Sclerosed liver hemangioma mimicking malignant tumor at MR imaging: Pathologic correlation

This case report illustrates atypical magnetic resonance (MR) imaging findings in a liver hemangioma mimicking a malignant lesion—lower signal intensity than cerebrospinal fluid on T2-weighted spin-echo images and lack of early enhancement on dynamic contrast material—enhanced gradient-echo images. Pathologic analysis demonstrated nearly total replacement of the vascular cavities by dense fibrous tissue. In this rare, sclerosed form, this lesion could not be defined as a hemangioma with MR imaging.     

Multiple occult vascular malformations of the brain and spinal cord: MRI diagnosis

Summary We report a patient with multiple angiographically occult vascular malformations in the brain and spine. Magnetic resonance imaging showed multiple lesions in brain and spine with hypointense areas on both T1 and T2-weighted images. These hypointense areas are usually secondary to hemosiderin deposits consistent with remote bleeding in the lesions. We conclude that when magnetic resonance reveals an intraspinal lesion with signal intensity characteristics consistent with a vascular malformation, an examination of the brain should be performed to rule out associated intracranial lesions. The finding of multiple lesions in the brain with identical signal intensity characteristics reinforces the diagnosis of vascular malformation.     

Benign liver lesions: implications of detection in cancer patients

A review of liver sonograms obtained for cancer patients (excluding primary liver cancers) over a 12 year period found 829 benign lesions: non-parasitic cysts (427 cases), hemangiomas (216 cases), solitary calcifications (79 cases), focal fatty infiltration (62 cases), and miscellaneous lesions (45 cases). These benign pathologies represented 41.8% of the focal hepatic lesions observed during this period in this population; hepatic metastases accounted for the remaining 58.2%. Marked female predilection was noted for the nonparasitