that must be done, there are two methods in ICP monitoring: invasive ICP monitoring methodes and non-invasive measuring method. Increasing of ICP will decrease the compliance of brain, pulsation of artery more clearly, and the component of vein is lost. /* Style Definitions */ table.MsoNormalTable {mso-style-name:"Table Normal"; mso-tstyle-rowband-size:0; mso-tstyle-colband-size:0; mso-style-noshow:yes; mso-style-priority:99; mso-style-qformat:yes; mso-style-parent:""; mso-padding-alt:0in 5.4pt 0in 5.4pt; mso-para-margin:0in; mso-para-margin-bottom:.0001pt; mso-pagination:widow-orphan; font-size:11.0pt; font-family:"Calibri","sans-serif"; mso-ascii-font-family:Calibri; mso-ascii-theme-font:minor-latin; mso-fareast-font-family:"Times New Roman"; mso-fareast-theme-font:minor-fareast; mso-hansi-font-family:Calibri; mso-hansi-theme-font:minor-latin; mso-bidi-font-family:"Times New Roman"; mso-bidi-theme-font:minor-bidi;}

  11. Application of Intraoperative Ultrasonography for Guiding Microneurosurgical Resection of Small Subcortical Lesions

    Energy Technology Data Exchange (ETDEWEB)

    Wang, Jia; Duan, Yun You; Liu, Xi; Wang, Yu; Gao, Guo Dong; Qin, Huai Zhou; Wang, Liang [Tangdu Hospital of the Fourth Military Medicine University, Xi an (China)

    2011-10-15

    We wanted to evaluate the clinical value of intraoperative ultrasonography for real-time guidance when performing microneurosurgical resection of small subcortical lesions. Fifty-two patients with small subcortical lesions were involved in this study. The pathological diagnoses were cavernous hemangioma in 25 cases, cerebral glioma in eight cases, abscess in eight cases, small inflammatory lesion in five cases, brain parasite infection in four cases and the presence of an intracranial foreign body in two cases. An ultrasonic probe was sterilized and lightly placed on the surface of the brain during the operation. The location, extent, characteristics and adjacent tissue of the lesion were observed by high frequency ultrasonography during the operation. All the lesions were located in the cortex and their mean size was 1.3 {+-} 0.2 cm. Intraoperative ultrasonography accurately located all the small subcortical lesions, and so the neurosurgeon could provide appropriate treatment. Different lesion pathologies presented with different ultrasonic appearances. Cavernous hemangioma exhibited irregular shapes with distinct margins and it was mildly hyperechoic or hyperechoic. The majority of the cerebral gliomas displayed irregular shapes with indistinct margins, and they often showed cystic and solid mixed echoes. Postoperative imaging identified that the lesions had completely disappeared, and the original symptoms of all the patients were significantly alleviated. Intraoperative ultrasonography can help accurately locate small subcortical lesions and it is helpful for selecting the proper approach and guiding thorough resection of these lesions.

  12. [Managing focal incidental renal lesions].

    Science.gov (United States)

    Nicolau, C; Paño, B; Sebastià, C

    2016-01-01

    Incidental renal lesions are relatively common in daily radiological practice. It is important to know the different diagnostic possibilities for incidentally detected lesions, depending on whether they are cystic or solid. The management of cystic lesions is guided by the Bosniak classification. In solid lesions, the goal is to differentiate between renal cancer and benign tumors such as fat-poor angiomyolipoma and oncocytoma. Radiologists need to know the recommendations for the management of these lesions and the usefulness of the different imaging techniques and interventional procedures in function of the characteristics of the incidental lesion and the patient's life expectancy.

  13. Analysis of the intracranial lesions, cerebrovascular conditions and lacunar infarction in patients with migraine%偏头痛与脑血管发育异常、脑白质变性、脑腔梗关系分析

    Institute of Scientific and Technical Information of China (English)

    赵轶; 席刚明

    2014-01-01

    目的:观察偏头痛患者脑血管情况及颅内病变情况。方法:以住院偏头痛患者为研究对象、同一时期无偏头痛患者为对照,进行神经影像学比较。结果:58例偏头痛患者中,有脑腔梗病灶19例(32.76%),有脑白质变性17例(29.31%),有脑血管异常37例(63.79%)。61例对照组中有脑腔梗病灶9例(14.75%),有脑白质变性5例(8.20%),有脑血管异常13例(21.31%)。2组比较差异均有统计学意义(P<0.05)。结论:偏头痛与脑白质病变、脑腔梗有关,血管因素可能参与偏头痛的发作。%Objective:To obtain the intracranial lesions and cerebrovascular conditions in patients with migraine.Methods:Patient with migraine collected from the hospitalized were compared with patients with non-migraine in their neurimaging findings.Results:Among 58 patients with migraine, 19 had a or more lacunar infarctions;17 had white matter lesions and 37 had cerebrovascular abnormalities, while 61 patients with non-migraine had 9 lacunar infarctions, 5 white matter lesions and 13 cerebrovascular abnormalities. They were all signiifcantly different(P<0.05).Conclusion:Migraine was associated with the white matter lesions and lacunar infarction, while vascular factors may be involved in the migraine.

  14. Imaging spectrum and pitfalls of {sup 11}C-methionine position emission tomography in a series of patients with intracranial lesions

    Energy Technology Data Exchange (ETDEWEB)

    Ito, Kimiteru [Dept. of Radiology, Tokyo Metropolitan Geriatric Hospital and Institute of Gerontology, Tokyo (Japan); Matsuda, Hiroshi [Integrative Brain Imaging Center, National Center of Neurology and Psychiatry, Tokyo (Japan); Kubota, Kazoo [Div. of Nuclear Medicine, National Center for Global Health and Medicine, Tokyo (Japan)

    2016-06-15

    {sup 11}C-methionine (Met) positron emission tomography (PET) is one of the most commonly used PET tracers for evaluating brain tumors. However, few reports have described tips and pitfalls of {sup 11}C-Met PET for general practitioners. Physiological {sup 11}C-Met uptake, anatomical variations, vascular disorders, non-tumorous lesions such as inflammation or dysplasia, benign brain tumors and patient condition during {sup 11}C-Met PET examination can potentially affect the image interpretation and cause false positives and negatives. These pitfalls in the interpretation of {sup 11}C-Met PET images are important for not only nuclear medicine physicians but also general radiologists. Familiarity with the spectrum and pitfalls of {sup 11}C-Met images could help prevent unfavorable clinical results caused by misdiagnoses.

  15. What Causes Cystic Fibrosis?

    Science.gov (United States)

    ... page from the NHLBI on Twitter. What Causes Cystic Fibrosis? A defect in the CFTR gene causes cystic ... in the severity of the disease. How Is Cystic Fibrosis Inherited? Every person inherits two CFTR genes—one ...

  16. Cystic Fibrosis Research

    Science.gov (United States)

    ... please turn Javascript on. Feature: Steady Advances Against Cystic Fibrosis Cystic Fibrosis Research Past Issues / Fall 2012 Table of Contents "Remarkable strides in cystic fibrosis research over the past two decades have culminated ...

  17. Diagnosis of cystic lymphangioma of the colon by endoscopic ultrasound: Biopsy is not needed!

    Science.gov (United States)

    Bhutani, Manoop S.; Annangi, Srinadh; Koduru, Pramoda; Aggarwal, Aakash; Suzuki, Rei

    2016-01-01

    Cystic lymphangioma of the colon (CLC) is a rare benign lesion that is usually asymptomatic and found incidentally during colonoscopy. Limitations in the conventional noninvasive diagnostic techniques have led to surgical resection of these lesions for diagnostic confirmation. Classic endoscopic ultrasound (EUS) findings of colonic cystic lymphangioma are submucosal anechoic cystic spaces with septations, intact muscularis propria, and no solid component. Patients who are asymptomatic with lesions having classic appearance as cystic lymphangioma with EUS can be observed without any intervention. We herein report a case of cystic lymphangioma of distal transverse colon in an asymptomatic patient diagnosed noninvasively using 20-MHz miniprobe EUS and managed conservatively without any surgical intervention.

  18. Intracranial aneurysms.

    Science.gov (United States)

    Puskar, G; Ruggieri, P M

    1995-08-01

    MR angiography provides a rapid, accurate, and extremely flexible noninvasive evaluation of intracranial aneurysms without the cost and risk of conventional angiography. TOF and phase contrast techniques each have specific advantages and disadvantages that can be selectively exploited to optimize aneurysm evaluation. Present indications for MR angiography in aneurysm evaluation include: (1) the presence of incidental findings on a CT or MR examination that suggest the possibility of aneurysm (Figs. 7 and 8), (2) when angiography is contraindicated or when the risk is too high, (3) non-invasive follow-up of patients with known aneurysms, (4) patient refusal of contrast angiography, and (5) evaluation of patients with specific clinical symptoms (i.e., third cranial nerve palsy) or patients with non-specific subacute symptoms in whom an aneurysm might explain the clinical presentation. Although MR angiography certainly can detect aneurysms with a high rate of sensitivity and specificity, detailed decision analyses generally have not supported the overall benefit of this type of screening. Future technical advances as well as advances in the overall understanding of aneurysms may one day prove unequivocally the benefit of MR angiography in screening high-risk patient groups. MR angiography has not yet been clinically evaluated as a tool in the evaluation of acute subarachnoid hemorrhage. Potential obstacles to such an evaluation include the clinical instability of SAH patients, limited spatial resolution of the MR angiography acquisitions, the potential for subarachnoid blood or focal intraparenchymal hematomas to obscure or mimic small aneurysms, and the unreliability of MR angiography in demonstrating vasospasm. Currently these factors continue to provide an integral role for contrast angiography in aneurysm evaluation.

  19. Management of dual intracranial germinoma by radiotherapy alone

    Directory of Open Access Journals (Sweden)

    Rakesh Gupta

    2015-01-01

    Full Text Available Synchronous intracranial germ cell tumor in the pineal and suprasellar region is rare. They represent only 5-10% of all intracranial germinomas. They are also known by the entity "double midline atypical teratoma" and are common in the second decade of life. We report a case of an 11-year-old girl having dual midline intracranial lesions with obstructive hydrocephalus treated by ventriculo-peritoneal shunt. Diagnosis of germinoma was made on the basis of imaging and elevated beta-human chorionic gonadotropin in cerebrospinal fluid. Radiotherapy was instituted, which resulted in the total disappearance of both the lesions. Clinical expression, diagnosis and management strategies are discussed.

  20. Monitoring of Intracranial Pressure During Intracranial Endoscopy

    Directory of Open Access Journals (Sweden)

    Rajeev Kumar

    2013-08-01

    Full Text Available Background: Intracranial endoscopy is a minimum invasive procedure, which reduces trauma to the brain, is cost-effective, and carries a shortened hospital stay with an improved postoperative outcome. Objective: To monitor intracranial pressure changes during intracranial endoscopy among children and adults under general anesthesia/sedation, and to compare the intracranial pressure changes between children and adults receiving general anesthesia and among adults receiving general anesthesia and sedation. Methods: The present cross-sectional study was conducted in one of the tertiary care hospitals of Lucknow. This was carried out in the department of neurosurgery from January 2008 to December 2008. Patients who were not fit for general anesthesia received local anesthesia under sedation. Patients participating in the study were divided into three groups. Intracranial pressure was recorded at specific intervals. Parametric data were subjected to statistical analysis using a student\\s t test. Result: A total of 70 patients were undergoing intracranial endoscopy under general anesthesia during the study period. In both groups A and B, intracranial pressure increases the maximum during inflation of the balloon. In group C, all the variations in ICP were found to be statistically significant. In the comparison of intracranial pressure changes between groups A and B, no significant difference was found. All correlations in the comparison of groups B and C were found to be statistically significant (p< 0.001. Conclusion: There is a need for continuous intraoperative monitoring of ICP intracranial endoscopy, because ICP increases in various stages of the procedure, which can be detrimental to the perfusion of the brain. [Arch Clin Exp Surg 2013; 2(4.000: 240-245

  1. Adult multilocular cystic nephroma: Report of six cases with clinical, radio-pathologic correlation and review of literature

    Directory of Open Access Journals (Sweden)

    Christopher Wilkinson

    2013-01-01

    Conclusions: MCN is a benign cystic lesion and clinical presentations are nonspecific with symptoms such as abdominal pain, hematuria and urinary tract infection. These nonspecific clinical presentations and confusing radiological features create difficult preoperative differentiation from malignant cystic renal neoplasms.

  2. Multifocal fibrosclerosis with intracranial pachymeningitis.

    Science.gov (United States)

    Kitano, A; Shimomura, T; Okada, A; Takahashi, K

    1995-04-01

    A 29-year-old woman with a 4-year history of multifocal fibrosclerosis showed unique neurologic complications. Episcleritis, orbital pseudotumor, and eosinophilic phlegmon preceded intracranial inflammatory pachymeningitis. The pachymeningitis was associated with disturbance of the visual field, incomplete Gerstmann's syndrome, and pseudotumor cerebri. T2-weighted magnetic resonance images revealed a high signal intensity lesion in the left temporal and occipital lobes, and gadolinium-enhanced T1-weighted images revealed the enhancement of the thickened left tentorial leaf. The laboratory data suggested that the etiology might be autoimmunological. The disease and MRI abnormalities improved following administration of corticosteroids.

  3. Congenital cystic neck masses: embryology and imaging appearances, with clinicopathological correlation.

    Science.gov (United States)

    Gaddikeri, Santhosh; Vattoth, Surjith; Gaddikeri, Ramya S; Stuart, Royal; Harrison, Keith; Young, Daniel; Bhargava, Puneet

    2014-01-01

    Congenital cystic masses of the neck are uncommon and can present in any age group. Diagnosis of these lesions can be sometimes challenging. Many of these have characteristic locations and imaging findings. The most common of all congenital cystic neck masses is the thyroglossal duct cyst. The other congenital cystic neck masses are branchial cleft cyst, cystic hygroma (lymphangioma), cervical thymic and bronchogenic cysts, and the floor of the mouth lesions including dermoid and epidermoid cysts. In this review, we illustrate the common congenital cystic neck masses including embryology, clinical findings, imaging features, and histopathological findings.

  4. The value of MRI in the diagnosis of benign cystic lesions in the floor of the mouth%口底区良性囊性病变的MRI诊断

    Institute of Scientific and Technical Information of China (English)

    赵航; 齐先龙; 郑宁; 李蕊; 隋庆兰

    2016-01-01

    Objective To investigate the value of MRI in the diagnosis and differential diagnosis of benign cystic lesions in the floor of the mouth.Methods The location and MR imaging features of 43 patients with 44 benign cystic lesions in the floor of the mouth were analyzed,all of which were confirmed by surgical pathol-ogy.Results Of 44 benign lesions in the floor of the mouth,15 cases were located in the midline and 29 cases in the off-midline.20 cases of ranula (1 case of bilateral) were oval or irregular masses at sublingual space or submandibular space,which showed hypointensity or isointensity on T1WI and hyperintensity on T2WI and narrower tail sigh in plunging ranulas.10 cases of thyroglossal duct cyst were manifested as oval cystlike mass either in the midline of the anterior neck at the level of the hyoid bone or within the strap muscles, which showed hyperintensity or isointensity on T1WI and hyperintensity on T2WI.Of 9 cases of epidermoid cyst,which the anatomical sites were scattered,showed and they were round or irregular shape cystlike mas-ses and hyperintensity on DWI.3 cases of dermoid cyst at sublingual space displayed inhomogeneous signal on T1WI and T2WI.1 of them showed characteristic“a sack of marbles”sigh and signal loss on fat-saturated images.2 cases of lymphangioma in the submandibular space showed multilocular mass with slightly hyperin-tensity on T1WI and more hyperintensity on T2WI.Conclusion The manifestation of MRI of the benign cystic lesions in the floor of the mouth is characteristic,and it is of high value in the differentiation and preoperative localization in oral and maxillofacial surgery.%目的:探讨口底区良性囊性病变的MRI影像学特征。方法回顾性分析经穿刺或手术病理证实的口底区良性囊性病变43例44个病灶的解剖部位及MRI表现。结果口底区良性囊性病变共43例患者44个病灶,中线区15个,偏侧29个。其中,舌下囊肿19例20个病灶(1例为双侧),表

  5. Epidural Cystic Spinal Meningioma: A Case Report.

    Science.gov (United States)

    Zhang, Ji; Chen, Zheng-he; Wang, Zi-feng; Sun, Peng; Jin, Jie-tian; Zhang, Xiang-heng; Zhao, Yi-ying; Wang, Jian; Mou, Yong-gao; Chen, Zhong-ping

    2016-03-01

    Cystic spinal meningioma (CSM) is an uncommon meningioma variant. Extradural CSMs are particularly rare and difficult to distinguish from other intraaxial tumors. This study presents a case of a 36-year-old woman with intraspinal extradual CSM at the thoracolumbar spine. She experienced persistent weakness, progressive numbness, and sensory disturbance in the right lower limb. Magnetic resonance imaging (MRI) of the patient revealed an irregular cystic mass at the thoracic 11 to lumbar 3 levels dorsally. This case was misdiagnosed as other neoplasms prior to surgery because of the atypical radiographic features and location of the tumor. Extradural CSMs should be considered in the differential diagnosis of intraspinal extradural cystic neoplasms. Complete removal of cystic wall provides an optimal outcome, rendering the lesion curable.

  6. Nontraumatic intracranial hemorrhage.

    Science.gov (United States)

    Fischbein, Nancy J; Wijman, Christine A C

    2010-11-01

    Nontraumatic (or spontaneous) intracranial hemorrhage most commonly involves the brain parenchyma and subarachnoid space. This entity accounts for at least 10% of strokes and is a leading cause of death and disability in adults. Important causes of spontaneous intracranial hemorrhage include hypertension, cerebral amyloid angiopathy, aneurysms, vascular malformations, and hemorrhagic infarcts (both venous and arterial). Imaging findings in common and less common causes of spontaneous intracranial hemorrhage are reviewed.

  7. Thirty-nine cases of intracranial hemangiopericytoma and anaplastic hemangiopericytoma: A retrospective review of MRI features and pathological findings

    Energy Technology Data Exchange (ETDEWEB)

    Zhou, Jun-lin, E-mail: zjl601@163.com [Department of Medical Imaging, First Affiliated Hospital of Xi' an Jiaotong University (School of Medicine), Postcode: 710061, Xi' an (China); Department of Radiology, The Second Hospital of Lanzhou University, Postcode: 730030, Lanzhou (China); Liu, Jian-li; Zhang, Jing [Department of Radiology, The Second Hospital of Lanzhou University, Postcode: 730030, Lanzhou (China); Zhang, Ming, E-mail: lzjl601@163.com [Department of Medical Imaging, First Affiliated Hospital of Xi' an Jiaotong University (School of Medicine), Postcode: 710061, Xi' an (China)

    2012-11-15

    Objective: To retrospectively review the imaging features of surgically and pathologically confirmed intracranial hemangiopericytoma and anaplastic hemangiopericytoma. Methods: Thirty-nine cases of surgically and pathologically confirmed hemangiopericytoma and anaplastic hemangiopericytoma were analyzed retrospectively. The MRI features were compared with pathological findings in all cases. Results: Of the 39 cases, 21 were anaplastic hemangiopericytoma (WHO grade III) and the remaining cases were hemangiopericytoma (WHO grade II); all lesions were solitary. MRI of anaplastic hemangiopericytoma showed that 20 cases were lobulated, and nine grew cross-leaf. The lesions showed mixed iso-high-low signal (n = 20) or iso-signal (n = 1) on plain T1WI, and mixed high-low signal (n = 20) or iso-signal (n = 1) on plain T2WI. After contrast injection, marked heterogeneous enhancement was seen in 19 cases. Significant necrosis and cystic changes were seen in 16 cases, and the 'dural tail sign' was found in two cases. Ten cases had bony destruction, and 16 showed significant peritumoral edema. In 18 cases of hemangiopericytoma, nine were oval-shaped and three grew cross-leaf. The lesions showed mixed iso-low signal (n = 10) or iso-signal (n = 8) on plain T1WI, and mixed iso-high signal (n = 10) or iso-signal (n = 8) on plain T2WI. After contrast injection, significant uniform enhancement was seen in 10 cases. Significant necrosis and cystic changes were seen in seven cases, and 'dural tail sign' was seen in six cases. Two cases had bony destruction. No case showed significant peritumoral edema. Pathological immunohistochemical Ki67 staining showed a concentration of {approx}18.4% positive cells in anaplastic hemangiopericytoma, whereas in hemangiopericytoma it was 7.12%. Conclusion: Imaging findings of intracranial anaplastic hemangiopericytoma had more pronounced lobulation, cross-leaf growth tendency, more and easier bleeding, more necrosis, more cystic

  8. Cystic changes associated with pulmonary tuberculosis: a case report

    Institute of Scientific and Technical Information of China (English)

    CAI Hou-rong; CAO Min; MENG Fan-qing; LI Wei-chun

    2006-01-01

    @@ There are a wide range of computed tomography (CT) findings in patients with pulmonary tuberculosis, including diffuse or localized nodules,reticular opacities, ground glass attenuation, air trapping, consolidation, cavitation, fibrosis, lymph nodes enlargement, and septal thickening.1-3However, CT findings of pulmonary tuberculosis that appeared as multiple cystic lesions were very rare.3,4Herein, the CT findings appeared as multiple cystic lesions in a patient with pulmonary tuberculosis are reported.

  9. [Primary Pelvic Cystic Echinococcosis].

    Science.gov (United States)

    Yaman, İsmail; İnceboz, Ümit; İnceboz, Tonay; Keyik, Bahar; Uzgören, Engin

    2015-06-01

    Cystic echinococcosis caused by Echinococcus granulosus is still an important health problem in endemic areas. Cystic echinococcosis may involve different organs or areas with the most common sites being the liver and the lungs. Pelvic involvement has previously been reported and was mainly accepted as secondary to cystic echinococcosis in other organs, isolated pelvic involvement is very rare. In this case report, we aimed to present the case with pelvic cystic mass that was finally diagnosed with isolated pelvic cystic echinococcosis in and after the operation, and we would like to draw attention to include "cystic echinococcosis" in the differential diagnosis of pelvic masses.

  10. Pediatric intracranial primary anaplastic ganglioglioma.

    Science.gov (United States)

    Lüdemann, Wolf; Banan, Rouzbeh; Hartmann, Christian; Bertalanffy, Helmut; Di Rocco, Concezio

    2017-02-01

    Primary intracranial anaplastic gangliogliomas are rare tumors in the pediatric patient group. Most of them present with symptoms of elevated pressure or symptomatic epilepsy. Extraaxial location is far more common than axial location. On MRI examination, they mimic pilocytic astrocytomas. The outcome after surgery depends mainly on the possible amount of surgical resection, and oncological therapy is necessary to prevent recurrence of the disease. An 11-year-old boy presented with headache and double vision due to obstructive hydrocephalus. MRI of the brain revealed an axial partially contrast enhancing lesion in the quadrigeminal plate extending from the cerebellum to the pineal gland and causing hydrocephalus. Subtotal removal of the lesion was performed, and the diagnosis of an anaplastic ganglioglioma was established and confirmed by the reference center. At the latest follow up (3 months), the boy is without any neurological symptoms and scheduled for radiation therapy as well as chemotherapy.

  11. Intracranial manifestations of malignant lymphomas

    Energy Technology Data Exchange (ETDEWEB)

    Galanski, M.; Fahrendorf, G.; Urbanitz, D.; Beckmann, A.; Elger, C.

    1985-06-01

    Approximately 10% of patients with malignant lymphoma will show neurological symptoms at some time during the course of their illness. In non-Hodgkin lymphoma, CNS involvement is more frequent than in Hodgkin's disease. Diffuse histiocytic and poorly differentiated lymphomas, bone marrow involvement, advanced tumor stage and hematogenous spread are particular risk factors. Invasion of the spinal canal is the most common type of CNS involvement. Intracranial lesions, which are comparatively rare, may present as intracerebral metastases, epi- or subdural masses or focal or diffuse leptomeningeal disease. Lymphomatous leptomeningitis usually cannot be demonstrated by CT. On the other hand, dural and cerebral parenchymal lesions are sometimes highly characteristic of lymphoma as a result of their features and location.

  12. Are the Intracranial Lipomas Always Asymptomatic?

    Directory of Open Access Journals (Sweden)

    Mustafa Yilmaz

    2014-02-01

    Full Text Available Intracranial lipomas are rarely observed, and accepted as the congenital lesion of central nervous system. Intracranial lipomas are usually based centrally and have benign character. In the brain, it is mostly localized in pericallosal region, quadrigeminal system, and suprasellar region and cerebellopontine angles. As being mostly asymptomatic, the patients occasionally constitute clinical symptoms according to localization area. These symptoms are systemic symptoms such as cephalalgia, drowsiness, crisis and ataxy. In this article, we aimed to present the intracranial lipomas phenomenon which was diagnosed to have caused ptosis and upper lateral sight problem, namely causing localized neurological symptom, situated in mesencephalon and having pressure effect, regarding a 57-year old male patient brought to the emergency service with the nausea, throwing up and cephalalgia ailments.

  13. Cystic fibrosis

    Directory of Open Access Journals (Sweden)

    Radlović Nedeljko

    2012-01-01

    Full Text Available Cystic fibrosis (CF is a multisystemic autosomal recessive disease caused by a defect in the expression of CFTR protein, i.e. chloride channel present in the apical membrane of respiratory, digestive, reproductive and sweat glands epithelium. It primarily occurs in the Caucasians, while being considerably or exceptionally rare in persons of other races. Absence, deficit or structural and functional abnormalities of CFTR protein lead to mucosal hyperconcentration in the respiratory, digestive and reproductive systems and malabsorption of chloride and sodium in the sweat glands. Thus, the clinical features of patients’ with CF are predominated by respiratory, digestive and reproductive disorders, as well as the tendency to dehydration in the condition of increased sweating. Beside genotype variations, the degree of disease manifestation is also essentially influenced by various exogenous factors, such as the frequency and severity of respiratory infections, the level of aero-pollution, quality of immunoprophylaxis, patients’ nutritional condition and other. Chloride concentration of over 60 mmol/L in sweat, a high level of immunoreactive chymotrypsinogen in blood and the verification of homozygous mutation of CFTR gene are the basic methods in the diagnostics of the disease. CF belongs to the group of severe and complex chronic diseases, and therefore requires multidisciplinary therapeutic approach. Owing to the improvement of healthcare provision, most patients with CF now survive into adulthood. In addition, their quality of life is also considerably improved.

  14. Learning about Cystic Fibrosis

    Science.gov (United States)

    ... Testing for Cystic Fibrosis Consensus Development Conference Statement Learning About Cystic Fibrosis What do we know about ... and treatment information. Hosted by the Dolan DNA Learning Center at Cold Spring Harbor Laboratory. What is ...

  15. Spontaneous intracranial hypotension.

    LENUS (Irish Health Repository)

    Fullam, L

    2012-01-31

    INTRODUCTION: Spontaneous\\/primary intracranial hypotension is characterised by orthostatic headache and is associated with characteristic magnetic resonance imaging findings. CASE REPORT: We present a case report of a patient with typical symptoms and classical radiological images. DISCUSSION: Spontaneous intracranial hypotension is an under-recognised cause of headache and can be diagnosed by history of typical orthostatic headache and findings on MRI brain.

  16. NOISY INTRACRANIAL TUMORS

    NARCIS (Netherlands)

    VANDOOREN, BTH; VANBRUGGEN, AC; MOOIJ, JJA; HEW, JM; JOURNEE, HL

    1994-01-01

    Transorbital sound recordings were obtained from 21 patients with intracranial tumours, 28 patients with intracranial aneurysms and 20 control patients. The group of patients with tumours consisted of 12 patients with gliomas, of whom 6 had low-grade gliomas and 6 had high-grade gliomas, and 9 patie

  17. Unruptured intracranial aneurysms

    NARCIS (Netherlands)

    Backes, Daan

    2016-01-01

    Rupture of an intracranial aneurysm results in aneurysmal subarachnoid hemorrhage (SAH), a subtype of stroke with an incidence of 9 per 100,000 person-years and a case-fatality around 35%. In order to prevent SAH, patients with unruptured intracranial aneurysms can be treated by neurosurgical or end

  18. Paediatric intracranial aneurysms

    Directory of Open Access Journals (Sweden)

    A A Wani

    2006-01-01

    Full Text Available Intracranial aneurysms in childhood account for 1-2% of intracranial aneurysms.[1],[2] These aneurysms have unique characteristics that make them different from those in adults. These differences are evident in their epidemiology, location, clinical spectrum, association with trauma and infection, complications and outcome.

  19. Cystic fibrosis: case report

    Energy Technology Data Exchange (ETDEWEB)

    Park, Si Hyun; Lee, Hyun Ju; Kim, Ji Hye; Park, Chol Heui [Gachon Medical School, Inchon (Korea, Republic of)

    2002-12-01

    Cystic fibrosis is an autosomal recessive genetic disease. Among Caucasians, it is the most common cause of pulmonary insufficiency during the first three decades of life. The prevalence of cystic fibrosis varies according to ethnic origin: it is common among Caucasians but rare among Asians. We report a case in which cystic fibrosis with bronchiectasis and hyperaeration was revealed by high-resolution CT, and mutation of the cystic fibrosis conductance transmembrane regulator gene (CFTR) by DNA analysis.

  20. X线数字化断层融合成像与MSCT在颌骨牙源性囊性病变诊断中的评估对比%Comparison of assessments with digital tomosynthesis and MSCT in diagnosis of odontogenic cystic lesions of the jaws

    Institute of Scientific and Technical Information of China (English)

    梁昌富; 李建军; 陈旺生; 刘富金; 董丽伟; 钟少波

    2014-01-01

    目的:评估X线数字化断层融合(TOMOS)成像在口腔有固定金属假牙颌骨牙源性囊性病变诊断中的应用价值,并与多层螺旋CT(MSCT)进行对比。方法:回顾性分析40例经病理证实的口腔有固定金属假牙颌骨牙源性囊性病变的影像资料,所有病例均行MSCT及TOMOS扫描,其中13例增强。将两种检查方法的影像表现特征进行分类比较,评估其显示病灶及毗邻结构的优劣和诊断价值。结果:两种方法在评价病变的结构特点、病变与皮质及周围器官关系比较差异无显著性(一致性检验Kappa值>0.4),显示根尖改变TOMOS优于MSCT,有伪影干扰时,对纯囊性及囊实性灶的诊断准确率,TOMOS优于MSCT,但显示软组织受侵犯不如MSCT。结论: TOMOS与MSCT在显示颌骨牙源性囊性病变影像特点作用相当,值得推广,当病灶有金属伪影干扰时,应选择TOMOS。%Objective To evaluate the value of digital tomosynthesis (TOMOS)in diagnosis of odontogenic cystic lesions of the jaws with oral fixed metal dentures, and compared with multi-slice spiral CT (MSCT). Methods The imaging findings of 40 cases with fixed metal dentures pathologically proved odontogenic cystic lesions of the jaws jn retrospective were retrospectively analyzed.All cases were performed by MSCT and TOMOS scanning,and 13 cases enhanced at the same time. The characteristics of the imaging findings in TOMOS and MSCT were compared. The diagnosis merits and disadvantages, especially their ability to detect the lesions and adjacent structures,were assessed. Results There were no significant difference (consistency check Kappa value>0.4) in evaluating the structure characteristics of the lesions, the relationgship between the lesions and cortex ,and the relationship between the lesions and surrounding organs. TOMOS is superior to MSCT in displaying apical change, the same in pure cystic and cystic-solid lesions

  1. Differentiating Concussion From Intracranial Pathology in Athletes.

    Science.gov (United States)

    Cripps, Andrea; Livingston, Scott C

    2017-01-01

    Clinical Scenario: A cerebral concussion is a traumatically induced transient disturbance of brain function characterized by a complex pathophysiologic process and is classified as a subset of mild traumatic brain injury. The occurrence of intracranial lesions after sport-related head injury is relatively uncommon, but the possibility of serious intracranial injury (ICI) should be included in the differential diagnosis. ICIs are potentially life threatening and necessitate urgent medical management; therefore, prompt recognition and evaluation are critical to proper medical management. One of the primary objectives of the initial evaluation is to determine if the concussed athlete has an acute traumatic ICI. Athletic trainers must be able promptly recognize clinical signs and symptoms that will enable them to accurately differentiate between a concussion (ie, a closed head injury not associated with significant ICI) and an ICI. The identification of predictors of intracranial lesions is, however, relatively broad. Focused Clinical Question: Which clinical examination findings (ie, clinical signs and symptoms) indicate possible intracranial pathology in individuals with acute closed head injuries?

  2. Cystic fibroadenoma of the breast: a case report.

    Science.gov (United States)

    Durak, Merih Güray; Karaman, Ilgın; Canda, Tülay; Balci, Pınar; Harmancioğlu, Omer

    2011-01-01

    Fibroadenoma is the most common breast tumor in adolescent and young women. Fibroadenomas that consist of sclerosing adenosis, papillary apocrine metaplasia, epithelial calcifications, and/or cysts greater than 3 mm are considered as complex fibroadenoma. The relative risk of developing breast cancer in patients with complex fibroadenoma is increased, compared to women with noncomplex fibroadenoma. Extensive cystic degeneration in a fibroadenoma, so called "cystic fibroadenoma" is very rare. Herein, we present a case of such a lesion in a 43-year-old female who has been on follow-up for fibrocystic changes of the breast, and discuss both radiological and histopathologic differential diagnosis of this lesion with other cystic lesions of the breast, including cystic papilloma. The patient is free of disease after 17 months of clinical follow-up.

  3. Interdisciplinary Management of Cystic Neoplasms of the Pancreas

    Directory of Open Access Journals (Sweden)

    Linda S. Lee

    2012-01-01

    Full Text Available Cystic neoplasms of the pancreas are increasingly recognized due to the frequent use of abdominal imaging. It is reported that up to 20% of abdominal cross-sectional scans identify incidental asymptomatic pancreatic cysts. Proper characterization of pancreatic cystic neoplasms is important not only to recognize premalignant lesions that will require surgical resection, but also to allow nonoperative management of many cystic lesions that will not require resection with its inherent morbidity. Though reliable biomarkers are lacking, a wide spectrum of diagnostic modalities are available to evaluate pancreatic cystic neoplasms, including radiologic, endoscopic, laboratory, and pathologic analysis. An interdisciplinary approach to management of these lesions which incorporates recent, specialty-specific advances in the medical literature is herein suggested.

  4. A Case Of Ollier′s Disease With Intracranial Enchondroma

    Directory of Open Access Journals (Sweden)

    Sidharthan Neeraj

    2005-01-01

    Full Text Available The syndrome of multiple enchondromas is known as Ollier′s disease. Enchondromas are benign tumours of hyaline cartilage arising within the medullary cavity of tubular bones. We are reporting the case of a 16 year old girl with Ollier′s disease who presented with seizures and brainstem compression. A MRI scan of brain showed an intracranial space-occupying lesion in the region of clivus. The intracranial tumour was surgically removed and the histopathology confirmed the diagnosis of enchondroma. Intracranial enchondroma is an extremely rare situation and reported for the first time from south India.

  5. Musical hallucinations associated with seizures originating from an intracranial aneurysm.

    Science.gov (United States)

    Roberts, D L; Tatini, U; Zimmerman, R S; Bortz, J J; Sirven, J I

    2001-04-01

    Hallucinations are defined as sensory phenomena in the absence of external sensory stimuli. Auditory hallucinations have been shown to arise from many different intracranial lesions, but seizures manifesting as musical hallucinations triggered by unruptured intracranial aneurysms are rare. We present a case of persistent, episodic musical hallucinations associated with seizures that led to the discovery of 2 small intracranial aneurysms. Typical electroencephalographic findings for seizure activity were observed but resolved after surgical clipping of the aneurysms. Concomitantly, the patient's hallucinations resolved. The literature on musical hallucinations is reviewed.

  6. Diagnosis and evaluation of intracranial arteriovenous malformations

    OpenAIRE

    Andrew Conger; Charles Kulwin; Lawton, Michael T; Cohen-Gadol, Aaron A.

    2015-01-01

    Background: Ideal management of intracranial arteriovenous malformations (AVMs) remains poorly defined. Decisions regarding management of AVMs are based on the expected natural history of the lesion and risk prediction for peritreatment morbidity. Microsurgical resection, stereotactic radiosurgery, and endovascular embolization alone or in combination are all viable treatment options, each with different risks. The authors attempt to clarify the existing literature′s understanding of the natu...

  7. Parasellar lesions

    Energy Technology Data Exchange (ETDEWEB)

    Ruscalleda, J. [Hospital Sant Pau, Radiology Department, Neuroradiology, Barcelona (Spain)

    2005-03-01

    The sellar and parasellar region is an anatomically complex area that represents a crucial crossroad of important adjacent structures, e.g. orbits, cavernous sinus and its content, polygon of Willis, hypothalamus through the pituitary stalk and dural reflections forming the diaphragm sellae and the walls of the cavernous sinuses. Although the cavernous sinus represents the most relevant parasellar structure, from the practical and clinical point of view all the structures that surround the sella turcica can be included in the parasellar region. CT and, mainly, MRI are the imaging modalities to study and characterise the normal anatomy and the majority of processes in this region. We present a practical short review of the most relevant CT and MRI characteristics, such as location, nature of contrast enhancement and presence of cystic components, together with clinical findings, which permit differentiation of the most frequent and less common lesions found in the parasellar region. Learning objectives: A short review of the anatomy and clinical symptoms related to the parasellar region. Radiological characterisation, mainly by MRI, of the many lesions that alter the structure and function of sellar and parasellar anatomy. Description of the MRI features that permit differentiation among less common lesions. (orig.)

  8. CT diagnosis of hyperdense intracranial neoplasms. Review of the literature

    Energy Technology Data Exchange (ETDEWEB)

    Ishikura, Reiichi; Ando, Kumiko; Tominaga, Satoru; Nakao, Norio [Hyogo College of Medicine, Nishinomiya (Japan); Ikeda, Jouta; Takemura, Yuriko; Morikawa, Tsutomu

    1999-03-01

    In contrast to typical astrocytic tumors that show hypodense areas on computed tomographic images, some intracranial tumors show hyperdense areas on CT images. The major reasons for hyperdensity on CT images are hypercellular lesions, intratumoral calcification, and intratumoral hemorrhage. Malignant lymphomas, germinomas, and medulloblastomas show homogenous hyperdensity on CT images because of their hypercellularity. Tumorous lesions such as subependymal giant cell astrocytomas, oligodendrogliomas, ependymomas, central neurocytomas, craniopharyngiomas, and meningiomas often present with hyperdense calcified lesions on CT images. Intratumoral hemorrhage also causes hyperdensity on CT images, and is often associated with metastatic brain tumors, glioblastomas, pituitary adenomas, and rarely with any of the other intracranial tumors. Although magnetic resonance imaging is now the major diagnostic tool for diseases of the central nervous system, the first imaging studies for patients with neurologic symptoms are still CT scans. Hyperdense areas on CT images are a clue to making an accurate diagnosis of intracranial neoplasms. (author)

  9. Computed tomography of intracranial tuberculosis

    Energy Technology Data Exchange (ETDEWEB)

    Park, Yong Lan; Lee, Jung Suk; Eun, Chung Kie; Kim, Soon Yong [School of Medicine, Kyung Hee University, Seoul (Korea, Republic of)

    1981-09-15

    CT is a valuable method in determining number, location and extent of lesions, although a definite diagnosis is often not possible on CT. In intracranial tuberculosis, CT was helpful in the diagnosis, assessing the degree of hydrocephalus and evaluating the effectiveness of antituberculous therapy. Twenty-one cases of clinically proven intracranial tuberculosis were studied by CT in our hospital during last 3 years. Of them, eighteen cases were tuberculous meningitis and the rests were tuberculoma. The results were as follows: 1. Tuberculous meningitis presented the following three patterns of CT findings according to its disease process. a. In early stage of the disease, suspicious multiple isodense small nodules in the cerebral and cerebellar hemispheres showed dense enhancement in postcontrast scan representing miliary tubercles. b. In later stage of the disease, precontrast scan showed partial or total obliteration of the basal and sylvian cisterns with mild dilatation of ventricular system. Postcontrast scan showed dense enhancement of basal and sylvian cisterns. This type of finding was the most common in our series. c. Moderate to marked dilatation of ventricle with or without a cluster of calcifications in suprsella area on precontrast scan was seen in far later stage of as a sequellae of the disease. No enhancement was noted in postcontrast study. 2. Tuberculoma showed an isodense or slightly hyperdense area in the cerebral or cerebellar hemisphere with associated minimal edema in precontrast study. Postcontrast scan showed a small ring enhancement with central lucent area.

  10. Intracranial pressure monitoring

    Science.gov (United States)

    ICP monitoring; CSF pressure monitoring ... There are 3 ways to monitor pressure in the skull (intracranial pressure). INTRAVENTRICULAR CATHETER The intraventricular catheter is the most accurate monitoring method. To insert an intraventricular catheter, a ...

  11. Increased intracranial pressure

    Science.gov (United States)

    ... patient's bedside in an emergency room or hospital. Primary care doctors may sometimes spot early symptoms of increased intracranial pressure such as headache, seizures, or other nervous system problems. An MRI ...

  12. Intracranial germinoma with ventricular system dissemination

    Directory of Open Access Journals (Sweden)

    Shi-yun CHEN

    2014-05-01

    Full Text Available Objective To study the clinical, neuroimaging and histopathological features of intracranial germinoma.  Methods One case of intracranial germinoma with ventricular system dissemination was reported, and related literatures were reviewed.  Results A 34-year-old male complained of progressive dizziness for 30 d and manifested unsteady gait for 45 d. Radiological examinations revealed low signal intensity on T1WI and hyperintense on T2WI in the corpus callosum, left cerebellum, around the fourth ventricle, aqueduct mesencephalon, the ventral pons and pineal region, with even or uneven enhancement after contrast. The clinical initial diagnosis was "intracranial multiple focal lesions and high possibility of multiple sclerosis". After well response to glucocorticoid impact and dehydration, the patient stopped taking drugs but presented relapse and exacerbation. Later, he underwent biopsy on pineal region and was diagnosed as intracranial germinoma. Microscopically, the big germ cells and lymphocytes coexisted. Tumor cells were epithelioid cells with transparent cytoplasm, prominent nuclei and mitotic activity. Lymphocytes were distributed along interstitial substance of vessel and fiber, and individual syncytiotrophoblasts were sprasely distributed. Immunohistochemical staining showed tumor cells were positive for CD117 and OCT3/4, and the syncytiotrophoblasts were positive for β-human chorionic gonadotropin ( β-hCG. The clinical symptoms were completely alleviated after radiotherapy and chemotherapy.  Conclusions Because of the sensitivity for radiotherapy and chemotherapy, intracranial germinoma can be diagnosed and treated early to improve its prognosis. However, it is very easy to disseminate along with ventricular system and form multiple lesions, leading to atypical clinical and imaging manifestations, which is a big challenge for clinical diagnosis. doi: 10.3969/j.issn.1672-6731.2014.05.010

  13. Idiopathic intracranial hypertension

    DEFF Research Database (Denmark)

    Yri, Hanne M; Jensen, Rigmor H

    2015-01-01

    AIMS: The aims of this article are to characterize the headache in idiopathic intracranial hypertension (IIH) and to field-test the ICHD diagnostic criteria for headache attributed to IIH. MATERIALS AND METHODS: We included 44 patients with new-onset IIH. Thirty-four patients with suspected...... tinnitus may suggest intracranial hypertension. Based on data from a well-defined IIH cohort, we propose a revision of the ICDH-3 beta diagnostic criteria with improved clinical applicability and increased sensitivity and specificity....

  14. Treatment of cystic craniopharyngioma with 90Y-Colloid. Four clinical cases.

    Science.gov (United States)

    Sabaté-Llobera, A; Rojas-Camacho, J G; Mora Salvadó, J; Acebes Martín, J J; Rodríguez-Gasén, A; Ramal Leiva, D; Martín-Comín, J

    2013-01-01

    Craniopharyngioma is a histologically benign and frequently cystic intracranial tumor. It may present aggressive behavior due to compression from nearby structures. Its therapeutic management is complicated because although surgery is the usual treatment of choice, it is not exempt of high morbidity and mortality and frequent tumor recurrence. In craniopharyngiomas with a significant cystic component,internal irradiation with radioactive isotopes is a therapeutic alternative to conventional treatments. We present the cases of four patients with cystic craniopharyngiomas who were treated with intracystic administration of 90Y-colloid, and their evolution after the treatment. Copyright © 2012 Elsevier España, S.L. and SEMNIM. All rights reserved.

  15. [Correction of intracranial pressure in patients with traumatic intracranial hemorrhages].

    Science.gov (United States)

    Virozub, I D; Chipko, S S; Chernovskiĭ, V I; Cherniaev, V A

    1986-01-01

    Therapeutical correction of intracranial pressure changes were conducted in 14 patients suffering from traumatic intracranial hematomas by endolumbar administration of physiological solution. The distinguishing feature of this method is the possibility of continuous control of the intracranial pressure level by means of long-term graphic recording of epidural pressure. This makes it possible to perform endolumbar administration of physiological solution in a dose which is determined by the initial level of epidural intracranial pressure. Therapeutic correction of intracranial pressure by endolumbar injection of physiological solution proved successful in the initial stages of dislocation of the brain and in stable intracranial hypotension.

  16. Premalignant cystic neoplasms of the pancreas.

    Science.gov (United States)

    Dudeja, Vikas; Allen, Peter J

    2015-02-01

    Due to increasing utilization of cross-sectional imaging, asymptomatic pancreatic cysts are frequently being diagnosed. Many of these cysts have premalignant potential and offer a unique opportunity for cancer prevention. Mucinous cystic neoplasm and intraductal papillary mucinous neoplasm are the major premalignant cystic neoplasms of pancreas. The prediction of the risk of malignancy (incidental and future risk of malignant transformation) and balancing the risks of watchful waiting with that of operative management with associated mortality and morbidity is the key to the management of these lesions. We review the literature that has contributed to the development of our approach to the management of these cystic neoplasms. We provide an overview of the key features used in diagnosis and in predicting malignancy. Particular attention is given to the natural history and management decision making.

  17. How Is Cystic Fibrosis Treated?

    Science.gov (United States)

    ... page from the NHLBI on Twitter. How Is Cystic Fibrosis Treated? Cystic fibrosis (CF) has no cure. However, ... help oral pancreatic enzymes work better. Treatments for Cystic Fibrosis Complications A common complication of CF is diabetes . ...

  18. Genetics Home Reference: cystic fibrosis

    Science.gov (United States)

    ... Me Understand Genetics Home Health Conditions cystic fibrosis cystic fibrosis Enable Javascript to view the expand/collapse boxes. Download PDF Open All Close All Description Cystic fibrosis is an inherited disease characterized by the buildup ...

  19. Diagnosis and evaluation of intracranial arteriovenous malformations

    Science.gov (United States)

    Conger, Andrew; Kulwin, Charles; Lawton, Michael T.; Cohen-Gadol, Aaron A.

    2015-01-01

    Background: Ideal management of intracranial arteriovenous malformations (AVMs) remains poorly defined. Decisions regarding management of AVMs are based on the expected natural history of the lesion and risk prediction for peritreatment morbidity. Microsurgical resection, stereotactic radiosurgery, and endovascular embolization alone or in combination are all viable treatment options, each with different risks. The authors attempt to clarify the existing literature's understanding of the natural history of intracranial AVMs, and risk-assessment grading scales for each of the three treatment modalities. Methods: The authors conducted a literature review of the existing AVM natural history studies and studies that clarify the utility of existing grading scales available for the assessment of peritreatment risk for all three treatment modalities. Results: The authors systematically outline the diagnosis and evaluation of patients with intracranial AVMs and clarify estimation of the expected natural history and predicted risk of treatment for intracranial AVMs. Conclusion: AVMs are a heterogenous pathology with three different options for treatment. Accurate assessment of risk of observation and risk of treatment is essential for achieving the best outcome for each patient. PMID:25984390

  20. Intracranial chordoma presenting as acute hemorrhage in a child: Case report and literature review

    Directory of Open Access Journals (Sweden)

    Kenneth A Moore

    2015-01-01

    Conclusion: There are few previous reports of petroclival chordomas causing acute intracranial hemorrhage. To the authors′ knowledge, this is the first case of a petroclival chordoma presenting as acute intracranial hemorrhage in a pediatric patient. Although uncommon, it is important to consider chordoma when evaluating a patient of any age presenting with a hemorrhagic lesion of the clivus.

  1. Neonatal cystic fibrosis screening test

    Science.gov (United States)

    Cystic fibrosis screening - neonatal; Immunoreactive trypsinogen; IRT test; CF - screening ... Cystic fibrosis is a disease passed down through families. CF causes thick, sticky mucus to build up in ...

  2. European experts consensus statement on cystic tumours of the pancreas.

    Science.gov (United States)

    Del Chiaro, Marco; Verbeke, Caroline; Salvia, Roberto; Klöppel, Gunter; Werner, Jens; McKay, Colin; Friess, Helmut; Manfredi, Riccardo; Van Cutsem, Eric; Löhr, Matthias; Segersvärd, Ralf

    2013-09-01

    Cystic lesions of the pancreas are increasingly recognized. While some lesions show benign behaviour (serous cystic neoplasm), others have an unequivocal malignant potential (mucinous cystic neoplasm, branch- and main duct intraductal papillary mucinous neoplasm and solid pseudo-papillary neoplasm). European expert pancreatologists provide updated recommendations: diagnostic computerized tomography and/or magnetic resonance imaging are indicated in all patients with cystic lesion of the pancreas. Endoscopic ultrasound with cyst fluid analysis may be used but there is no evidence to suggest this as a routine diagnostic method. The role of pancreatoscopy remains to be established. Resection should be considered in all symptomatic lesions, in mucinous cystic neoplasm, main duct intraductal papillary mucinous neoplasm and solid pseudo-papillary neoplasm as well as in branch duct intraductal papillary mucinous neoplasm with mural nodules, dilated main pancreatic duct >6mm and possibly if rapidly increasing in size. An oncological partial resection should be performed in main duct intraductal papillary mucinous neoplasm and in lesions with a suspicion of malignancy, otherwise organ preserving procedures may be considered. Frozen section of the transection margin in intraductal papillary mucinous neoplasm is suggested. Follow up after resection is recommended for intraductal papillary mucinous neoplasm, solid pseudo-papillary neoplasm and invasive cancer.

  3. Incidental finding of malignant renal cystic tumour diagnosed sonographically

    Directory of Open Access Journals (Sweden)

    Stojanović Milan

    2008-01-01

    Full Text Available Introduction Malignant cystic renal tumor is a rare variant of renal malignancy. Cystic neoplasm results from haemorrhage, necrosis and colliquation of a solid tumour or tumour occurring within the wall of a cyst. That pathoanatomic substratum reflects characteristic sonographic features indicating its malignant nature. It is important to distinguish a simple cyst (not requiring surgery from intracystic malignant lesion because it requires surgery. Case Outline The authors present a 59-year-old woman with a sonographic finding of a simple cyst in the upper pole of the right kidney revealed during gynaecological ultrasonography. Immediately afterwards, the radiologist performed renal sonography and its finding was a cystic lesion suggestive of malignancy. Further evaluation by CT scan showed that the lesion was clearly malignant. After surgery, the histological finding verified cystic renal cancer. Conclusion Ultrasonography may reveal a complex cyst and solid mass but requires an experienced sonographer. Contrast CT scan would be performed to examine the "suspicious" lesion because it clearly shows if a cystic lesion is benign or malignant. .

  4. Intracranial pressure monitoring in severe traumatic brain injury

    Directory of Open Access Journals (Sweden)

    Apetrei Al. Cosmin

    2014-06-01

    Full Text Available Intracranial pressure monitoring seems to be an indispensable stage in management of severe traumatic brain injured patient. Since 2009, this technique completes our trauma protocol. The study has been carried out from 2011 to 2013 in Prof. Dr. N. Oblu hospital in Iasi. There have been included in the study patients with severe craniocerebral trauma, who had traumatic brain lesions CT detected and Glasgow score between 3 and 8. The age ranged from 16 to 60, an average of 35.5 years old. 50% of the studied cases had a favorable outcome. Diagrams associated to this category of patients showed increases in intracranial pressure above normal values but without repeated values above 50 mm Hg. Most of those patients had a good evolution under medical treatment. Monitoring intracranial pressure is an extremely useful stage in treating intracranial high pressure in traumatology and it should be included in the equipment of any intensive therapy section caring traumatic patients

  5. Pancreatic pseudocyst or a cystic tumor of the pancreas?

    Institute of Scientific and Technical Information of China (English)

    Mohammad Ezzedien Rabie; Ismail El Hakeem; Mohammad Saad Al Skaini; Ahmad El Hadad; Salim Jamil; Mian Tahir Shah; Mahmoud Obaid

    2014-01-01

    Pancreatic pseudocysts are the most common cystic lesions of the pancreas and may complicate acute pancreatitis, chronic pancreatitis, or pancreatic trauma. While the majority of acute pseudocysts resolve spontaneously, few may require drainage. On the other hand, pancreatic cystic tumors, which usualy require extirpation, may disguise as pseudocysts. Hence, the distinction between the two entities is crucial for a successful outcome. We conducted this study to highlight the fundamental differences between pancreatic pseudocysts and cystic tumors so that relevant management plans can be devised. We reviewed the data of patients with pancreatic cystic lesions that underwent intervention between June 2007 and December 2010 in our hospital. We identified 9 patients (5 males and 4 females) with a median age of 40 years (range, 30-70 years). Five patients had pseudocysts, 2 had cystic tumors, and 2 had diseases of undetermined pathology. Pancreatic pseudocysts were treated by pseudocystogastrostomy in 2 cases and percutaneous drainage in 3 cases. One case recurred after percutaneous drainage and required pseudocystogastrostomy. The true pancreatic cysts were serous cystadenoma, which was treated by distal pancreatectomy, and mucinous cystadenocarcinoma, which was initialy treated by drainage, like a pseudocyst, and then by distal pancreatectomy when its true nature was revealed. We conclude that every effort should be exerted to distinguish between pancreatic pseudocysts and cystic tumors of the pancreas to avoid the serious misjudgement of draining rather than extirpating a pancreatic cystic tumor. Additionaly, percutaneous drainage of a pancreatic pseudocyst is a useful adjunct that may substitute for surgical drainage.

  6. Direct cervical arterial access for intracranial endovascular treatment

    Energy Technology Data Exchange (ETDEWEB)

    Blanc, R. [Fondation Rothschild, Department of Interventional Neuroradiology, Paris (France); APHP, Hopital Henri Mondor, Service de Neuroradiologie Diagnostique et Therapeutique, Creteil Cedex (France); Piotin, M.; Mounayer, C.; Spelle, L. [Fondation Rothschild, Department of Interventional Neuroradiology, Paris (France); Moret, J. [Fondation Rothschild, Department of Interventional Neuroradiology, Paris (France); Hopital de la Fondation Ophtalmologique Adolphe de Rothschild, Service de Neuroradiologie Interventionnelle, Paris Cedex 19 (France)

    2006-12-15

    Tortuous vasculature is a cause of failure of endovascular treatment of intracranial vascular lesions. We report our experience of direct cervical accesses in patients in whom the arterial femoral route was not attainable. In this retrospective study, 42 direct punctures of the carotid or the vertebral arteries at the neck were performed in 38 patients. The vessel harboring the intracranial lesion was punctured at the neck above the main tortuosity, a sheath was then positioned under fluoroscopic control to allow a stable access to the intracranial circulation. After the procedure, the sheath was removed and hemostasis was gained either by manual compression or by an arterial closure device (4 of 42, 9%). The cervical route allowed access to all intracranial lesions in all 42 procedures. A complication was encountered in six procedures (14%) related to the direct puncture. In 2 of the 42 procedures (4%), a transient vasospasm was encountered. A cervical hematoma formed in 3 of the 42 procedures (7%) after sheath withdrawal (one patient in whom an 8F sheath had been used, required surgical evacuation of a hematoma compressing the upper airways; the other patients did well without surgical evacuation). In the remaining patient (1 of 42 procedures, 2%), a small asymptomatic aneurysm at the puncture site was seen on the follow-up angiogram. Direct cervical arterial approaches to accessing the intracranial circulation is effective in patients in whom the femoral route does not allow the navigation and stabilization of guiding catheters. (orig.)

  7. Cystic Odontoma in a Patient with Hodgkin’s Lymphoma

    Directory of Open Access Journals (Sweden)

    Victor Costa

    2015-01-01

    Full Text Available Cystic odontoma is a rare entity, which is characterized by the association of a cyst with complex/compound odontoma. The aim of this study was to report the case of a 5-year-old male patient diagnosed previously with Hodgkin’s lymphoma and treated successfully with chemotherapy and radiotherapy, who developed a mandibular odontogenic lesion. Physical examination revealed a swelling on the right side of the mandible. Radiographically, a well-defined radiolucent area surrounded by radiopaque material was observed. An incisional biopsy was performed and microscopic analysis showed a cystic lesion consisting of an atrophic epithelium comprising 2-3 cell layers and the absence of inflammation in the cystic capsule. The cyst was decompressed and the lesion was removed after 3 months of follow-up. Microscopic analysis of the surgical specimen showed a cystic hyperplastic epithelium surrounded by an intense chronic inflammatory cell infiltrate, which was in close contact with mineralized tissue resembling dentin and cementum. The final diagnosis was cystic odontoma. Since chemotherapy can affect the growth and development of infant teeth, a relationship between chemotherapy-associated adverse events and cystic odontoma is suggested in the present case.

  8. Cystic Odontoma in a Patient with Hodgkin's Lymphoma

    Science.gov (United States)

    Costa, Victor; Caris, Adriana Rocha; León, Jorge Esquiche; Ramos, Carolina Judica; Jardini, Vaneska; Kaminagakura, Estela

    2015-01-01

    Cystic odontoma is a rare entity, which is characterized by the association of a cyst with complex/compound odontoma. The aim of this study was to report the case of a 5-year-old male patient diagnosed previously with Hodgkin's lymphoma and treated successfully with chemotherapy and radiotherapy, who developed a mandibular odontogenic lesion. Physical examination revealed a swelling on the right side of the mandible. Radiographically, a well-defined radiolucent area surrounded by radiopaque material was observed. An incisional biopsy was performed and microscopic analysis showed a cystic lesion consisting of an atrophic epithelium comprising 2-3 cell layers and the absence of inflammation in the cystic capsule. The cyst was decompressed and the lesion was removed after 3 months of follow-up. Microscopic analysis of the surgical specimen showed a cystic hyperplastic epithelium surrounded by an intense chronic inflammatory cell infiltrate, which was in close contact with mineralized tissue resembling dentin and cementum. The final diagnosis was cystic odontoma. Since chemotherapy can affect the growth and development of infant teeth, a relationship between chemotherapy-associated adverse events and cystic odontoma is suggested in the present case. PMID:26618008

  9. Cystic Odontoma in a Patient with Hodgkin's Lymphoma.

    Science.gov (United States)

    Costa, Victor; Caris, Adriana Rocha; León, Jorge Esquiche; Ramos, Carolina Judica; Jardini, Vaneska; Kaminagakura, Estela

    2015-01-01

    Cystic odontoma is a rare entity, which is characterized by the association of a cyst with complex/compound odontoma. The aim of this study was to report the case of a 5-year-old male patient diagnosed previously with Hodgkin's lymphoma and treated successfully with chemotherapy and radiotherapy, who developed a mandibular odontogenic lesion. Physical examination revealed a swelling on the right side of the mandible. Radiographically, a well-defined radiolucent area surrounded by radiopaque material was observed. An incisional biopsy was performed and microscopic analysis showed a cystic lesion consisting of an atrophic epithelium comprising 2-3 cell layers and the absence of inflammation in the cystic capsule. The cyst was decompressed and the lesion was removed after 3 months of follow-up. Microscopic analysis of the surgical specimen showed a cystic hyperplastic epithelium surrounded by an intense chronic inflammatory cell infiltrate, which was in close contact with mineralized tissue resembling dentin and cementum. The final diagnosis was cystic odontoma. Since chemotherapy can affect the growth and development of infant teeth, a relationship between chemotherapy-associated adverse events and cystic odontoma is suggested in the present case.

  10. 内镜经鼻蝶入路手术治疗鞍区囊性病变46例临床分析%Treatment of cystic lesions in sella through transsphenoidal endoscopic endonasal approach:retrospective analysis of 46 cases

    Institute of Scientific and Technical Information of China (English)

    于焕新; 刘钢

    2015-01-01

    目的 分析鞍区囊性病变患者的临床和影像学特征并总结内镜经鼻蝶入路手术治疗的手术经验.方法 回顾性分析2003年6月至2013年9月在天津市环湖医院经手术和病理确诊的鞍区囊性病变46例患者的临床资料,其中颅咽管瘤11例,囊性垂体瘤14例,Rathke囊肿12例,垂体脓肿9例.比较46例患者的临床特点、影像学特征、手术治疗方法及术后复发情况.结果 全部患者均采用内镜下经鼻蝶入路手术治疗.术后头痛缓解26例,未缓解8例;垂体功能者恢复正常18例,未恢复15例;尿崩症恢复正常8例,未恢复正常4例;视力、视野改善12例,未改善2例.全部病例随访6 ~72个月,术后复发7例,其中颅咽管瘤4例,垂体脓肿2例,囊性垂体腺瘤1例.无严重并发症及死亡病例发生.46例患者中颅咽管瘤患者发病年龄较小、视力和视野症状明显、肿瘤多位于鞍上、第三脑室压迫、手术易复发.囊性垂体腺瘤常呈囊实性,侵犯海绵窦、实性部分均匀强化.Rathke囊肿表现为单纯囊性,临床症状出现较晚.垂体脓肿病程短,容易出现尿崩症,多个激素水平低下,影像学检查可见病变环形强化.结论 鞍区囊性病变的临床特点和影像学特征互相重叠,但又有一定的特异性.内镜经鼻蝶入路微创手术治疗鞍区囊性病变是安全、有效的手术治疗方法.%Objective To analyze the clinical and imaging characteristics of patients with cystic lesions in sella region and to describe the experience of endoscopic transsphenoidal surgery.Methods Fourty-six cases of cystic lesions in sella region confirmed by surgery and pathology between June 2003 and September 2013 were retrospectively analysed.The clinical features,imaging,surgical technique and postoperative recurrence in 46 cases were presented.Results All lesions were resected through transsphenoidal endoscopic endonasal approach.Followed up lasted from 6 months to 6 years

  11. Cystic Granular Cell Ameloblastoma

    OpenAIRE

    Thillaikarasi, Rathnavel; Balaji, Jayaram; Gupta, Bhawna; Ilayarja, Vadivel; Vani, Nandimandalam Venkata; Vidula, Balachander; Saravanan, Balasubramaniam; Ponniah, Irulandy

    2010-01-01

    Ameloblastoma is a locally aggressive benign epithelial odontogenic tumor, while unicystic ameloblastoma is a relatively less aggressive variant. Although rare in unicystic or cystic ameloblastoma, granular cell change in ameloblastoma is a recognized phenomenon. The purpose of the present article is to report a case of cystic granular cell ameloblastoma in 34-year old female.

  12. Findings of computed tomography in intracranial tuberculosis

    Energy Technology Data Exchange (ETDEWEB)

    Jo, H. G.; Bae, K. S.; Lee, H. K.; Kwon, K. H.; Kim, K. J. [Soonchunhyang University College of Medicine, Seoul (Korea, Republic of)

    1983-12-15

    In intracranial tuberculosis, the Computed Tomography (CT) is a new radiological technique which is helpful in diagnosis and determining the location, extents of the lesion. It can also make it possible to assess the presence and degree of the complications and to evaluate the effectiveness of treatment. 25 cases of clinically proven intracranial tuberculosis were studied by CT, in Soonchunhyang hospital from Jun. 1980 to Jun. 1983. The result were as follows; 1. 4 cases were normal in CT finding, despite of the clinically proven tuberculous meningitis. 2. Total or partial obliteration of cisterns were observed in 13 cases. 3. Intense abnormal contrast enhancement of the cisterns were observed in 8 cases. 4. 19 cases show moderate to marked ventricular dilatation. 5. 2 cases of cerebral infarction were observed. 6. One case of tuberculoma was observed.

  13. Intracranial neurenteric cyst traversing the brainstem

    Directory of Open Access Journals (Sweden)

    Jasmit Singh

    2015-01-01

    Full Text Available Neurenteric cysts (NECs, also called enterogenous cysts, are rare benign endodermal lesions of the central nervous system that probably result from separation failure of the notochord and upper gastrointestinal tract. Most frequently they are found in the lower cervical spine or the upper thoracic spine. Intracranial occurrence is rare and mostly confined to infratentorial compartment, in prepontine region [51%]. Other common locations are fourth ventricle and cerebellopontine angle. There are few reports of NEC in medulla or the cerebellum. Because of the rarity of the disease and common radiological findings, they are misinterpreted as arachnoid or simple cysts until the histopathological confirmation, unless suspected preoperatively. We herein report a rare yet interesting case of intracranial NEC traversing across the brainstem.

  14. Image-guided drainage of cystic vestibular schwannomata.

    Science.gov (United States)

    Barrett, Chris; Prasad, K S Manjunath; Hill, John; Johnson, Ian; Heaton, Judith M; Crossman, John E; Mendelow, Alexander D

    2010-01-01

    The management of vestibular schwannomata is controversial. Surveillance remains an acceptable option for elderly patients or those with small lesions. Stereoradiosurgery is also an option, while surgery is often preferred in younger patients with larger lesions. In elderly patients with lesions causing brainstem compression, craniotomy is a major undertaking. We report two cases of cystic cerebellopontine angle tumours in patients with co-morbidity, who were managed successfully with image-guided insertion of a cystoperitoneal shunt.

  15. [Intracranial epidural abscess in a newborn secondary to skin catheter].

    Science.gov (United States)

    Fernández, L M; Domínguez, J; Callejón, A; López, S; Pérez-Avila, A; Martín, V

    2001-08-01

    Intracranial epidural abscesses are uncommon lesions, being more frequents in older children and adults. They commonly arise as a result of direct extension of a preexisting infection and rarely present with focal deficit. We present a case of a 11-days old preterm infant who developed an intracranial epidural abscess as a result of an infected scalp vein catheter. The diagnosis was made on the basis of the cranial ultrasound and CT scan images. An identified strain of Enterococcus faecium was cultured from all the samples. The patient underwent a right frontal craniotomy with drainage of the abscess and a 2-week total course of intravenous antibiotics was administrated. CT scan imaging 3 week after the procedure demonstrated no evidence of residual lesion. When present, a scalp vein catheter, in absence of others predisponing factors, must be considered as an etiologic agent for an intracranial epidural abscess in this age-group.

  16. Impending Airway Compromise due to Cystic Hygroma

    Directory of Open Access Journals (Sweden)

    Itai Shavit

    2011-05-01

    Full Text Available We report on a 3-month-old infant, who arrived in the pediatric emergency department (ED with a cervical cystic hygroma causing an impending compromise of the airway. We recognize that such a lesion can rapidly progress, and the judicious use of imaging in the ED may help to avoid airway compromise and possibly fatal complications. [West J Emerg Med. 2011;12(4:368–369.

  17. Adenoid Cystic Carcinoma of the Larynx

    Directory of Open Access Journals (Sweden)

    Roopesh Sankaran

    2014-06-01

    Full Text Available This is case where a middle aged gentleman presented with history of progressively worseninghoarseness for 1 year. On further history taking and examination including imaging noted patient had supraglottic mass arising from left ventricle, measuring 2x2cm with smooth surface mimicking a benign lesion. Histopatological examination revealed as adenoid cystic carcinoma of left ventricle with perineural invasion . [Cukurova Med J 2014; 39(3.000: 611-615

  18. Charactics of cerebrovescular lesion,collateral circulation in Moyamoya syndrome secondary to intracranial atherosclerotic disease%动脉粥样硬化性大脑中动脉狭窄继发Moyamoya 综合征的脑血管病变及侧支循环分布模式

    Institute of Scientific and Technical Information of China (English)

    徐宁; 张千; 李先锋

    2014-01-01

    Objective To investigate the charactics of cerebrovescular lesion,collateral circulation in Moyamoya syndrome secondary to intracranial atherosclerotic disease.Methods 26 subjects were identified by digital subtraction angiography between August 2006 and December 2013.Evaluating the correlation between moyamoya vessels ,intracranial arterial lesions and the degree of leptomeningeal anastomosis.Results 1 7 pa-tients had moyamoya vessels.The presence of moyamoya vessels was associated with ipsilateral or contralateral anterior cerebral artery stenosis to the occluded MCA (P =0.004)and poor development of anterior leptomen-ingeal anastomosis (P =0.012).It was also associated with vascular lesions involving more than one intracrani-al branch vessel in patients with moyamoya syndrome secondary to atherosclerosis.Conclusions Moyamoya vessels might be associated with poorly developed leptomeningeal collateral vessels.%目的:探讨动脉粥样硬化性大脑中动脉狭窄继发 moyamoya 综合征的脑血管病变及侧支循环分布模式。方法收集2010年8月~2013年12月经 DSA 证实动脉粥样硬化性大脑中动脉狭窄患者26例。评估 moyamoya 血管网建立与颅内血管病变及软脑膜侧支循环开放度之间的关系。结果26例患者中 moy-amoya 综合征组17例,非 moyamoya 综合征组9例。moyamoya 综合征组4例患者在 MCA 闭塞侧 A1段表现为细小或缺如,而非 moyamoya 综合征组9例 A1段表现正常。moyamoya 综合征组11例在 MCA 一侧或对侧的 ACA 上发现动脉粥样硬化性狭窄或闭塞病变,而非 moyamoya 综合征组未发现上述病变(P =0.004)。非 moyamoya 综合征组所有患者均显示自 ACA 到达 M1或 M2节段足够的软脑膜侧支循环,而 moy-amoya 综合征组仅有8例(P =0.012)。结论动脉粥样硬化所致的 moyamoya 血管网重建可能与软脑膜侧支循环建立不佳有关。

  19. Differentiation of common pancreatic cystic neoplasms based upon multiplicity of cysts

    Energy Technology Data Exchange (ETDEWEB)

    Jung, Yoon Young; Byun, Jae Ho; Kim, Jin Hee; Lee, Seung Soo; Kim, Hyoung Jung [Dept. of Radiology and Research Institute of Radiology, Asan Medical Center, University of Ulsan College of Medicine, Seoul (Korea, Republic of)

    2015-01-15

    To evaluate the multiplicity and mean number of cystic lesions in patients with branch duct intraductal papillary mucinous neoplasms (BD-IPMNs), serous cystadenomas (SCAs), and mucinous cystic neoplasms (MCNs) of the pancreas. Two hundred and eighty-eight patients with pathologically proven cystic neoplasms of the pancreas underwent preoperative CT and/or MRI. These patients were divided into the following three groups: BD-IPMN, SCA, and MCN groups. Two radiologists retrospectively analyzed the CT and MRI examinations to determine the multiplicity (i.e., more than one lesion) and mean number of cystic lesions per patient. Among the three groups, statistical comparison of multiplicity of cystic lesions was performed. The BD-IPMN group consisted of 155 patients with 176 BD-IPMNs, with multiplicity in 15 patients (9.7%) and a mean 1.14 BD-IPMNs per patient (range, 1.3). The SCA group consisted of 67 patients with 69 SCAs, with multiplicity in one patient (1.5%) and a mean 1.03 SCAs per patient (range, 1.3). The MCN group consisted of 67 patients with 67 MCNs, with no multiplicity. Multiple cystic lesions were significantly more common in the BD-IPMN group than in the SCA and MCN groups (p = 0.003). BD-IPMNs were more frequently associated with multiplicity of cystic lesions than SCAs or MCNs of the pancreas.

  20. MRI of intracranial germ cell tumours

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    Sumida, M. [Dept. of Neurosurgery, Hiroshima Univ. School of Medicine, Hiroshima (Japan); Uozumi, T. [Dept. of Neurosurgery, Hiroshima Univ. School of Medicine, Hiroshima (Japan); Kiya, K. [Dept. of Neurosurgery, Hiroshima Univ. School of Medicine, Hiroshima (Japan); Mukada, K. [Dept. of Neurosurgery, Hiroshima Univ. School of Medicine, Hiroshima (Japan); Arita, K. [Dept. of Neurosurgery, Hiroshima Univ. School of Medicine, Hiroshima (Japan); Kurisu, K. [Dept. of Neurosurgery, Hiroshima Univ. School of Medicine, Hiroshima (Japan); Sugiyama, K. [Dept. of Neurosurgery, Hiroshima Univ. School of Medicine, Hiroshima (Japan); Onda, J. [Dept. of Neurosurgery, Hiroshima Univ. School of Medicine, Hiroshima (Japan); Satoh, H. [Dept. of Neurosurgery, Hiroshima Univ. School of Medicine, Hiroshima (Japan); Ikawa, F. [Dept. of Neurosurgery, Hiroshima Univ. School of Medicine, Hiroshima (Japan); Migita, K. [Dept. of Neurosurgery, Hiroshima Univ. School of Medicine, Hiroshima (Japan)

    1995-01-01

    We reviewed MRI findings in proven intracranial germ cell tumours in 22 cases, 12 of whom received Gd-DTPA. On T1-weighted images, the signal intensity of the tumour parenchyma was moderately low in 19 cases and isointense in 3; on T2-weighted images, it was high in all cases. Regions of different intensity thought to be cysts were found in 17 (77 %): 7 of 12 patients with germinoma (58 %) and in all other cases. Of the 13 patients with pineal lesions T1-weighted sagittal images showed the aqueduct to be obstructed in 5, stenotic in 7 and normal in 1. Strong contrast enhancement was observed in all 12 cases. Of the 14 patients with suprasellar lesions, 5 were found to have an intrasellar extension, and in 3 of these, the normal pituitary gland, which could be distinguished from the tumour, was displaced anteriorly. Ten patients (45 %) had multiple lesions. (orig.)

  1. Ruptured Intracranial Mycotic Aneurysm in Infective Endocarditis: A Natural History

    Directory of Open Access Journals (Sweden)

    Isabel Kuo

    2010-01-01

    discovered on CT Angiography. His lesion quickly progressed into an intraparenchymal hemorrhage, requiring emergent craniotomy and aneurysm clipping. Current recommendations on the management of intracranial Mycotic Aneurysms are based on few retrospective case studies. The natural history of the patient's ruptured aneurysm is presented, as well as a literature review on the management and available treatment modalities.

  2. Congenital cystic lung malformations; Konnatale zystische Lungenfehlbildungen

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    Stoever, B.; Scheer, I.; Bassir, C. [Klinik fuer Strahlenheilkunde, Berlin (Germany). Abt. Paediatrische Radiologie, Charite; Mau, H. [Campus Virchow-Klinikum, Klinik fuer Kinderchirurgie, Berlin (Germany); Chaoui, R. [Campus Mitte, Klinik fuer Geburtsmedizin, Berlin (Germany); Henrich, W. [Campus Virchow-Klinikum, Klinik fuer Geburtsmedizin, Berlin (Germany); Schwabe, M. [Campus Mitte, Inst. fuer Pathologie, Berlin (Germany); Wauer, R. [Campus Mitte, Klinik fuer Neonatologie, Berlin (Germany)

    2006-04-15

    Purpose: The aim of the study concerning congenital cystic lung malformations was to evaluate prenatal diagnoses postnatally to determine prognostic factors as well as to define optimized perinatal management. Materials and Methods: The study is based on 45 prenatal ultrasound examinations depicting fetal cystic lung lesions. 32 of the mothers had follow-up examinations. 5 pregnancies were terminated due to CCAM and additional malformations. Complete regression of the lesions was seen prenatally in 8 cases and postnatally in 5 children. Results: Surgical intervention due to respiratory insufficiency was necessary in 4 neonates. According to the imaging results, CCAM was present in 4 cases and sequestration in 7 patients. No correlation between the imaging findings and the surgical results was found in 3 children: One child suffered from rhadomyoid dysplasia, and in the case of the second child, a left-sided hernia of the diaphragm and additional sequestration were detected. The third child showed AV malformation. The cystic lesions of the 14 children operated upon were proven histologically. The degree of accuracy in the present study was high. Conclusion: Precise perinatal management is warranted in order to determine according to the clinical relevance surgical intervention and to prevent complications after the first year of life. This is performed during the neonatal period for respiratory insufficient neonates and within the first year of life for clinically stable children. (orig.)

  3. Individual surgical treatment of intracranial arachnoid cyst in pediatric patients

    Directory of Open Access Journals (Sweden)

    Chao Wang

    2013-01-01

    Full Text Available Background and Aim: Intracranial arachnoid cysts (IAC are benign congenital cystic lesions filled with cerebrospinal fluid (CSF. This study evaluated microsurgical craniotomy and endoscopy in the surgical treatment of IAC. Materials and Methods: Eight-one consecutive pediatric patients with IAC were surgically treated between January 2004 and January 2011. The surgical procedures included microsurgical craniotomy and endoscopy. Symptoms at presentation, location of IAC, surgical treatment options, and effectiveness were evaluated. Results: There were 43 males and 38 females and the mean age was 8.7 years (range between 1 month and 14 years at the time of surgery. The cyst location was supratentorial in 72 patients and infratentorial in 9 patients, arachnoid cyst were identified. Follow-up period ranged between 2 and 8 years. Of the 49 patients with headache 83.67% of patients had cure and 10.2% had significant improvement. Of the eight patients with hydrocephalus and gait disturbances, six (75% had complete total relief of symptoms and two (25% patients had significant improvement. Four of the six patients with cognitive decline and weakness showed improvement. Of the 18 patients with epilepsy seizure freedom was: Engle class I grade I in 14 (77.78% patients; class II in 2 (11.11% patients; and class III in 2 (11.11% patients. Follow-up studies from 2 to 8 years showed that headache was cured in 41 of the 49 cases (83.67%, significantly improved in 5 cases (10.20%, and showed no variation in 3 cases (6.12%. Hydrocephalus and gait disturbances were controlled in six of the eight cases (75.00% and significantly improved in two cases (25.00%. Cognitive decline and weakness were obviously improved in four of the six cases (66.67% and exhibited no variation in two cases (33.33%. According to the Engle standard, the following results were obtained from 18 patients with epilepsy: Grade I in 14 cases (77.78%; grade II in 2 cases (11.11%; and grade III

  4. Individual surgical treatment of intracranial arachnoid cyst in pediatric patients.

    Science.gov (United States)

    Wang, Chao; Han, Guoqiang; You, Chao; Liu, Chuangxi; Wang, Jun; Xiong, Yunbiao

    2013-01-01

    Intracranial arachnoid cysts (IAC) are benign congenital cystic lesions filled with cerebrospinal fluid (CSF). This study evaluated microsurgical craniotomy and endoscopy in the surgical treatment of IAC. Eight-one consecutive pediatric patients with IAC were surgically treated between January 2004 and January 2011. The surgical procedures included microsurgical craniotomy and endoscopy. Symptoms at presentation, location of IAC, surgical treatment options, and effectiveness were evaluated. There were 43 males and 38 females and the mean age was 8.7 years (range between 1 month and 14 years) at the time of surgery. The cyst location was supratentorial in 72 patients and infratentorial in 9 patients, arachnoid cyst were identified. Follow-up period ranged between 2 and 8 years. Of the 49 patients with headache 83.67% of patients had cure and 10.2% had significant improvement. Of the eight patients with hydrocephalus and gait disturbances, six (75%) had complete total relief of symptoms and two (25%) patients had significant improvement. Four of the six patients with cognitive decline and weakness showed improvement. Of the 18 patients with epilepsy seizure freedom was: Engle class I grade I in 14 (77.78%) patients; class II in 2 (11.11%) patients; and class III in 2 (11.11%) patients. Follow-up studies from 2 to 8 years showed that headache was cured in 41 of the 49 cases (83.67%), significantly improved in 5 cases (10.20%), and showed no variation in 3 cases (6.12%). Hydrocephalus and gait disturbances were controlled in six of the eight cases (75.00%) and significantly improved in two cases (25.00%). Cognitive decline and weakness were obviously improved in four of the six cases (66.67%) and exhibited no variation in two cases (33.33%). According to the Engle standard, the following results were obtained from 18 patients with epilepsy: Grade I in 14 cases (77.78%); grade II in 2 cases (11.11%); and grade III in 2 cases (11.11%). Eleven cases with local or general

  5. Post-contrast FLAIR MR imaging of the brain in children: normal and abnormal intracranial enhancement

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    Goo, Hyun Woo; Choi, Choong-Gon [Department of Radiology, Asan Medical Center, University of Ulsan College of Medicine, 388-1 Poongnap-dong, Songpa-gu, Seoul (Korea)

    2003-12-01

    To describe the normally enhancing intracranial structures on fluid-attenuated inversion recovery (FLAIR) MRI and evaluate the usefulness of postcontrast FLAIR images of the brain in the assessment of enhancing lesions by comparing postcontrast FLAIR imaging with postcontrast T1-weighted (T1-W) imaging in children. In 218 children, 249 pre- and postcontrast FLAIR MRI examinations of the brain were obtained consecutively between August 2001 and April 2002. The normally enhancing intracranial structures on FLAIR imaging were assessed in 77 MRI studies of 74 children who showed normal intracranial imaging findings. In 86 MRI studies in 68 children who showed enhancing intracranial lesions, lesion conspicuity on postcontrast FLAIR imaging was compared with that on postcontrast T1-W imaging for all lesions (n=107), intra-axial lesions (n=40), or extra-axial lesions (n=67). The normally enhancing intracranial structures on FLAIR MRI were the choroid plexus (99%, 76/77), pituitary stalk (84%, 65/77), pineal gland (71%, 55/77), dural sinuses (26%, 20/77), and cortical veins (9%, 7/77). Of all the enhancing lesions, lesion conspicuousness on postcontrast FLAIR imaging was better than postcontrast T1-weighted imaging in 42, equal in 28, and worse in 37. Of 40 intra-axial lesions, lesion conspicuousness on postcontrast FLAIR imaging was better in 6, equal in 10, and worse in 24. Of 67 extra-axial lesions, lesion conspicuity on postcontrast FLAIR imaging was better in 36, equal in 18, and worse in 13. Conspicuousness of extra-axial lesions was significantly better than that of intra-axial lesions on postcontrast FLAIR imaging (P<0.001). The choroid plexus, pituitary stalk, pineal gland, dural sinuses, and cortical veins show normal enhancement on postcontrast FLAIR MRI in children, and postcontrast FLAIR imaging appears better than postcontrast T1-W imaging in the assessment of extra-axial enhancing lesions in children. (orig.)

  6. 脱钙冻干骨混合自体骨髓治疗下颌骨囊肿摘除术后骨缺损%Treatment of intraosseous cystic lesions of the mandible by conservative enucleation and cavity filling with allogenic freeze-dried bone mixed with autologous bone marrow

    Institute of Scientific and Technical Information of China (English)

    廖隽琨; 叶剑涛; 陈伟良

    2014-01-01

    目的:探讨脱钙冻干骨混合自体骨髓治疗下颌骨囊肿摘除术后骨缺损的疗效。方法42例下颌骨囊肿摘除术后采取脱钙冻干骨混合自体骨髓填充缺损,观察手术临床效果,并行术前术后放射线检查。结果1例术后出血,2例创口延期愈合,随访13~48个月2例牙源性角化囊性瘤复发,其余术后愈合良好。结论脱钙冻干骨混合自体骨髓可用来治疗下颌骨囊肿摘除术后骨缺损。%Objective To evaluate the outcome of defect filling with allogenic freeze-dried bone mixed with bone marrow following conservative enucleation of large intraosseous cystic lesions of the mandible.Methods Forty-two patients with large intraosseous cystic lesions of the mandible were treated by defect filling with allogenic freeze-dried bone combined with bone marrow following conservative cyst enucleation.All patients were evaluated postoperatively by repeated clinical examination done by the operating surgeon.Radiograph-ic examination was performed using panoramic radiographs taken before operation,immediately after operation,6 months and 1 2 months after operation.Results Postoperative hemorrhage occurred in one patient.Wound dehiscence occurred in two patients,and the wound-healing was delayed.All patients showed satisfactory healing.The patients were followed-up for 1 3-48 months using panoramic radio-graphic examination.Recurrence was seen in 2 patients with KCOTs.Clinical and panoramic radiographic examination showed no resid-ual or recurrent cyst in the remaining patients.Conclusions We demonstrate successful clinical application of allogenic freeze-dried bone mixed with autologous bone marrow as an alternative filling material for intraosseous cystic lesions of the mandible after conserva-tive enucleation.

  7. Cystic pancreatic neuroendocrine tumors: To date a diagnostic challenge.

    Science.gov (United States)

    Caglià, Pietro; Cannizzaro, Maria Teresa; Tracia, Angelo; Amodeo, Luca; Tracia, Luciano; Buffone, Antonino; Amodeo, Corrado; Cannizzaro, Matteo Angelo

    2015-09-01

    Cystic PNETs are an uncommon neoplasms increasingly detected in current clinical practice which often present a diagnostic challenges to both the experienced radiologist and pathologist. The aim of this study was to review the available literature to summarize current data that compare and evaluate both the clinical and pathologic features of cystic pancreatic neuroendocrine tumors. A systematic review of the current literature was performed using the search engines EMBASE and PubMed to identify all studies reporting on cystic pancreatic neuroendocrine tumors. The MeSH search terms used were "cystic pancreatic neuroendocrine tumors", "endocrine neoplasms", and "pancreatic cysts". Multiple combinations of the keywords and MeSH terms were used. The clinical evaluation of cystic pancreatic lesions appears to suffer from same limitations despite the improvement in the diagnostic tools. Subsequently, we highlight diagnostic pitfalls and differential diagnosis of these cystic tumors. In this review we discuss current advances in the application of the imaging modalities and characteristics features with special emphasize on endoscopic ultrasound (EUS), and EUS guide fine needle aspiration (EUS-FNA). Cystic neuroendocrine tumor in the pancreas underlines the clinical impact of endoscopic ultrasound in the work-up of patients with unclear lesions in the pancreas. EUS-FNA cytology and cyst fluid analysis is a useful adjunct to abdominal imaging for the diagnosis of pancreatic cystic lesions. Due to the evident diagnostic difficulties, we hypothesize that cyst fluid characteristics, including cytomorphological features, is the most accurate test to achieve a preoperative diagnosis and to provide a basis for prognostic prediction. Copyright © 2015 IJS Publishing Group Limited. Published by Elsevier Ltd. All rights reserved.

  8. Intracranial artery dissection

    NARCIS (Netherlands)

    Sikkema, T.; Uyttenboogaart, Maarten; Eshghi, O.; De Keyser, J.; Brouns, R.; van Dijk, J.M.C.; Luijckx, G. J.

    2014-01-01

    The aim of this narrative review is to evaluate the pathogenesis, clinical features, diagnosis, treatment and prognosis of intracranial artery dissection (IAD). IAD is a rare and often unrecognized cause of stroke or subarachnoid haemorrhage (SAH), especially in young adults. Two types of IAD can be

  9. Intracranial artery dissection

    NARCIS (Netherlands)

    Sikkema, T.; Uyttenboogaart, Maarten; Eshghi, O.; De Keyser, J.; Brouns, R.; van Dijk, J.M.C.; Luijckx, G. J.

    The aim of this narrative review is to evaluate the pathogenesis, clinical features, diagnosis, treatment and prognosis of intracranial artery dissection (IAD). IAD is a rare and often unrecognized cause of stroke or subarachnoid haemorrhage (SAH), especially in young adults. Two types of IAD can be

  10. Computerized tomographic evaluation of intracranial metastases

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    Kim, Bo Yong; Lee, Mi Sook; Choi, Jin Ok; Jeon, Doo Sung; Kim, Hong Soo; Rhee, Hak Song [Presbyterian Medical Center, Chonju (Korea, Republic of)

    1986-12-15

    In a study of intracranial metastases, 46 cases having satisfactory clinical, operative and histological proofs were analyzed by computerized tomography at Presbyterian Medical Center from May, 1982 to February, 1986. The results were as follows: 1. The male to female ratio of intracranial metastases were 67:33. The 5th decade group (34.8%) was the most prevalent age group, followed by the 6th decade (21.7%) and 7th decade (21.7%). 2. The number of lesions was found be: single -25 cases (54.3%); multiple -21 cases (45.7%). 3. The source of intracranial metastases found to be: lung 15 cases (32.6%); unknown 12 cases (26.0%); chorioca 3 cases (6.5%); liver 3 cases (6.5%); stomach 2 cases (4.3%); parotid, breast, kidney, prostate, melanoma, rectal ca, rhabdomyosarcoma, nasal ca, lymphoma, testicular ca, cervix, each 1 case (2.2%). 4. The locations of the intracranial metastases were as follows: Cerebral hemisphere 37.7% in parietal region Cerebral hemisphere 15.9% in in frontal region Cerebral hemisphere 13.4% in occipital region Cerebral hemisphere 10.5% in temporal region Cerebellar hemisphere 3.2% Cerebellopontine angle 3.2% Intraventricular 4.8% Meninges 4.8% Skull vault 6.5% 5. Peritumor edema was found to be: Grade II-17 cases (37.0%): Grade III-14 cases (30.4%); Grade I-8 cases (17.4%); Grade 0-7 cases (15.2%) in that order. 6. The chief complaints of intracranial metastases on admission, were as follows: Headache 30 cases (65.2%); Vomiting 11 cases (23.9%); deteriorated mental state 10 cases (21.7%); Hemiplegia 7 cases (15.2%); visual disturbance 6 cases (13.0%); hemiparesis 4 cases (8.7%); seizure 4 cases (8.7%); other symptoms were less frequent. 7. On pre-contrast scan, hyperdense lesions were present in 18 cases (39.1%); hypodense lesions in 15 cases (32.6%); mixed density in 8 cases (17.4%); isodensity was present in 5 cases (10.9%). On post-contrast scan, ring enhancement was seen in 19 cases (41.3%); nodular enhancement in 17 cases (37%), mixed ring

  11. Cystic Lung Diseases: Algorithmic Approach.

    Science.gov (United States)

    Raoof, Suhail; Bondalapati, Praveen; Vydyula, Ravikanth; Ryu, Jay H; Gupta, Nishant; Raoof, Sabiha; Galvin, Jeff; Rosen, Mark J; Lynch, David; Travis, William; Mehta, Sanjeev; Lazzaro, Richard; Naidich, David

    2016-10-01

    Cysts are commonly seen on CT scans of the lungs, and diagnosis can be challenging. Clinical and radiographic features combined with a multidisciplinary approach may help differentiate among various disease entities, allowing correct diagnosis. It is important to distinguish cysts from cavities because they each have distinct etiologies and associated clinical disorders. Conditions such as emphysema, and cystic bronchiectasis may also mimic cystic disease. A simplified classification of cysts is proposed. Cysts can occur in greater profusion in the subpleural areas, when they typically represent paraseptal emphysema, bullae, or honeycombing. Cysts that are present in the lung parenchyma but away from subpleural areas may be present without any other abnormalities on high-resolution CT scans. These are further categorized into solitary or multifocal/diffuse cysts. Solitary cysts may be incidentally discovered and may be an age related phenomenon or may be a remnant of prior trauma or infection. Multifocal/diffuse cysts can occur with lymphoid interstitial pneumonia, Birt-Hogg-Dubé syndrome, tracheobronchial papillomatosis, or primary and metastatic cancers. Multifocal/diffuse cysts may be associated with nodules (lymphoid interstitial pneumonia, light-chain deposition disease, amyloidosis, and Langerhans cell histiocytosis) or with ground-glass opacities (Pneumocystis jirovecii pneumonia and desquamative interstitial pneumonia). Using the results of the high-resolution CT scans as a starting point, and incorporating the patient's clinical history, physical examination, and laboratory findings, is likely to narrow the differential diagnosis of cystic lesions considerably. Copyright © 2016 American College of Chest Physicians. Published by Elsevier Inc. All rights reserved.

  12. Muscular cystic hydatidosis: case report

    Directory of Open Access Journals (Sweden)

    Naspetti Riccardo

    2007-03-01

    Full Text Available Abstract Background Hydatidosis is a zoonosis caused by Echinococcus granulosus, and ingesting eggs released through the faeces from infected dogs infects humans. The location of the hydatid cysts is mostly hepatic and/or pulmonary, whereas musculoskeletal hydatidosis is very rare. Case presentation We report an unusual case of primary muscular hydatidosis in proximity of the big adductor in a young Sicilian man. The patient, 34 years old, was admitted to the Department of Infectious and Tropical Diseases for ultrasonographic detection, with successive confirmation by magnetic resonance imaging, of an ovular mass (13 × 8 cm in the big adductor of the left thigh, cyst-like, and containing several small cystic formations. Serological tests for hydatidosis gave negative results. A second drawing of blood was done 10 days after the first one and showed an increase in the antibody titer for hydatidosis. The patient was submitted to surgical excision of the lesion with perioperatory prophylaxis with albendazole. The histopathological examination of the bioptic material was not diriment in the diagnosis, therefore further tests were performed: additional serological tests for hydatidosis for the evaluation of IgE and IgG serotype (Western Blot and REAST, and molecular analysis of the excised material. These more specific serological tests gave positive results for hydatidosis, and the sequencing of the polymerase chain reaction products from the cyst evidenced E. granulosus DNA, genotype G1. Any post-surgery complications was observed during 6 following months. Conclusion Cystic hydatidosis should always be considered in the differential diagnosis of any cystic mass, regardless of its location, also in epidemiological contests less suggestive of the disease. The diagnosis should be achieved by taking into consideration the clinical aspects, the epidemiology of the disease, the imaging and immunological tests but, as demonstrated in this case, without

  13. Rapid increase in cystic volume of an anaplastic astrocytoma misdiagnosed as neurocysticercosis: A case report

    Science.gov (United States)

    Li, Hong-Jiang; Han, Hong-Xiu; Feng, Dong-Fu

    2016-01-01

    Reports describing a rapid increase in the cystic volume of anaplastic astrocytoma (AA) in a short time frame are rare. The present study reports the case of a 68-year-old male who was admitted to the No. 9 People's Hospital, Shanghai Jiaotong University School of Medicine (Shanghai, China), with a small cystic brain lesion and positive immunological testing for cysticercosis. Head magnetic resonance imaging (MRI) showed a cystic lesion, 6 mm in diameter, in the left frontal lobe. Neurocysticercosis was suspected and the patient was treated with a clinical trial of albendazole and steroids. A period of 25 days later, the patient's condition had deteriorated, and MRI revealed a cystic lesion in the left frontal lobe; thereafter, the cystic lesion was removed and a diagnosis of AA was established. The tumor was soft, ivory white and gelatinous due to myxoid degeneration. In this case, tumor-related angiogenesis and microvascular extravasation (blood-brain barrier disruption) may have been the main cause of the rapid increase in the cystic volume in such a short time frame. The similarity of the glioma and cysticercus antigens may have been the cause of the positive reactions in the cystic fluid. The present study reports the rare occurrence of a rapid increase of cystic volume and potential diagnostic difficulties. PMID:27698865

  14. Modifying Factors of Cystic Fibrosis Disease: Residual Chloride Secrefion, Genefic Background and Epigenetics

    NARCIS (Netherlands)

    I. Bronsveld (Inez)

    2000-01-01

    textabstractCystic fibrosis (CF) is an autosomal recessive disease caused by genetic lesions in the cystic fibrosis transmembrane conductance regulator (CFTR) gene. This CFTR gene was cloned in 1989,1-3 and located to the long arm of chromosome 7 (7q3L2). lt encodes the CFTR protein that functions a

  15. Mixed solid and cystic acoustic neuroma: MR features and differential diagnosis

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    Denys, A. [Service de Neuroradiologie-CIERM Hopital de Bicetre, Univ. de Paris Sud, 78, 94 Kremlin-Bicetre (France); Duvoisin, B. [Service de Neuroradiologie-CIERM Hopital de Bicetre, Univ. de Paris Sud, 78, 94 Kremlin-Bicetre (France)]|[Dept. of Radiodiagnosis, University Hospital, Lausanne (Switzerland); Fernandes, J.G. [Service de Neuroradiologie-CIERM Hopital de Bicetre, Univ. de Paris Sud, 78, 94 Kremlin-Bicetre (France); Doyon, D. [Service de Neuroradiologie-CIERM Hopital de Bicetre, Univ. de Paris Sud, 78, 94 Kremlin-Bicetre (France)

    1991-11-01

    We present a very rare case of combined cystic and solid acoustic neuroma investigated by magnetic resonance imaging (MRI). This case illustrates the value of MRI in the characterization of tumours in the posterior cranial fossa, particularly acoustic neuromas, and its diagnostic impact in unusual situations. The differential diagnosis of cystic and mixed lesions in the cerebellopontine angle is discussed. (orig.)

  16. Cystic Abnormalities of the Spinal Cord and Vertebral Column.

    Science.gov (United States)

    da Costa, Ronaldo C; Cook, Laurie B

    2016-03-01

    Cystic lesions of the vertebral column and spinal cord are important differential diagnoses in dogs with signs of spinal cord disease. Synovial cysts are commonly associated with degenerative joint disease and usually affect the cervical and lumbosacral regions. Arachnoid diverticulum (previously known as cyst) is seen in the cervical region of large breed dogs and thoracolumbar region of small breed dogs. This article reviews the causes, diagnosis, and treatment of these and other, less common, cystic lesions. Copyright © 2016 Elsevier Inc. All rights reserved.

  17. Hamartoma cístico retrorretal Retrorectal cystic hamartoma

    Directory of Open Access Journals (Sweden)

    Cleverson Winston de Liz Medeiros

    2002-08-01

    Full Text Available A 32-year-old woman was referred to our institution for a pelvic mass. She was asymptomatic and was found to have a mass on rectal examination. Magnetic resonance showed a large solid-cystic mass and the patient underwent complete surgical excision with pathologic findings suggesting retrorectal cyst-hamartoma. Tailgut cysts (or retrorectal cystic hamartomas are rare congenital lesions settled in the retrorectal (presacral space. They are made up of cysts lined by multiple types of epithelium, often predominantly mucin-secreting. The lesion requires complete surgical excision to prevent complications of recurrence, infection or carcinomatous degeneration.

  18. Cystic lymphangioma of the pancreas

    Institute of Scientific and Technical Information of China (English)

    Radoje B Colovic; Nikica M Grubor; Marjan T Micev; Henry Dushan E Atkinson; Vitomir I Rankovic; Mihajlo M Jagodic

    2008-01-01

    Lymphangioma of the pancreas is an extremely rare benign turnout of lymphatic origin, with fewer than 60 published cases. Histologically, it is polycystic, with the cysts separated by thin septa and lined with endothelial cells. Though congenital, it can affect all age groups, and occurs more frequently in females. Patients usually present with epigastric pain and an associated palpable mass. Complete excision is curative, even though, depending on the tumour location, surgery may be simple or involve extensive pancreatic resection and anastomoses. The authors present a 49-year-old woman in whom a polycystic septated mass, 35 mm × 35 mm in size, was discovered by ultrasonography (US) in the body of the pancreas during investigations for epigastric pain and nausea. At surgery, a well circumscribed polycystic tumor was completely excised, with preservation of the pancreatic duct. The postoperative recovery was uneventful. Histology confirmed a microcystic lymphangioma of the pancreas. Immunohistochemistry showed cystic endothelial cells reactivity to factor Ⅷ -RA (++), CD31 (+++) and CD34 (-). Postoperatively, abdominal pain disappeared and the patient remained symptomfree for 12 mo until now. Although extremely rare, lymphangioma of the pancreas should be taken into consideration as a differential diagnosis of a pancreatic cystic lesion, especially in women.

  19. Surgical Management of Intracranial Neuroenteric Cysts: The UCSF Experience.

    Science.gov (United States)

    Breshears, Jonathan D; Rutkowski, Martin J; McDermott, Michael W; Cha, Soonmee; Tihan, Tarik; Theodosopoulos, Philip V

    2015-12-01

    Objective Modern surgical experience with intracranial neuroenteric cysts is limited in the literature. We review our 15-year institutional experience with these rare lesions. Design Single-institution retrospective study. Setting Large North American tertiary care center. Participants Histologically confirmed cases of intracranial neuroenteric cyst from January 2000 to September 2014. Main Outcome Measures Pre- and postoperative modified Rankin Scale (mRS) scores, extent of resection, and postoperative complications are reported. Clinical presentation, imaging features, pathology, and operative approach are discussed. Results Five spinal and six intracranial neuroenteric cysts were surgically treated over a 15-year period. Median age at presentation for the intracranial cysts was 38.5 years. Mean cyst diameter was 3.8 cm. Five cysts were located in the pre-pontomedullary cistern, and one was located in the third ventricle. Gross total resection was achieved in four of the five posterior fossa cysts through a far lateral transcondylar approach. Postoperative complications included aseptic meningitis (one), transient abducens palsy (one), and pseudomeningocele requiring reoperation (three). Postoperative mRS scores improved to ≤1 by 6.5 months median follow-up. Conclusions Intracranial neuroenteric cysts are rare lesions with a variable imaging appearance. Complete surgical resection through a far lateral transcondylar approach is possible and usually results in symptom improvement or resolution.

  20. Cystic neoplasms of the pancreas: A diagnostic challenge

    Institute of Scientific and Technical Information of China (English)

    Grant F Hutchins; Peter V Draganov

    2009-01-01

    Cystic neoplasms of the pancreas are increasingly recognized due to the expanding use and improved sensitivity of cross-sectional abdominal imaging. Major advances in the last decade have led to an improved understanding of the various types of cystic lesions and their biologic behavior. Despite significant improvements in imaging technology and the advent of endoscopic-ultrasound (EUS)-guided fineneedle aspiration, the diagnosis and management of pancreatic cystic lesions remains a significant clinical challenge. The first diagnostic step is to differentiate between pancreatic pseudocyst and cystic neoplasm.If a pseudocyst has been effectively excluded, the cornerstone issue is then to determine the malignant potential of the pancreatic cystic neoplasm. In the majority of cases, the correct diagnosis and successful management is based not on a single test but on incorporating data from various sources including patient history, radiologic studies, endoscopic evaluation, and cyst fluid analysis. This review will focus on describing the various types of cystic neoplasms of the pancreas, their malignant potential, and will provide the clinician with a comprehensive diagnostic approach.

  1. Intracranial germ cell tumor mimicking anorexia nervosa.

    Science.gov (United States)

    Andreu Martínez, F J; Martínez Mateu, J M

    2006-12-01

    We report on a case of a 23 year-old female diagnosed as having a germ-cell tumour located in the sellar region. The patient referred anorexia, psychic disorders, weight loss of 15 kilograms and secondary amenorrhea during the previous three years. This is the reason why the patient was diagnosed as having anorexia nervosa. Subsequently, the patient presented some endocrine dysfunction. MRI revealed the existence of a lesion located in suprasellar and hypothalamic regions. This case shows that the presence of intracranial tumours next to the hypothalamus must be borne in mind as a rare but real possibility in cases of anorexia nervosa, specially in those non-typical cases.

  2. Intracranial blister aneurysms: clip reconstruction techniques.

    Science.gov (United States)

    Barrow, Daniel L; Pradilla, Gustavo; McCracken, D Jay

    2015-07-01

    Intracranial blister aneurysms are difficult to treat cerebrovascular lesions that typically affect the anterior circulation. These rare aneurysms can lead to acute rupture which usually cannot be treated via endovascular methods, but still require urgent surgical intervention. Surgical options are limited given their unique pathology and often require a combination of wrapping and clip reconstruction. In this video we present two patients with acute subarachnoid hemorrhage secondary to ruptured blister aneurysms. We demonstrate several surgical techniques for repairing the vascular defect with and without intraoperative rupture. The video can be found here: http://youtu.be/nz-JM45uKQU.

  3. Aplicabilidade da técnica de cell block na avaliação citológica do conteúdo de lesões de aspecto cístico dos maxilares Applicability of cell block technique for cytological evaluation of biological material collected from maxillary cystic lesions

    Directory of Open Access Journals (Sweden)

    Grasieli de Oliveira Ramos

    2012-04-01

    Full Text Available INTRODUÇÃO: A busca por novos métodos que auxiliem e simplifiquem de maneira eficaz o diagnóstico de lesões maxilares, cistos e tumores, objetiva beneficiar os pacientes e facilitar a atuação dos profissionais da área de diagnóstico bucal. Além dos dados clínicos, radiográficos e histopatológicos classicamente utilizados nos protocolos de investigação das lesões maxilares, a adaptação de técnicas já consagradas na medicina pode ser de grande valia. A técnica de cell block se propõe a auxiliar nesse processo, pois consiste na análise citológica de materiais, efusões e líquidos, coletados de lesões passíveis de punção aspirativa, como cistos e tumores císticos dos maxilares. OBJETIVO: Demonstrar a aplicabilidade da técnica de cell block para avaliação citológica de material biológico coletado a partir de lesões císticas dos maxilares. RESULTADOS: Das 20 lesões, das quais o conteúdo foi processado pela técnica, a avaliação citológica de cinco casos de tumores odontogênicos ceratocísticos (TOCs demonstrou a presença predominante de ceratina, sempre com áreas de paraceratina. Nos demais casos (cinco cistos dentígeros, cinco cistos radiculares e cinco cistos residuais foi observada a presença de hemácias, células inflamatórias e fendas de cristais de colesterol. CONCLUSÃO: A avaliação citológica, a partir da técnica de cell block, foi útil no estabelecimento do diagnóstico diferencial entre TOC e demais lesões estudadas, cistos radicular, residual e dentígero.INTRODUCTION: The search for new methods that aid and optimize the diagnosis of cystic and tumoral maxillary lesions aims to benefit both patients and professionals from oral diagnosis. In addition to clinical, radiographic and histological findings traditionally used in research protocol for maxillary lesions, the adaptation of widely used medical techniques may be very helpful. The cell block procedure streamlines this process

  4. [Cystic tumors of the pancreas: diagnosis, management and results].

    Science.gov (United States)

    Alfieri, Sergio; Pericoli Ridolfini, Marco; Bassi, Claudio; Gourgiotis, Stavros; Caprino, Paola; Pederzoli, Paolo; Sofo, Luigi; Doglietto, Giovanni Battista

    2008-01-01

    Pancreatic cystic tumours are rare and less frequent than other pancreatic tumours. In recent decades, these tumours are being diagnosed with increasing frequency due to the extensive availability of, and improvement in, modern imaging techniques and it is often possible not only to differentiate them preoperatively from other cystic pancreatic disorders but also from one another. Pancreatic cystic tumours comprise a variety of neoplasms with a wide range of malignant potential: serous cystic tumours are benign, whereas mucinous cystic tumours, and intraductal papillary mucinous tumours are considered premalignant, while solid pseudopapillary tumours have a non-aggressive behaviour in the vast majority of cases. Most patients have no symptoms; and when clinical signs are present, they never help us to identify the type of pathology. Serous cystic neoplasms usually do not mandate resection unless the lesion is symptomatic. Mucinous cystic neoplasms and intraductal papillary mucinous neoplasms have a premalignant or malignant tendency, and therefore need to be managed aggressively by pancreatic resection. Their prognosis is excellent in the absence of invasive disease, but the presence of invasive malignancy is associated with a poor prognosis. This review addresses the symptoms, diagnosis, management and prognosis of this group of tumours.

  5. Cystic fibrosis - nutrition

    Science.gov (United States)

    ... in recipes. Add marshmallows to fruit or hot chocolate. Add raisins, dates, or chopped nuts and brown ... AP, Quinton H. Evidence-based practice recommendations for nutrition-related management of children and adults with cystic ...

  6. Nasopharyngeal adenoid cystic carcinoma: magnetic resonance imaging features in ten cases

    Institute of Scientific and Technical Information of China (English)

    Xue-Wen Liu; Pei-Hong Wu; Chuan-Miao Xie; Hui Li; Rong Zhang; Zhi-Jun Geng; Yun-Xian Mo; Jing Zhao; Mu-Yan Cai; Yan-Chun Lv

    2012-01-01

    Nasopharyngeal adenoid cystic carcinoma (NACC) is a rare malignancy with high local invasiveness.To date,there is no consensus on the imaging characteristics of NACC.To address this,we retrospectively reviewed 10 cases of NACC and summarized the magnetic resonance imaging (MRI) features.MR images of 10 patients with histologically validated NACC were reviewed by two experienced radiologists.The location,shape,margin,signal intensity,lesion texture,contrast enhancement patterns,local invasion,and cervical lymphadenopathy of all tumors were evaluated.Clinical and pathologic records were also reviewed.No patients were positive for antibodies against Epstein-Barr virus (EBV).The imaging patterns of primary tumors were classified into two types as determined by location,shape,and margin.Of all patients,7 had tumors with a type 1 imaging pattern and 3 had tumors with a type 2 imaging pattern.The 4 tubular NACCs were all homogeneous tumors,whereas 3 (60%) of 5 cribriform NACCs and the sole solid NACC were heterogeneous tumors with separations or central necrosis on MR images.Five patients had perineural infiltration and intracranial involvement,and only 2 had cervical lymphadenopathy.Based on these results,we conclude that NACC is a local,aggressive neoplasm that is often negative for EBV infection and associated with a low incidence of cervical lymphadenopathy.Furthermore,MRI features of NACC vary in locations and histological subtypes.

  7. Cystic Pulmonary Metastasis in a Patient with Scalp Angiosarcoma: A Case Report

    Energy Technology Data Exchange (ETDEWEB)

    Kim, Ah Yeong; Lee, Kyung Soo; Han, Jong Ho; Kim, Ho Joong; Kim, Kwhan Mien; Baek, Chung Hwan [Samsugn Medical Center, Sungkyunkwan University School of Medicine, Seoul (Korea, Republic of)

    2011-08-15

    It has been well known that angiosarcoma (AS), particularly scalp AS, metastasizes to the lungs with multiple air-filled cystic lesions on chest computed tomography scans. Pneumothorax, due to cystic lesion rupture into the pleural space, is frequent;however, we do not exactly know how rapidly the metastatic lesions spread to the lungs or what the exact pathogenetic mechanism for cystic metastasis is. According to our experience, the speed of disease progression in pulmonary metastasis is relatively fast and the entire lungs may be involved within two or three months. The infiltrating spindle cell tumors in the alveolar walls are tethering the adjacent alveolar spaces in order to form a dilated air-filled cystic lesion.

  8. A pulmonary mucinous cystic tumour of borderline malignancy.

    Science.gov (United States)

    Bacha, D; Ayadi-Kaddour, A; Smati, B; Kilani, T; El Mezni, F

    2008-06-01

    We report a well-documented case of pulmonary mucinous cystic tumour of borderline malignancy involving the left lower lobe. The lesion was found incidentally by chest radiograph and CT scan with a provisional diagnosis of bronchioloalveolar carcinoma. The tumour was 4 cm in its greatest dimension, cystic and filled with gelatinous mucus. Microscopically, the neoplastic mucinous epithelium was composed of cuboidal cells with focally nuclear stratification and mild to moderate nuclear atypia. The patient has remained free from recurrence or metastases for 6 years. Pulmonary mucinous cystic tumour of borderline malignancy is a rare, recently described neoplasm, which spans a spectrum of tumours with malignant potential. The recent World Health Organization classification of lung tumours does not recognize this entity, which has a very good prognosis, and as such should be distinguished from classic pulmonary adenocarcinoma. Histological diagnosis can be difficult to distinguish from cystic bronchioloalveolar carcinoma or metastatic mucinous adenocarcinoma.

  9. Florid Cystic Endosalpingiosis (Müllerianosis) in Pregnancy

    Science.gov (United States)

    Montero-Balaguer, Beatriz; Desantes-Real, Domingo; Perales-Marín, Alfredo

    2016-01-01

    Cystic endosalpingiosis refers to the existence of heterotopic cystic müllerian tissue resembling structures of the fallopian tubes. We report a case of florid cystic endosalpingiosis discovered in a pregnant woman during a scheduled cesarean section and review the current knowledge of this disease. A 30-year-old woman with a twin pregnancy attended the hospital day unit at term. The first twin was in a breech presentation and a cesarean section was scheduled. During the procedure the uterine fundus and part of the body were seen completely seeded with multitude of cyst-like structures resembling hydatids of Morgagni. The immunohistochemistry analysis showed a positive expression for PAX8 (Box-8), CK7, and estrogen and progesterone receptors. The lesions did not disappear after pregnancy. Cystic endosalpingiosis should be always borne in mind, even in pregnancy, when it comes to making the differential diagnosis of a pelvic or systemic multicystic mass. PMID:27668111

  10. Giant cystic sacral schwannoma mimicking tarlov cyst: a case report.

    Science.gov (United States)

    Attiah, Mark A; Syre, Peter P; Pierce, John; Belyaeva, Elizaveta; Welch, William C

    2016-05-01

    To present a rare case of a giant schwannoma of the sacrum mimicking a Tarlov cyst. A 58-year-old woman had a 1-year history of low back pain. MRI revealed a large cystic mass in the sacral canal with bony erosion. Radiological diagnosis of Tarlov cyst was made. The patient underwent surgical treatment for the lesion, which revealed a solid mass. Histopathological examination of the tumor confirmed the diagnosis of schwannoma. The postoperative course was uneventful and the patient has had significant improvement in her pain 1 month postoperatively. Giant cystic schwannoma of the sacrum is a very rare diagnosis overlooked by practitioners for more common cystic etiologies, but its treatment is significantly different. Care should be taken to include this diagnosis in a differential for a cystic sacral mass.

  11. Current perspectives on pancreatic serous cystic neoplasms: Diagnosis, management and beyond

    Institute of Scientific and Technical Information of China (English)

    Xiao-Peng Zhang; Zhong-Xun Yu; Yu-Pei Zhao; Meng-Hua Dai

    2016-01-01

    Pancreatic cystic neoplasms have been increasingly recognized recently. Comprising about 16% of all resected pancreatic cystic neoplasms, serous cystic neoplasms are uncommon benign lesions that are usually asymptomatic and found incidentally. Despite overall low risk of malignancy, these pancreatic cysts still generate anxiety, leading to intensive medical investigations with considerable financial cost to health care systems. This review discusses the general background of serous cystic neoplasms, including epidemiology and clinical characteristics, and provides an updated overview of diagnostic approaches based on clinical features, relevant imaging studies and new findings that are being discovered pertaining to diagnostic evaluation. We also concisely discuss and propose management strategies for better quality of life.

  12. Intracranial saccular aneurysm in a child with only persistent headache.

    Science.gov (United States)

    Güngör, Olcay; Özkaya, Ahmet Kağan; Dilber, Cengiz; Çinar, Celal

    2015-06-01

    Headache is one of the common symptoms of intracranial aneursym. A 5-year-old child lately presented to our pediatric emergency department with persistent headache. Brain magnetic resonance imaging revealed a 7×8 mm rounded lesion with slowly heterogeneous low signal in T2 sequence consistent with a partial occluded aneurysm, in the right medial frontal lobe that close to anterior cerebral artery. Intracranial aneurysms are rare in children and they are noncommon without complications as our case. © The Author(s) 2014.

  13. Intracranial neurenteric cyst: A rare cause of chemical meningitis

    Directory of Open Access Journals (Sweden)

    Naseer A Choh

    2013-01-01

    Full Text Available Intracranial neurenteric cysts are exceedingly rare congenital intracranial lesions that result from disorder of gastrulation. Still, more rarely, the cyst contents may leak into the CSF and give rise to recurrent episodes of chemical meningitis. We present a case of chemical meningitis due to a leaking posterior fossa neurenteric cyst in a young female, with emphasis on its imaging features. The final diagnosis was achieved by sufficiently characteristic imaging features; histopathologic documentation could not be achieved as the patient denied surgery.

  14. Intracranial Atherosclerotic Disease

    Directory of Open Access Journals (Sweden)

    Maria Khan

    2011-01-01

    Full Text Available Intracranial atherosclerotic disease (ICAD is the most common proximate mechanism of ischemic stroke worldwide. Approximately half of those affected are Asians. For diagnosis of ICAD, intra-arterial angiography is the gold standard to identify extent of stenosis. However, noninvasive techniques including transcranial ultrasound and MRA are now emerging as reliable modalities to exclude moderate to severe (50%–99% stenosis. Little is known about measures for primary prevention of the disease. In terms of secondary prevention of stroke due to intracranial atherosclerotic stenosis, aspirin continues to be the preferred antiplatelet agent although clopidogrel along with aspirin has shown promise in the acute phase. Among Asians, cilostazol has shown a favorable effect on symptomatic stenosis and is of benefit in terms of fewer bleeds. Moreover, aggressive risk factor management alone and in combination with dual antiplatelets been shown to be most effective in this group of patients. Interventional trials on intracranial atherosclerotic stenosis have so far only been carried out among Caucasians and have not yielded consistent results. Since the Asian population is known to be preferentially effected, focused trials need to be performed to establish treatment modalities that are most effective in this population.

  15. Epidemiology and genetics of intracranial aneurysms.

    Science.gov (United States)

    Caranci, F; Briganti, F; Cirillo, L; Leonardi, M; Muto, M

    2013-10-01

    Intracranial aneurysms are acquired lesions (5-10% of the population), a fraction of which rupture leading to subarachnoid hemorrhage with devastating consequences. Until now, the exact etiology of intracranial aneurysms formation remains unclear. The low incidence of subarachnoid hemorrhage in comparison with the prevalence of unruptured IAs suggests that the vast majority of intracranial aneurysms do not rupture and that identifying those at highest risk is important in defining the optimal management. The most important factors predicting rupture are aneurysm size and site. In addition to ambiental factors (smoking, excessive alcohol consumption and hypertension), epidemiological studies have demonstrated a familiar influence contributing to the pathogenesis of intracranial aneurysms, with increased frequency in first- and second-degree relatives of people with subarachnoid hemorrhage. In comparison to sporadic aneurysms, familial aneurysms tend to be larger, more often located at the middle cerebral artery, and more likely to be multiple. Other than familiar occurrence, there are several heritable conditions associated with intracranial aneurysm formation, including autosomal dominant polycystic kidney disease, neurofibromatosis type I, Marfan syndrome, multiple endocrine neoplasia type I, pseudoxanthoma elasticum, hereditary hemorrhagic telangiectasia, and Ehlers-Danlos syndrome type II and IV. The familial occurrence and the association with heritable conditions indicate that genetic factors may play a role in the development of intracranial aneurysms. Genome-wide linkage studies in families and sib pairs with intracranial aneurysms have identified several loci on chromosomes showing suggestive evidence of linkage, particularly on chromosomes 1p34.3-p36.13, 7q11, 19q13.3, and Xp22. For the loci on 1p34.3-p36.13 and 7q11, a moderate positive association with positional candidate genes has been demonstrated (perlecan gene, elastin gene, collagen type 1 A2 gene

  16. Epidemiology and genetics of intracranial aneurysms

    Energy Technology Data Exchange (ETDEWEB)

    Caranci, F., E-mail: ferdinandocaranci@libero.it [Unit of Neuroradiology, Department of Diagnostic Radiology and Radiotherapy, Federico II University, Naples (Italy); Briganti, F., E-mail: frabriga@unina.it [Unit of Neuroradiology, Department of Diagnostic Radiology and Radiotherapy, Federico II University, Naples (Italy); Cirillo, L.; Leonardi, M. [Neuroradiology service, Bellaria Hospital, Bologna (Italy); Muto, M., E-mail: mutomar@tiscali.it [Neuroradiology Service Cardarelli Hospital Naples (Italy)

    2013-10-01

    Intracranial aneurysms are acquired lesions (5–10% of the population), a fraction of which rupture leading to subarachnoid hemorrhage with devastating consequences. Until now, the exact etiology of intracranial aneurysms formation remains unclear. The low incidence of subarachnoid hemorrhage in comparison with the prevalence of unruptured IAs suggests that the vast majority of intracranial aneurysms do not rupture and that identifying those at highest risk is important in defining the optimal management. The most important factors predicting rupture are aneurysm size and site. In addition to ambiental factors (smoking, excessive alcohol consumption and hypertension), epidemiological studies have demonstrated a familiar influence contributing to the pathogenesis of intracranial aneurysms, with increased frequency in first- and second-degree relatives of people with subarachnoid hemorrhage. In comparison to sporadic aneurysms, familial aneurysms tend to be larger, more often located at the middle cerebral artery, and more likely to be multiple. Other than familiar occurrence, there are several heritable conditions associated with intracranial aneurysm formation, including autosomal dominant polycystic kidney disease, neurofibromatosis type I, Marfan syndrome, multiple endocrine neoplasia type I, pseudoxanthoma elasticum, hereditary hemorrhagic telangiectasia, and Ehlers-Danlos syndrome type II and IV. The familial occurrence and the association with heritable conditions indicate that genetic factors may play a role in the development of intracranial aneurysms. Genome-wide linkage studies in families and sib pairs with intracranial aneurysms have identified several loci on chromosomes showing suggestive evidence of linkage, particularly on chromosomes 1p34.3–p36.13, 7q11, 19q13.3, and Xp22. For the loci on 1p34.3–p36.13 and 7q11, a moderate positive association with positional candidate genes has been demonstrated (perlecan gene, elastin gene, collagen type 1 A2

  17. Mouse models of intracranial aneurysm.

    Science.gov (United States)

    Wang, Yutang; Emeto, Theophilus I; Lee, James; Marshman, Laurence; Moran, Corey; Seto, Sai-wang; Golledge, Jonathan

    2015-05-01

    Subarachnoid hemorrhage secondary to rupture of an intracranial aneurysm is a highly lethal medical condition. Current management strategies for unruptured intracranial aneurysms involve radiological surveillance and neurosurgical or endovascular interventions. There is no pharmacological treatment available to decrease the risk of aneurysm rupture and subsequent subarachnoid hemorrhage. There is growing interest in the pathogenesis of intracranial aneurysm focused on the development of drug therapies to decrease the incidence of aneurysm rupture. The study of rodent models of intracranial aneurysms has the potential to improve our understanding of intracranial aneurysm development and progression. This review summarizes current mouse models of intact and ruptured intracranial aneurysms and discusses the relevance of these models to human intracranial aneurysms. The article also reviews the importance of these models in investigating the molecular mechanisms involved in the disease. Finally, potential pharmaceutical targets for intracranial aneurysm suggested by previous studies are discussed. Examples of potential drug targets include matrix metalloproteinases, stromal cell-derived factor-1, tumor necrosis factor-α, the renin-angiotensin system and the β-estrogen receptor. An agreed clear, precise and reproducible definition of what constitutes an aneurysm in the models would assist in their use to better understand the pathology of intracranial aneurysm and applying findings to patients.

  18. Myxoid liposarcoma presenting like a cystic neck swelling

    Directory of Open Access Journals (Sweden)

    Harmeet Sahni

    2015-05-01

    Full Text Available Soft tissue sarcomas are rare and unusual neoplasm's, accounting for approximately 1% of adult human cancers and 15% of pediatric malignancies. Most liposarcomas occur in deep soft tissues of the extremities and retroperitoneum; only a very small percentage (as low as 2% occurs in the head and neck. Here we present a case of a 48yr old male with a painless mass in the neck clinically presenting as a cystic swelling. The CT neck was suggestive of cystic lesion in the neck representing benign cystic lesion. The swelling was excised and sent for histopathology which was suggestive of myxoid liposarcoma. The patient was planned for wide excision of the edges and scar and adjuvant chemo and radio therapy. [Int J Res Med Sci 2015; 3(5.000: 1281-1284

  19. Large mucinous cystic neoplasm of the pancreas associated with pregnancy

    Institute of Scientific and Technical Information of China (English)

    2008-01-01

    Mucinous cystic neoplasms (MCNs) of the pancreas occur mostly in females and are potentially sex hormone-sensitive. However, a MCN occurring during pregnancy is quite rare. A 30-year-old woman in the tenth week of pregnancy was referred to us because of a rapid increase in lett hypochondrial distending pain. On ultrasound, the patient had a large intra-abdominal cystic lesion. She was thereafter diagnosed with missed abortion and a computed tomography scan showed that the lesion was a cystic tumor 18 cm in diameter originating from the pancreatic tail. The patient subsequently underwent tumor resection with distal pancreatectomy, sparing the spleen. Histopathological analysis of the specimen revealed a pancreatic MCN with moderate dysplasia. Immunohistochemically, the tumor was positive for both estrogen and progesterone receptors. To our knowledge, this is the first reported case of pancreatic MCN with moderate zysplasia in association with pregnancy. Our case strongly indicates that pancreatic MCN is female-hormone dependent.

  20. Management of large radicular cyst associated with amalgam particles in cystic lining.

    Science.gov (United States)

    Borkar, Swati A; Dhupar, Vikas; Gadkar, Abhilasha M; Nivedita, C K V S

    2016-01-01

    The failure of amalgam retrofilling and presence of an associated cystic lesion makes surgical endodontic intervention inevitable. Amalgam retrofilling can also give rise to mucoperiosteal tattoo formation and allow incorporation of amalgam particles in the cystic lining. Such a finding has not yet been reported in the endodontic literature. This case report describes the successful endodontic management of a large radicular cyst associated with failed amalgam retrofilling, mucoperiosteal tattoo and amalgam particles dispersed in the epithelial cystic lining. All four mandibular incisors associated with the lesion presented with Weine Type II canal anatomy. The follow-up revealed clinical and radiographic signs of healing.

  1. Management of large radicular cyst associated with amalgam particles in cystic lining

    Science.gov (United States)

    Borkar, Swati A.; Dhupar, Vikas; Gadkar, Abhilasha M.; Nivedita, C.K.V.S.

    2016-01-01

    The failure of amalgam retrofilling and presence of an associated cystic lesion makes surgical endodontic intervention inevitable. Amalgam retrofilling can also give rise to mucoperiosteal tattoo formation and allow incorporation of amalgam particles in the cystic lining. Such a finding has not yet been reported in the endodontic literature. This case report describes the successful endodontic management of a large radicular cyst associated with failed amalgam retrofilling, mucoperiosteal tattoo and amalgam particles dispersed in the epithelial cystic lining. All four mandibular incisors associated with the lesion presented with Weine Type II canal anatomy. The follow-up revealed clinical and radiographic signs of healing. PMID:27217645

  2. Endoscopic transnasal resection of ameloblastoma with intracranial extension.

    Science.gov (United States)

    Woodroffe, Royce W; Abel, Taylor J; Fletcher, Aaron; Grossbach, Andrew; Van Daele, Douglas J; O'Brien, Erin; Greenlee, Jeremy D W

    2014-05-01

    Ameloblastoma is a rare odontogenic tumor with characteristics of epithelial tissue that produces enamel for the developing tooth. This lesion is generally considered benign, but has malignant forms that invade locally and metastasize. We present a 60-year-old man with maxillary ameloblastoma that after multiple recurrences developed intracranial extension with dural involvement of the middle cranial fossa and was treated by endoscopic transnasal resection followed by radiation therapy. Our technique and intraoperative findings are described with a review of the literature on intracranial ameloblastoma. This patient represents a unique account of endoscopic transnasal resection being utilized in the treatment of intracranial extension of ameloblastoma and demonstrates potential for application in similar cases. Copyright © 2013 Elsevier Ltd. All rights reserved.

  3. Spontaneous regression of a cystic hypoglossal schwannoma causing unilateral tongue atrophy.

    Science.gov (United States)

    Durnford, Andrew J; Harrisson, Stuart E; Ditchfield, Adam; Shenouda, Emad

    2014-01-01

    A 60-year-old lady presented with intermittent headaches. Examination revealed striking marked unilateral tongue atrophy. Magnetic resonance imaging (MRI) revealed a cystic lesion in the hypoglossal canal and a provisional diagnosis of cystic hypoglossal schwannoma made. Annual surveillance scans showed stable appearances but surprisingly at 3 years they showed a significant reduction in the size of the lesion. Most patients with hypoglossal schwannomas present with ipsilateral hypoglossal nerve palsy; careful cranial nerve examination is vital in diagnosing such rare lesions. Little is known of their natural history, with most lesions undergoing surgery. This case highlights spontaneous regression following non-operative management.

  4. Giant solid-cystic hypothalamic hamartoma. Case report.

    Science.gov (United States)

    Dorfer, Christian; Kasprian, Gregor; Mühlebner, Angelika; Czech, Thomas

    2011-02-01

    Hypothalamic hamartomas are rare lesions for which different classification schemes have been proposed. The authors report on an exceptionally large solid-cystic hamartoma that led to hydrocephalus, precocious puberty, and intractable gelastic seizures. They discuss potential mechanisms of the development of hypothalamic hamartomas.

  5. Intracranial Hypertension in Children without Papilledema

    OpenAIRE

    Chelse, Ana B.; Epstein, Leon G.

    2015-01-01

    Researchers at Nationwide Children's Memorial Hospital studied the frequency of intracranial hypertension without papilledema in children followed in a multispecialty pediatric intracranial hypertension clinic.

  6. Multiple cystic lung disease

    Directory of Open Access Journals (Sweden)

    Flavia Angélica Ferreira Francisco

    2015-12-01

    Full Text Available Multiple cystic lung disease represents a diverse group of uncommon disorders that can present a diagnostic challenge due to the increasing number of diseases associated with this presentation. High-resolution computed tomography of the chest helps to define the morphological aspects and distribution of lung cysts, as well as associated findings. The combination of appearance upon imaging and clinical features, together with extrapulmonary manifestations, when present, permits confident and accurate diagnosis of the majority of these diseases without recourse to open-lung biopsy. The main diseases in this group that are discussed in this review are lymphangioleiomyomatosis, pulmonary Langerhans cell histiocytosis and folliculin gene-associated syndrome (Birt–Hogg–Dubé; other rare causes of cystic lung disease, including cystic metastasis of sarcoma, are also discussed. Disease progression is unpredictable, and understanding of the complications of cystic lung disease and their appearance during evolution of the disease are essential for management. Correlation of disease evolution and clinical context with chest imaging findings provides important clues for defining the underlying nature of cystic lung disease, and guides diagnostic evaluation and management.

  7. Adventitial cystic disease of the axillary artery.

    Science.gov (United States)

    Elster, Eric A; Hewlett, Stanley; DeRienzo, Damian P; Donovan, Sean; Georgia, Jeff; Yavorski, Chester C

    2002-01-01

    Adventitial cystic disease (ACD) is an extremely rare cause of arterial and venous insufficiency, with only 317 reported cases in the world literature. These lesions have been previously described in the popliteal fossa, external iliac artery, and distal brachial, radial, and ulnar arteries as well as in the proximal saphenous vein at the ankle. We describe here the first reported case of this disease in a proximal vessel, the axillary artery. A 33-year-old man was evaluated for upper extremity arterial insufficiency and was diagnosed with ACD on the basis of physical examination and radiographic findings, which was confirmed by pathological assessment. The patient was treated by excision of the lesion and interposition vein bypass. As this represents the first case of ACD in the proximal vasculature, it demonstrates that these lesions can occur in axial blood vessels.

  8. Intracranial Hemorrhage in Pregnancy

    Directory of Open Access Journals (Sweden)

    Afshan B. Hameed

    2012-11-01

    Full Text Available A pregnant woman with a mechanical prosthetic mitral valve was anticoagulated with low-molecular-weight heparin in the first trimester followed by warfarin until 36 weeks' gestation. She was then switched to intravenous unfractionated heparin infusion to allow for regional anesthesia in anticipation of vaginal delivery. She developed severe headache on hospital day 2 that was refractory to pain medications. Cranial imaging demonstrated a large subdural hematoma with midline shift. She delivered a healthy baby girl by cesarean section. Eventually, symptoms and intracranial abnormalities resolved over time. In conclusion, subdural hematoma is a relatively rare complication that requires multidisciplinary management plan.

  9. Pediatric intracranial aneurysms.

    Science.gov (United States)

    Tripathy, L N; Singh, S N

    2009-01-01

    The incidence of subarachnoid haemorrhage from intracranial aneurysms in the paediatric age group is extremely rare. Interestingly, occurrence of vasospasm has been reported to be less in comparison to the adults. Both coiling and clipping have been advocated in selected cases. Because of the thinness of the wall of the arteries, utmost care should be taken while handling these arteries during surgery. The overall results of surgery in children have been reported to be better than their adult counterparts. We present four such cases from our own experience. All these children were operated upon, where the solitary aneurysm in each case was clipped and all of them made a good recovery.

  10. Intracranial abscess in Ectopia Cordis.

    Science.gov (United States)

    Merola, Joseph; Tipper, Geoffrey Adrian; Hussain, Zakier; Balakrishnan, Venkataraman; Gan, Peter

    2014-08-25

    We present a case of intracranial abscess in a young female with Ectopia Cordis, an exceptionally rare cardiac condition. The neurosurgical implication is the predisposition to intracranial abscess formation. A heightened awareness of this association will aid diagnosis in similar clinical scenarios.

  11. Risk of Familial Intracranial Aneurysm

    OpenAIRE

    J Gordon Millichap; Millichap, John J.

    2014-01-01

    Investigators at University Medical Center Utrecht, Netherlands, studied the yield of long-term (up to 20 years) screening for intracranial aneurysms in individuals with a positive family history (2 or more first-degree relatives) of aneurysmal subarachnoid hemorrhage (aSAH) or unruptured intracranial aneurysm (1993-2013).

  12. Diagnosis and management of relapsing pancreatitis associated with cystic neoplasms of the pancreas

    Institute of Scientific and Technical Information of China (English)

    William R Brugge

    2008-01-01

    One of the most important causes of relapsing pancreatitis is a cystic neoplasm of the pancreas.These low grade malignancies may cause pancreatitis by obstructing or communicating with a pancreatic duct.Patients with relapsing pancreatitis and a focal fluid fluid collection should be investigated for the possibility of a mucinous cystic neoplasm.Cross sectional imaging can provide a diagnosis with the imaging findings of a low attenuation cystic lesion containing mural calcification (CT scanning) or a Iobular T2 enhancing lesion (MRCP).Endoscopic ultrasound can provide more detailed imaging with the ability to guide fine needle aspiration of the cyst fluid.Cyst fluid analysis can provide a diagnosis of a mucinous cystic lesion with the combination of cytology (mucinous epithelium),elevated carcinoembryonic antigen(CEA),and the presence of DNA mutations.Management of these patients consists of surgical resection and monitoring in patients not able to withstand surgery.

  13. Giant hypothalamic hamartoma associated with an intracranial cyst in a newborn

    Energy Technology Data Exchange (ETDEWEB)

    Lee, Joo Yeon; Khang, Shin Kwang [University of Ulsan College of Medicine, Seoul (Korea, Republic of); Yoon, Hye Kyung [Dept. of Radiology, Kangwon National University Hospital, Chuncheon (Korea, Republic of)

    2016-08-15

    We report the case of a giant hypothalamic hamartoma with a large intracranial cyst in a neonate. On ultrasonography, the lesion presented as a lobulated, mass-like lesion with similar echogenicity to the adjacent brain parenchyma, located anterior to the underdeveloped and compressed left temporal lobe, and presenting as an intracranial cyst in the left cerebral convexity without definite internal echogenicity or septa. The presence of a hypothalamic hamartoma and intracranial neurenteric cyst were confirmed by surgical biopsy. The association of a giant hypothalamic hamartoma and a neurenteric cyst is rare. Due to the rarity of this association, the large size of the intracranial cyst, and the resulting distortion in the regional anatomy, the diagnosis of the solid mass was not made correctly on prenatal high-resolution ultrasonography.

  14. A safe and efficacious alternative: sonographically guided internal jugular vein puncture for intracranial endovascular intervention.

    Science.gov (United States)

    Yeh, C-H; Wu, Y-M; Toh, C-H; Chen, Y-L; Wong, H-F

    2012-01-01

    Transvenous interventions for intracranial vascular lesions are usually performed via venous access of a femoral vein puncture. However, the transjugular route is an alternative with a shorter and less tortuous vascular access for intracranial lesions. Although puncture of the internal jugular vein is generally believed to be too dangerous owing to potential hazardous complications, the safety of the sonographically guided retrograde internal jugular vein puncture technique for intracranial intervention has not been fully evaluated in the English literature. We present our experience with a total of 44 transjugular intervention procedures between April 1999 and June 2010. We believe sonographically guided internal jugular vein puncture is a safe and efficacious technique for establishing transvenous access for an intracranial endovascular intervention.

  15. [Atypical intraperitoneal cystic masses].

    Science.gov (United States)

    Domínguez-Pérez, S T; Baeza-Herrera, C; Villalobos-Castillejos, A; González-Mateos, T; Aguilar-Venegas, M

    2010-01-01

    Omental, mesenteric and retroperitoneal cystic masses are very rare in pediatric population. They usually present as asymptomatic abdominal tumors and only occasionally a preoperative diagnosis is made. We presented 4 cases presented to our hospital during a 2-year period. All patients were male with an age ranged from 5 months to 7 years. Three patients had previous diagnosis of cystic mass by abdominal ultrasound. Three patients presented with acute abdomen and one patient with bowel obstruction. All patients underwent successful resection of the mass with no perioperative mortality.

  16. Fine-needle aspiration study of cystic papillary thyroid carcinoma: Rare cytological findings

    Directory of Open Access Journals (Sweden)

    Maral Mokhtari

    2016-01-01

    Full Text Available Background: Cystic papillary thyroid carcinoma (CPTC is a variant of papillary carcinoma that has many mimickers in cytological grounds. Aim: To study the cytomorphologic features of CPTC and compare them to those of other cystic thyroid lesions using fine-needle aspiration cytology (FNAC. We also aimed to identify the cytomorphologic features that distinguish CPTC from other cystic thyroid lesions. Materials and Methods: Seventy-three cases of CPTC were included in the study. The cytomorphologic features of these cases were analyzed. The FNA smears of other thyroid lesions with cystic changes (300 colloid goiters, 290 adenomatoid nodules, 11 follicular neoplasms, and 9 hurtle cell neoplasm were also studied. Results: The smears in CPTC revealed isolated follicular cells, small groups of cells with scalloped margins, cell swirls, small clusters with a cartwheel pattern, papillary clusters, intranuclear inclusions, nuclear grooves, sticky colloid, intracellular colloids, psammoma bodies, multinucleated giant cells, and foamy and hemosiderin laden macrophages. Small groups of cells with scalloped borders, cellular swirls, and small clusters with a cartwheel pattern were seen in CPTC, but not in other cystic lesions. Interestingly, mesothelial-like cells and hemophagocytic cells were seen in five and three cases of CPTC, respectively, but not in other cystic lesions. Conclusion: Mesothelial-like cells and hemophagocytic cells were observed in five and three cases of CPTC, respectively. Similar finding have not been previously reported in the literature.

  17. The Changing Spectrum of Surgically Treated Cystic Neoplasms of the Pancreas

    Directory of Open Access Journals (Sweden)

    Jennifer K. Plichta

    2015-01-01

    Full Text Available Introduction. While the incidence of pancreatic cystic lesions has steadily increased, we sought to evaluate the changes in their surgical management. Methods. Patients with pancreatic cystic lesions who underwent surgical resection from 2003 to 2013 were identified. Clinicopathologic factors were analyzed and compared to a similar cohort from 1992 to 2002. Results. There were 134 patients with pancreatic cystic lesions who underwent surgical resection from 2003 to 2013, compared to 73 from 1992 to 2002. The most common preoperative imaging was a CT scan, although 66% underwent EUS and 63% underwent biopsy. Pathology included 18 serous, 47 mucinous, 11 pseudopapillary, and 58 intraductal papillary mucinous neoplasms (IPMN. In comparing cohorts, there were significantly fewer serous lesions and more IPMN. Postoperative complication rates were similar, and perioperative mortality rates were comparable. Conclusion. There has been a dramatic change in surgically treated pancreatic cystic tumors over the past two decades. Our data suggests that the incorporation of new imaging and diagnostic tests has led to greater detection of cystic tumors and a decreased rate of potentially unnecessary resections. Therefore, all patients with cystic pancreatic lesions should undergo a focused CT-pancreas, and an EUS biopsy should be considered, in order to best select those that would benefit from surgical resection.

  18. Role of MR imaging in the diagnosis of intracranial germinoma

    Institute of Scientific and Technical Information of China (English)

    邱士军; 张雪林

    2003-01-01

    Objective: To investigate the role of MRI in the diagnosis of intracranial germinoma. Methods: MRI features of 19 cases of intracranial germinoma confirmed by operations and pathological findings were analyzed retrospectively. Results: Germinomas were found in the sellar region in 10 patients (including 5 males and 5 females), in the pineal region in 6 and in the thalamus and basal ganglia in 3, the 9 patients in the latter 2 groups all being males. The characteristic MRI findings of intracranial germinomas were as follows: (1) Lesions were isointense or slightly hypointense on T1WI while isointense or slightly hyperintense on T2WI. The germinomas in the sellar region and pineal region showed no edema, but lesions in the thalamus basal ganglia showed mild to moderate edema and space-occupying effects. (2) Homogeneous or inhomogeneous Gd-DTPA enhancement were seen in most of the tumors. Conclusion: Multiaxial imaging and Gd-DTPA enhancement in MRI are helpful in the diagnosis and differentiation of intracranial germinomas on the basis of the patient's gender, the location of the tumor and its imaging characteristics.

  19. Magnetic resonance imaging of cystic periventricular leukomalacia

    Energy Technology Data Exchange (ETDEWEB)

    Kadoi, Nobuaki; Nomura, Junko; Nowatari, Masahiko; Ohta, Takeo; Kamohara, Takashi; Yashiro, Kimio (Kitasato Univ., Sagamihara, Kanagawa (Japan). School of Medicine)

    1990-08-01

    A study was performed to assess the values of magnetic resonance (MR) imaging in evaluation and the follow up of patients with cystic periventricular leukomalacia. Ten patients selected for MR imaging were diagnosed as having periventricular cystic lesions based on US scans. The range of gestational ages was 27 to 32 weeks, and the range of birth weights was 927 to 2,046 g. Twenty MR examinations were carried out using a 0.5 T superconducting system (Resona; Yokogawa). On the first MR examinations, taken by 6 months of age, low signal intensity lesions within the periventricular white matter, moderate ventriculomegaly with irregularity of the ventricular wall and delayed myelination were observed. These were the MR findings observed in the subacute stage of PVL. On the second or the third MR examinations, taken after 12 months of age, increased signal intensity in periventricular white matter on T{sub 2} weighted images decreased volume of periventricular white matter and centrum semiovale and the ventriculomagaly with irregularity of ventricular wall were observed. However, progressions of myelination were proved to be not delayed in comparison with age matched controls. These were thought to be the MR findings of late stage of PVL. As the US findings of PVL have good correlation with pathologic changes revealed at autopsy, MR imaging can depict myelination and detect PVL lesion beyond the neonatal period. These observations demonstrate the value of the MR imaging for the follow up of the patients with PVL beyond the time of fontanel closure. (author).

  20. The management of the pancreatic cystic neoplasm: the role of the EUS in Japan.

    Science.gov (United States)

    Okabe, Yoshinobu; Kaji, Ryohei; Ishida, Yusuke; Tsuruta, Osamu; Sata, Michio

    2011-05-01

    Diagnosis of cystic lesions of the pancreas is made by clinical history taking, physical examination, blood biochemical tests and diagnostic imaging, such as transabdominal ultrasound, endoscopic ultrasound (EUS), cross-sectional imaging (computed tomography and/or magnetic resonance imaging) and endoscopic retrograde cholangiopancreatography, bearing in mind the known characteristic features of the various cystic lesions that can occur in this organ. Among others, EUS, endowed with a sharp local resolving power, has been described as a highly useful examination method, because it enables concurrent fine-needle aspiration (FNA). EUS has an important role in the differential diagnosis and tumor grading (benign, premalignant or malignant) of cystic lesions. Although the differential diagnosis of cystic lesions of the pancreas based on EUS morphology is practicable to some extent, there have also been reports showing that the diagnosis might vary with the endosonographer and that the diagnostic performance of this method for tumor grading is not necessarily high. In countries overseas, differential diagnosis and tumor grading of cystic lesions of the pancreas are actively undertaken not merely by EUS morphology, but also by cyst-fluid EUS-guided FNA (EUS-FNA) cytology and measurements of pancreatic enzymes and tumor markers, and importance is attached to EUS-FNA in the latest version of the American Society for Gastrointestinal Endoscopy Guideline and in the diagnostic strategies for cystic diseases of the pancreas. Meanwhile, the current Japanese consensus is that EUS-FNA is not recommended in cases of mucinous cystic lesions suspected as being intraductal papillary mucinous neoplasm or mucinous cystic neoplasm.

  1. Parry-Romberg syndrome with multiple intracranial cysts: A rare case report

    Directory of Open Access Journals (Sweden)

    Rakesh Gupta

    2016-01-01

    Full Text Available Parry-Romberg syndrome (PRS is a rare, poorly understood degenerative condition characterized by atrophic changes affecting one side of the face. The cause of these changes remains obscure. Migraine and facial pain such as trigeminal neuralgia are the most common neurological symptoms in this patient group. Sometimes, it causes epilepsy and rarely cerebral hemiatrophy, meningeal thickening, cortical dysgenesis, calcified lesions, aneurysms, and intracranial vascular malformations. Herein, the author reports the first case of PRS with multiple large intracranial cysts producing raised intracranial pressure.

  2. Tumefactive intracranial presentation of precursor B-cell acute lymphoblastic leukemia

    Energy Technology Data Exchange (ETDEWEB)

    Forester, Craig M. [University of Utah, Salt Lake City, UT (United States); Braunreiter, Chi L. [University of Utah, Division of Pediatric Hematology Oncology, Primary Children' s Medical Center, Salt Lake City, UT (United States); Helen DeVos Children' s Hospital, Department of Pediatric Hematology Oncology, Grand Rapids, MI (United States); Yaish, Hasan; Afify, Zeinab [University of Utah, Division of Pediatric Hematology Oncology, Primary Children' s Medical Center, Salt Lake City, UT (United States); Hedlund, Gary L. [Primary Children' s Medical Center, Department of Pediatric Radiology, Salt Lake City, UT (United States)

    2009-11-15

    In children, leukemia is the most common malignancy, and approximately 75% of leukemias are acute lymphoblastic leukemia (ALL). Central nervous system leukemia is found at diagnosis in fewer than 5% of children with ALL. Leukemic intracranial masses have been described with acute myeloid leukemia, but ALL presenting as a mass lesion is rare. We describe a unique case of an intracranial confirmed precursor B cell (pre-B) ALL mass in a 13-year-old girl that was diagnosed by brain CT, MRI and cerebral angiography, and confirmed by biopsy. This report details pertinent history and distinguishing imaging features of an intracranial ALL tumefaction. (orig.)

  3. MRI of intracranial germ-cell tumours

    Energy Technology Data Exchange (ETDEWEB)

    Liang, L.; Korogi, Y.; Sugahara, T.; Ikushima, I.; Shigematsu, Y.; Okuda, T.; Takahashi, M. [Department of Radiology, Kumamoto University School of Medicine (Japan); Kochi, M.; Ushio, Y. [Department of Neurosurgery, Kumamoto University School of Medicine (Japan)

    2002-05-01

    Abstract. Our aim was to review the MRI appearances of primary intracranial germ-cell tumours (GCT). We reviewed the MRI studies of 32 patients: 19 with germinomas, five with teratomas, one with an embryonal carcinoma, five with mixed and two with malignant nongerminomatous GCT. Eleven were in the pineal region, 12 suprasellar, five in the both sites, two in the basal ganglia and two in the corpus callosum. Contrast-enhanced images were available for 27 patients. The solid parts of GCT were nearly isointense with grey matter on both T1- and T2-weighted images. In seven patients with nongerminomatous GCT high-signal components were found on T1-weighted images, representing haemorrhage, high-protein fluid or fat. Cystic components were detected in 17 of 27 patients; eight germinomas and all nine nongerminomatous GCT had cysts. The solid components of germinomas enhanced homogeneously in eight cases and heterogeneously in 10, while all nongerminomatous GCT showed heterogeneous enhancement. MRI features tumours can facilitate correct diagnosis of GCT, including histological subtypes. (orig.)

  4. Case report 467: Cystic chondroblastoma left 4th rib

    Energy Technology Data Exchange (ETDEWEB)

    Sundaram, M.; McGuire, M.H.; Naunheim, K.; Schajowicz, F.

    1988-03-01

    A case of chondroblastoma in an 18-year-old female arising from a rib near the costotransverse articulation (presumably from the epiphysis of the articular process) has been described. The destructive pattern noted in the rib, associated with a large soft tissue mass, favored a malignant lesion rather than a benign one. Histologically, this tumor had large cystic and hemorrhagic components, consistent with the diagnosis of a cystic chondroblastoma of a rib. Curiously, this patient, like two others with chondroblastoma in a rib was asymptomatic, and attention to the abnormality was drawn from a routine chest radiography. The patient remains disease-free one and a half-years following surgery.

  5. Cystic breast lymphangioma in adult female: An unusual presentation

    Directory of Open Access Journals (Sweden)

    Chhanda Das

    2016-01-01

    Full Text Available Cystic lymphangiomas are rare benign tumor of the breast in adults. They are usually located in head and neck, axilla, and mediastinum. They are most commonly diagnosed in young children. Nearly 90% are apparent by the age of 2 years. Here, we reporting a case of 20-year-old female presented with gradually increasing painless swelling in the upper outer quadrant of her left breast for 1½ years. Mammography of the breast showed multiple irregular hypoechoic lesions associated with irregular duct dilatation. Lumpectomy was performed and diagnosed as cystic lymphangioma. Complete excision is the treatment of choice.

  6. Cystic tumors of the liver: A practical approach

    Institute of Scientific and Technical Information of China (English)

    Paolo Del Poggio; Marco Buonocore

    2008-01-01

    Biliary cyst tumors (cystadenoma and cystadenocarcinoma) are an indication for liver resection. They account for only 5% of all solitary cystic lesions of the liver, but differential diagnosis with multiloculated or complicated biliary cysts, atypical hemangiomas, hamartomas and lymphangiomas may be difficult. The most frequent challenge is to differentiate biliary cyst tumors from hemorrhagic cysts. Computerized tomography (CT) and magnetic resonance imaging (MRI) are often not diagnostic and in these cases fine needle aspiration (FNA) is used to confirm the presence of atypical biliary cells. FNA, however, lacks adequate sensitivity and specificity and should always be used in conjunction with imaging. Pre-operative differentiation of cystadenoma from cystadenocarcinoma is impossible and surgery must be performed if a biliary cyst tumor is suspected. When multiple cystic lesions are observed throughout the liver parenchyma, it is important to exclude liver metastasis, of which colonic cancer is the most common primary site. Multiple biliary hamartomas (von Meyenburg complex) can appear as a mixture of solid and cystic lesions and can be confused with cystic metastasis. Strong and uniform T2 hyperintensity on MRI is usually diagnostic, but occasionally a percutaneous biopsy may be required.

  7. Comparison of Clinico-Radiological Features between Congenital Cystic Neuroblastoma and Neonatal Adrenal Hemorrhagic Pseudocyst

    Energy Technology Data Exchange (ETDEWEB)

    Eo, Hong; Kim, Ji Hye; Jang, Kyung Mi; Yoo, So Young [Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul (Korea, Republic of); Lim, Gye Yeon [St. Mary' s Hospital Catholic University, Seoul (Korea, Republic of); Kim, Myung Joon [Severance Hospital Yonsei University, Seoul (Korea, Republic of); Kim, Ok Hwa [Ajou University Hospital, Suwon (Korea, Republic of)

    2011-02-15

    To evaluate the radiological and clinical findings of congenital cystic neuroblastomas as compared with those of the cystic presentation of neonatal adrenal hemorrhage. We analyzed the US (n = 52), CT (n = 24), and MR (n = 4) images as well as the medical records of 28 patients harboring congenital cystic neuroblastomas (n = 16) and neonatal adrenal hemorrhagic pseudocysts (n = 14). The history of prenatal detection, location, size, presence of outer wall enhancement, internal septations, solid portion, calcification, turbidity, vascular flow on a Doppler examination, and evolution patterns were compared in two groups of cystic lesions, by Fischer's exact test. All (100%) neuroblastomas and three (21%) of the 14 hemorrhagic pseudocysts were detected prenatally. Both groups of cystic lesions occurred more frequently on the right side; 11 of 16 (69%) for neuroblastomas and 11 of 14 (79%) for hemorrhagic pseudocysts. The size, presence of solid portion, septum, enhancement, and turbidity did not differ significantly (p > 0.05) between the two groups of cystic lesions. However, tiny calcifications (n = 3) and vascular flow on color Doppler US (n = 3) were noted in only neuroblastomas. The cystic neuroblastomas became complex solid and cystic masses, and did not disappear for up to 90 days in the three following cases, whereas 11 of the 14 (79%) hemorrhagic pseudocysts disappeared completely and the three remaining (27%) evolved to calcifications only. Although the imaging findings of two groups of cystic lesions were similar, prenatal detection, the presence of calcification on initial images, vascularity on color Doppler US, and evolution to a more complex mass may all favor neuroblastomas

  8. Intracranial Pressure Monitoring

    DEFF Research Database (Denmark)

    Raboel, P H; Bartek, J; Andresen, M;

    2012-01-01

    Monitoring of intracranial pressure (ICP) has been used for decades in the fields of neurosurgery and neurology. There are multiple techniques: invasive as well as noninvasive. This paper aims to provide an overview of the advantages and disadvantages of the most common and well-known methods as ......-invasive techniques are without the invasive methods' risk of complication, but fail to measure ICP accurately enough to be used as routine alternatives to invasive measurement. We conclude that invasive measurement is currently the only option for accurate measurement of ICP....... as well as assess whether noninvasive techniques (transcranial Doppler, tympanic membrane displacement, optic nerve sheath diameter, CT scan/MRI and fundoscopy) can be used as reliable alternatives to the invasive techniques (ventriculostomy and microtransducers). Ventriculostomy is considered the gold...

  9. Stenting for Atherosclerotic Stenosis of the Intracranial or Skull Base Cerebral Arteries: Effectiveness and Problems

    OpenAIRE

    Harakuni, T.; Hyodo, A.; Shingaki, T.; Kugai, M.; Kinjyo, T.; Tsuchida, H.; Sugimoto, K.; Yoshii, Y.; Matsumaru, Y.

    2004-01-01

    Since May 1992, we have performed percutaneous transluminal angioplasty (PTA) or stenting 70 times for 65 lesions in 62 patients with atherosclerotic stenosis of the intracranial or skull base cerebral arteries. Stenting was carried out nine times for nine lesions in nine cases. Stenting was performed on patients with an average age of 62. The patients were eight men and one woman. The stenotic lesions involved the internal carotid artery (petrous portion) in four cases, the internal carotid ...

  10. Intracranial solitary fibrous tumor: Imaging findings

    Energy Technology Data Exchange (ETDEWEB)

    Clarencon, Frederic, E-mail: fredclare5@msn.com [Department of Neuroradiology, Pitie-Salpetriere Hospital, APHP, 75013 Paris (France); Bonneville, Fabrice [Department of Neuroradiology, Hopital Rangueil, Toulouse University Hospital, 31000 Toulouse (France); Rousseau, Audrey [Department of Neuropathology, Pitie-Salpetriere Hospital (France); Galanaud, Damien [Department of Neuroradiology, Pitie-Salpetriere Hospital, APHP, 75013 Paris (France); Kujas, Michele [Department of Neuropathology, Pitie-Salpetriere Hospital (France); Naggara, Olivier [Department of Neuroradiology, St Anne Hospital, 75014 Paris (France); Cornu, Philippe [Department of Neurosurgery, Pitie-Salpetriere Hospital (France); Chiras, Jacques [Department of Neuroradiology, Pitie-Salpetriere Hospital, APHP, 75013 Paris (France)

    2011-11-15

    Objective: To study the neuroimaging features of intracranial solitary fibrous tumors (ISFTs). Materials and methods: Retrospective study of neuroimaging features of 9 consecutive histopathologically proven ISFT cases. Location, size, shape, density, signal intensity and gadolinium uptake were studied at CT and MRI. Data collected from diffusion-weighted imaging (DWI) (3 patients), perfusion imaging and MR spectroscopy (2 patients), and DSA (4 patients) were also analyzed. Results: The tumors most frequently arose from the intracranial meninges (7/9), while the other lesions were intraventricular. Tumor size ranged from 2.5 to 10 cm (mean = 6.6 cm). They presented multilobular shape in 6/9 patients. Most ISFTs were heterogeneous (7/9) with areas of low T2 signal intensity that strongly enhanced after gadolinium administration (6/8). Erosion of the skull was present in about half of the cases (4/9). Components with decreased apparent diffusion coefficient were seen in 2/3 ISFTs on DWI. Spectroscopy revealed elevated peaks of choline and myo-inositol. MR perfusion showed features of hyperperfusion. Conclusion: ISFT should be considered in cases of extra-axial, supratentorial, heterogeneous, hypervascular tumor. Areas of low T2 signal intensity that strongly enhance after gadolinium injection are suggestive of this diagnosis. Restricted diffusion and elevated peak of myo-inositol may be additional valuable features.

  11. MRI and CT findings of intracranial neurosyphilis

    Energy Technology Data Exchange (ETDEWEB)

    Suh, Hong Kil; Shim, Ya Seong; Kim, Seon Bok; Kim, Uk Jung; Lee, Shin Ho; Jung, Hae Kyuong; Lee, Eil Seong; Kang, Ik Won [Hallym University College of Medicine, Seoul (Korea, Republic of); Cho, Hyeun Cha [Sungkyunkwan University College of Medicine, Seoul (Korea, Republic of)

    1999-02-01

    To evaluate the CT and MRI findings of neurosyphilis. We retrospectively reviewed the CT and MR imaging findings in five patients with intracranial neurosyphilis confirmed by CSF, VDRL, TPHA, and clinical follow-up. MR imaging was performed in all five cases, and CT in two. The MRI and CT findings of intracranial neurosyphilis included infarction (n=3), focal inflammation (n=1) and encephalopathy (n=1). There was a total of ten infaretions : three of the basal ganglia, two each of the frontal lobe, watershed zone, and cerebellum, and one of the occipital lobe. Intaretion was most common in MCA territory (n=9; 50%), followed by the watershed zone (16.6%), posterior cerebral artery territory (16.6%), and posterior inferior cerebellar artery territory (11.1%). The size of the lesion varied from 1cm to larger than one lobe. One patient showed diffuse high signal intensity in the left temporal lobe, but on follow-up MRI, this had resolved. The most common finding of neurosyphilis, as seen on MRI and CT, was infarction in middle cerebral arterial territory.

  12. Idiopathic Intracranial Hypertension (Pseudotumor Cerebri)

    Science.gov (United States)

    ... children and tends to be “secondary” which affects males and females equally. The second group, post pubescent teenagers, tends to fit the adult stereotype. How is pediatric idiopathic intracranial hypertension diagnosed? If ...

  13. Spinal and Intracranial Epidural Abscess

    Directory of Open Access Journals (Sweden)

    J Gordon Millichap

    2009-03-01

    Full Text Available Presentation, epidemiology, diagnosis and treatment of spinal epidural abscess (SEA and intracranial epidural abscess (ICEA are reviewed by researchers at The John's Hopkins University School of Medicine, Baltimore, MD, and Universidad de Santander, Columbia.

  14. 颅内单发转移瘤的磁共振成像的影像表现%Imaging of single magnetic resonance imaging metastasis of intracranial manifestation

    Institute of Scientific and Technical Information of China (English)

    李松涛

    2014-01-01

    目的:探讨颅内单发转移瘤的磁共振成像(MRI)表现,进一步提高影像诊断的准确性,指导临床的下一步治疗。方法回顾性分析我院就诊20例颅内单发转移瘤患者,采用T1WI、T2WI平扫、增强扫描以及功能MRI,对所有患者进行影像学检查,观察瘤体的MRI表现。结果20例颅内转移瘤均为单发病例,幕上17例,幕下3例。 MRI表现囊实性和实性,囊实性病变14例,实性部分呈稍长T1稍长T2信号,FLAIR呈稍高信号,囊性部分呈长T1长T2信号或短T1长T2信号,FLAIR序列呈高信号,实性部分及囊壁呈不规则环形强化。囊性病变有5例,囊壁呈等信号,囊内呈长T1长T2信号,FLAIR序列呈高信号,囊壁明显强化。单体素磁共振频谱(MRS)检查:未见N-乙酰天门冬氨酸(NAA)峰,胆碱(Cho)峰明显升高。磁共振扩散加权成像(DWI)检查的病例病灶均以囊性为主,囊壁弥散稍受限,囊内弥散不受限,表观扩散系数(ADC)图囊壁呈等信号,囊内呈高信号。结论颅内单发转移瘤的MRI表现有其相对特征性,在结合病史及功能磁共振检查,可较大提高其诊断准确率,为临床下一步治疗提供良好的帮助。%Objective To investigate MRI manifestation of the intracranial tumor, to further improve the accu-racy of imaging diagnosis, to guide the clinical treatment. Methods Retrospectively analysed 20 cases of intracranial metastatic tumor patients in our hospital, using T1WI, T2WI plain scan, enhanced scan and functional MRI, all the pa-tients underwent imaging examination, and observed the MRI manifestations of tumor. Results Twenty cases of in-tracranial metastases were solitary cases, 17 cases of supratentorial, infratentorial in 3 cases.MRI findings of cystic and solid, cystic lesions in 14 cases, the solid part showed slightly long T1 and long T2 signal, FLAIR showed slightly high-er signal, cystic part was

  15. Intrathoracic cystic hygroma with sudden respiratory distress mimicking pneumonia

    Directory of Open Access Journals (Sweden)

    Umesh Goneppanavar

    2012-01-01

    Full Text Available Benign cystic lesions such as cystic hygroma commonly manifest as progressively increasing swelling in the neck with or without compression effects. Rarely, they present with sudden respiratory distress in instances such as infection or haematoma resulting in a sudden increase in the size of the tumour. We present a seven month old child with sudden onset respiratory distress without any obvious neck swelling. The chest X ray findings correlated with the history and were suggestive of right upper lobe pneumonia that leads to a wrong diagnosis of aspiration pneumonia. However, presence of a deviated trachea in the neck raised a suspicion of possible mass. Computed tomogram showed a large cystic mass in the right upper mediastinum with tracheal collapse. We caution intensivists and paediatricians that sudden respiratory distress in infants in the absence of obvious neck swelling does not rule out possibility of intrathoracic tumour.

  16. Ectopic opening of cystic dilatation of the ejaculatory duct into enlarged prostatic utricle.

    Science.gov (United States)

    Lin, Jian-Zhong; Wu, Hong-Fei; Wang, Ji-Chen; Le, Mei-Zhao; Yu, Hong-Bo; Zhou, He-Tong

    2012-01-01

    A 28-year-old man was referred to our department for the management of recurrent hemospermia during the past 5 years. Genital examination and hormonal levels were normal. Semen analysis showed no change in volume and pH; however, hemospermia and asthenozoospermia were observed. Ultrasonography and computed tomography scan revealed the presence of a cystic lesion with calcification in the terminal part of seminal vesicles adjoining the prostate gland. The following vasography and endoscopic retrograde urethrography demonstrated 2 communicating cystic dilatations arising from the verumontanum. The diagnosis of cystic dilatation of the ejaculatory duct opening into an enlarged prostatic utricle was reached. Transurethral unroofing of the cyst was separately performed with a successful outcome. The characteristic of the 2 cystic dilatations was confirmed by pathologic examination. To the best of our knowledge, this is the first case of ectopic cystic dilatation of the ejaculatory duct opening into an enlarged prostatic utricle.

  17. [Effects of solcoseryl on the cerebral blood flow, intracranial pressure, systemic blood pressure and EEG in acute intracranial hypertensive cats (author's transl)].

    Science.gov (United States)

    Kubota, S; Asakura, T; Kitamura, K

    1976-02-01

    The experiment was performed on 86 cases under intraperitoneal pentobarbital anesthesia. One balloon was placed in the extradural space of right frontal region, and the other balloon was placed in the left extradural space and the intracranial pressure was measured. A needle was stereotaxically inserted into the subcortical area in order to measure the cerebral blood flow. Systemic blood pressure was recorded by inserting a catheter into the femoral artery, and electrocorticogram was also recorded. An expanding intracranial lesion was made by inflating the extradural balloon with physiological saline. The animals were arbitrarily divided into two groups.: 1) light or moderate groups which intracranial pressure before the injection of drug was below 400 mmH2O. 2) severe groups above 400 mmH2O. After the maintenance of the pressure, Solcoseryl was infused intravenously. The investigation was focused to observe whether Solcoseryl reveales any potent effect on cerebral blood flow, intracranial pressure, systemic blood pressure and on electroencephalogram in acute intracranial hypertension. Results 1) Intravenous injection of Solcoseryl had the effect of lowering intracranial pressure in the light or moderate and severe groups. Particularly, dose of 80 mg/kg showed the marked effect, though with a rebound phenomenon in the light or moderate groups. Furthermore, the effect was more marked and lasting by drip infusion of Solcoseryl and also by intravenous injection of Solcoseryl after pretreatment with hydrocortisone, and at this time no rebound phenomenon was recognized. 2) Solcoseryl had the effect of increasing the cerebral blood flow accompained with the lowering of intracranial pressure. 3) Systemic blood pressure was transiently lowered by the injection of Solcoseryl 20 mg/kg or 80 mg/kg and recovered immediately. 4) Solcoseryl had no effect on electroencephalogram in the severe groups. Conclusion On the basis of these results, it is rational to conclude that

  18. Intracranial Aspergillosis in an Immunocompetent Young Woman.

    Science.gov (United States)

    Panda, Prasan Kumar; Mavidi, Sunil Kumar; Wig, Naveet; Garg, Ajay; Nalwa, Aasma; Sharma, M C

    2017-01-04

    Intracranial aspergillosis (ICA) is very rare in the immunocompetent individuals, usually misdiagnosed as a tumor or an abscess. A high index of clinical suspicion is required in patients who present with focal neurological deficits, headache, or seizures. We report the case of a 25-year-old immunocompetent female, who presented with a 15-month history of headache, seizures, left-sided proptosis and ophthalmoplegia, and right hemiparesis. Recovery from the symptoms and decrease in the lesion size seen on the radiological assessment were achieved through two decompressive craniotomies followed by prolonged combined systemic antifungal therapies. Although the initial neuroimaging suggested a mitotic pathology, the surgical sample confirmed ICA. Now the patient is on single antifungal therapy (Tab. voriconazole, 200 mg twice daily) and doing her daily activities, but with a reduced intelligent quotient. We report a challenging case of ICA where multiple courses of combined antifungal therapies and repeat surgeries paved the way for a good prognosis.

  19. Cystic fibrosis. Diagnosis.

    Directory of Open Access Journals (Sweden)

    Luis Ortigosa

    2009-11-01

    Full Text Available Cystic fibrosis (CF is one of the most frequent inherited mortal diseases in Caucasian population. Dysfunction in exocrine glands is described in CF patients, with severe pancreatic insufficiency and chronic lung disease. CF is inherited as an autosomal recessive disorder. More than 1000 disease-associated mutations in the cystic fibrosis transmembrane conductance regulator (CFTR gene have been described. DF508 mutation is the most common mutation in the CF gen. Diagnosis in CF is based on clinical and laboratory tests findings. Meconial ileus, CF in other relatives, chronic lung disease, congenital absence of the vas deferens with azoospermia are among other clinical findings, main criteria in CF patients. Two positive results in sweat chloride test , or demonstration in nasal epithelial ionic transport alteration (nasal potential difference and identification of two CF mutations in the patient are laboratory findings in CF.

  20. Abdominal cystic lymphangioma mimicking appendicitis.

    Science.gov (United States)

    Wake, Sarah; Abhyankar, Aruna; Hutton, Kim

    2013-06-01

    A cystic lymphangioma arising within the abdomen is a rare entity in children. It may present with an abdominal mass and symptoms of abdominal pain, vomiting, and anorexia. These nonspecific clinical symptoms are often attributed to more common acute pediatric conditions. In this report, we describe two pediatric cases of intra-abdominal cystic lymphangioma that were initially diagnosed and treated as appendicitis. True diagnosis was only achieved on surgical excision and pathological investigation of cystic material.

  1. [News in cystic fibrosis].

    Science.gov (United States)

    Delaisi, B

    2013-08-01

    The improvement over the last two decades in the treatment of cystic fibrosis led to an increase in life expectancy approaching 40 years at birth. Logically, the population of adult patients has been increasing and is currently 50% of patients followed in France. These therapeutic advances have justified the establishment in 2003 of a generalized neonatal screening for cystic fibrosis. The latest data of this screening show an incidence of CF of 1/5359 live births, far below the incidence of 1/2500 which was widely accepted twenty years ago. The performance of this screening is currently based on the dosage of trypsin immuno reactive, followed in case of exceeding the threshold of a search of the 30 most common mutations, can detect around 96% of 150 to 200 CF cases every year. Therefore, the possibility of a false negative of the screening cannot be excluded and evocative symptoms of cystic fibrosis, even for children born after 2003, will lead to prescribe a sweat test. While treatments available so far goal consequences of cystic fibrosis, a new therapeutic class to correct the functional defect of the mutated protein, called CFTR modulators, is emerging. Ivacaftor, leader of this new class, belonging to the category of "CFTR potentiator" got its access on the market in September 2012 for patients carrying the G551D mutation. New other molecules, named "CFTR correctors" which can have synergistic effect with ivacaftor and concern patients carrying the most common mutation--DF 508--are under development. Copyright © 2013. Published by Elsevier Masson SAS.

  2. Endoscope-assisted microneurosurgery for intracranial aneurysms

    Directory of Open Access Journals (Sweden)

    Renato Juan Galzio

    2013-12-01

    Full Text Available Background:The endovascular techniques has widely changed the treatment of intracranial aneurysms.However surgery still represent the best therapeutic option in case of broad-based and complex lesions.The combined use of endoscopic and microsurgical techniques (EAM may improve surgical results. Objective:The purpose of our study is to evaluate the advantages and limits of EAM for intracranial aneurysms.Methods:Between January 2002 and December 2012,173 patients,harbouring 206 aneurysms were surgically treated in our department with the EAM technique.157 aneurysms were located in the anterior circulation and 49 were in the posterior circulation.Standard tailored approaches,based on skull base surgery principles,were chosen.The use of the endoscope included three steps:initial inspection,true operative time and final inspection.For each procedure,an intraoperative video and an evaluation schedule were prepared,to report surgeons’ opinions about the technique itself.In the first cases,we always used the endoscope during surgical procedures in order to get an adequate surgical training.Afterwards we became aware in selecting cases in which to apply the endoscopy,as we started to become familiar with its advantages and limits.Results:After clipping,all patients were undergone postoperative cerebral angiography.No surgical mortality related to EAM were observed.Complications directly related to endoscopic procedures were rare.Conclusions:Our retrospective study suggests that endoscopic efficacy for aneurysms is only scarcely influenced by the preoperative clinical condition (Hunt-Hess grade,surgical timing,presence of blood in the cisterns (Fisher grade and/or hydrocephalus.However the most important factors contributing to the efficacy of EAM are determined by the anatomical locations and sizes of the lesions.Furthermore,the advantages are especially evident using dedicated scopes and holders,after an adequate surgical training to increase the

  3. Ultrasonographic findings of low-grade endometrial stromal sarcoma of the uterus with a focus on cystic degeneration

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    Park, Ga Eun; Rha, Sung Eun; Oh, Soon Nam; Lee, Ah Won; Lee, Keun Ho; Kim, Mee Ran [Seoul St. Mary' s Hospital, College of Medicine, The Catholic University of Korea, Seoul (Korea, Republic of)

    2016-03-15

    The goal of this study was to perform a retrospective analysis of the ultrasonographic findings associated with low-grade endometrial stromal sarcoma. Ten pathologically confirmed cases of low-grade endometrial stromal sarcoma at our institution from January 2007 to April 2014 were retrospectively reviewed. All patients underwent a preoperative transvaginal ultrasound. Two radiologists came to a consensus regarding the location, size, margin, and echogenicity of the tumor, as well as the presence of intratumoral cystic degeneration and its extent and configuration. Low-grade endometrial stromal sarcoma manifested as an intramural mass protruding into the endometrial cavity (n=6) or as a purely intramural mass (n=4). The maximal diameter of the lesion ranged from 4 to 9.1 cm (mean, 6.2 cm). The imaging features of low-grade endometrial stromal sarcoma were variable: six cases involved predominantly solid masses containing cystic degeneration, one was a predominantly unilocular cystic mass, two were ill-defined infiltrative solid masses, and one was a well-defined solid mass. Among the seven cases with internal cystic degeneration, five patients showed a multiseptated cystic area or a cystic area with multiple small clusters, while a unilocular cystic area within the tumor was found in two patients. Low-grade endometrial stromal sarcoma is associated with variable ultrasonographic findings with regard to the location, margin, and configuration of the lesion. Multiseptated cystic areas and multiple small areas of cystic degeneration are common.

  4. Molecular Diagnosis of Cystic Fibrosis.

    Science.gov (United States)

    Deignan, Joshua L; Grody, Wayne W

    2016-01-01

    This unit describes a recommended approach to identifying causal genetic variants in an individual suspected of having cystic fibrosis. An introduction to the genetics and clinical presentation of cystic fibrosis is initially presented, followed by a description of the two main strategies used in the molecular diagnosis of cystic fibrosis: (1) an initial targeted variant panel used to detect only the most common cystic fibrosis-causing variants in the CFTR gene, and (2) sequencing of the entire coding region of the CFTR gene to detect additional rare causal CFTR variants. Finally, the unit concludes with a discussion regarding the analytic and clinical validity of these approaches.

  5. INTRACRANIAL PRESSURE MONITORING TECHNIQUE

    Directory of Open Access Journals (Sweden)

    Ida Bagus Adi Kayana

    2013-03-01

    Full Text Available Head injury is the most significant cause of increased morbidity and mortality. An estimated 1.4 million head injuries occur each year, with and more than 1.1 million come to the Emergency Unit. On each patient head injury, an increase in intracranial pressure (ICP related to poor outcomes and aggressive therapy to increased ICP can improve the outcomes. ICP monitoring is the most widely used because of the prevention and control of ICP as well as maintain the pressure increase perfusion of cerebral (Cerebral Perfusion Pressure/CPP is the basic purpose of handling head injury. There are two methods of monitoring ICP that is an invasive methods (directly and non-invasive techniques (indirectly. The method commonly used, namely intraventricular and intraparenkimal (microtransducer sensor because it is more accurate but keep attention to the existence of the risk of bleeding and infection resulting from installation. Monitoring of ICT can determine the actions that avoid further brain injury, which can be lethal and irreversibel.

  6. Clinicopathologic features of intracranial central neurocytomas in 2 dogs.

    Science.gov (United States)

    Rossmeisl, J H; Piñeyro, P; Sponenberg, D P; Garman, R H; Jortner, B S

    2012-01-01

    In humans, central neurocytomas are rare and typically benign intracranial tumors found within the lateral ventricles, although extraventricular variants have been reported. Intracranial central neurocytomas have not been previously recognized in domestic animals. To describe the clinicopathologic features of canine intracranial central neurocytomas. Two dogs with spontaneous intracranial and intraventricular neoplasms. Both dogs experienced seizures, rapid neurological deterioration, and death from tumor-associated complications within 5 days of the onset of clinical signs, and had neoplastic masses within the lateral ventricles. A brain MRI was performed in 1 dog, which revealed a T1-isointense, heterogeneously T2 and FLAIR hyperintense, and markedly and heterogeneously contrast-enhancing mass lesions within both lateral ventricles. Histologically, the neoplasms resembled oligodendrogliomas. The diagnosis of central neurocytoma was supported by documenting expression of multiple neuronal markers, including neuron-specific enolase, synaptophysin, neural-cell adhesion molecule, and neuronal nuclear antigen within the tumors, and ultrastructural evidence of neuronal differentiation of neoplastic cells. Central neurocytoma should be a differential diagnosis for dogs with intraventricular brain masses. Morphologic differentiation of central neurocytoma from other intraventricular neoplasms, such as ependymoma or oligdendroglioma, can be difficult, and definitive diagnosis often requires immunohistochemical or ultrastructural confirmation of the neural origin of the neoplasm. Copyright © 2012 by the American College of Veterinary Internal Medicine.

  7. Cystic angiomatosis with splenic involvement: unusual MRI findings

    Energy Technology Data Exchange (ETDEWEB)

    Vanhoenacker, F.M. [Dept. of Radiology, Univ. Hospital Antwerp, Edegem (Belgium); Dept. of Radiology, AZ St-Maarten, Campus Duffel, Duffel (Belgium); Schepper, A.M. [Dept. of Radiology, Univ. Hospital Antwerp, Edegem (Belgium); Raeve, H. [Dept. of Pathology, Univ. Hospital Antwerp, Edegem (Belgium); Berneman, Z. [Dept. of Hematology, Univ. Hospital Antwerp, Edegem (Belgium)

    2003-12-01

    Cystic angiomatosis is a rare disorder with a poor prognosis. We describe a case of a 33-year-old woman who presented with longstanding bone pain, hemolytic anemia, and an enlarged spleen. Radiologically, multiple osseous lesions with a mixed pattern of lytic and sclerotic areas were seen within the shoulders, spine, and pelvis. On CT and MRI of the abdomen, the spleen was markedly enlarged, with internal hyperdense foci on non-contrast CT scan, corresponding to low signal intensity areas on all MR pulse sequences. After administration of contrast, a mottled enhancement pattern throughout the entire spleen was seen both on CT and MRI. Cystic angiomatosis was proven by histological analysis of a biopsy specimen of an involved vertebra and histopathological examination of the spleen after subsequent splenectomy. This is the first report of a patient with disseminated cystic angiomatosis with splenic involvement in which the MRI features differ from the previous reports. Instead of the usual pattern consisting of multiple well-defined cystic lesions, a diffuse involvement replacing the entire spleen, with heterogeneous signal intensities on T2-weighted images and heterogeneous enhancement pattern, was seen in our patient. (orig.)

  8. CT findings and differential diagnosis of cystic neck masses

    Energy Technology Data Exchange (ETDEWEB)

    Lee, Ji Yeon; Lee, Kil Jun; Jeong, Seong Ki; Han, Seong Nim; Tae, Seok; Shin, Kyoung Ja; Lee, Sang Chun [Seoul Red Cross Hospital, Seoul (Korea, Republic of)

    1995-10-15

    The purpose of this study is to analyze the CT features of the cystic masses in the neck and to review differential diagnosis. We retrospectively reviewed and analyzed the CT findings of 22 histopathologically proved, cystic neck masses in regard to the location in fascial plane and relationship with adjacent organ. Of 22 cases, ten congenital cysts two ranulas, seven inflammatory lesions, and three solid tumors were included. Ten congenital cystic masses were located in typical locations as branchial cleft cyst (5) in mandibular angle, thyroglossal duct cyst (3) in visceral space embeded within the strap muscles, cystic hygroma (1) and cavernous hemangioma (1) in posterior cervical space with insinuating appearance. Two cases of ranula included one simple ranula localized in sublingual space and a plunging ranula extending to adjacent submandibular space. Seven cases of inflammatory lesions were characterized by multispatial locations and good contrast-enhancement of walls and adjacent tissue. Solid masses of low density mimicking cyst were two pleomorphic adenomas of submandibular gland and one neurilemmoma. It is considered that thorough analysis of the CT findings with attention to typical location, CT appearance, and the relationship with the adjacent structures usually leads to the correct diagnosis.

  9. Pigmented villonodular synovitis of the temporomandibular joint with intracranial extension: A case series and systematic review.

    Science.gov (United States)

    Safaee, Michael; Oh, Taemin; Sun, Matthew Z; Parsa, Andrew T; McDermott, Michael W; El-Sayed, Ivan H; Bloch, Orin

    2015-08-01

    Pigmented villonodular synovitis (PVNS) is a rare proliferative disorder of the synovial membrane. PVNS generally affects large joints but occasionally involves the temporomandibular joint (TMJ), with occasional extension into the middle cranial fossa. The purpose of this study was to report our experience with PVNS along with a focused literature review. Patients with PVNS of the TMJ treated at the University of California - San Francisco from 2007 to 2013 were reviewed. A PubMed search was performed to identify additional cases. Five patients underwent surgical resection, with 1 recurrence at 61 months. A literature review identified 58 patients, 19 of which had intracranial involvement. Interestingly, intracranial extension was more common in men. Intracranial extension was not associated with an increased rate of recurrence. PVNS of the TMJ is a rare entity associated with excellent outcomes, even with intracranial extension. Management should consist of maximal resection, with radiotherapy reserved for extensive or recurrent lesions. © 2014 Wiley Periodicals, Inc.

  10. Multiple Intracranial Meningiomas: A Review of the Literature and a Case Report

    Directory of Open Access Journals (Sweden)

    F. Koech

    2013-01-01

    Full Text Available Multiple intracranial meningiomas are a condition where there is more than one meningioma in several intracranial locations in the same patient without signs of neurofibromatosis. Incidence varies from 1 to 10%. The prognosis of multiple intracranial meningioma does not differ from benign solitary meningiomas despite the multiplicity. However, the simultaneous occurrence of different grades of malignancy is observed in one-third of multiple meningiomas. Surgery remains the best option for treatment of symptomatic lesions. Our case review aims to present and discuss a 75-year-old female patient diagnosed with multiple intracranial meningiomas, describing their clinical, radiological, histological characteristics. It also highlights the fact that the patient had two tumours, underwent surgery, and so far has a good quality of life.

  11. Primary retroperitoneal mature cystic teratoma with focal enteric type adenocarcinoma in a post-partum woman: report of a case with literature review.

    Science.gov (United States)

    Hong, Wei; Dumoff, Kimberly L; Torigian, Drew A; Bing, Zhanyong

    2013-02-11

    Teratomas are characterized by containing tissue from all three germinal cell layers. Occasionally, somatic type malignancies develop within a mature cystic teratoma. We reported here a rare case of enteric type adenocarcinoma, with associated dysplastic epithelial precursor lesion, arising within a mature cystic teratoma in the retroperitoneum of a 30-year-old woman status post vaginal delivery 11 weeks earlier. The mass is 17.5 cm and cystic. A polypoid mass component measuring 4.7×4.2×2.5 cm was located inside the cystic component. Microscopically, the majority of the specimen was a mature cystic teratoma with all three germinal cell layers. The polypoid mass component was an adenocarcinoma with an adjacent dysplastic epithelial precursor lesion. The adenocarcinoma was diffusely positive for CK20 and CDX-2, and focally positive for CD7, indicating enteric differentiation. A brief review of retroperitoneal mature cystic teratomas with associated somatic type malignancy was performed.

  12. Primary retroperitoneal mature cystic teratoma with focal enteric type adenocarcinoma in a post-partum woman: report of a case with literature review

    Directory of Open Access Journals (Sweden)

    Zhanyong Bing

    2013-02-01

    Full Text Available Teratomas are characterized by containing tissue from all three germinal cell layers. Occasionally, somatic type malignancies develop within a mature cystic teratoma. We reported here a rare case of enteric type adenocarcinoma, with associated dysplastic epithelial precursor lesion, arising within a mature cystic teratoma in the retroperitoneum of a 30-year-old woman status post vaginal delivery 11 weeks earlier. The mass is 17.5 cm and cystic. A polypoid mass component measuring 4.7x4.2x2.5 cm was located inside the cystic component. Microscopically, the majority of the specimen was a mature cystic teratoma with all three germinal cell layers. The polypoid mass component was an adenocarcinoma with an adjacent dysplastic epithelial precursor lesion. The adenocarcinoma was diffusely positive for CK20 and CDX-2, and focally positive for CD7, indicating enteric differentiation. A brief review of retroperitoneal mature cystic teratomas with associated somatic type malignancy was performed.

  13. Birt-Hogg-Dubé syndrome and intracranial vascular pathologies.

    Science.gov (United States)

    Kapoor, Rahul; Evins, Alexander I; Steitieh, Diala; Bernardo, Antonio; Stieg, Philip E

    2015-12-01

    Birt-Hogg-Dubé syndrome, first described in 1977, is a rare autosomal dominant condition that commonly presents with skin lesions, including fibrofolliculomas and trichodiscomas; pulmonary cysts; spontaneous pneumothoraces; and renal cancer. We present the only known cases of intracranial vascular pathologies in patients with Birt-Hogg-Dubé syndrome. We present three cases (three female; age range 18-50) of intracranial vascular lesions in Birt-Hogg-Dubé patients, including two aneurysms and one arteriovenous malformation, and review one previously reported case of carotid aplasia. Due to the rarity of Birt-Hogg-Dubé syndrome and significant variations in its clinical presentation, it is difficult to assess whether or not Birt-Hogg-Dubé patients are predisposed to intracranial vascular pathologies. We hypothesize that increased transcription of hypoxia-inducible factor 1-alpha, resulting from a mutated form of the protein folliculin transcribed by the Birt-Hogg-Dubé gene, may be associated with vascular pathogenesis in Birt-Hogg-Dubé patients and thus provide a possible molecular basis for a link between these two conditions.

  14. Fetal intracranial tumors: a review of 27 cases

    Energy Technology Data Exchange (ETDEWEB)

    Cassart, M.; Avni, F. [Erasme University Hospital, Department of Medical Imaging, Brussels (Belgium); Bosson, N.; Garel, C. [Hopital d' Enfants Armand-Trousseau, Department of Medical Imaging, Paris (France); Eurin, D. [Charles Nicolle Hospital, Department of Pediatric Imaging, Rouen (France)

    2008-10-15

    Fetal intracranial tumors are rare. The diagnosis is generally made on histology after birth. The aim of this study was to analyze clinical and imaging data in a series of fetal intracranial tumors and emphasize the findings that may help approach the diagnosis antenatally. We retrospectively analyzed imaging and clinical findings in 27 cases of fetal intracranial tumors assessed by ultrasound (27/27) and MR imaging (24/27). A histological diagnosis was always obtained. Main diagnoses included 15 germinal tumors (13 teratomas), 4 glial tumors, 2 craniopharyngiomas and 3 hamartomas. Average gestational age at diagnosis was 27 weeks for teratomas, 21 weeks for hamartomas and 34 weeks for glial tumors. All tumors but one were supra tentorial, and the lesion extended in the posterior fossa in two teratomas. A heterogeneous pattern, which was more frequently seen in teratomas, was better visualized by MR than US imaging. In addition, in two cases of teratomas, MR imaging better assessed the extension of the tumor. Teratomas and gliomas are the most frequent brain tumors in the fetus. US and MR imagings appear complementary in the prenatal assessment of these lesions. (orig.)

  15. Inverted cystic tubulovillous adenoma involving Brunner's glands of duodenum

    Institute of Scientific and Technical Information of China (English)

    Ji Hoon Kim; Jong-Jae Park; Jung Woo Choi; Yeon Seok Seo; Beom Jae Lee; Jong Fun Yeon; Jae Seon Kim; Kwan Soo Byun; Young-Tae Bak; Insun Kim

    2007-01-01

    Benign neoplasia of the duodenum are very rare.Moreover, duodenal tubulovillous adenomas are more uncommon lesions. The microscopic structure of tubulovillous adenoma has frond-like projection of mucosa with branching papillary structure and generally upward growth into the lumen. We describe a 72-year-old man who showed aduodenal tubulovillous adenoma with unusual inverted cystic growth pattern.Interestingly, this tubulovillous adenomatous lesion was interrupted by gastric metaplasia in the deep portion of the cyst and was closely surrounded by Brunner's glands. Although histogenesis of gastric metaplasia of duodenum is not fully understood, Brunner's glands has been suggested as a precursor for gastric metaplasia.Therefore, these findings argued that this adenoma arises from Brunner's glands through gastric metaplasia.This is the first case of inverted cystic tubulovillous adenoma involving Brunner's glands of duodenum with gastric metaplasia.

  16. High-resolution intracranial vessel wall MRI in an elderly asymptomatic population: comparison of 3T and 7T

    Energy Technology Data Exchange (ETDEWEB)

    Harteveld, Anita A.; Kolk, Anja G. van der; Dieleman, Nikki; Siero, Jeroen C.W.; Luijten, Peter R.; Zwanenburg, Jaco J.M.; Hendrikse, Jeroen [University Medical Center Utrecht, Department of Radiology, Postbox 85500, Utrecht (Netherlands); Worp, H.B. van der; Frijns, Catharina J.M. [University Medical Center Utrecht, Department of Neurology and Neurosurgery, Brain Center Rudolf Magnus, Utrecht (Netherlands); Kuijf, Hugo J. [University Medical Center Utrecht, Image Sciences Institute, Utrecht (Netherlands)

    2017-04-15

    Several intracranial vessel wall sequences have been described in recent literature, with either 3-T or 7-T magnetic resonance imaging (MRI). In the current study, we compared 3-T and 7-T MRI in visualising both the intracranial arterial vessel wall and vessel wall lesions. Twenty-one elderly asymptomatic volunteers were scanned by 3-T and 7-T MRI with an intracranial vessel wall sequence, both before and after contrast administration. Two raters scored image quality, and presence and characteristics of vessel wall lesions. Vessel wall visibility was equal or significantly better at 7 T for the studied arterial segments, even though there were more artefacts hampering assessment. The better visualisation of the vessel wall at 7 T was most prominent in the proximal anterior cerebral circulation and the posterior cerebral artery. In the studied elderly asymptomatic population, 48 vessel-wall lesions were identified at 3 T, of which 7 showed enhancement. At 7 T, 79 lesions were identified, of which 29 showed enhancement. Seventy-one percent of all 3-T lesions and 59 % of all 7-T lesions were also seen at the other field strength. Despite the large variability in detected lesions at both field strengths, we believe 7-T MRI has the highest potential to identify the total burden of intracranial vessel wall lesions. (orig.)

  17. 左肾上腺区特殊囊性占位病变的诊治——附胃重复囊肿二例报告%Diagnosis and treatment of specially cystic lesion located at the area of the left adrenal gland : 2 cases reports of adult gastric duplicated cyst

    Institute of Scientific and Technical Information of China (English)

    王海涛; 张继伟; 阎乙夫; 夏溟

    2012-01-01

    Objective To evaluate thedifferential diagnosis of specially cystic masses located at the area of the left adrenal gland,and to improve the understanding of the clinical symptoms and pathological features,diagnosis and treatment of gastric duplicated cyst.Methods A retrospective study,with literature review,of clinical characteristics and imaging findings of pathologically proved gastric duplicated cyst in 2 adults (2 males,28 years and 42 years)was conducted.Two patients presented no clinical manifestation.Abdominal ultrasonography and CT scan revealed a cystic lesion,in the area of the left adrenal gland,with a thickness wall,measuring 5 cm ×6 cm× 7 cm and 8 cm × 12 cm × 13 cm,attached to the greater curvature of the stomach.The lesion had septums,and the walls and septums could not be enhanced.Preoperative diagnosis of patients was misdiagnosed as a cyst of the left adrenal gland,with inflection or bleeding.Results Complete excision was performed by laparoscopic surgery in all cases.The lesion located in the area of left adrenal gland and no communication between the duplicated cyst and the lumen of stomach was detected.Postoperatively,the lesions were pathologically proved to be gastric duplicated cyst.There was no recurrence during the follow-up of 8 months and 2 years.Conclusions Preoperative definite diagnosis of adult gastric duplication cyst is very difficult.Ultrasonography and Computed Tomography are valuable imaging modality for locating the site and determining the nature of adult gastric duplicated cyst.Preoperative definite diagnosis could be made by EUS (endoscopic ultrasonography) and EUS-guided fine needle aspiration biopsy in gastric duplicated cyst.Although adult gastric duplicated cyst is an extremely rare disease entity,but this unusual developmental abnormality should be include in the differential diagnosis of cystic masses located the area of the left adrenal gland.Because of the possibility of malignancy of the cyst

  18. [Cystic fibrosis in 2008].

    Science.gov (United States)

    Durieu, I; Josserand, R Nove

    2008-11-01

    To describe the epidemiological, physiopathological, clinical and therapeutic knowledge concerning cystic fibrosis (CF). Important modifications in the health organization of the care concerning this orphan disease have been implemented in France. The life expectancy has dramatically increased, as well as the knowledge concerning the pathological structure and function of the CFTR gene and protein. This will lead to the development of emerging drug treatments for this lethal disease. The life expectancy is predicted to exceed 40 years for children born in the 2000s. As a result, there has been a tremendous growth of the adult population that reached 40% of the overall approximately 5000 patients included in the CF French registry (Observatoire National de la Mucoviscidose). Lung disease remains the primary cause of morbidity and mortality. The characteristic phenotypic presentation associates bronchial and rhinosinusal symptoms, pancreatic insufficiency and liver disease. Bronchial damage leads to progressive chronic respiratory insufficiency. Diabetes mellitus and osteoporosis frequently appears in adulthood. Neonatal screening has been implemented in France since 2002. It will prevent delayed diagnosis and its deleterious consequences. Some atypical cases of CF presenting only with one or two organ system involvement can be diagnosed in adulthood. Isolated chronic rhinosinusitis, bronchiectasis, congenital bilateral absence of vas deferens, recurrent pancreatitis, allergic bronchopulmonary aspergillosis, and some case of cholangitis may so revealed late form of cystic fibrosis. The health care is organized in cystic fibrosis centres. Despite gene discovery, treatment still remains symptomatic, based on intensive pulmonary and nutritional treatments. Challenges for new treatments are to correct the basic defect, either by gene therapy or by pharmacological modulation of the abnormal physiological processes.

  19. Cystic fibrosis and sleep.

    Science.gov (United States)

    Katz, Eliot S

    2014-09-01

    Sleep disturbances are frequently observed in cystic fibrosis (CF). The resultant sleep fragmentation, short sleep duration, and gas-exchange abnormalities are postulated to contribute to the neurocognitive, cardiovascular, and metabolic abnormalities associated with CF. There are no outcomes data to establish the optimal procedure for screening and treating CF patients for sleep-related respiratory abnormalities. Therapy with supplemental oxygen and bilevel ventilation are widely considered to be effective in the short term, but there are few evidence-based data to support long-term improvements in morbidity and mortality. Copyright © 2014 Elsevier Inc. All rights reserved.

  20. [Cystic pyeloureteritis. Our approach].

    Science.gov (United States)

    Castillo Jimeno, J M; González de Garibay, A S; Ruiz Rubio, J L; Sebastián Borruel, J L

    1992-05-01

    We report a case of massive cystic pyeloureteritis that had been diagnosed by ureterorenoscopy in a patient with recurrent urinary infection and episodes of nephritic colic. The reports published in the literature indicate there is no specific treatment for this disease whose etiology is unknown. Its pathogenesis has not been well-established and it is difficult to distinguish from other urothelial filling defects. Although it has also been reported that it may progress to malignancy, we believe that the therapeutic approach should be conservative.

  1. Childhood abdominal cystic lymphangioma

    Energy Technology Data Exchange (ETDEWEB)

    Konen, Osnat; Rathaus, Valeria; Shapiro, Myra [Department of Diagnostic Imaging, Meir General Hospital, Sapir Medical Centre, Kfar Saba (Israel); Dlugy, Elena [Department of Paediatric Surgery, Schneider Medical Centre, Sackler School of Medicine, Tel-Aviv University (Israel); Freud, Enrique [Department of Paediatric Surgery, Sapir Medical Centre, Sackler School of Medicine, Tel-Aviv University (Israel); Kessler, Ada [Department of Diagnostic Imaging, Sourasky Medical Centre, Tel-Aviv (Israel); Horev, Gadi [Department of Diagnostic Imaging, Schneider Medical Centre, Tel-Aviv (Israel)

    2002-02-01

    Background: Abdominal lymphangioma is a rare benign congenital malformation of the mesenteric and/or retroperitoneal lymphatics. Clinical presentation is variable and may be misleading; therefore, complex imaging studies are necessary in the evaluation of this condition. US and CT have a major role in the correct preoperative diagnosis and provide important information regarding location, size, adjacent organ involvement, and expected complications. Objective: To evaluate the clinical and imaging findings of seven children with proven abdominal cystic lymphangioma. Materials and methods: Clinical and imaging files of seven children with pathologically proven abdominal lymphangioma, from three university hospitals, were retrospectively evaluated. Patient's ages ranged from 1 day to 6 years (mean, 2.2 years). Symptoms and signs included evidence of inflammation, abnormal prenatal US findings, chronic abdominal pain, haemorrhage following trauma, clinical signs of intestinal obstruction, and abdominal distension with lower extremities lymphoedema. Plain films of five patients, US of six patients and CT of five patients were reviewed. Sequential imaging examinations were available in two cases. Results: Abdominal plain films showed displacement of bowel loops by a soft tissue mass in five of six patients, two of them with dilatation of small bowel loops. US revealed an abdominal multiloculated septated cystic mass in five of six cases and a single pelvic cyst in one which changed in appearance over 2 months. Ascites was present in three cases. CT demonstrated a septated cystic mass of variable sizes in all available five cases. Sequential US and CT examinations in two patients showed progressive enlargement of the masses, increase of fluid echogenicity, and thickening of walls or septa in both cases, with multiplication of septa in one case. At surgery, mesenteric lymphangioma was found in five patients and retroperitoneal lymphangioma in the other two

  2. Syphilis mimicking idiopathic intracranial hypertension

    DEFF Research Database (Denmark)

    Yri, Hanne; Wegener, Marianne; Jensen, Rigmor

    2011-01-01

    Idiopathic intracranial hypertension (IIH) is a condition of yet unknown aetiology affecting predominantly obese females of childbearing age. IIH is a diagnosis of exclusion as raised cerebrospinal fluid pressure may occur secondary to numerous other medical conditions. An atypical phenotype...... or an atypical disease course should alert the physician to reevaluate a presumed IIH-diagnosis. The authors report a case of a 32-year-old non-obese male with intracranial hypertension, secondary to a syphilitic central nervous system infection, initially misdiagnosed as being idiopathic. Upon relevant...... antibiotic treatment, signs and symptoms of elevated intracranial pressure resolved completely. Syphilis is a rare, but very important, differential diagnosis that in this case was clinically indistinguishable from IIH....

  3. Sex differences in intracranial arterial bifurcations

    DEFF Research Database (Denmark)

    Lindekleiv, Haakon M; Valen-Sendstad, Kristian; Morgan, Michael K;

    2010-01-01

    Subarachnoid hemorrhage (SAH) is a serious condition, occurring more frequently in females than in males. SAH is mainly caused by rupture of an intracranial aneurysm, which is formed by localized dilation of the intracranial arterial vessel wall, usually at the apex of the arterial bifurcation. T....... The female preponderance is usually explained by systemic factors (hormonal influences and intrinsic wall weakness); however, the uneven sex distribution of intracranial aneurysms suggests a possible physiologic factor-a local sex difference in the intracranial arteries....

  4. Sex differences in intracranial arterial bifurcations

    DEFF Research Database (Denmark)

    Lindekleiv, Haakon M; Valen-Sendstad, Kristian; Morgan, Michael K

    2010-01-01

    Subarachnoid hemorrhage (SAH) is a serious condition, occurring more frequently in females than in males. SAH is mainly caused by rupture of an intracranial aneurysm, which is formed by localized dilation of the intracranial arterial vessel wall, usually at the apex of the arterial bifurcation....... The female preponderance is usually explained by systemic factors (hormonal influences and intrinsic wall weakness); however, the uneven sex distribution of intracranial aneurysms suggests a possible physiologic factor-a local sex difference in the intracranial arteries....

  5. Contrast-enhanced multidetector computerized tomography for odontogenic cysts and cystic-appearing tumors of the jaws: is it useful?

    Science.gov (United States)

    Kakimoto, Naoya; Chindasombatjaroen, Jira; Tomita, Seiki; Shimamoto, Hiroaki; Uchiyama, Yuka; Hasegawa, Yoko; Kishino, Mitsunobu; Murakami, Shumei; Furukawa, Souhei

    2013-01-01

    The purpose of this study was to investigate the usefulness of computerized tomography (CT), particularly contrast-enhanced CT, in differentiation of jaw cysts and cystic-appearing tumors. We retrospectively analyzed contrast-enhanced CT images of 90 patients with odontogenic jaw cysts or cystic-appearing tumors. The lesion size and CT values were measured and the short axis to long axis (S/L) ratio, contrast enhancement (CE) ratio, and standard deviation ratio were calculated. The lesion size and the S/L ratio of keratocystic odontogenic tumors were significantly different from those of radicular cysts and follicular cysts. There were no significant differences in the CE ratio among the lesions. Multidetector CT provided diagnostic information about the size of odontogenic cysts and cystic-appearing tumors of the jaws that was related to the lesion type, but showed no relation between CE ratio and the type of these lesions. Copyright © 2013 Elsevier Inc. All rights reserved.

  6. Epithelioid Hemangioendothelioma of the Femur with Benign Cystic Appearance

    Energy Technology Data Exchange (ETDEWEB)

    Choi, Jung Ah; Kang, Heung Sik [Dept. of Radiology, Seoul National University Bundang Hospital, Seongnam (Korea, Republic of); Kim, Yeo Goon [Dept. of Radiology and Institute of Radiation Medicine, Seoul National University College of Medicine, Seoul (Korea, Republic of); Chung, Jin Haeng [Dept. of Patholgy, Seoul National University Bundang Hospital, Seongnam (Korea, Republic of); Oh, Joo Han [Dept. of Orthopedic Surgery, Seoul National University Bundang Hospital, Seongnam (Korea, Republic of)

    2011-12-15

    An epithelioid hemangioendothelioma is an intermediate grade tumor between hemangioma and angiosarcoma that frequently shows marked enhancement because it is a vascular tumor. Herein, we describe a rare case of a malignant epithelioid hemangioendothelioma of the femur that was mistaken as a benign lesion such as a simple bone cyst or fibrous dysplasia because the tumor had a benign cystic appearance on MRI and its imaging findings showed a histopathologic correlation.

  7. Surgical case of intracranial osteoma arising from the falx

    Science.gov (United States)

    Takeuchi, Satoru; Tanikawa, Rokuya; Tsuboi, Toshiyuki; Noda, Kosumo; Miyata, Shiro; Ota, Nakao; Hamada, Fumihiro; Kamiyama, Hiroyasu

    2016-01-01

    Intracranial osteomas completely unrelated to osseous tissues are extremely rare. In the present study, the case of a 40-year-old female who presented with persistent headache is reported. Computed tomography (CT) and bone window CT revealed an ossified lesion in the frontal area. Fast imaging employing steady-state acquisition (FIESTA)/CT venography fusion imaging demonstrated that the mass was located just below the superior sagittal sinus and cortical veins, and had adhered partially to these veins. Surgery achieved complete tumor removal with preservation of the cortical veins and superior sagittal sinus. The histological examination findings were compatible with osteoma. The present postoperative course was uneventful. The present rare case of intracranial osteoma originating from the falx was successfully treated surgically. Preoperative FIESTA/CT venography fusion imaging was very useful to demonstrate adhesion between the tumor mass and the superior sagittal sinus and cortical veins. PMID:27588144

  8. Characteristic CT and MRI findings of intracranial chondroma

    Energy Technology Data Exchange (ETDEWEB)

    Duan, Fuhong; Qiu, Shijun; Liu, Zhenyin; Lv, Xiaofei; Feng, Xia; Xiong, Wei; An, Jie; Chen, Jing; Yang, Weicong; Wen, Chuhong [Department of Medical Imaging Center, Nanfang Hospital, Southern Medical University, Guangzhou, Guangdong (China)], E-mail: qiushijun006@163.com; Jiang, Jianwei; Chang, Jun [Department of Radiology, The Third Affiliated Hospital of Nantong University, Wuxi, Jiangsu (China)

    2012-12-15

    Background. Intracranial chondromas are rare benign tumors. To date, few data are available on their neuroradiological features. Purpose. To describe a series of patients with intracranial chondroma and to analyze and discuss the computed tomography (CT) and magnetic resonance imaging (MRI) features that may distinguish chondromas from other intracranial neoplasms. Material and Methods. We retrospectively analyzed clinical and medical imaging data of six patients who had pathologically confirmed intracranial chondromas in our two institutions between July 2006 and September 2011. Both CT and MRI scanning were performed in all six cases. Results. Five tumors were located at the skull base and one originated from the falx. CT images revealed well-demarcated, irregular lobulated and variable density masses with obvious calci?cation (6/6), no or slight enhancement, without peritumoral edema, and frequently accompanied by erosion and destruction of surrounding bone (5/6). Tumor parenchyma appeared heterogeneously hypointense on T1WI, and hyperintense or mixed hyperintense and hypointense on T2WI, while the calcification appeared hypointense on T1WI and T2WI in five cases, demonstrating significant inhomogeneous enhancement on postcontrast MRI, which revealed the typical 'punica granatum seeds' sign. Only one case showed homogeneous low signal intensity on T1WI and high signal intensity on T2WI, and relatively uniform obvious enhancement on postcontrast scans. Conclusion. These characteristic CT and MR findings, combined with the location of the lesions and the history of a long duration of clinical symptoms, may prove helpful in differentiating intracranial chondromas from other more common tumors.

  9. Intracranial calcification in central diabetes insipidus.

    Science.gov (United States)

    Al-Kandari, Salwa Ramadan; Pandey, Tarun; Badawi, Mona H

    2008-01-01

    Intracranial calcification is a known but extremely rare complication of diabetes insipidus. To date, only 16 patients have been reported and all had the peripheral (nephrogenic) type of diabetes insipidus. We report a child with intracranial calcification complicating central diabetes insipidus. We also report a child with nephrogenic diabetes insipidus, and compare the patterns of intracranial calcification.

  10. Intracranial calcification in central diabetes insipidus

    Energy Technology Data Exchange (ETDEWEB)

    Al-Kandari, Salwa R. [Al Razi Hospital, Department of Clinical Radiology, Kuwait (Kuwait); Pandey, Tarun [Al Razi Hospital, Department of Clinical Radiology, Kuwait (Kuwait); University of Arkansas for Medical Sciences, Radiology Department, Little Rock, AR (United States); Badawi, Mona H. [Al-Adan Hospital, Department of Paediatrics, Kuwait (Kuwait)

    2008-01-15

    Intracranial calcification is a known but extremely rare complication of diabetes insipidus. To date, only 16 patients have been reported and all had the peripheral (nephrogenic) type of diabetes insipidus. We report a child with intracranial calcification complicating central diabetes insipidus. We also report a child with nephrogenic diabetes insipidus, and compare the patterns of intracranial calcification. (orig.)

  11. Pseudoarachnoiditis in Spontaneous Intracranial Hypotension

    Directory of Open Access Journals (Sweden)

    Özlem Alkan

    2011-03-01

    Full Text Available Spontaneous intracranial hypotension is an important cause of new daily persistent headaches in young and middle-aged individuals. The diagnosis is made based on low cerebrospinal fluid pressure with characteristic findings upon brain and spinal magnetic resonance imaging (MRI. We present the case of a 15-year-old boy with spontaneous intracranial hypotension. Although his brain MRI was normal, his lumbar spinal MRI showed clustering of the nerve roots characteristic of arachnoiditis. Radionuclide cisternography revealed an epidural leak, which was treated with an epidural blood patch. The patient reached a near-full recovery within 24 h, and the lumbar spinal MRI findings mimicking arachnoiditis disappeared.

  12. Syphilis mimicking idiopathic intracranial hypertension

    DEFF Research Database (Denmark)

    Yri, Hanne; Wegener, Marianne; Jensen, Rigmor

    2011-01-01

    or an atypical disease course should alert the physician to reevaluate a presumed IIH-diagnosis. The authors report a case of a 32-year-old non-obese male with intracranial hypertension, secondary to a syphilitic central nervous system infection, initially misdiagnosed as being idiopathic. Upon relevant......Idiopathic intracranial hypertension (IIH) is a condition of yet unknown aetiology affecting predominantly obese females of childbearing age. IIH is a diagnosis of exclusion as raised cerebrospinal fluid pressure may occur secondary to numerous other medical conditions. An atypical phenotype...

  13. Multiple Metastatic Intracranial Lesions Associated with Left Atrial Myxoma

    Science.gov (United States)

    Kierdaszuk, Biruta; Gogol, Paweł; Kolasa, Anna; Maj, Edyta; Zakrzewska-Pniewska, Beata; Gołębiowski, Marek; Kamińska, Anna M.

    2014-01-01

    Summary Background One of the most common cardiac tumors is myxoma. Despite its predominantly benign course, diverse cardiological, systemic as well as neurological complications have been reported. Case Report We are the first from Poland to present the case of a patient with multiple central nervous system metastases associated with the left atrial myxoma. Various diagnostic, neuroradiological and histopathological procedures were described. The patient underwent cardiac surgery. Conclusions Follow-up studies excluded the recurrence of the heart tumor and confirmed partial resolution of brain metastases. Nevertheless, subsequent neurological assessment was advised according to the literature data and possible late relapses mainly due to cerebral emboli. PMID:25152797

  14. Prognosis by tumor location in adults with intracranial ependymomas.

    Science.gov (United States)

    Sayegh, Eli T; Aranda, Derick; Kim, Joseph M; Oh, Taemin; Parsa, Andrew T; Oh, Michael C

    2014-12-01

    Intracranial ependymomas are rare tumors in adults. Thus, factors affecting prognosis are poorly understood. We performed a study to investigate whether tumor location is an important prognostic factor in adults who undergo surgery for intracranial ependymomas. PubMed was searched to identify studies that reported clinical outcomes in adult patients with intracranial ependymoma. Data were extracted for patient and tumor characteristics, extent of resection, progression-free survival (PFS), and overall survival (OS). Tumors were categorized as supratentorial or infratentorial and extraventricular or intraventricular. Presenting clinical features and tumor characteristics were tabulated. Kaplan-Meier and multivariate Cox regression survival analyses were performed to determine PFS and OS by tumor location. Extent of resection was also analyzed by tumor location. A total of 183 patients were included in the meta-analysis. Patients presented at a mean of 8.2months with a myriad of clinical features. The mean tumor size was 3.38 cm, and 19.3% of tumors were cystic. Supratentorial tumors were most commonly located in the frontal and parietal lobes, and infratentorial tumors in the fourth ventricle. Supratentorial tumors demonstrated significantly poorer PFS (pinfratentorial tumors, despite a higher rate of gross total resection (GTR) for the supratentorial tumors (72.6% versus 42.1%). Extraventricular ependymomas displayed significantly poorer PFS than intraventricular ependymomas (p=0.009). In summary, supratentorial ependymomas have significantly poorer PFS and OS than their infratentorial counterparts, despite being more conducive to GTR, suggesting increased clinical aggressiveness. Extraventricular location is also associated with significantly poorer PFS than intraventricular location.

  15. Management of giant intracranial ICA aneurysms with combined extracranial-intracranial anastomosis and endovascular occlusion.

    Science.gov (United States)

    Serbinenko, F A; Filatov, J M; Spallone, A; Tchurilov, M V; Lazarev, V A

    1990-07-01

    Nine patients with giant internal carotid artery (ICA) aneurysms (greater than 2.5 cm in diameter) were subjected to a combined extracranial-intracranial (EC-IC) bypass procedure and endovascular ICA occlusion during 1987 and 1988. The procedures were performed under one anesthetic. In all cases the collateral circulation had been judged insufficient on the basis of a strict preoperative testing protocol including: cerebral panangiography, electroencephalography, somatosensory potential recording, and cerebral blood flow monitoring during manual compression of the ICA in the neck. There were four intracavernous ICA aneurysms, four carotid-ophthalmic artery aneurysms, and one supraclinoid ICA aneurysm. All patients showed symptoms and signs of compression of the surrounding nervous structures. In the five cases of intradural lesions, the artery was occluded at the level of the aneurysm neck, so the ophthalmic artery had to be occluded. There was, nevertheless, no case of worsening of vision following surgery, and all nine patients showed significant improvement following the combined procedure. A combined EC-IC bypass procedure and endovascular ICA occlusion allows for immediate verification of the surgical results and appears to be a worthwhile method for treating giant intracranial aneurysms.

  16. Pyelo-cystic Reflux in F-18 FDG PET Scan Due to Ureteral Obstruction

    Energy Technology Data Exchange (ETDEWEB)

    Reyhan, Mehmet [Baskent Univ., Adana (Turkmenistan)

    2013-09-15

    A 72-year-old woman with a history of cervical cancer was treated with brachytherapy and chemotherapy. Combined F-18 FDG PET/CT performed for restaging demonstrated increased FDG uptake in a hypodense cystic lesion at the posterior part of the right renal cortex and a hypermetabolic soft tissue mass at the right parailiac region suggestive of a metastatic lymph node causing ureteral obstruction. There had been no FDG uptake in the cystic lesion on the FDG PET/CT study performed 1 year before. These findings suggest that the increased FDG uptake in the cystic lesion was caused by pyelocystic reflux due to ureteral obstruction secondary to parailiac lymph node metastasis (Figs. 1 and 2). Several renal lesions may have increased metabolism, such as renal cell carcinoma, lymphoma, oncocytoma, adult Wilms' tumor, angiomyolipoma, metastatic lesions, xanthogranulo-matous pyelonephritis and infected cyst. Most of these lesions are solid. Some infected renal cysts may be FDG avid, but in this situation increased FDG uptake is observed on the wall of the cyst. In our case, FDG uptake was seen in the entire cystic lesion. The patient had no symptoms or laboratory findings related to infection. Cysts are the most common space-occupying lesions of the kidney. The vast majority of these are simple cysts that are usually unilateral and solitary. Simple cysts are asymptomatic, except when complications exist such as hemorrhage, infection or rupture. There have been a few reports on spontaneous communications between renal cysts and the pyelocaliceal system, in most cases involving ruptures of the cysts into the pyelocaliceal system due to increased intracystic pressure caused by bleeding or infection of the cyst. In the present case, the cause of the connection between the cystic cavity and the pyelocaliceal system is the increased pressure in the renal pelvic cavity due to the ureteral obstruction secondary to parailiac lymph node metastasis.

  17. Endoscope-assisted microsurgery for intracranial aneurysms.

    Science.gov (United States)

    Kalavakonda, Chandrasekar; Sekhar, Laligam N; Ramachandran, Pranatartiharan; Hechl, Peter

    2002-11-01

    We discuss the role of the endoscope in the microsurgical treatment of intracranial aneurysms, analyzing its benefits, risks, and disadvantages. This was a prospective study of 55 patients with 79 aneurysms, treated between July 1998 and June 2001, for whom the endoscope was used as an adjunct in the microsurgical treatment of their lesions. Seventy-one aneurysms were located in the anterior circulation, and eight were located in the posterior circulation. Thirty-seven patients presented with subarachnoid hemorrhage. Eighteen patients had unruptured aneurysms, of whom 5 presented with mass effect, 2 presented with transient ischemic attacks, and 11 were without symptoms. In all cases, the endoscope was used in addition to microsurgical dissection and clipping (sometimes before clipping, sometimes during clipping, and always after clipping), for observation of the neck anatomic features and perforators and verification of the optimal clip position. Intraoperative angiography was performed for all patients after aneurysm clipping. In the majority of cases, the endoscope was very useful for the assessment of regional anatomic features. It allowed better observation of anatomic features, compared with the microscope, for 26 aneurysms; in 15 cases, pertinent anatomic information could be obtained only with the endoscope. The duration of temporary clipping of the parent artery was significantly reduced for two patients. The clip was repositioned because of a residual neck or inclusion of the parent vessel during aneurysm clipping in six cases, and the clip position was readjusted because of compression of the optic nerve in one case. One patient experienced a small aneurysm rupture that was directly related to use of the endoscope, but this was easily controlled, with no sequelae. For many patients, the combination of the neuro-endoscope and the micro-Doppler probe made intraoperative angiography redundant. "Endoscope-assisted microsurgery" is a major advance in the

  18. Intradiploic epidermoid cyst with intracranial hypertension syndrome: Report of two cases and literature review

    Directory of Open Access Journals (Sweden)

    J.C. Moreira-Holguin

    2015-01-01

    Conclusion: These benign lesions, although they are of low incidence, are seen very rarely in intradiploic locations and above all, of significant size, may produce significant mass effect in patients, which was initially tolerated because of its slow growth, however, they may become decompensate and cause intracranial hypertension syndrome.

  19. Malignant transformation of intracranial meningeal melanocytoma. Case report and review of the literature.

    Science.gov (United States)

    Wang, Fulin; Qiao, Guangyu; Lou, Xin; Song, Xin; Chen, Wei

    2011-08-01

    Meningeal melanocytoma is an uncommon pigmented neoplasm that affects the CNS and develops in the cranial and spinal leptomeninges. Here we report on a case of malignant transformation of intracranial supratentorial meningeal melanocytoma which recurred after 3 years as malignant melanoma. This case demonstrates that the biological behavior of melanocytoma is uncertain and that these lesions may recur as malignant melanoma.

  20. Tic douloureux in patients with incidental intracranial meningioma; MR findings and review of literature

    Directory of Open Access Journals (Sweden)

    A. Elsotouhy

    2015-06-01

    We discuss two middle aged ladies who presented with trigeminal neuralgia, MRI in both of them revealed the presence of intracranial extra-axial mass lesions with the characteristic features of meningioma causing trigeminal nerve compression and explaining the cause of neuralgia.

  1. Bilateral upregulation of α-synuclein expression in the mouse substantia nigra by intracranial rotenone treatment.

    Science.gov (United States)

    Carriere, Candace H; Kang, Na Hyea; Niles, Lennard P

    2017-02-01

    The pesticide rotenone has been shown to cause systemic inhibition of mitochondrial complex I activity, with consequent degeneration of dopamine neurons along the nigrostriatal pathway, as observed in Parkinson's disease (PD). Recently, intracranial infusion of rotenone was found to increase the protein levels of the Lewy body constituents, α-synuclein and small ubiquitin-related modifier-1(SUMO-1), in the lesioned hemisphere of the mouse brain. These findings are supportive of a mouse model of PD, but information about the dopamine-synthesizing enzyme, tyrosine hydroxylase (TH), an essential marker of dopaminergic status, was not reported. Clarification of this issue is important because an intracranial rotenone mouse model of Parkinson's disease has not been established. Towards this end, the present study examined the effects of intracranial rotenone treatment on TH and α-synuclein immunohistochemistry in addition to forelimb motor function. Mice were unilaterally infused with either vehicle or rotenone (2μg/site) in both the medial forebrain bundle and the substantia nigra. The forelimb asymmetry (cylinder) test indicated a significant decrease in use of the contralateral forelimb in lesioned animals as compared to the sham group. Densitometric analysis revealed a significant depletion of TH immunofluorescence within the ipsilateral striatum and substantia nigra of lesioned animals. Moreover, a significant bilateral increase in α-synuclein immunofluorescence was found in the substantia nigra of lesioned mice, as compared to control animals. These findings indicate that this intracranial rotenone mouse model will be useful for studies of neurodegenerative disorders such as PD.

  2. BENIGN INTRACRANIAL HYPOTENSION WITH INCIDENTAL PARASAGITTAL MENINGIOMA

    Directory of Open Access Journals (Sweden)

    Sukumar

    2015-12-01

    Full Text Available Benign intracranial hypotension, otherwise called as idiopathic intracranial hypotension is caused by CSF leaks due to disruption in spinal meninges. It is most commonly caused by disruption and leak at cervical and thoracic spine. Imaging is sometimes the most important key to the diagnosis of idiopathic intracranial hypotension, which helps in appropriate treatment of the patient. Here, we are presenting a case of benign intracranial hypotension associated with incidental parasagittal meningioma. The presence of benign intracranial hypotension was confirmed by taking MR myelogram.

  3. Challenges in the prenatal and post-natal diagnosis of mediastinal cystic hygroma: a case report

    Directory of Open Access Journals (Sweden)

    Nazir Sarfraz

    2008-08-01

    Full Text Available Abstract Introduction Cystic hygroma is a benign congenital neoplasm that mostly presents as a soft-tissue mass in the posterior triangle of the neck. Pure mediastinal lesions are uncommon; the vast majority are asymptomatic and are an incidental finding in adulthood. The diagnosis is often made intra- or postoperatively. Prenatal identification is exceptional and post-natal diagnosis also proves challenging. Case presentation We report one such case that was mistaken for other entities in both the prenatal and immediate post-natal period. Initial and follow-up antenatal ultrasound scans demonstrated a multicystic lesion in the left chest, and the mother was counselled about the possibility of her baby having a congenital diaphragmatic hernia. Initial post-natal chest radiographs were reported as normal. An echocardiogram and thoracic computed tomography scan confirmed a complex multiloculated cystic mediastinal mass. The working diagnoses were of a mediastinal teratoma or congenital cystic adenomatous malformation. At operation, the lesion was compressed by the left lung and was found to be close to the left phrenic nerve, which was carefully identified and preserved. After excision, histopathological examination of the mass confirmed the diagnosis of cystic hygroma. Postoperative dyspnoea was observed secondary to paradoxical movement of the left hemidiaphragm and probable left phrenic neuropraxia. This settled conservatively with excellent recovery. Conclusion Despite the fact that isolated intrathoracic cystic hygroma is a rare entity, it needs to be considered in the differential diagnosis of foetal and neonatal mediastinal masses, particularly for juxtadiaphragmatic lesions. The phrenic nerve is not identifiable on prenatal ultrasound imaging, and it is therefore understandable that a mass close to the diaphragm may be mistaken for a congenital diaphragmatic hernia because of the location, morphology and potential phrenic nerve compression

  4. Imaging intracranial tuberculosis in childhood

    Energy Technology Data Exchange (ETDEWEB)

    Jamieson, D.H. [Dept. of Radiology, Red Cross War Memorial Children`s Hospital, Rondebosch (South Africa)

    1995-05-01

    A morphologically based imaging review of intracranial tuberculosis in childhood is presented. The computed tomography and magnetic resonance features of parenchymal tuberculoma, tuberculous meningitis and meningeal/meniningocerebral tuberculoma are illustrated. Recent insight into the nature of tuberculoma necrosis and its magnetic resonance correlation is reviewed. Pathogenesis, relevant clinical background and the role of modern imaging is discussed. (orig.)

  5. Nutritional Issues in Cystic Fibrosis.

    Science.gov (United States)

    Solomon, Missale; Bozic, Molly; Mascarenhas, Maria R

    2016-03-01

    The importance of maintaining adequate nutrition in patients with cystic fibrosis has been well known for the past 3 decades. Achieving normal growth and maintaining optimal nutrition is associated with improved lung function. Comprehensive and consistent nutritional assessments at regular intervals can identify those at risk of nutritional failure and uncover micronutrient deficiencies contributing to malnutrition. Management of malnutrition in cystic fibrosis should follow a stepwise approach to determine the causes and comorbidities and to develop a nutritional plan. Nutritional management is crucial at every stage in a person's life with cystic fibrosis and remains a cornerstone of management.

  6. Clinical evaluation of stereoscopic DSA for vascular lesions

    OpenAIRE

    大川,元臣; 児島, 完治; 影山,淳一; 日野, 一郎; 高島, 均; 玉井,豊理; 田邉,正忠; 大本, 尭史; 植田, 清隆; 藤原, 敬

    1989-01-01

    Seventy-one series of stereoscopic DSA utilized on thirty-nine patients with intracranial vascular lesions were evaluated by comparison with subtracted magnified angiograms or independently. All stereoscopic series had good or fairly good stereoscopic quality. Stereoscopic DSA was useful in the preoperative stereoscopic vascular analysis of vascular lesions such as aneurysms, arteriovenous malformations, cartotid-cavernous fistulas, obstructive or stenotic vascular lesions and vascular elonga...

  7. Morel-Lavallee lesion

    Institute of Scientific and Technical Information of China (English)

    Li Hui; Zhang Fangjie; Lei Guanghua

    2014-01-01

    Objective To review current knowledge of the Morel-Lavallee lesion (MLL) to help clinicians become familiar with this entity.Familiarization may decrease missed diagnoses and misdiagnoses.It could also help steer the clinician to the proper treatment choice.Data sources A search was performed via PubMed and EMBASE from 1966 to July 2013 using the following keywords:Morel-Lavallee lesion,closed degloving injury,concealed degloving injury,Morel-Lavallee effusion,Morel-Lavallee hematoma,posttraumatic pseudocyst,posttraumatic soft tissue cyst.Study selection Chinese and English language literatures relevant to the subject were collected.Their references were also reviewed.Results Morel-Lavallee lesion is a relatively rare condition involving a closed degloving injury.It is characterized by a filled cystic cavity created by separation of the subcutaneous tissue from the underlying fascia.Apart from the classic location over the region of the greater trochanter,MLLs have been described in other parts of the body.The natural history of MLL has not yet been established.The lesion may decrease in volume,remain stable,enlarge progressively or show a recurrent pattern.Diagnosis of MLL was often missed or delayed.Ultrasonography,computed tomography,and magnetic resonance imaging have great value in the diagnosis of MLL.Treatment of MLL has included compression,local aspiration,open debridement,and sclerodesis.No standard treatment has been established.Conclusions A diagnosis of MLL should be suspected when a soft,fluctuant area of skin or chronic recurrent fluid collection is found in a region exposed to a previous shear injury.Clinicians and radiologists should be aware of both the acute and chronic appearances to make the correct diagnosis.Treatment decisions should base on association with fractures,the condition of the lesion,symptom and desire of the patient.

  8. [Current perspectives on endodontic treatment of teeth with chronic periapical lesions].

    Science.gov (United States)

    Canalda Sahli, C

    1990-01-01

    The author study in this article histopathological aspects of periapical lesions, intra-granulomatous epithelial proliferation phenomenon as pathogenic mechanism of microscopic cystic cavities formation, diagnostic problems of them all, as well as the most actual therapeutic perspectives.

  9. Pancreatic Cystic Fluid Reference Set — EDRN Public Portal

    Science.gov (United States)

    The proposed reference set will be designed to evaluate biomarkers for the following applications aimed at determining whether a patient would benefit from surgical resection of their cystic lesion: 1. Distinguish between pancreatic cysts that have high-malignant potential and cysts that have low or no malignant potential at time of endoscopic ultrasound evaluation. a. By analysis of blood b. By analysis of pancreatic cystic fluid 2. Distinguish between cysts that have any malignant potential (high and low) and cysts that have no malignant potential (benign lesions) at time of endoscopic ultrasound evaluation. a. By analysis of blood b. By analysis of pancreatic cystic fluid 3. Distinguish between a cyst that is mucinous (malignant potential) or non-mucinous (no malignant potential) at time of endoscopic ultrasound evaluation. a. By analysis of blood b. By analysis of pancreatic cystic fluid 4. Distinguish between pancreatic cysts that have high-malignant potential and cysts that have low or no malignant potential at time of evaluation in surgery clinic. a. By analysis of blood 5. Distinguish between cysts that have any malignant potential (high and low) and cysts that have no malignant potential (benign lesions) at time of evaluation in surgery clinic. a. By analysis of blood 6. Distinguish between a cyst that is mucinous (malignant potential) or non-mucinous (no malignant potential) at time of evaluation in surgery clinic. a. By analysis of blood If successful in meeting these afore-mentioned objectives, these results can then be used in the development of future studies at identifying the need for additional evaluation (i.e., endoscopic ultrasound with fine needle aspiration) of an incidental cyst

  10. Profile of cystic fibrosis

    Directory of Open Access Journals (Sweden)

    Mona M. El-Falaki

    2014-09-01

    Full Text Available It was generally believed that Cystic fibrosis (CF is rare among Arabs; however, the few studies available from Egypt and other Arabic countries suggested the presence of many undiagnosed patients. The aim of the present study was to determine the frequency of CF patients out of the referred cases in a single referral hospital in Egypt. A total of 100 patients clinically suspected of having CF were recruited from the CF clinic of the Allergy and Pulmonology Unit, Children’s Hospital, Cairo University, Egypt, throughout a 2 year period. Sweat chloride testing was done for all patients using the Wescor macroduct system for collection of sweat. Quantitative analysis for chloride was then done by the thiocyanate colorimetric method. Patients positive for sweat chloride (⩾60 mmol/L were tested for the ΔF508 mutation using primer specific PCR for cystic fibrosis transmembrane conductance regulator (CFTR gene. Thirty-six patients (36% had a positive sweat chloride test. The main clinical presentations in patients were chronic cough in 32 (88.9%, failure to thrive in 27 (75%, steatorrhea in 24 (66.7%, and hepatobiliary involvement in 5 (13.9%. Positive consanguinity was reported in 50% of CF patients. Thirty-two patients were screened for ΔF508 mutation. Positive ΔF508 mutation was detected in 22 (68.8% patients, 8 (25% were homozygous, 14 (43.8% were heterozygous, and 10 (31.3% tested were negative. CF was diagnosed in more than third of patients suspected of having the disease on clinical grounds. This high frequency of CF among referred patients indicates that a high index of suspicion and an increasing availability of diagnostic tests lead to the identification of a higher number of affected individuals.

  11. [Cystic lymphangioma of the scrotum].

    Science.gov (United States)

    Oliver Llinares, F; Roques Serradilla, J L; Ruíz Jiménez, J I; Desus Ruíz, J; Segarra Llido, V

    1980-01-01

    The authors present a case of cystic lymphangioma of the scrotum. They stress the rarity of this location. They also comment upon the embriology, clinical picture and treatment of these benign tumours.

  12. [Lung physiotherapy in cystic fibrosis].

    Science.gov (United States)

    Gursli, S; Haanaes, O C

    1991-02-28

    This article is intended as a brief practical guide for physicians and physiotherapists concerned with the treatment of cystic fibrosis. Physiotherapeutic techniques for the treatment of chest diseases have been developed and modified as advances have taken place in the medical management of cystic fibrosis. The article describes forced expiratory technique, positive expiratory pressure, postural drainage, autogenic drainage and other techniques. Patients with cystic fibrosis live longer and have a better quality of life than ever before, but progressive deterioration of lung function will always be their most serious problem. Physical activity and chest physiotherapy are essential parts of all treatment regimens for cystic fibrosis. It is important to realize that the physiotherapist is a very important member of the team which includes nurses, physicians-and the patient.

  13. Abdominal Cystic Lymphangioma Mimicking Appendicitis

    OpenAIRE

    Wake, Sarah; Abhyankar, Aruna; Hutton, Kim

    2013-01-01

    A cystic lymphangioma arising within the abdomen is a rare entity in children. It may present with an abdominal mass and symptoms of abdominal pain, vomiting, and anorexia. These nonspecific clinical symptoms are often attributed to more common acute pediatric conditions. In this report, we describe two pediatric cases of intra-abdominal cystic lymphangioma that were initially diagnosed and treated as appendicitis. True diagnosis was only achieved on surgical excision and pathological investi...

  14. Alveolar inflammation in cystic fibrosis

    DEFF Research Database (Denmark)

    Ulrich, Martina; Worlitzsch, Dieter; Viglio, Simona

    2010-01-01

    BACKGROUND: In infected lungs of the cystic fibrosis (CF) patients, opportunistic pathogens and mutated cystic fibrosis transmembrane conductance regulator protein (CFTR) contribute to chronic airway inflammation that is characterized by neutrophil/macrophage infiltration, cytokine release...... accumulated in type II alveolar epithelial cells, lacking CFTR. P. aeruginosa organisms were rarely present in inflamed alveoli. CONCLUSIONS: Chronic inflammation and remodeling is present in alveolar tissues of the CF lung and needs to be addressed by anti-inflammatory therapies....

  15. Prevalence of cystic paraurethral structures in asymptomatic women at endovaginal and perineal sonography

    Energy Technology Data Exchange (ETDEWEB)

    Cross, Justin J.L.; Fynes, Michelle; Berman, Laurence; Perera, Divaka

    2001-07-01

    AIM: To prospectively assess the prevalence of paraurethral cystic structures in asymptomatic adult women. PATIENTS AND METHODS: One hundred and forty consecutive women undergoing endovaginal sonography with no history of lower urinary tract symptoms. RESULTS: Paraurethral cystic structures were identified in 4/140 subjects (2.9%). Ultrasound assessment allowed rapid definition of the site, size and vascularity of these lesions and was well tolerated by the patient. CONCLUSION: This is the first prospective ultrasound study to determine the prevalence of paraurethral cystic structures in a large consecutive cohort of asymptomatic women. Our findings are in accordance with previously published post-mortem data and surgical series which have estimated the prevalence of paraurethral cystic structures to be between 1 and 6%. Cross, J.J.L. et al.(2001)

  16. A pigmented calcifying cystic odontogenic tumor associated with compound odontoma: a case report and review of literature

    Directory of Open Access Journals (Sweden)

    Borkosky Silvia S

    2007-09-01

    Full Text Available Abstract Background Pigmented intraosseous odontogenic lesions are rare with only 47 reported cases in the English literature. Among them, pigmented calcifying cystic odontogenic tumor, formerly known as calcifying odontogenic cyst, is the most common lesion with 20 reported cases. Methods A case of pigmented calcifying cystic odontogenic tumor associated with odontoma occurring at the mandibular canine-premolar region of a young Japanese boy is presented with radiographic, and histological findings. Special staining, electron microscopic study and immunohistochemical staining were also done to characterize the pigmentation. Results The pigments in the lesion were confirmed to be melanin by Masson-Fontana staining and by transmission electron microscopy. The presence of dendritic melanocytes within the lesion was also demonstrated by S-100 immunostaining. Conclusion The present case report of pigmented calcifying cystic odontogenic tumor associated with odontoma features a comprehensive study on melanin and melanocytes, including histochemical, immunohistochemical and transmission electron microscopic findings.

  17. PET examination in intracranial tumor diagnosis of a cat

    Science.gov (United States)

    Angyal, G.; Csepura, G.; Balkay, L.; Galuska, L.; Molnár, J.; Valastyán, I.

    2008-12-01

    This paper shows the significance of the Positron Emission Tomography (PET) in the veterinary medication through a case study of a cat brain tumor. A castrated male cat with bilateral mydriasis and blindness arrived at the veterinary clinic. After physical, laboratory and neurological investigations other sickness was ruled out and the inkling of the intracranial lesion had come to light. Brain tumor seemed the most likely to cause the illness because other symptoms appeared (for example: anorexia, depression) and they progrediated fast. PET examination, using 18F-FDG isotope, was performed to confirm the possible causes of the cat's symptoms

  18. What Are the Signs and Symptoms of Cystic Fibrosis?

    Science.gov (United States)

    ... Twitter. What Are the Signs and Symptoms of Cystic Fibrosis? The signs and symptoms of cystic fibrosis (CF) ... respiratory, digestive, or reproductive systems of the body. Cystic Fibrosis Figure A shows the organs that cystic fibrosis ...

  19. Intracranial tuberculosis in children : CT findings before and after treatment

    Energy Technology Data Exchange (ETDEWEB)

    Jung, Hye Weon; Kim, In One; Kim, Woo Sun; Hwang, Yong Seong; Yeon, Kyung Mo [Seoul National Univ. College of Medicine, Seoul (Korea, Republic of)

    1996-08-01

    To analyze the CT findings of intracranial tuberculosis in children at initial stage and during follow-up after treatment. We evaluated 25 patients who were diagnosed by CSF analysis or response to anti-tuberculous medication as suffering from intracranial tuberculosis. There were 13 boys and 12 girls aged between 4 months and 14 years. Twenty-five initial and sixty-three follow-up CT scans were retrospectively analyzed. We evaluated the pattern of cisternal enhancement, the locations of infarction, and the presence of calcification and parenchymal granuloma. The changes of hydrocephalus and related complications, as well as cisternal abnormality during anti-tuberculous medication were also evaluated. The initial findings on CT scan were hydrocephalus(75%), cisternal obliteration in precontrast study(64%), thick-line or ring-shaped cisternal enhancement on postcontrast study(44%), infarctions(32%), calcifications(32%), periventricular edema(28%), and parenchymal granulomas(16%). On follow-up CT scan, hydrocephalus and cisternal enhancement had decreased to 35% and 82%, respectively, and the granulomas had changed to calcified nodules(100%). Ventriculo-peritoneal shunt or external ventricular drainage was needed in nine patient, and ventriculitis or complication of shunt procedure developed in four. Intracranial tuberculosis in children presented predominantly as meningitis involving basal cisterns and was associated with hydrocephalus. Infarction and calcification may be seen as parenchymal lesion. In spite of medical treatment, drainage was needed in about half the patients. During this treatment, the resolution of hydrocephalus, decreased cisternal enhancement, and calcification of the granlomas were seen.

  20. Mercury poisoning as a cause of intracranial hypertension.

    Science.gov (United States)

    Gençpınar, Pınar; Büyüktahtakın, Başak; İbişoğlu, Zeynep; Genç, Şakir; Yılmaz, Aygen; Mıhçı, Ercan

    2015-05-01

    Mercury poisoning is a rare but fatal toxicologic emergency. Neurologic manifestations involving the central nervous system are seen usually with chronic mercury intoxication. The most commonly seen complaints are headache, tremor, impaired cognitive skills, weakness, muscle atrophy, and paresthesia. Here, we present a male patient who was chronically exposed to elemental mercury and had papilledema and intracranial hypertension without parenchymal lesion in the central nervous system. A 12-year-old male patient was referred to our emergency room because of severe fatigue, generalized muscle pain and weakness, which was present for a month. Physical examination revealed painful extremities, decreased motor strength and the lack of deep tendon reflexes in lower extremities. He had mixed type polyneuropathy in his electromyography. Whole blood and 24-hour urinary mercury concentrations were high. A chelation therapy with succimer (dimercaptosuccinic acid) was started on the fourth day of his admission. On the seventh day of his admission, he developed headache and nausea, and bilateral papilledema and intracranial hypertension were detected on physical examination. Acetazolamide was started and after 1 month of treatment, the fundi examination was normal. The patient stayed in the hospital for 35 days and was then discharged with acetazolamide, vitamin B6, gabapentin, and followed as an outpatient. His clinical findings were relieving day by day. Although headache is the most common symptom in mercury poisoning, the clinician should evaluate the fundus in terms of intracranial hypertension.

  1. Coexistence of intracranial epidermoid tumor and multiple cerebral aneurysms

    Science.gov (United States)

    Yao, Pei-Sen; Lin, Zhang-Ya; Zheng, Shu-Fa; Lin, Yuan-Xiang; Yu, Liang-Hong; Jiang, Chang-Zhen; Kang, De-Zhi

    2017-01-01

    Abstract Rationale: There were a few case reports concerning epidermoid tumor coexisted with multiple cerebral aneurysms. Here, we present one case of coexistence of intracranial epidermoid tumor and multiple cerebral aneurysms and performed a literature review. Patient concerns: A 42 years old male patient was admitted to our institution with complaints of headache and dizziness. Interventions: The radiological examinations showed a hypointense lesion in the right parasellar and petrous apex region and an ipsilateral saccular aneurysm originated from the M2–M3 junction of the right middle cerebral artery (MCA) and a saccular aneurysm of the clinoid segment of right internal carotid artery (ICA). Interventions: The patients underwent a right frontotemporal approach for removal of the epidermoid tumor and clipping of the MCA aneurysm in one stage. The aneurysm located at the clinoid segment of ICA was invisible and untreated during operation. Outcomes: No postoperative complications were found in the patient. The patient's follow up after 5 years of surgical treatment was uneventful, and the untreated aneurysm remains stable. Lessons: The coexistence of intracranial epidermoid tumor and cerebral aneurysm is a rare event. The secondly inflammation in cerebral arterial wall may be responsible for the aneurysm formation. Surgical treatment of the intracranial epidermoid tumor and cerebral aneurysm repair may be an optimal scheme in one stage. PMID:28151901

  2. Flow diversion for complex intracranial aneurysms in young children.

    Science.gov (United States)

    Navarro, Ramon; Brown, Benjamin L; Beier, Alexandra; Ranalli, Nathan; Aldana, Philipp; Hanel, Ricardo A

    2015-03-01

    Pediatric intracranial aneurysms are exceedingly rare and account for less than 5% of all intracranial aneurysms. Open surgery to treat such aneurysms has been shown to be more durable than endovascular techniques, and durability of treatment is particularly important in the pediatric population. Over the past 2 decades, however, a marked shift in aneurysm treatment from open surgery toward endovascular procedures has occurred for adults. The authors describe their early experience in treating 3 unruptured pediatric brain aneurysms using the Pipeline embolization device (PED). The first patient, a girl with Majewski osteodysplastic primordial dwarfism Type II who was harboring multiple intracranial aneurysms, underwent two flow diversion procedures for a vertebrobasilar aneurysm and a supraclinoid internal carotid artery aneurysm. The second patient underwent PED placement on a previously coiled but enlarging posterior communicating artery aneurysm. All procedures were uneventful, with no postsurgical complications, and led to complete angiographic obliteration of the aneurysms. To the authors' knowledge, this is the first series of flow diversion procedures in children reported in the medical literature. While flow diversion is a new and relatively untested technology in children, outcomes in adults have been promising. For challenging lesions in the pediatric population, flow diversion may have a valuable role as a well-tolerated, safe treatment with durable results. Many issues remain to be addressed, such as the durability of flow diverters over a very long follow-up and vessel response to growth in the presence of an endoluminal device.

  3. Idiopathic intracranial hypertension in children: Diagnostic and management approach.

    Science.gov (United States)

    Albakr, Abdulrahman; Hamad, Muddathir H; Alwadei, Ali H; Bashiri, Fahad A; Hassan, Hamdy H; Idris, Hiyam; Hassan, Saeed; Muayqil, Taim; Altweijri, Ikhlass; Salih, Mustafa A

    2016-01-01

    Idiopathic intracranial hypertension (IIH) is a rare neurological disorder in children. It is characterized by raised intracranial pressure (ICP) in the absence of brain parenchymal lesion, vascular malformations, hydrocephalus, or central nervous system (CNS) infection. The diagnosis is usually confirmed by high opening pressure of cerebrospinal fluid (CSF) with exclusion of secondary causes of intracranial hypertension. If not treated properly, it may lead to severe visual dysfunction. Here we review the etiology, clinical presentation, diagnostic criteria and management of IIH in children through illustration of the clinical and radiological presentation of a 13-year-old overweight girl who presented with severe headache, diplopia and bilateral papilledema. Otherwise, she had unremarkable neurological and systemic examinations. Lumbar puncture showed a high CSF opening pressure (360-540 mmH2O). Her investigations showed normal complete blood count (CBC), normal renal, liver, and thyroid function tests. Cerebrospinal fluid (CSF) and blood chemistry were unremarkable. Magnetic resonant image (MRI) of the brain demonstrated empty sella turcica, tortuous optic nerves, and flattening of the posterior sclera. Magnetic resonant venography (MRV) showed focal narrowing of the distal transverse sinuses and absence of venous sinus thrombosis. She required treatment with acetazolamide and prednisolone. With medical treatment, weight reduction, and exercise, our patient had a remarkable improvement in her symptoms with resolution of papilledema in two months. This review highlights the importance of early recognition and management of IIH to prevent permanent visual loss.

  4. Endovascular Interventions for Idiopathic Intracranial Hypertension and Venous Tinnitus: New Horizons.

    Science.gov (United States)

    Hui, Ferdinand K; Abruzzo, Todd; Ansari, Sameer A

    2016-05-01

    Pulsatile tinnitus from intracranial venous abnormalities is an uncommon cause of pulse synchronous tinnitus. Endovascular therapies may have applications in many of these disease conditions. They have the advantage of being minimally invasive and may selectively eliminate the site of turbulence. Venous stenting has been used successfully to treat venous stenoses with low complication rates and high success rates in patients with idiopathic intracranial hypertension though randomized controlled data are lacking. Careful exclusion of other causes of tinnitus should be performed before consideration for surgical or endovascular treatment of presumed causative lesions of venous tinnitus.

  5. Cystic fibroadenoma: report of a rare case with review of literature.

    Science.gov (United States)

    Bhat, Amoolya; Vijaya, C; Gowda, V S Shankare

    2015-01-01

    Fibroadenomas with a predominant cystic change are called cystic fibroadenomas. These are extremely rare forms of fibroadenomas and only one case has been reported so far. They are classified under the category of complex fibroadenomas. Complex fibroadenomas are a rare variant of fibroadenomas occurring in elderly females. They are characterized by presence of one of the complex features along with the usual patterns of fibroadenoma such as cysts more than 3 mm, papillary apocrine metaplasia, or sclerosing adenosis. Patients with these lesions have higher chances of developing carcinoma of breast. We present a case of 35 years old lady with a freely mobile mass in the left breast diagnosed as cystic fibroadenoma after thorough histopathological examination of the lesion.

  6. Chronic osteitic rhinosinusitis as a manifestation of cystic fibrosis: A case report

    Energy Technology Data Exchange (ETDEWEB)

    Jadhav, Aniket B. [Dept. of Diagnostic and Biomedical Sciences, The University of Texas School of Dentistry at Houston, Houston (United States); Lurie, Alan G.; Tadinata, Aditya [Dept. of Diagnostic Sciences, Oral and Maxillofacial Radiology, The University of Connecticut School of Dental Medicine, Farmington (United States)

    2014-09-15

    A 28 year old male patient with a history of cystic fibrosis (CF) was referred to the University of Connecticut School of Dental Medicine for an evaluation of a cystic lesion in the right maxilla using cone-beam computed tomography (CBCT). CF is an autosomal recessive disease characterized by an abnormal production of viscous mucus, affecting the mucociliary clearance. The CBCT scan revealed a large cystic lesion in the right maxilla extending from the right maxillary second molar to the midline in the region of the right central incisor with a significant buccal expansion. Further evaluation revealed complete opacification of the paranasal sinuses with medial bulging of the lateral maxillary sinus walls. The maxillary and sphenoid sinuses also appeared hypoplastic. The peculiar finding seen in this case was the presence of marked sclerosis and an increase in the thickness of the adjacent bony framework. This report aimed to describe the common sinonasal findings associated with CF and its underlying pathophysiology.

  7. OK432 (picibanil) efficacy in an adult with cystic cervical lymphangioma. A case report.

    Science.gov (United States)

    Alonso, Juan; Barbier, Luis; Alvarez, Julio; Romo, Laura; Martín, Jesús C; Arteagoitia, Iciar; Santamaría, Joseba

    2005-01-01

    Cervical cystic lymphangioma (CCL) is a rare and benign tumour involving congenital and cystic abnormalities derived from lymphatic vessels. The most accepted treatment continues to be surgical excision. However, when this infiltrates vital neurovascular neck structures, complete excision is difficult and if only partial, the recurrence rate is very high. The most frequently used alternative treatment is to inject sclerosants into the lesion. The use of these techniques has reported good results in children; however, there are few references thereof with regard to adults. We are reporting on a cervical cystic lymphangioma in a male aged 22, treated with an intra-lesion injection of 20 cc with 0.01 mg/cc dilution of OK-432 (picibanil) in physiological serum. Sole complications were fever and local reaction where the solution was injected. One month after treatment the lymphangioma had totally remitted and sixteen months later continues in remittance.

  8. Temporal bone chondroblastoma with secondary aneurysmal bone cyst presenting as an intracranial mass with clinical seizure activity.

    Science.gov (United States)

    Stapleton, Christopher J; Walcott, Brian P; Linskey, Katy R; Kahle, Kristopher T; Nahed, Brian V; Asaad, Wael F

    2011-06-01

    Chondroblastomas are rare tumors that characteristically arise from the epiphyseal cartilage of long bones of the immature skeleton. Intracranial involvement is uncommon, though the squamous portion of the temporal bone is preferentially affected due to its cartilaginous origin. Patients with temporal bone chondroblastomas classically present with otologic symptoms, while primary neurological complaints are rare. In this report, we describe a 33 year-old man with a chondroblastoma of the temporal bone and an associated aneurysmal bone cyst constituting a large intracranial mass lesion who presented with new-onset seizure activity. We review issues relevant to the pathology and treatment of these lesions.

  9. The minor symptoms of increased intracranial pressure: 101 patients with benign intracranial hypertension.

    Science.gov (United States)

    Round, R; Keane, J R

    1988-09-01

    Of 101 patients with benign intracranial hypertension not related to vasculitis, neck stiffness occurred in 31, tinnitus in 27, distal extremity paresthesias in 22, joint pains in 13, low back pain in 5, and gait "ataxia" in 4. Symptoms resolved promptly upon lowering the intracranial pressure by lumbar puncture, and were probably directly caused by intracranial hypertension. Awareness of these "minor" symptoms of increased intracranial pressure can facilitate diagnosis and management.

  10. Adenoid cystic carcinoma of the sublingual gland: A case report

    Energy Technology Data Exchange (ETDEWEB)

    Song, Ji Young [Dept. of Oral and Maxillofacial Surgery, School of Medicine, Jeju National University, Jeju (Korea, Republic of)

    2016-12-15

    Adenoid cystic carcinoma (ACC) of the sublingual gland is an extremely rare neoplasm. The clinicopathological characteristics of ACC are slow-growing swelling with or without ulceration, perineural spread, local recurrence, and distant metastasis. This report describes a 58-year-old male who had a slowly growing swelling without ulceration on the right side of the mouth floor that had been present for 1 month. In a radiological examination, the mass showed multilocular cystic features and no bony or tongue muscle invasion. No enlarged cervical lymph nodes were detected. Excisional biopsy and histological analysis showed that the lesion was ACC. In addition to reporting a rare case of ACC, this report also discusses the differential diagnosis and treatment of ACC with a review of the relevant literature.

  11. Cystic lymphangioma in the submandibular triangle in the adult

    Energy Technology Data Exchange (ETDEWEB)

    Kim, Eun Kyung; Han, Won Jeong; Kim, Sang Joon [Dankook Univ., Seoul (Korea, Republic of)

    2001-09-15

    Cystic lymphangioma is an uncommon benign developmental tumor of the lymphatic system, seen rarely in adults. A 23-year-old man visited DKUDH complaining of the painless swelling in the right submandibular triangle area. It was reported that swelling had increased since 5 months ago. Clinically, fluctuant and mobile mass was palpated at the right submancivular area. CT scan showed a large, well-defined, homogenous low density mass, measuring 5.0X2.5X4.0 cm. T1W MRI scan demonstrated a large, multiseptated homogenous low signal mass with septum and rim enhancement. Proton-density and T2W MRI scan showed mass of high signal intensity. MRI scan was able to delineate better the enhanced multiseptation and extent of the lesion. Histopathologically, a lobulated cystic mass lined by a layer of flattened endothelium was observed.

  12. PULMONARY CYSTIC ECHINOCOCCOSIS

    Science.gov (United States)

    Santivanez, Saul; Garcia, Hector H.

    2012-01-01

    Pulmonary cystic echinococosis, a zoonosis caused by the larvae of the dog tapeworm Echinococcus granulosus, is considered as a major public health problem in those countries where dogs are used to care for large herds because of the incapacitating effects produced in affected population. The ratio lung:liver involvement is higher in children than in adults. A higher proportion of lung cases are discovered incidentally on a routine x-ray evaluation; the majority of infected people remain asymptomatic until the cyst enlarges sufficiently to cause symptoms. The majority of symptoms are caused by mass effect from the cyst volume; the presence of complications caused by cysts broke changes the clinical presentation; the principal complication is cyst rupture, producing cough, chest pain, hemoptysis, or vomica. Diagnosis is obtained by imaging evaluation (Chest X-ray or CT scan), supported by serology in the majority of cases. Surgery is the main therapeutic approach, having as principal objective, the removal of the parasite, preventing intraoperative dissemination; the use of pre surgical chemotherapy reduces the chances of seeding and recurrence; treatment using benzimidazoles is the preferred treatment when surgery is not available, or complete removal is not feasible PMID:20216420

  13. Ultrasonography in children of cystic abdominal masses not related to the genitourinary system.

    Science.gov (United States)

    Milburn, J M; Merritt, C R

    1995-10-01

    A variety of cystic abdominal masses not related to the genitourinary tract may be encountered in the pediatric population. Ultrasound is the most informative imaging modality in the workup of these masses which include lymphangiomas, duplication cysts, enteric cysts, mesothelial cysts, pseudocysts, choledochal cysts, and gastrointestinal teratomas. The clinical and sonographic characteristics of these lesions are presented.

  14. Cardiovascular magnetics resonance diagnosis of cystic tumor of the atrioventricular node

    Directory of Open Access Journals (Sweden)

    Wang Xuedong

    2009-04-01

    Full Text Available Abstract Late gadolinium enhanced (LGE cardiovascular magnetic resonance (CMR has proven to be the gold standard for viability assessment. LGE CMR is also useful for identifying the nature of cardiac masses or lesions. We report a case of a rare primary cystic tumor of the atrioventricular node, in which CMR proved to be valuable.

  15. Pulmonary artery stent for bronchial adenoid cystic carcinoma causing pulmonary artery stenosis

    DEFF Research Database (Denmark)

    Smith, Corey Allister; Kotlyar, Eugene; Mellemkjaer, Soren;

    2014-01-01

    A 46-year-old woman presented with a 6-month history of dyspnea and weight loss on a background of previous pneumonectomy for bronchial adenoid cystic carcinoma 14 years beforehand. Several years prior to this presentation, she had developed left vocal cord palsy and a metastatic lesion...

  16. Mucinous Cystic Neoplasms of Pancreas

    Science.gov (United States)

    Naveed, Shah; Qari, Hasina; Banday, Tanveer; Altaf, Asma; Para, Mah

    2014-01-01

    The purpose of this study was to investigate the actual management of mucinous cystic neoplasm (MCN) of the pancreas. A systematic review was performed in December 2009 by consulting PubMed MEDLINE for publications and matching the key words “pancreatic mucinous cystic neoplasm”, “pancreatic mucinous cystic tumor”, “pancreatic mucinous cystic mass”, “pancreatic cyst” and “pancreatic cystic neoplasm” to identify English language articles describing the diagnosis and treatment of the MCN of the pancreas. In total, 16,322 references ranging from January 1969 to December 2009 were analyzed and 77 articles were identified. No articles published before 1996 were selected because MCNs were not previously considered to be a completely autonomous disease. Definition, epidemiology, anatomopathological findings, clinical presentation, preoperative evaluation, treatment and prognosis were reviewed. MCNs are pancreatic mucin-producing cysts with a distinctive ovarian-type stroma localized in the body-tail of the gland and occurring in middle-aged females. The majority of MCNs are slow growing and asymptomatic. The prevalence of invasive carcinoma varies between 6% and 55%. Preoperative diagnosis depends on a combination of clinical features, tumor markers, computed tomography (CT), magnetic resonance imaging, endoscopic ultrasound with cyst fluid analysis and positron emission tomography-CT. Surgery is indicated for all MCNs.

  17. Histiocytic tumor of Meckel's cave. An intracranial equivalent of juvenile xanthogranuloma of the skin.

    Science.gov (United States)

    Paulus, W; Kirchner, T; Michaela, M; Kühl, J; Warmuth-Metz, M; Sörensen, N; Müller-Hermelink, H K; Roggendorf, W

    1992-01-01

    We present the case of a 7-year-old boy who had a solitary mass within Meckel's cave that recurred 6 weeks after the initial resection. The histological, immunohistochemical, electron-microscopical, and molecular genetical features established the lesion's histiocytic nature. Our findings showed that it was closely related to juvenile xanthogranuloma, a benign lesion that usually occurs in the skin but has not yet been histologically confirmed in the brain. The present tumor is different from other intracranial histiocytic and xanthogranulomatous lesions.

  18. A Unique Case of Intracranial Mucormycosis Following an Assault

    Science.gov (United States)

    Hussain, Fadilah S

    2016-01-01

    Intracranial mucormycosis is a very unusual presentation of an infection after a depressed skull fracture due to an assault. Only sporadic cases have been reported in the literature previously. A 30-year-old male with a traumatic brain injury following an assault, status-post debridement and elevation of a depressed skull fracture, was discharged home several weeks postoperatively. A CT scan of the head with contrast was obtained due to mental status changes and revealed an enhancing ring-shaped lesion in the right frontal lobe consistent with a brain abscess. The patient was taken to the operating room for image-guided excisional biopsy of the lesion, with pathology revealing mucormycosis.  PMID:27672528

  19. Using Cystic Fibrosis Therapies for Non-Cystic Fibrosis Bronchiectasis.

    Science.gov (United States)

    ElMaraachli, Wael; Conrad, Douglas J; Wang, Angela C C

    2016-03-01

    Non-cystic fibrosis bronchiectasis (NCFB) is an increasingly prevalent disease that places a significant burden on patients and health systems globally. Although many of the therapies used to treat NCFB were originally developed as cystic fibrosis (CF) therapies, not all of them have been demonstrated to be efficacious in NCFB and some may even be harmful. This article explores the evidence for which therapeutic strategies used to treat CF have been translated into the care of NCFB. The conclusion is that therapies for adult NCFB cannot be simply extrapolated from CF clinical trials, and in some instances, doing so may actually result in harm.

  20. A Case of Bilateral Cystic Partially Differentiated Nephroblastoma vs Cystic Wilms' Tumor: Highlighting a Diagnostic Dilemma.

    Science.gov (United States)

    Stout, Thomas E; Au, Jason K; Hicks, J M; Gargollo, Patricio C

    2016-06-01

    Cystic partially differentiated nephroblastoma (CPDN) is a rare multicystic renal tumor along the spectrum of cystic nephroma and cystic Wilms' tumor. There have only been two previously reported cases of bilateral CPDN in the literature. We present here a case of bilateral CPDN vs cystic Wilms' tumor treated with neoadjuvant and adjuvant chemotherapy in addition to a bilateral partial nephrectomy. We also review the relevant literature regarding CPDN in an effort to aid in diagnosis and management of these rare cystic renal tumors.

  1. Intraosseous adenoid cystic carcinoma of maxilla: A rare case report

    Directory of Open Access Journals (Sweden)

    Prasannasrinivas Suresh Deshpande

    2013-01-01

    Full Text Available Adenoid cystic carcinoma (ACC accounts for approximately 6-10% of all salivary gland tumors. Palatal minor salivary glands, parotid, and sub-mandibular glands are usually affected. Rarely, these lesions arising intraosseously have been reported. Mandible is commonly involved than maxilla. The present case is a giant ACC involving the right maxilla. A thorough clinical and radiographic evaluation was performed to assess the involvement of surrounding vital structures along with a meticulous metastatic work-up. Computed tomography showed a giant lesion in maxilla encroaching the left nasal fossa, antrum, buccal space, and oral cavity. No metastasis was noted. Histological evaluation from multiple sites showed both cribriform and solid patterns. Radiotherapy was given as patient did not comply for surgery. Though central ACC is extremely rare, especially in maxilla, it should be included in the differentials for lesions in maxilla. A prompt diagnosis with treatment and long-term follow-up is advised in such cases.

  2. Cystic Fibrosis (CF): Chloride Sweat Test

    Science.gov (United States)

    ... Old Feeding Your 1- to 2-Year-Old Cystic Fibrosis (CF) Chloride Sweat Test KidsHealth > For Parents > Cystic Fibrosis (CF) Chloride Sweat Test Print A A A ... It Is A chloride sweat test helps diagnose cystic fibrosis (CF) , an inherited disorder that makes kids sick ...

  3. What's it Like to Have Cystic Fibrosis?

    Science.gov (United States)

    ... Emergency Room? What Happens in the Operating Room? Cystic Fibrosis KidsHealth > For Kids > Cystic Fibrosis Print A A A What's in this article? ... with a condition she's known all her life — cystic fibrosis (say: SIS-tik fi-BRO-sus). Her parents ...

  4. IMAGING EVALUATION OF SEROUS CYSTADENOMAS AND MUCINOUS CYSTIC TUMORS OF THE PANCREAS

    Institute of Scientific and Technical Information of China (English)

    Manavendra Upadhyaya; LIU Yu; CHEN Ke-min

    2009-01-01

    Objective To evaluate imaging features of the serous cystadenomas and mucinous cystic tumors of the pancreas.Methods The imaging findings in 59 patients with pathologically proven serous cystadenomas (SCs), mucinous cystadenomas (MCs), and mucinous cystadenocarcinomas (MCCs) of the pancreas were reviewed for location, thickness of septa or the cyst wall, number of cysts, diameter of the largest cyst, lesion calcification, presence of mural node or solid enhancing component, dilatation of the main pancreatic duct (MPD), lesion communication with MPD, invasion of surrounding organs, and regional lymphadenopathy.Results The characteristic imaging feature of SCs was that of microcystic lesion with >6 cysts, the diameter of the largest cyst being <2cm. Mucinous cystic tumors (MCTs) including MCs and MCCs were that of macrocystic lesion with <6 cysts, the diameter of the largest cyst being >2 cm. MCs was that of a lesion with smooth and regular cyst wall and septa, the wall/septa thickness being <0.3 cm. MCCs was that of a cystic lesion with thick irregular septa, presence of mural node or solid enhancing component, invasion of surrounding structures. These findings were of statistical significance.Conclusion SCs, MCs, and MCCs have characteristic imaging features. Analysis of the number of cysts, septation features, mural node or solid enhancing component, diameter of the largest cyst, dilatation of the pancreatic duct, and invasion of surrounding structures often can successfully subtype tumors into benign SCs or potentially malignant MCs or malignant MCCs.

  5. Diagnosis of intracranial occlusive vascular disease and evaluation of extracranial-intracranial (EC/IC) arterial bypass using three-dimensional magnetic resonance angiography

    Energy Technology Data Exchange (ETDEWEB)

    Aoki, Takashi; Houkin, Kiyohiro; Kamiyama, Hiroyasu; Iwasaki, Yoshinobu; Abe, Hiroshi (Hokkaido Univ., Sapporo (Japan). School of Medicine); Kawaguchi, Susumu; Kashiwabara, Takeshi; Koiwa, Mitsuyuki

    1993-01-01

    The three-dimensional time-of-flight (TOF) magnetic resonance angiograms (MRA) were studied to evaluate its accuracy in the assessment of the intracranial carotid occlusive lesions, collateral circulation and also the patency of extracranial-intracranial (EC/IC) arterial bypass surgery. All occlusive lesions of the intracranial major arteries seen in conventional angiograms were revealed clearly with MRA. However MRA had its practical limitation in the evaluation of the leptomeningeal anastomosis (collateral circulation) probably due to the deterioration of contrast in its slow flow and saturation effect of the magnetization. In addition to that, MRA often exaggerated the severity of the stenotic lesions, mostly in severe cases. The postoperative state of collateral flow and the patency of EC/IC bypass could be evaluated as properly with MRA as with conventional angiography, although MRA was limited in spatial resolution and evaluation of flow direction. In conclusion, MRA was considered to be a reliable non-invasive modality as a screening examination for the evaluation of the carotid occlusive disease and as the follow-up study of the post-operative patients with EC/IC bypass surgery. (author).

  6. The diagnosis of intracranial carotid occlusive disease and the evaluation of extracranial-intracranial arterial bypass using three-dimensional magnetic resonance angiography

    Energy Technology Data Exchange (ETDEWEB)

    Aoki, Takeshi; Houkin, Kiyohiro; Kamiyama, Hiroyasu; Iwasaki, Yoshinobu; Abe, Hiroshi (Hokkaido Univ., Sapporo (Japan). School of Medicine); Koiwa, Mitsuyuki; Kawaguchi, Susumu; Kashiwaba, Takeshi

    1993-02-01

    Three-dimensional time-of-flight (TOF) magnetic resonance angiograms (MRA) were studied in order to evaluate their accuracy in the assessment of intracranial carotid occlusive lesions, collateral circulation, and the usefulness of extracranial-intracranial (EC/IC) arterial bypass surgery. All occlusive lesions of the intracranial major arteries seen in conventional angiograms were clearly revealed with MRA. However, MRA had a practical limitation in the evaluation of leptomeningeal anastomosis (collateral circulation), probably because of the deterioration of the contrast in its slow flow and because of the saturation effect of the magnetization. In addition, MRA often exaggerated the severity of the stenotic lesions, mostly in severe cases. The post-operative state of the collateral flow and the usefulness of EC/IC bypass could be evaluated as properly with MRA as with conventional angiography, although MRA was limited in its spatial resolution and in its evaluation of the flow direction. In conclusion, MRA was considered to be a reliable, non-invasive modality for use as a screening examination for the evaluation of carotid occlusive disease and as a follow-up, post-operative study of patients who have received EC/IC bypass surgery. (author).

  7. A series of 64 cases of pancreatic cystic neoplasia from an institutional study of China

    Institute of Scientific and Technical Information of China (English)

    Yuan Ji; Wen-Hui Lou; Da-Yong Jin; Tian-Tao Kuang; Meng-Su Zeng; Yun-Shan Tan; Hai-Ying Zeng; Akesu Sujie; Xiong-Zeng Zhu

    2006-01-01

    AIM: To recognize cystic neoplasia of the pancreas and thus to identify a panel of curable diseases. METHODS: Sixty-four cases of cystic neoplasia of the pancreas, including 28 cases of intraductal papillary mucinous neoplasia (IPMN), 12 Cases of serous cystic neoplasia (SCN), 11 cases of mucinous cystic neoplasia (MCN), 11 cases of solid pseudo-papillary neoplasia (SPN), and 2 cases of solid tumor with cystic degeneration were examined immunohistochemically for their expression of MUC1, MUC2, MUC4, MUC5AC, and MUC6, as well as other related antigens.RESULTS: Adenoma type of IPMN and borderline lesions exhibited high expressions of MUC2, and MUCSAC. Tn contrast, IPMN with invasive carcinoma component showed MUC1 immunoreactivity. SCN was mainly positive for MUC1 and MUC6, while negative for MUC2, MUC4 and MUC5AC. Noninvasive MCN, regardless of its cellular atypia degree, was positive for MUC5AC and negative for MUC1. MUC1 expression was only observed in patients with an invasive component. No mucin expression was found in SPN.CONCLUSION: Mucin profile may, in conjunction with histologic study, provide important information on tumor types and patient treatment of cystic neoplasia of the pancreas.

  8. Intraventricular mass lesions at magnetic resonance imaging: iconographic essay - part 2*

    Science.gov (United States)

    de Castro, Felipe Damásio; Reis, Fabiano; Guerra, José Guilherme Giocondo

    2014-01-01

    The present essay is illustrated with magnetic resonance images obtained at the authors' institution over the past 15 years and discusses the main imaging findings of intraventricular tumor-like lesions (colloid cyst, oligodendroglioma, astroblastoma, lipoma, cavernoma) and of inflammatory/infectious lesions (neurocysticercosis and an atypical presentation of neurohistoplasmosis). Such lesions represent a subgroup of intracranial lesions with unique characteristics and some imaging patterns that may facilitate the differential diagnosis. PMID:25741092

  9. Intraventricular mass lesions at magnetic resonance imaging: iconographic essay - part 2

    Energy Technology Data Exchange (ETDEWEB)

    Castro, Felipe Damasio de; Reis, Fabiano; Guerra, Jose Guilherme Giocondo, E-mail: fdamasiocastro@gmail.com [Universidade Estadual de Campinas (Unicamp), Campinas, SP (Brazil)

    2014-07-15

    The present essay is illustrated with magnetic resonance images obtained at the authors’ institution over the past 15 years and discusses the main imaging findings of intraventricular tumor-like lesions (colloid cyst, oligodendroglioma, astroblastoma, lipoma, cavernoma) and of inflammatory/infectious lesions (neurocysticercosis and an atypical presentation of neurohistoplasmosis). Such lesions represent a subgroup of intracranial lesions with unique characteristics and some imaging patterns that may facilitate the differential diagnosis. (author)

  10. PATHOGENESIS OF OPTIC DISC EDEMA IN RAISED INTRACRANIAL PRESSURE

    Science.gov (United States)

    Hayreh, Sohan Singh

    2015-01-01

    Optic disc edema in raised intracranial pressure was first described in 1853. Ever since, there has been a plethora of controversial hypotheses to explain its pathogenesis. I have explored the subject comprehensively by doing basic, experimental and clinical studies. My objective was to investigate the fundamentals of the subject, to test the validity of the previous theories, and finally, based on all these studies, to find a logical explanation for the pathogenesis. My studies included the following issues pertinent to the pathogenesis of optic disc edema in raised intracranial pressure: the anatomy and blood supply of the optic nerve, the roles of the sheath of the optic nerve, of the centripetal flow of fluids along the optic nerve, of compression of the central retinal vein, and of acute intracranial hypertension and its associated effects. I found that, contrary to some previous claims, an acute rise of intracranial pressure was not quickly followed by production of optic disc edema. Then, in rhesus monkeys, I produced experimentally chronic intracranial hypertension by slowly increasing in size space-occupying lesions, in different parts of the brain. Those produced raised cerebrospinal fluid pressure (CSFP) and optic disc edema, identical to those seen in patients with elevated CSFP. Having achieved that, I investigated various aspects of optic disc edema by ophthalmoscopy, stereoscopic color fundus photography and fluorescein fundus angiography, and light microscopic, electron microscopic, horseradish peroxidase and axoplasmic transport studies, and evaluated the effect of opening the sheath of the optic nerve on the optic disc edema. This latter study showed that opening the sheath resulted in resolution of optic disc edema on the side of the sheath fenestration, in spite of high intracranial CSFP, proving that a rise of CSFP in the sheath was the essential pre-requisite for the development of optic disc edema. I also investigated optic disc edema with

  11. Phase contrast MRI in intracranial aneurysms

    NARCIS (Netherlands)

    van Ooij, P.

    2012-01-01

    Intracranial aneurysms are outpouchings of intracranial arteries that cause brain hemorrhage after rupture. Unruptured aneurysms can be treated but the risk of treatment may outweigh the risk of rupture. Local intra-aneurysmal hemodynamics can contribute substantially to the rupture risk estimation

  12. Traumatic and alternating delayed intracranial hematomas

    Energy Technology Data Exchange (ETDEWEB)

    Lesoin, F.; Redford, H.; Jomin, M.; Viaud, C.; Pruvo, J.

    1984-11-01

    Repeat computed tomography has enabled us to confirm the concept of delayed hematomas. With this in mind we report two cases of alternating, post-traumatic intracranial hematomas; confirming also the role of tamponade after surgical removal of an intracranial hematoma.

  13. Acute surgical management in idiopathic intracranial hypertension.

    LENUS (Irish Health Repository)

    Zakaria, Zaitun

    2012-01-01

    Idiopathic intracranial hypertension is a headache syndrome with progressive symptoms of raised intracranial pressure. Most commonly, it is a slow process where surveillance and medical management are the main treatment modalities. We describe herein an acute presentation with bilateral sixth nerve palsies, papilloedema and visual deterioration, where acute surgical intervention was a vision-saving operation.

  14. Migraine before rupture of intracranial aneurysms

    DEFF Research Database (Denmark)

    Lebedeva, Elena R; Gurary, Natalia M; Sakovich, Vladimir P

    2013-01-01

    Rupture of a saccular intracranial aneurysm (SIA) causes thunderclap headache but it remains unclear whether headache in general and migraine in particular are more prevalent in patients with unruptured SIA.......Rupture of a saccular intracranial aneurysm (SIA) causes thunderclap headache but it remains unclear whether headache in general and migraine in particular are more prevalent in patients with unruptured SIA....

  15. Peripancreatic cystic lymphangioma with secondary hemorrhage: A rare case report

    Directory of Open Access Journals (Sweden)

    Kanapilly Francis Magdalene

    2016-01-01

    Full Text Available Lymphangiomas are thought to be true neoplasms, hamartomas or lymphangiectasias. Intra-abdominal lymphangiomas are rare and occur most frequently in children. This is a case report of a 27-year-old female with recurrent episodes of the left-sided upper abdominal pain of 2 years duration. She gives a history of intermittent nausea and vomiting. Liver function test and complete blood count with differential were normal. During the initial stages of illness, the serum lipase was elevated; the serum amylase level was normal all through the entire period. The upper gastrointestinal endoscopy suggested hiatal hernia and mild duodenitis. Two computed tomography scans done at 5 months interval showed a hypodense lesion in the distal tail of pancreas with irregular margins. The size of lesions had decreased from 15 mm × 14 mm to 13.5 mm × 10 mm during this period. Endoscopic ultrasound showed ill-defined area in the distal tail of pancreas and pseudocyst was suspected. Magnetic resonance cholangiopancreatography after 2 months showed a cystic lesion in the tail of pancreas of size 11 mm × 10 mm. Due to increasing severity of pain and fainting spells, the patient was taken up for a distal pancreatectomy. The histopathologic examination confirmed a diagnosis of peripancreatic cystic lymphangioma with secondary hemorrhage. During the postoperative period, the drain amylase was high suggestive of grade A pancreatic fistula. Gradually, the levels decreased, the patient became stable and discharged after pneumococcal vaccination.

  16. Lesiones laborales

    OpenAIRE

    2015-01-01

    Las lesiones laborales se producen por un esfuerzo repetitivo, cuando un exceso de presión se ejerce sobre una parte del cuerpo provocando lesiones óseas, articulares, musculares y daños en los tejidos. Los accidentes laborales también pueden producir una lesión en el organismo y esto sumado a diversos factores es un problema para la reinserción laboral de los trabajadores de la energía eléctrica. Objetivo: Establecer cuáles son las lesiones más frecuentes que afectan a los ...

  17. Ureteritis cystica: A rare benign lesion

    Directory of Open Access Journals (Sweden)

    F. Ibrahim

    2014-09-01

    Full Text Available Ureteritis cystica is an uncommon benign pathology of the ureter. The etiology is unclear but the diagnosis has become much easier to make with the routine use of ureteroscopy for diagnosis of ureteric lesions. We present a case of a 63 year old Sudanese woman with a history of repeated attacks of right loin pain in whom magnetic resonance urography (MRU showed multiple filling defects in the right ureter. These were initially thought to be malignant urothelial lesions. Ureteroscopy revealed cystic smooth walled masses which discharged tiny turbid fluid on biopsy. An intraoperative diagnosis of ureteritis cystica was confirmed. The patient was managed conservatively.

  18. Intracranial arteriopathy in tuberous sclerosis complex.

    Science.gov (United States)

    Boronat, Susana; Shaaya, Elias A; Auladell, Maria; Thiele, Elizabeth A; Caruso, Paul

    2014-07-01

    Arterial aneurysms, mostly aortic and intracranial, have been occasionally reported in patients with tuberous sclerosis complex. Brain magnetic resonance imaging reports of 404 patients with definite and 16 patients with either probable or possible tuberous sclerosis complex were revised for intracranial aneurysms. Among these patients, brain images of 220 patients with definite and 16 with probable or possible tuberous sclerosis complex were reviewed. Intracranial aneurysms were reported in 3 of 404 patients with a definite diagnosis (0.74%) (general population: 0.35%), including 2 children. A fourth intracranial aneurysm was found in a patient with probable tuberous sclerosis complex, who did not have tubers or subependymal nodules but had clinical manifestations related to neural crest derivatives, including lymphangioleiomyomatosis and extrarenal angiomyolipomas. The authors hypothesize that neural crest dysfunction can have a major role in intracranial arteriopathy in tuberous sclerosis complex, as smooth muscle cells in the forebrain vessels are of neural crest origin.

  19. A revised classification system and recommendations from the Baltimore consensus meeting for neoplastic precursor lesions in the pancreas

    NARCIS (Netherlands)

    Basturk, Olca; Hong, Seung Mo; Wood, Laura D.; Adsay, N. Volkan; Albores-Saavedra, Jorge; Biankin, Andrew V.; Brosens, Lodewijk A A; Fukushima, Noriyoshi; Goggins, Michael; Hruban, Ralph H.; Kato, Yo; Klimstra, David S.; Klöppel, Günter; Krasinskas, Alyssa; Longnecker, Daniel S.; Matthaei, Hanno; Offerhaus, G. Johan A; Shimizu, Michio; Takaori, Kyoichi; Terris, Benoit; Yachida, Shinichi; Esposito, Irene; Furukawa, Toru

    2015-01-01

    International experts met to discuss recent advances and to revise the 2004 recommendations for assessing and reporting precursor lesions to invasive carcinomas of the pancreas, including pancreatic intraepithelial neoplasia (PanIN), intraductal papillary mucinous neoplasm (IPMN), mucinous cystic ne

  20. Evaluation of hyperdense renal lesions incidentally detected on single-phase post-contrast CT using dual-energy CT

    Science.gov (United States)

    Park, Jung Jae; Park, Byung Kwan

    2016-01-01

    Objective: To investigate the utility of dual-energy CT (DECT) for differentiating between solid and benign cystic lesions presenting as hyperdense renal lesions incidentally detected on single-phase post-contrast CT. Methods: 90 hyperdense renal lesions incidentally detected on single-phase post-contrast CT were evaluated with follow-up DECT. DECT protocols included true non-contrast (TNC), DE corticomedullary and DE late nephrographic phase imaging. The CT numbers of hyperdense renal lesions were calculated on linearly blended and iodine overlay (IO) images, and the results were compared. Results: In total, 47 benign cystic and 43 solid renal lesions were analyzed. For differentiating between solid and benign cystic lesions on the two phases, the specificity and accuracy of all lesions and lesions  0.05). For all types of lesions ≥1.5 cm, the CT numbers between linearly blended and IO images and between TNC and virtual non-contrast images were not statistically different (p > 0.05). Conclusion: DECT may be useful for differentiating between solid and benign cystic lesions presenting as hyperdense renal lesions incidentally detected on single-phase post-contrast CT, particularly with the size ≥1.5 cm. Advances in knowledge: DECT may be used to characterize hyperdense renal lesions ≥1.5 cm incidentally detected on single-phase post-contrast CT, without the use of TNC images. PMID:27043480

  1. Intracranial metastasis from primary transitional cell carcinoma of female urethra: case report & review of the literature

    Directory of Open Access Journals (Sweden)

    Kim In-Young

    2011-01-01

    Full Text Available Abstract Background Transitional cell carcinoma (TCC of the female urethra is a rare urological malignancy, and intracranial metastasis of this cancer has not yet been reported in the literature. This review is intended to present a case of multiple intracranial metastasis in a female patient with a remote history of primary urethral TCC. Case Presentation A 49-year-old woman, presented with a prolapsed mass in urethral orifice that was diagnosed as primary urethral TCC with distant lung and multiple bone metastases. The patient subsequently underwent chemotherapy under various regimens. A year later, the patient developed headache and vomiting which as was found to be due to multiple intracranial metastasis. The patient underwent surgical resection of the largest lesion located on the cerebellum, and consecutively gamma knife radiosurgery was performed for other small-sized lesions. Pathological examination of the resected mass revealed a metastatic carcinoma from a known urethral TCC. Serial work-up of systemic metastasis revealed concomitant aggravation of lung, spleen, and liver metastasis. The patient died of lung complication 2 months after the diagnosis of brain metastasis. Conclusion To the best of our knowledge, this is the first reported case of cerebral metastasis from primary urethral TCC, with pathological confirmation. As shown in intracranial metastasis of other urinary tract carcinoma, this case occurred in the setting of uncontrolled systemic disease and led to dismal prognosis in spite of aggressive interventional modalities.

  2. MRI Features of Intracranial Primitive Neuroectodermal Tumors in Adults:Comparing with Histopathological Findings

    Institute of Scientific and Technical Information of China (English)

    石浩军; 孔祥泉; 徐海波; 徐丽莹; 刘定西

    2004-01-01

    Summary: The MRI appearances of 7 adult patients with pathologically proven intracranial primitive neuroectodermal tumors (PNET) were retrospectively analyzed. The MRI features were compared with findings in pathology and surgery. In this group, the tumor masses were most commonly found in the semisphere of cerebrum and in the vermis of cerebellum. They were relatively large and 4 were in lobulated shape. All of them had well-defined margins. MR images showed the tumors to be mildly or obviously hypointense on Ti-weighted images and hyperintense on T2-weighted images. Most masses had heterogeneous appearances with some cystic and necrotic areas. Intratumoral haemorrhage and focal calcification were occasionally seen. Mostly, there was no or only mild surrounding edema. Marked inhomogeneous contrast enhancement on MRI was seen in 6 cases except one. Two patients with multiple intracranial metastases were revealed on MR images. In this series, there was good correlation between MRI features and findings in pathology and surgery.These results showed that certain MRI features might suggest the diagnosis of intracranial PNET in adults. MRI is an effective technique to detect these tumors and is helpful to treatment planning and follow-up.

  3. Stereotactic radiosurgery for intracranial meningiomas

    Energy Technology Data Exchange (ETDEWEB)

    Kida, Yoshihisa; Kobayashi, Tatsuya; Tanaka, Takayuki; Oyama, Hirofumi; Iwakoshi, Takayasu (Komaki City Hospital, Hokkaido (Japan))

    1994-07-01

    Stereotactic radiosurgery for intracranial meningiomas was attempted using a 201-source cobalt gamma knife. Forty patients bearing 42 tumors were involved in this study. Their ages ranged from 30 to 91 years, with an average of 55.1 years. The most frequent sites of origin were the parasellar and petroclival regions. The mean tumor diameter was 27.2 mm and the marginal tumor dose of radiosurgery ranged from 10 to 20 Gy, depending on tumor location and size. Serial imaging studies with MRI were obtained in all 40 cases, in which minor tumor shrinkage was demonstrated in 7.9%, 40.0% and 53.3% at 6, 12 and 18 months after radiosurgery respectively. Only two tumors became enlarged after the treatment. Obvious low signal intensity on MRI, indicating central tumor necrosis, was found in 32% at 12 months and 40% at 18 months. Four large tumors over 40 mm in mean diameter were treated by staged radiosurgery with intervals of 1.5 to 7 months. A similar good response was able to be obtained in all 4 cases, even though they were treated with a marginal dose less than 12 Gy. Symptomatic edema occurred in 5 cases (12.5%) within 12 months and required corticosteroid therapy and hyperosmotic diuresis. In conclusion stereotactic radiosurgery has proved to be an effective and relatively safe method for the treatment of intracranial meningiomas. (author).

  4. Desmopressin Acetate in Intracranial Haemorrhage

    Directory of Open Access Journals (Sweden)

    Thomas Kapapa

    2014-01-01

    Full Text Available Introduction. The secondary increase in the size of intracranial haematomas as a result of spontaneous haemorrhage or trauma is of particular relevance in the event of prior intake of platelet aggregation inhibitors. We describe the effect of desmopressin acetate as a means of temporarily stabilising the platelet function. Patients and Methods. The platelet function was analysed in 10 patients who had received single (N=4 or multiple (N=6 doses of acetylsalicylic acid and 3 patients (control group who had not taken acetylsalicylic acid. All subjects had suffered intracranial haemorrhage. Analysis was performed before, half an hour and three hours after administration of desmopressin acetate. Statistical analysis was performed by applying a level of significance of P≤0.05. Results. (1 Platelet function returned to normal 30 minutes after administration of desmopressin acetate. (2 The platelet function worsened again after three hours. (3 There were no complications related to electrolytes or fluid balance. Conclusion. Desmopressin acetate can stabilise the platelet function in neurosurgical patients who have received acetylsalicylic acid prior to surgery without causing transfusion-related side effects or a loss of time. The effect is, however, limited and influenced by the frequency of drug intake. Further controls are needed in neurosurgical patients.

  5. Imaging of Soft Tissue Lesions of the Foot and Ankle

    Directory of Open Access Journals (Sweden)

    Seyed Hassan Mostafavi

    2010-05-01

    Full Text Available Differential diagnosis of soft tissue lesions of the foot may be narrowed with imaging. The cystic nature of ganglia, synovial cysts, and bursitis can be confirmed with MR imaging or sonography. Location and signal characteristics of noncystic lesions may suggest Morton's neuroma, giant cell tumor of the tendon sheath and plantar fibromatosis. Synovial-based lesions of the foot and ankle can be differentiated based on presence or absence of mineralization, lesion density, signal intensity, and the enhancement pattern. Knowledge of the incidence of specific neoplasms of the foot and ankle based on patient age aids in providing a limited differential diagnosis

  6. Cystic echinococcosis of the liver

    DEFF Research Database (Denmark)

    Branci, Sonia; Ewertsen, Caroline; Thybo, Søren

    2012-01-01

    Cystic echinococcosis (CE) of the liver can be treated with ultrasound-guided puncture, aspiration, injection, and re-aspiration (PAIR), with surgery and with benzimidazole derivatives. The aim of this study was to review available data concerning treatment modality and outcome for patients treat...

  7. Lung transplantation for cystic fibrosis

    NARCIS (Netherlands)

    Adler, Frederick R; Aurora, Paul; Barker, David H; Barr, Mark L; Blackwell, Laura S; Bosma, Otto H; Brown, Samuel; Cox, D R; Jensen, Judy L; Kurland, Geoffrey; Nossent, George D; Quittner, Alexandra L; Robinson, Walter M; Romero, Sandy L; Spencer, Helen; Sweet, Stuart C; van der Bij, Wim; Vermeulen, J; Verschuuren, Erik A M; Vrijlandt, Elianne J L E; Walsh, William; Woo, Marlyn S; Liou, Theodore G

    2009-01-01

    Lung transplantation is a complex, high-risk, potentially life-saving therapy for the end-stage lung disease of cystic fibrosis (CF). The decision to pursue transplantation involves comparing the likelihood of survival with and without transplantation as well as assessing the effect of wait-listing

  8. Lactate in cystic fibrosis sputum

    DEFF Research Database (Denmark)

    Bensel, Tobias; Stotz, Martin; Borneff-Lipp, Marianne

    2011-01-01

    Antibiotic therapy is thought to improve lung function in patients with cystic fibrosis (CF) by decreasing neutrophil-derived inflammation. We investigated the origin and clinical significance of lactate in the chronically inflamed CF lung. Methods Lactate was measured in sputa of 18 exacerbated ...

  9. Cystic echinococcosis of the liver

    DEFF Research Database (Denmark)

    Branci, Sonia; Ewertsen, Caroline; Thybo, Søren;

    2012-01-01

    Cystic echinococcosis (CE) of the liver can be treated with ultrasound-guided puncture, aspiration, injection, and re-aspiration (PAIR), with surgery and with benzimidazole derivatives. The aim of this study was to review available data concerning treatment modality and outcome for patients treated...... for CE of the liver in a Danish tertiary reference center....

  10. Pseudomembranous colitis in cystic fibrosis.

    Science.gov (United States)

    Nagakumar, Prasad

    2013-05-01

    Cystic fibrosis (CF) patients may require frequent courses of antibiotics and repeated hospital admissions. Although children with CF have high carriage rate for C.difficile, they rarely develop colitis. Pseudomembranous colitis is more common in adult post lung transplant CF patients. Although rare, paseudomembranous colitis should be considered in CF patients presenting with abdominal symptoms even in the absence of diarrhoea.

  11. Normal osseous variants presenting as cystic or lucent areas on radiography and CT imaging: a pictorial overview

    Energy Technology Data Exchange (ETDEWEB)

    Wilde, Vally de; Maeseneer, Michel de E-mail: midema@village.uunet.be; Lenchik, Leon; Roy, Peter van; Beeckman, Paul; Osteaux, Michel

    2004-07-01

    We present a number of commonly encountered pseudolesions. These represent areas of the skeleton that are relatively radiolucent simulating an osteolytic or cystic lesion. Such areas discussed in this article include the superolateral humeral head, rhomboid fossa of the clavicle, scapular defect, supratrochlear foramen, biceps tendon insertion, vascular channel of the ulna, distal condylar area of the knee, 'bone in bone' disturbance, dorsal defect of the patella, metadiaphyseal area, 'Wards' triangle', inframalleolar fossa of the fibula, and anterior lytic defect of the calcaneus. We provide an overview of commonly encountered pseudolesions, that may lead to false positive diagnosis of an osteolytic or cystic lesion.

  12. Well-differentiated pancreatic neuroendocrine tumor with solitary hepatic metastasis presenting as a benign cystic mass: A case report

    Energy Technology Data Exchange (ETDEWEB)

    Ahn, Su Joa; Choi, Seung Joon; Kim, Hyung Sik; Kim, Jeong Ho; Choi, Hye Young [Dept. of Radiology, Gachon University Gil Hospital, Incheon (Korea, Republic of)

    2014-05-15

    Pancreatic neuroendocrine tumors and their hepatic metastases have an inconsistent appearance with only a small percentage of lesions appearing as cystic masses in computed tomography (CT) and magnetic resonance imaging (MRI). Therefore, they can be mistaken as benign or infectious lesions, which can lead to a false diagnosis with delayed or inadequate treatment. We reported a patient with upper abdominal pain that lasted for several months, caused by a huge cystic neuroendocrine carcinoma of the liver. This was mistakenly interpreted as a complicated or hydatid cyst, and the findings in the CT and MRI was presented.

  13. Peritoneal benign cystic mesothelioma in a patient with presentation of ascites, a case report

    Directory of Open Access Journals (Sweden)

    S. Peyvandi

    2007-01-01

    Full Text Available Abstract Cystic mesotheloma is an uncommon lesion of the peritoneum occurring predominantly in women of reproductive age. The case was a 21 years girl presented with 4 years history of mild abdominal distension and periodic pain. The results of the clinical examinations were normal. Sonography and CT scan confirmed gross ascites. The results of paraclinical tests were normal without any positive findings for etiology of ascites. During laparoscopy multiple transparent cysts were found in pelvic and culdesac. All cysts were removed by laparoscopy. Histology confirmed benign cystic mesotheloma. Reviewing the records revealved that this case is the second case of mesothelial cysts that presented with ascites.

  14. Cerebral multicystic lesions in a child with neurofibromatosis

    OpenAIRE

    İsikay, Sedat; Yilmaz, Kutluhan

    2013-01-01

    Neurofibromatosis type 1 (NF-1) is an autosomal dominant neurocutaneous syndrome, with frequent involvement of the central nervous system (CNS). As well as abnormal cellular differentiation, disordered cell migration during development is the most common cause of the various brain lesions. Cystic lesions are rarely observed in neurocutaneous diseases, and the origin of the cysts is not known. This paper presents a rare case, a child at the age of 3, who was diagnosed as NF-1 and was observed ...

  15. [Therapeutic update in cystic fibrosis].

    Science.gov (United States)

    Durupt, S; Nove Josserand, R; Durieu, I

    2014-06-01

    We present the recent therapeutic advances in the cystic fibrosis care. It concerns improvements in symptomatic treatment with the development of dry powder inhaled antibiotics that improved quality of life, and innovative treatments namely the modulators of the cystic fibrosis transmembrane protein conductance regulator (CFTR), molecules which act specifically at the level of the defective mechanisms implied in the disease. The life expectancy of cystic fibrosis patients born after 2000, is estimated now to be about 50 years. This improvement of survival was obtained with the organization of the care within the specialized centers for cystic fibrosis (Centre de ressource et de compétences de la mucoviscidose) and remains still based on heavy symptomatic treatments. Dry powder inhaled antibiotics constitute a significant time saving for patients to whom all the care can achieve two hours daily. Since 2012, the modulators of CFTR, molecules allowing a pharmacological approach targeted according to the type of the mutations, allows a more specific approach of the disease. Ivacaftor (Kalydeco(®)) which potentialises the function of the CFTR protein expressed on the cellular surface is now available for patients with the G551D mutation. Lumacaftor is going to be tested in association with ivacaftor in patients with the F508del mutation, that is present in at least 75% of the patients. The ataluren which allows the production of a functional protein CFTR in patients with a no sense mutation is the third representing of this new therapeutic class. We presently have numerous symptomatic treatments for the cystic fibrosis care. The development of CFTR modulators, today available to a restricted number of patients treated with ivacaftor represents a very promising therapeutic avenue. It will represent probably the first step to a personalized treatment according to CFTR genotype. Copyright © 2013 Société nationale française de médecine interne (SNFMI). Published by

  16. Cone Beam Computed Tomography Findings in Calcifying Cystic Odontogenic Tumor Associated with Odontome: A Case Report

    Directory of Open Access Journals (Sweden)

    Tushar Phulambrikar

    2015-12-01

    Full Text Available The calcifying cystic odontogenic tumor (CCOT is a rare cystic odontogenic neoplasm frequently found in association with odontome. This report documents a case of CCOT associated with an odontome arising in the anterior maxilla in a 28-year-old man. Conventional radiographs showed internal calcification within the lesion but were unable to visualize its relation with the adjacent structures and its accurate extent. In this case cone beam computed tomography (CBCT could accurately reveal the extent and the internal structure of the lesion which aided the presumptive diagnosis of the lesion as CCOT. This advanced imaging technique proved to be extremely useful in the radiographic assessment and management of this neoplasm of the maxilla.

  17. Radiotherapy for Lowly Malignant Cranial Inflammatory Myofibroblastic Tumor Accompanied with Intracranial Invasion: Case Report and Literature Review

    Institute of Scientific and Technical Information of China (English)

    Jungang Ma; Xueqin Yang; Ge Wang; Xian Yu; Nan Hu; Yanhai Liu; Zhenzhou Yang

    2012-01-01

    Inflammatory myofibroblastic tumor (IMT) is rare in clinical practice. As its treatment mainly involves surgery, radiotherapy alone is seldom reported in literature. Here we report a case of lowly malignant cranial IMT with intracranial invasion in a female patient. As surgery was not suitable, intensity modulated radiation therapy (IMRT) was administered. After radiotherapy, the cranial lesions tended to show efficacy.

  18. [Intracranial occlusion of the internal carotid artery after minor closed head injury].

    Science.gov (United States)

    Nakashima, S; Tomokiyo, M; Koga, H; Furukawa, Y; Nomura, S; Shimokawa, S; Nakagawa, S; Anegawa, S; Hayashi, T

    2001-10-01

    Thrombosis of the extracranial portion of the internal carotid artery as a result of nonpenetrating head and neck injury is not uncommon. However, intracranial occlusion of the internal carotid artery after minor head and neck injury without skull fracture is rare. We report a case of 14-year-old male who suffered a minor head injury during an athletic meeting of his school and developed a right hemiparesis and a lethargy state resulting from thrombosis of the supraclinoid portion of the left internal carotid artery. On admission, skull films and a CT scan revealed no abnormality. One hour later, he fully recovered. One day later, no definite lesions were detected on T1-weighted and T2-weighted image of MRI, but an abnormal high signal lesion in the left frontal lobe was detected on diffusion-weighted image of MRI. On additional MR angiography, intracranial occlusion of the internal carotid artery due to dissection was demonstrated.

  19. NEUROMONITORING IN PATIENTS WITH INTRACRANIAL NONTRAUMATIC HEMORRHAGE

    Directory of Open Access Journals (Sweden)

    M. A. Alakova

    2015-01-01

    Full Text Available Background: Investigation of patients with intracranial non-traumatic hemorrhage (INH with the use of prolonged electroencephalographic (EEG monitoring allows for more effective identification of acute symptomatic seizures, subclinic epileptiform activity, local and diffuse abnormalities that are markers of brain functional activity.Aim: To increase treatment efficacy of patients with INH.Materials and methods: Thirty three patients were assessed in acute period of INH. Assessments included clinical and neurological examination, NIHSS (National Institute of Health Stroke Severity scale, GCS (Glasgow coma scale, HHS (Hunt-Hess scale; prolonged EEG monitoring with computerized tomography and/or magnetic resonance imaging of the brain. Patients received medical and surgical treatment (minimally invasive endovascular interventions or open operations, such as aneurysm clipping or wrapping/coating.Results: Twenty seven patients had open-type surgeries (among them, 23 patients had aneurysm clipping and 4, aneurysm wrapping. Two patients underwent the procedure of aneurysm embolization. Four patients were treated conservatively. According to results of prolonged pre-, peri- and postoperative EEG monitoring, most of patients had signs of disorganized electrical activity, with no regional differences, fragmented or absent alfa rhythm and diffuse polymorphic theta-activity. Marked EEG abnormalities correlated with severity registered with the assessment scales and with outcomes. During the study, epileptiform activity was registered in 1 patient, EEG comate in 3, diffuse abnormalities in 15 and local abnormalities in 14.Conclusion: The use of prolonged pre-, peri- and postoperative EEG monitoring allows for timely identification of status epilepticus, including the one without seizures. Minimally invasive interventions performed on time are associated with better prognosis in INH patients, whereas marked EEG abnormalities are associated with low scores of

  20. Hyperdense lesions in CT of cerebral toxoplasmosis. Lesiones hiperdensas en TC en la toxoplamosis cerebral

    Energy Technology Data Exchange (ETDEWEB)

    Quiones Tapia, D.; Ramos Amador, A.; Monereo Alonso, A.

    1994-01-01

    We report a case of cerebral toxoplasmosis in a patient with stage IV C[sub 1] AIDS who presented hyperdense CT images 13 days after beginning antitoxoplasma treatment. These lesions could be caused by calcifications or blood. The attenuation values lead us to believe that they are calcium. Intracranial calcification in adult cerebral toxoplasmosis is an uncommon finding. Its presence in AIDS patients should not suggest any etiology other than toxoplasmosis. (Author) 16 refs.

  1. Temporal comparative analysis of computed tomography with ultrasound for intracranial hemorrhage in premature infants

    Energy Technology Data Exchange (ETDEWEB)

    Quisling, R.G.; Reeder, J.D.; Kaude, J.V.; Setzer, E.S.

    1983-02-01

    This study focuses on comparison of computed tomography and ultrasound in premature infants with intracranial hemorrhage and its complications. It was determined that close correlation (95%) exists between CT and ultrasound for evaluations of ventriculomegaly. Although there is reasonable correlation for the identification and localization of periventricular, intraventricular and choroidal hemorrhages, ultrasound defined such lesions at higher rates. Subarachnoid blood and periventricular edema were diagnosed better or exclusively by CT.

  2. New techniques for intracranial stent navigation in patients with tortuous arteries

    Energy Technology Data Exchange (ETDEWEB)

    Choi, Hyun Wook; Koo, Young Baek; Lee, Tae Hong; Kim, Hak Jin; Lee, Jun Woo; Kim, Chang Won; Kim, Suk; Choo, Ki Seok; Jeong, Yeon Joo; Lee, Suk Hong [Pusan National University Hospital, Pusan (Korea, Republic of)

    2005-07-15

    We wanted to describe several new techniques of intracranial stenting that are helpful for navigating the stent delivery system in the tortuous carotid or vertebral arteries. Between May 1998 and June 2004, 65 patients with 73 symptomatic, stenotic intracranial arteries (more than 50%) were successfully treated with stent-assisted angioplasty. In eleven of the total cases, the standard technique failed to navigate the stent delivery system into the objective lesion because of the tortuous path of the carotid or vertebral arteries. In these cases, several new techniques were used to overcome the vessels' tortuous path. The several new techniques were 1) the waiting method (20-30 minutes) after advancement of microwire across the lesion; 2) the double wires technique using an additional microwire; and 3) the coaxial double guiding catheters technique using an additional smaller guiding catheter. Five lesions were located in the middle cerebral arteries, four were in the supraclinoid internal carotid arteries, and two were in the distal vertebral arteries. In all difficult cases, intracranial artery stenting was performed successfully by using the several new techniques. The waiting method made smooth stent navigation possible in 5 cases, the double wire technique was successful in 4 cases and the coaxial double guiding catheter technique was successful in 2 case. There was no complication related to the new techniques. In difficult cases where the standard technique failed to navigate the stent delivery system into the objective lesion because of the vessels' tortuous path, these new techniques for intracranial stent navigation were usefully implemented.

  3. Primary intracranial malignant melanoma in an adolescent girl: A case report

    OpenAIRE

    Sajeeb Mondal; Rajashree Pradhan; Subrata Pal; Supratik Bhattacharya; Arindam Banerjee; Debosmita Bhattacharyya

    2016-01-01

    Primary intracranial malignant melanoma is a very rare tumor, and most of the central nervous system melanomas are metastatic diseases. Diagnosis needs extensive dermatological, opthalmological, and radiological workup to exclude metastatic melanoma. Histologically, it should be differentiate from benign melanocytic lesions, pigmented choroid plexus carcinoma, and pigmented papillary medulloblastoma. Here, we are reporting a case of primary malignant melanoma of posterior fossa in an adolesce...

  4. Columnar cell lesions of the breast: clinical significance and molecular background

    NARCIS (Netherlands)

    Verschuur-Maes, A.H.J.

    2012-01-01

    Columnar cell lesions (CCLs) of the breast have since long been regarded as possible precursor lesions of breast cancer. CCLs are cystically dilated ducts lined by columnar cell epithelium, with or without atypia. Intraluminal secretions and microcalcifications are frequently seen and the microcalci

  5. Cerebral venous etiology of intracranial hypertension and differentiation from idiopathic intracranial hypertension

    Directory of Open Access Journals (Sweden)

    Stefan Mircea Iencean

    2015-03-01

    Full Text Available This study presents the characteristics that distinguish between idiopathic intracranial hypertension (ICH and ICH caused by intracranial vascular damage. Twenty-one patients with ICH were included in this study. The analysis of the symptomatology correlated with the values of intracranial pressure, and the imaging findings revealed significant differences between these two types of ICH. ICH caused by intracranial venous vascular damage is named vascular ICH. Vascular ICH has a known etiology, such as cerebral vascular illness, and a relatively rapid increase in intracranial pressure of approximately 21 cmH2O and imaging findings show characteristic images of thrombosis or stenosis of the intracranial venous system, while all brain images (computed tomography, magnetic resonance imaging, angio-magnetic resonance imaging are normal in idiopathic ICH. The treatment of vascular ICH is etiologic, pathogenic, and symptomatic, but that of idiopathic ICH is only symptomatic.

  6. Cerebral venous etiology of intracranial hypertension and differentiation from idiopathic intracranial hypertension.

    Science.gov (United States)

    Iencean, Stefan Mircea; Poeata, Ion; Iencean, Andrei Stefan; Tascu, Alexandru

    2015-03-01

    This study presents the characteristics that distinguish between idiopathic intracranial hypertension (ICH) and ICH caused by intracranial vascular damage. Twenty-one patients with ICH were included in this study. The analysis of the symptomatology correlated with the values of intracranial pressure, and the imaging findings revealed significant differences between these two types of ICH. ICH caused by intracranial venous vascular damage is named vascular ICH. Vascular ICH has a known etiology, such as cerebral vascular illness, and a relatively rapid increase in intracranial pressure of approximately 21 cmH2O and imaging findings show characteristic images of thrombosis or stenosis of the intracranial venous system, while all brain images (computed tomography, magnetic resonance imaging, angio-magnetic resonance imaging) are normal in idiopathic ICH. The treatment of vascular ICH is etiologic, pathogenic, and symptomatic, but that of idiopathic ICH is only symptomatic. Copyright © 2015. Published by Elsevier Taiwan.

  7. INTRACRANIAL MENINGIOMAS - MR IMAGING FINDINGS IN 30 CASES

    Directory of Open Access Journals (Sweden)

    Bonthu

    2016-03-01

    Full Text Available OBJECTIVE To present the magnetic resonance imaging findings of 30 cases of intracranial meningiomas diagnosed in a single institute. Magnetic resonance imaging (MRI with contrast is the modality of choice for diagnosis of meningiomas. Objective of this study was to describe typical and atypical locations and findings of intracranial meningiomas on magnetic resonance imaging. MATERIALS AND METHODS This study was conducted at Department of Radiology, Government General Hospital, Kakinada from January 2013 to August 2014 over a period of 20 months. 30 patients of intracranial meningiomas of 15-75 years’ age group were studied. RESULTS A higher incidence noted in females. Most of the tumours are solitary. The most common sites of occurrence are the cerebral convexities, parasagittal location/falx, posterior fossa, sphenoid ridge, olfactory groove. Majority were typical (WHO grade 1 in 96.6%, only 3.4% were atypical (WHO grade 2. Most of the tumours showed low signal on T1- (60% and high signal on T2- (68% and FLAIR (69% weighted images. Also, the lesions showed heterogeneous signal on T1 (60%, T2 (68% and FLAIR (64% sequences. After contrast administration, 67% of the tumours presented intense and 33% showed moderate and heterogenous enhancement. The most common sites of occurrence are the cerebral convexities, parasagittal location/falx, posterior fossa, sphenoid ridge, olfactory groove and others accounting for 33.3%, 20%, 20%, 10%, 6.7%, 10% respectively. Areas of vasogenic oedema around the tumours were seen in 33% of the cases. Twenty percent of the cases showed bone infiltration, and the dural tail sign was seen in 56% of the tumours. CONCLUSION The diagnosis of meningioma is usually straightforward except when it presents in unusual locations and with atypical imaging characteristics. MRI is the modality of choice for diagnosis as well as for predicting the success of its complete removal.

  8. Primary intracranial malignant lymphoma. Report of nine cases

    Energy Technology Data Exchange (ETDEWEB)

    Matsumoto, Mikiro; Ohtsuka, Takatsugu; Kuroki, Takao; Shibata, Iekado; Terao, Hideo; Kudo, Motoshige

    1988-12-01

    Nine cases of primary intracranial malignant lymphoma, which accounts for 3.3 % of all intracranial tumors seen in the authors' institution, were studied in terms of diagnostic computed tomographic (CT) features, the tumors' histologic appearance, treatment, post-treatment blood immunologic and cerebrospinal fluid (CSF) characteristics, and outcome. The patients were seven males and two females aged 42 to 67 years. Their chief signs and symptoms on admission were intracranial hypertension, focal signs, and disturbance of consciousness. CT, which proved the most useful preoperative diagnostic technique, demonstrated multiple lesions in seven cases and, in all cases, regions of isodensity or slight high density that were enhanced by contrast medium. According to the patterns of enhancement, the tumors were classed as diffuse (three cases) or nodular (six cases). The former is considered typical of malignant lymphoma, whereas the latter type was sometimes indistinguishable from metastatic tumor and meningioma. At surgery, one patient underwent radical tumor excision, two partial removal, and six biopsy only. Histologic examination revealed one tumor to be of the diffuse small cell type, three of the medium cell type, and five of the large cell type (Lymphoma Study Group classification). Of seven tumors in which lymphocytes were examined by peroxidase-antiperoxidase staining, four were of the B cell type. Postoperatively, whole brain irradiation with 29 to 46 Gy was followed by local irradiation with 15 to 50 Gy. If the tumor persisted, one of three chemotherapies was administered. In one case, methotrexate was given intrathecally. Seven patients were divided into two groups: long remission (three) and recurrence (four). These two groups were compared in terms of serum immunoglobulin levels, T and B cell ratios, CSF characteristics, CT features, tumor cell type, and treatment. No clear differences were found.

  9. Intracranial involvement in plasmacytomas and multiple myeloma: a pictorial essay

    Energy Technology Data Exchange (ETDEWEB)

    Cerase, Alfonso; Gennari, Paola; Monti, Lucia; Venturi, Carlo [Azienda Ospedaliera Universitaria Senese, Unit of Diagnostic and Therapeutic Neuroradiology, and InterDepartmental Center of Nuclear Magnetic Resonance, Policlinico ' Santa Maria alle Scotte' , Siena (Italy); Tarantino, Annachiara; Muccio, Carmine Franco [Azienda Ospedaliera ' G. Rummo' , Unit of Neuroradiology, Department of Neurosciences, Benevento (Italy); Gozzetti, Alessandro [University of Siena, Unit of Hematology and Transplants, Policlinico ' Santa Maria alle Scotte' , Siena (Italy); Di Blasi, Arturo [Azienda Ospedaliera ' G. Rummo' , Unit of Pathology, Department of Oncology, Benevento (Italy)

    2008-08-15

    The purpose of this pictorial essay is to increase awareness of the clinical presentation, neuroradiological findings, treatment options, and neuroradiological follow-up of plasmacytomas and multiple myeloma with intracranial growth. This pictorial essay reviews the clinical features and neuroradiological findings in seven patients (four women, three men; age range at diagnosis 62-82 years) followed in two institutions. Six patients, one with IgG-{kappa} plasmacytoma, and five with IgG-{kappa}(n=3), IgG-{lambda}(n=1), and nonsecretory (n=1) multiple myeloma, had been seen over a period of 9 years in one institution, and the other patient with IgG-{kappa} plasmacytoma had been seen over a period of 3.5 years in the other. Intracranial involvement is rare, most frequently resulting from osseous lesions in the cranial vault, skull base, nose, or paranasal sinuses. Primary dural or leptomeningeal involvement is rarer. Some typical findings of a dural and/or osseous plasmacytoma include iso- to hyperdensity on CT scan, T1 equal to high signal intensity and T2 markedly hypointense signal on MRI, and high vascularity possibly documented on intraarterial digital subtraction angiography. However, the neuroradiological findings generally lack specificity, since they are generally no different from those of meningioma, metastasis, lymphoma, dural sarcoma, plasma cell granuloma, infectious meningitis, and leptomeningeal carcinomatosis. The spectrum of clinical and neuroradiological evaluation shows that intracranial involvement from plasmacytoma and multiple myeloma must be taken into account in the differential diagnosis of cranial osseous and meningeal disease. (orig.)

  10. Headache following intracranial neuroendovascular procedures.

    Science.gov (United States)

    Baron, Eric P; Moskowitz, Shaye I; Tepper, Stewart J; Gupta, Rishi; Novak, Eric; Hussain, Muhammad Shazam; Stillman, Mark J

    2012-05-01

    Predicting who will develop post-procedure headache (PPH) following intracranial endovascular procedures (IEPs) would be clinically useful and potentially could assist in reducing the excessive diagnostic testing so often obtained in these patients. Although limited safety data exist, the use of triptans or dihydroergotamine (DHE) often raise concern when used with pre/post-coiled aneurysms. We sought to determine risk factors for PPH following IEP, to evaluate the utility of diagnostic testing in patients with post-coil acute headache (HA), and to record whether triptans and DHE have been used safely in this clinical setting. We conducted a retrospective chart review of adult patients undergoing IEPs. Bivariate analyses were conducted to compare patients who did and did not develop PPH. We reviewed records pertaining to 372 patients, of whom 263 underwent intracranial coil embolizations, 21 acrylic glue embolizations, and 88 stent placements. PPH occurred in 72% of coil patients, 33% of glue patients, and 14% of stent patients. Significant risk factors for post-coil HA were female gender, any pre-coil HA history, smoking, and anxiety/depression. A pre-stent history of HA exceeding 1 year's duration, and smoking were risk factors for post-stent HA. A pre-glue history of HA exceeding 1 year was the only risk factor for post-glue HA. In the small subgroup available for study, treatment with triptans or DHE was not associated with adverse events in pre/post-coiled aneurysms. Diagnostic testing was low yield. Occurrence of PPH was common after IEPs and especially so with coiling and in women, smokers, and those with anxiety/depression, and was often of longer duration than allowed by current International Classification of Headache Disorders-II criteria. The yield of diagnostic testing was low, and in a small subgroup treatment with triptans or DHE did not cause adverse events in pre/post-coiled aneurysms. Prospective studies are needed to confirm these findings.

  11. Occult intracranial injury in infants.

    Science.gov (United States)

    Greenes, D S; Schutzman, S A

    1998-12-01

    The objectives of this study were as follows: (1) to determine whether clinical symptoms and signs of brain injury are sensitive indicators of intracranial injury (ICI) in infants admitted with head trauma, (2) to describe the clinical characteristics of infants who have ICI in the absence of symptoms and signs of brain injury, and (3) to determine the clinical significance of those ICIs diagnosed in asymptomatic infants. We conducted a retrospective analysis of all infants younger than 2 years of age admitted to a tertiary care pediatric hospital with acute ICI during a 6(1/2)-year period. Infants were considered symptomatic if they had loss of consciousness, history of behavior change, seizures, vomiting, bulging fontanel, retinal hemorrhages, abnormal neurologic examination, depressed mental status, or irritability. All others were considered to have occult ICI. Of 101 infants studied, 19 (19%; 95% confidence interval [CI] 12%, 28%) had occult ICI. Fourteen of 52 (27%) infants younger than 6 months of age had occult ICI, compared with 5 of 34 (15%) infants 6 months to 1 year, and none of 15 (0%) infants older than 1 year. Eighteen (95%) infants with occult ICI had scalp contusion or hematoma, and 18 (95%) had skull fracture. Nine (47%) infants with occult ICI received therapy for the ICI. No infants with occult ICI (0%) (95% CI 0, 14%) required surgery or medical management for increased intracranial pressure. Only 1 subject (5%) with occult ICI had any late symptoms or complications: a brief, self-limited convulsion. We found that 19 of 101 ICIs in infants admitted with head trauma were clinically occult. All 19 occult ICIs occurred in infants younger than 12 months of age, and 18 of 19 had skull fractures. None experienced serious neurologic deterioration or required surgical intervention. Physicians cannot depend on the absence of clinical signs of brain injury to exclude ICI in infants younger than 1 year of age.

  12. Hypertensive response to raised intracranial pressure in infancy.

    OpenAIRE

    Kaiser, A M; Whitelaw, A G

    1988-01-01

    Mean arterial pressure and intracranial pressure were measured serially in six infants with intracranial hypertension (intracranial pressure greater than 20 mm Hg), and cerebral perfusion pressure was calculated from their difference. Overall, mean arterial pressure increased with rising intracranial pressure at a mean rate of 0.20 mm Hg/mm Hg. This caused a fall in cerebral perfusion pressure with increasing intracranial pressure at a mean rate of 0.80 mm Hg/mm Hg overall, although cerebral ...

  13. Recommendations for quality improvement in genetic testing for cystic fibrosis European Concerted Action on Cystic Fibrosis

    NARCIS (Netherlands)

    Dequeker, E; Cuppens, H; Dodge, J; Estivill, [No Value; Goossens, M; Pignatti, PF; Scheffer, H; Schwartz, M; Schwarz, M; Tummler, B; Cassiman, JJ

    These recommendations for quality improvement of cystic fibrosis genetic diagnostic testing provide general guidelines for the molecular genetic testing of cystic fibrosis in patients/individuals. General strategies for testing as well as guidelines for laboratory procedures, internal and external

  14. Clinical and pathological features of intracranial meningiomas in children: A retrospective analysis

    Institute of Scientific and Technical Information of China (English)

    Kun Yang; Lisheng He; Linsun Dai; Jian Chen; Zhixiong Lin

    2006-01-01

    nerve damage in 4cases(27%,4/15),instability of gait and incoordination in 2 cases,conscious disturbance in 3 cases,nystagmus in 2 cases and lump under scalp in 1 case.②Imaging examination:Most of tumor CT plain scans were slightly high-density imaging. Most enhanced scanning appeared well-distributed enhancement and clear boundary.MRI examination observed the lumor appeared equal or long T1 or longer T2 abnormal mixed singles with clear boundary.Two cases had cystic lesion of tumor and 8 cases had peritumor edema.Digital substraction angiography(DSA)observed that theirs obvious tumor staining and displecement of corresponding brain vessels due to compression in 2 cases.③Preoperative misdiagnosis:Six children(40%,6/15)were misdiagnosed to have other diseases due to the untypical symptoms,including diseases of gastrointestinal tract in 3 cases.eye diseases in 2 cases.and encephalitis in 1 case.Most cases were diagnosed after CT or MRI scanning.④Sites and sizes of tumors:Tumor located at supratentodal parts in 13 cases(87%.13,15),including cerebral convexity in 7 cases(46.7%.7/15),intraventdcle in 2 cases(13.3%,2/15),carebral parenchyma in 2 cases(13.3%,2/15),parafalx and parasagittal sinus in 2 cases respectively.Tumor located at infratentodal part in 2 cases(13.3%,2/15),which at cerebellar hemisphere and cerebellopontine angle respectively.The maximal diameter of tumor was 1.3-8.0 cm with an average of 4.6 cm.⑤Pathological types: The pathoiogical examination reported that the meningioma was benign in 11 cases(73.3%,11/15)and malignant in 4 cases(26.7%,4/15).Among the benign meningiomas,it was syncytial in 5 cases.fibrous in 4 cases,and transitional in 2 cases.⑥Treatments:All the menigiomas of children were resected.and 14 cases(93.3%,14/15)had the tumor resected totally (Simpson grades Ⅰ-Ⅲ),including Simpson grade Ⅰ resection in 7 cases,grade Ⅱ in 4 Cases,and grade Ⅲ in 3 cases.One case only underwent subtotal resection(Simpson Ⅳ),this Case had

  15. Pink lesions.

    Science.gov (United States)

    Giacomel, Jason; Zalaudek, Iris

    2013-10-01

    Dermoscopy (dermatoscopy or surface microscopy) is an ancillary dermatologic tool that in experienced hands can improve the accuracy of diagnosis of a variety of benign and malignant pigmented skin tumors. The early and more accurate diagnosis of nonpigmented, or pink, tumors can also be assisted by dermoscopy. This review focuses on the dermoscopic diagnosis of pink lesions, with emphasis on blood vessel morphology and pattern. A 3-step algorithm is presented, which facilitates the timely and more accurate diagnosis of pink tumors and subsequently guides the management for such lesions.

  16. Association between Venous Angioarchitectural Features of Sporadic Brain Arteriovenous Malformations and Intracranial Hemorrhage.

    Science.gov (United States)

    Alexander, M D; Cooke, D L; Nelson, J; Guo, D E; Dowd, C F; Higashida, R T; Halbach, V V; Lawton, M T; Kim, H; Hetts, S W

    2015-05-01

    Intracranial hemorrhage is the most serious outcome for brain arteriovenous malformations. This study examines associations between venous characteristics of these lesions and intracranial hemorrhage. Statistical analysis was performed on a prospectively maintained data base of brain AVMs evaluated at an academic medical center. DSA, CT, and MR imaging studies were evaluated to classify lesion side, drainage pattern, venous stenosis, number of draining veins, venous ectasia, and venous reflux. Logistic regression analyses were performed to identify the association of these angiographic features with intracranial hemorrhage of any age at initial presentation. Exclusively deep drainage (OR, 3.42; 95% CI, 1.87-6.26; P < .001) and a single draining vein (OR, 1.98; 95% CI, 1.26-3.08; P = .002) were associated with hemorrhage, whereas venous ectasia (OR, 0.52; 95% CI, 0.34-0.78; P = .002) was inversely associated with hemorrhage. Analysis of venous characteristics of brain AVMs may help determine their prognosis and thereby identify lesions most appropriate for treatment. © 2015 by American Journal of Neuroradiology.

  17. Association Between Venous Angioarchitectural Features of Sporadic Brain Arteriovenous Malformations and Intracranial Hemorrhage

    Science.gov (United States)

    Alexander, Matthew D.; Cooke, Daniel L.; Nelson, Jeffrey; Guo, Diana E.; Dowd, Christopher F.; Higashida, Randall T.; Halbach, Van V.; Lawton, Michael T.; Kim, Helen; Hetts, Steven W.

    2015-01-01

    Background and Purpose Intracranial hemorrhage is the most serious outcome for brain arteriovenous malformations (AVM). This study examines associations between venous characteristics of these lesions and intracranial hemorrhage. Materials and Methods Statistical analysis was performed on a prospectively maintained database of brain AVMs evaluated at an academic medical center. DSA, CT, and MRI studies were evaluated to classify lesion side, drainage pattern, venous stenosis, number of draining veins, venous ectasia, and venous reflux. Logistic regression analyses were performed to identify association of these angiographic features with intracranial hemorrhage of any age at initial presentation. Results Exclusively deep drainage (OR 3.42, 95% CI 1.87–6.26, p<0.001) and a single draining vein (OR 1.98, 95% CI 1.26–3.08, p=0.002) were associated with hemorrhage, whereas venous ectasia (OR 0.52, 95% CI 0.34–0.78, p=0.002) was inversely associated with hemorrhage. Conclusion Analysis of venous characteristics of brain AVMs may help determine their prognosis and thereby identify lesions most appropriate for treatment. PMID:25634722

  18. Failure of the Cystic Fibrosis Transmembrane Conductance Regulator to Conduct ATP

    Science.gov (United States)

    Reddy, M. M.; Quinton, P. M.; Haws, C.; Wine, J. J.; Grygorczyk, R.; Tabcharani, J. A.; Hanrahan, J. W.; Gunderson, K. L.; Kopito, R. R.

    1996-03-01

    The cystic fibrosis transmembrane conductance regulator (CFTR) is chloride ion channel regulated by protein kinase A and adenosine triphosphate (ATP). Loss of CFTR-mediated chloride ion conductance from the apical plasma membrane of epithelial cells is a primary physiological lesion in cystic fibrosis. CFTR has also been suggested to function as an ATP channel, although the size of the ATP anion is much larger than the estimated size of the CFTR pore. ATP was not conducted through CFTR in intact organs, polarized human lung cell lines, stably transfected mammalian cell lines, or planar lipid bilayers reconstituted with CFTR protein. These findings suggest that ATP permeation through the CFTR is unlikely to contribute to the normal function of CFTR or to the pathogenesis of cystic fibrosis.

  19. Papillary thyroid microcarcinoma in Graves′ disease presenting as a cystic neck mass

    Directory of Open Access Journals (Sweden)

    Milind Patil

    2015-01-01

    Full Text Available The presentation of papillary thyroid microcarcinoma (PTMC as a solitary cystic neck mass is uncommon. Additionally, its association with Graves′ disease is very rare. We report a case of occult PTMC, who presented with a cystic neck mass in the background of Graves′ disease without any goiter. Imaging like ultrasound of neck, single photon emission computed tomography-CT (SPECT-CT, and technetium scan failed to detect any lesion in the thyroid, which was picked up only by the contrast-enhanced computed tomography (CECT of neck. The patient underwent total thyroidectomy with right modified lymph node dissection. Our case highlights the presentation of metastatic PTMC as a differential diagnosis of a cystic neck mass even in a patient with Graves′ disease without any thyroid enlargement.

  20. Conservative approach to recurrent calcifying cystic odontogenic tumor occupying the maxillary sinus: a case report

    Science.gov (United States)

    2016-01-01

    Calcifying cystic odontogenic tumor (CCOT) is an uncommon benign cystic neoplasm of the jaw that develops from the odontogenic epithelium. Invasion into the maxillary sinus by a CCOT is not a typical, and the recurrence of the cystic variant of CCOT in the posterior maxilla is rare. This report describes a recurrent CCOT occupying most of the maxillary sinus of a 24-year-old male patient. As a treatment, marsupialization was carried out as a means of decompression, and the involved teeth were all endodontically treated. Afterward, surgical enucleation was performed. The size of the lesion continued to shrink after marsupialization, and the maxillary sinus restored its volume. This patient has been followed-up for 3 years after the surgery, and there have not been any signs of recurrence. PMID:27847742

  1. Cystic fibrosis from the gastroenterologist's perspective.

    Science.gov (United States)

    Ooi, Chee Y; Durie, Peter R

    2016-03-01

    Cystic fibrosis is a life-limiting, recessive disease caused by mutations in the cystic fibrosis transmembrane conductance regulator (CFTR) gene. Increased survival outcomes and the multisystem nature of the disease, including the involvement of hepatobiliary and gastrointestinal tracts, now require the need for more extensive knowledge and expertise in cystic fibrosis among gastroenterologists. Manifestations are either a direct consequence of the primary defect in cystic fibrosis or a secondary complication of the disease or therapy. Adult patients with cystic fibrosis also have an increased risk of malignancy in the gastrointestinal and pancreatico-biliary tracts compared with the general population. Novel treatments that target the basic defects in the CFTR protein have emerged, but to date not much is known about their effects on the gastrointestinal and hepatobiliary systems. The introduction of such therapies has provided new opportunities for the application of intestinal endpoints in clinical trials and the understanding of underlying disease mechanisms that affect the gut in cystic fibrosis.

  2. Isolated cystic tuberculosis of medial cuneiform: a case report

    Directory of Open Access Journals (Sweden)

    Nadeem Ali

    2013-08-01

    Full Text Available Isolated tuberculosis of foot is a rare entity. Plenty of literature is available on osteoarticular tuberculosis but literature on tuberculosis of foot is limited. Additionally the condition mimics variety of other foot pathologies which can delay diagnosis and add to morbidity. We present a twelve year old boy who presented clinically with swelling, pain and discharging sinus of foot with a cystic lesion in medial cuneiform on radiography. Though histopathology and Ziehl Nielsen staining later on established the diagnosis, but initially it was mistaken as a case of mycotic osteomyelitis. Tuberculosis of foot, though rare, should always be one of the differential diagnoses in a patient presenting with bony lesion on radiography irrespective of absence of constitutional symptoms and negative tests for tuberculosis. If battery of tests fails to establish diagnosis, open biopsy with curettage and histopathology should be considered to work out the final diagnosis. [Int J Res Med Sci 2013; 1(4.000: 592-595

  3. Facial cystic lymphangioma in adults.

    Science.gov (United States)

    Biasotto, Matteo; Clozza, Emanuele; Tirelli, Giancarlo

    2012-07-01

    Lymphangiomas are uncommon congenital malformations of the lymphatic system, generally diagnosed during childhood. These malformations are rarely seen in adults, and the literature provides poor guidelines for treatment options that must be carefully applied to the facial region. Diagnosis in adult subjects is difficult to achieve, and also management of these conditions is still challenging because they tend to infiltrate adjacent tissues, causing frequent relapses. Radical surgery is the main form of treatment, avoiding the sacrifice of function or aesthetics of the patient. Two cases of cystic lymphangioma of the facial region found in adults are described from a clinical and pathologic point of view. The aim of this article was to point out that an early recognition of cystic lymphangioma is a crucial goal to initiate a prompt treatment avoiding serious complication.

  4. [Historical compilation of cystic fibrosis].

    Science.gov (United States)

    Navarro, Salvador

    2016-01-01

    Cystic fibrosis is the most common life-shortening recessively inherited disorder in the Caucasian population. The genetic mutation that most frequently provokes cystic fibrosis (ΔF508) appeared at least 53,000years ago. For many centuries, the disease was thought to be related to witchcraft and the "evil eye" and it was only in 1938 that Dorothy H. Andersen characterized this disorder and suspected its genetic origin. The present article reviews the pathological discoveries and diagnostic and therapeutic advances made in the last 75 years. The review ends with some considerations for the future. Copyright © 2015 Elsevier España, S.L.U. and AEEH y AEG. All rights reserved.

  5. Posttraumatic Cranial Cystic Fibrous Dysplasia

    Directory of Open Access Journals (Sweden)

    Arata Tomiyama

    2011-01-01

    Full Text Available A 14-year-old was girl admitted to our hospital with a subcutaneous mass of the occipital head. The mass had grown for 6 years, after she had sustained a head injury at the age of 6, and was located directly under a previous wound. Skull X-ray Photograph (xp, computed tomography (CT, and magnetic resonance imaging (MRI showed a bony defect and cystic changes in the skull corresponding to a subcutaneous mass. Bone scintigraphy revealed partial accumulation. The patient underwent total removal of the skull mass, and the diagnosis from the pathological findings of the cyst wall was fibrous dysplasia (FD. The radiographic findings for cystic cranial FD can be various. Progressive skull disease has been reported to be associated with head trauma, but the relationship between cranial FD and head trauma has not been previously reported. Previous studies have suggested that c-fos gene expression is a key mechanism in injury-induced FD.

  6. Unruptured intracranial aneurysms: benign curiosity or ticking bomb?

    Science.gov (United States)

    Mitchell, Patrick; Gholkar, Anil; Vindlacheruvu, Raghu R; Mendelow, A David

    2004-02-01

    15 years ago, the treatment of incidentally discovered intracranial aneurysms was straightforward with a good evidence base behind it. When intracranial aneurysms were identified, people were referred to neurosurgeons who would offer surgical repair if the patient was in reasonable health and had a good life expectancy. Since that time, several studies have given contradictory evidence for what should be done with these lesions, and a new technique for the repair of aneurysms, endovascular coil embolisation, has been developed. Here we review the research and make several recommendations. First, incidentally discovered aneurysms in the anterior circulation less than 7 mm in size in people with no personal or family history of subarachnoid haemorrhage should be left untreated. Second, people with remaining life expectancy of less than 20 years or so (ie, those over age 60 years) should be informed that from a statistical point of view the benefits of treatment do not outweigh the risks. Third, in all other cases treatment with surgical clipping or coil embolisation should be advised. And finally, if surgical treatment is not feasible then medical hypotensive treatment may be a viable alternative.

  7. Virtual MRI endoscopy of the intracranial cerebrospinal fluid spaces

    Energy Technology Data Exchange (ETDEWEB)

    Shigematsu, Y.; Korogi, Y.; Hirai, T. [Kumamoto Univ. (Japan). Dept. of Radiology; Okuda, T.; Ikushima, I.; Sugahara, T.; Liang, L.; Ge, Y.; Takahashi, M.

    1998-10-01

    We used constructive interference in steady state (CISS) 3D Fourier transform (3DFT) MRI data sets to obtain three-dimensional (3D) virtual MRI endoscopic views of the intracranial cerebrospinal fluid (CSF) spaces, processing them with a commercially available perspective endoscopic algorithm. We investigated the potential of the intracranial virtual MRI endoscopy applied to visualisation of the pathology in 13 patients with surgically confirmed trigeminal neuralgia (3), hemifacial spasm (3), acoustic neuroma (3), suprasellar germinoma (1), Langerhans cell histiocytosis (1), lateral ventricle nodules (1) and pituitary dwarfism (1). All images were acquired using a 1.5-T imager employing a circular polarised head coil. The CISS-3DFT data sets were transferred to a workstation for processing with the perspective endoscopic algorithm. Postprocessing for virtual MRI endoscopy was possible for all data sets. The lesions in 12 patients, and their complex anatomical relationships with the surrounding structures, were well seen on the 3D images. A small acoustic neuroma in the internal auditory meatus was not seen using virtual endoscopy. Although virtual MRI endoscopy has limitations, it provides 3D images which cannot be acquired using any other procedure. (orig.) With 6 figs., 16 refs.

  8. Delayed intracranial hematoma following stereoelectroencephalography for intractable epilepsy: case report.

    Science.gov (United States)

    Derrey, Stéphane; Lebas, Axel; Parain, Dominique; Baray, Marie Gilles; Marguet, Christophe; Freger, Pierre; Proust, François

    2012-12-01

    Intracranial bleeding following stereoelectroencephalography (sEEG) is rare and commonly occurs early after electrode implantation. The authors report the case of a delayed intracranial hematoma following sEEG. This 10-year-old boy was referred to the authors' department to undergo an sEEG study for intractable epilepsy, with the hypothesis of a single localized epileptic zone in the left precentral region. To perform the exploration, 14 depth electrodes were implanted under stereotactic conditions. The results of a postoperative CT scan performed routinely at the end of the surgical procedure were normal. Eight days later, following an epileptic seizure, the child's condition worsened. The neurological examination revealed a left hemiparesis, agitation, and coma due to a right subdural hematoma with intraparenchymal bleeding. Despite a surgical evacuation followed by a decompressive craniectomy, the curative treatments were stopped 1 week later due to severe diffuse ischemic lesions found on MRI studies. This is the first observation of a delayed hematoma following an sEEG procedure. The mechanism underlying this complication remains unclear, but the rupture of a growing pseudoaneurysm caused by the electrode's implantation or the tearing of a neighboring vessel by an electrode were suspected. In consequence, physicians must remain vigilant during the entire sEEG recording period and probably also several days after electrode removal.

  9. Factor XIII Deficiency and Intracranial Hemorrhage

    OpenAIRE

    1990-01-01

    A 38 month old boy with excessive bleeding following circumcision as a newborn and two episodes of intracranial hemorrhage at four months and at 85 months of age is reported from the Scott and White Clinic, Temple, TX.

  10. Aspirin-Induced Neonatal Intracranial Hemorrhage

    OpenAIRE

    1994-01-01

    A term newborn infant with intracranial hemorrhage associated with maternal acetylsalicylic acid ingestion before delivery is reported from the Departments of Pediatrics and Neurology, Eastern Virginia Medical School, Norfolk, VA.

  11. MR angiography after coiling of intracranial aneurysms

    NARCIS (Netherlands)

    Schaafsma, J.D.

    2012-01-01

    Introduction Endovascular occlusion with detachable coils has become an alternative treatment to neurosurgical clipping of intracranial aneurysms over the last two decades. Its minimal invasiveness is the most important advantage of this treatment compared to clipping. The disadvantage of occlusion

  12. Rapid natural resolution of intracranial hematoma

    Institute of Scientific and Technical Information of China (English)

    吴明灿; 刘建雄; 罗国才; 张志文; 闵杰; 余辉; 姚远

    2004-01-01

    Objective:To investigate the clinical characteristics of intracranial hematoma and the mechanism involved in its rapid natural resolution. Methods:Seventeen cases of intracranial hematoma with typical clinical and CT manifestations were retrospectively studied. Results: Intracranial hematoma was found obviously decreased in size within 72 h after its occurrence in 8 cases. The rest 9 cases presented complete resolution. Conclusions: Rapid natural resolution of acute epidural hematoma is mostly found in teenagers and the resolution is correlated with cranial fracture at the hematoma site. As for acute subdural hematoma, its rapid resolution is associated with the transfer of cerebrospinal fluid toward subdural space, the lavage effect, and the compression caused by the increased intracranial pressure or the space left resulting from redistribution of the hematoma in brain atrophy.

  13. Atypical imaging appearances of intracranial meningiomas

    Energy Technology Data Exchange (ETDEWEB)

    O' Leary, S. [Radiology Department, Derriford Hospital, Plymouth (United Kingdom); Adams, W.M. [Radiology Department, Derriford Hospital, Plymouth (United Kingdom); Parrish, R.W. [Radiology Department, Derriford Hospital, Plymouth (United Kingdom); Mukonoweshuro, W. [Radiology Department, Derriford Hospital, Plymouth (United Kingdom)]. E-mail: William.mukonoweshuro@phnt.swest.nhs.uk

    2007-01-15

    Meningiomas are the commonest primary, non-glial intracranial tumours. The diagnosis is often correctly predicted from characteristic imaging appearances. This paper presents some examples of atypical imaging appearances that may cause diagnostic confusion.

  14. Intracranial aneurysm associated with relapsing polychondritis

    Energy Technology Data Exchange (ETDEWEB)

    Coumbaras, M.; Boulin, A.; Pierot, L. [Dept. of Neuroradiology, Hopital Foch, Suresnes (France); Piette, A.M.; Bletry, O. [Dept. of Medicine, Hopital Foch, Suresnes (France); Graveleau, P. [Dept. of Neurology, Hopital Foch, Suresnes (France)

    2001-07-01

    We describe a 50-year-old man with relapsing polychondritis (RP) involving auricular cartilage, uveitis and hearing loss, who had an aneurysm of the anterior cerebral artery. Intracranial aneurysm is a rare manifestation of RP. (orig.)

  15. Male Breast Adenoid Cystic Carcinoma

    Directory of Open Access Journals (Sweden)

    Seung Jin Yoo

    2013-10-01

    Full Text Available Introduction: Adenoid cystic carcinoma (ACC of the breast is a rare condition, and cases in male patients are even less common. Case: We describe a case of ACC of the breast with axillary lymph node metastasis, disseminated osteolytic bone metastasis and bone marrow involvement in a 41-year-old man. Conclusion: Male breast ACC is an extremely rare malignancy; there can be difficulty in obtaining a final diagnosis. We report this case because of its rarity.

  16. Langerhans' cell histiocytosis presenting with an intracranial epidural hematoma

    Energy Technology Data Exchange (ETDEWEB)

    Lee, K.-W. [Department of Pediatrics, Loma Linda Children' s Hospital and University Medical Center, Loma Linda, CA (United States); McLeary, M.S. [Div. of Pediatric Radiology, Loma Linda Children' s Hospital and University Medical Center, Loma Linda, CA (United States); Zuppan, C.W. [Dept. of Pathology, Loma Linda Children' s Hospital and University Medical Center, Loma Linda, CA (United States); Won, D.J. [Div. of Pediatric Neurosurgery, Loma Linda University Children' s Hospital, Loma Linda, CA (United States)

    2000-05-01

    An 8-year-old boy developed vomiting and severe headache following minor head trauma. A CT scan of the head demonstrated a lytic lesion of the skull and adjacent epidural hematoma. Surgical evacuation and removal of the skull lesion and hematoma were carried out, and pathologic evaluation resulted in a diagnosis of Langerhans' cell histiocytosis (LCH). Epidural involvement of Langerhans' cell histiocytosis is very rare, and we report the first case of LCH presenting as an intracranial epidural hematoma. (orig.)

  17. Cystic tumors of the pancreas: Opportunities and risks

    Institute of Scientific and Technical Information of China (English)

    Marco; Del; Chiaro; Caroline; Verbeke

    2015-01-01

    Pancreatic cystic neoplasms(PCNs) are a high prevalence disease. It is estimated that about 20% of the general population is affected by PCNs. Some of those lesions can progress till cancer, while others behave in a benign fashion. In particular intraductal papillary mucinousneoplasms of the pancreas can be considered as the pancreatic analogon to colonic polyps. Treatment of these precursor lesions at an early stage can potentially reduce pancreas cancer mortality and introduce a new "era" of preemptive pancreatic surgery. However, only few of those lesions have an aggressive behavior. The accuracy of preoperative diagnosis, i.e., the distinction between the various PCNs is around 60%, and the ability to predict the future outcome is also less accurate. For this reason, a significant number of patients are currently over-treated with an unnecessary, high-risk surgery. Furthermore, the majority of patients with PCN are on life-long follow-up with imaging modality, which has huge cost implications for the Health Care System for limited benefits considering that a significant proportion of PCNs are or behave like benign lesions. The current guidelines for the diagnosis and management of PCNs are more based on expert opinion than on evidence. For all those reasons, the management of cystic tumors of the pancreas remains a controversial area of pancreatology. On one hand, the detection of PCNs and the surgical treatment of pre-cancerous neoplasms can be considered a big opportunity to reduce pancreatic cancer related mortality. On the other hand, PCNs are associated with a considerable risk of under- or over- treatment of patients and incur high costs for the Health Care System.

  18. Intracranial chondroma of the occipital lobe

    Energy Technology Data Exchange (ETDEWEB)

    Mobbs, R.J.; Narula, S.; Berger, M.; Kwok, B.C.T. [Prince of Wales Hospital, Sydney, NSW (Australia). Departments of Neurosurgery and Radiology

    1998-02-01

    A case report of an intracranial chondroma is discussed with emphasis on magnetic resonance imaging. A case is presented of a chondroma originating in the left occipital pole close to the vertex in a 29-year-old female. Pathologic and radiologic findings with emphasis on the MR appearances are reported, followed by a brief discussion of the recent literature involving solitary intracranial chondroma. Copyright (1998) Blackwell Science Pty Ltd 12 refs., 3 figs.

  19. Intracranial leiomyosarcoma in a patient with AIDS

    Energy Technology Data Exchange (ETDEWEB)

    Brown, H.G.; Burger, P.C. [Johns Hopkins Medical Institutions, Baltimore, MD (United States). Dept. of Pathology; Olivi, A.; Sills, A.K. [Department of Neurosurgery, Johns Hopkins Medical Institutions, Baltimore, MD (United States); Barditch-Crovo, P.A. [Department of Medicine, Johns Hopkins Medical Institutions, Baltimore, MD (United States); Lee, R.R. [Department of Radiology, Johns Hopkins Medical Institutions, Baltimore, MD (United States)

    1999-01-01

    We report an intracranial leiomyosarcoma in the pontine cistern of a 34-year-old woman infected with the human immunodeficiency virus (HIV). The clinical, radiological and pathological data are reviewed. The tumor was Epstein-Barr virus (EBV) positive by in situ hybridization. This case emphasizes that smooth muscle neoplasms arising in the setting of immunocompromise can occur intracranially, and corroborates a hypothesis that EBV coinfection may have a role in development of these tumors. (orig.) (orig.) With 6 figs., 22 refs.

  20. Cognitive function in idiopathic intracranial hypertension

    DEFF Research Database (Denmark)

    Yri, Hanne Maria; Fagerlund, Birgitte; Forchhammer, Hysse Birgitte;

    2014-01-01

    OBJECTIVE: To explore the extent and nature of cognitive deficits in patients with idiopathic intracranial hypertension (IIH) at the time of diagnosis and after 3 months of treatment. DESIGN: Prospective case-control study. SETTING: Neurological department, ophthalmological department and a terti......OBJECTIVE: To explore the extent and nature of cognitive deficits in patients with idiopathic intracranial hypertension (IIH) at the time of diagnosis and after 3 months of treatment. DESIGN: Prospective case-control study. SETTING: Neurological department, ophthalmological department...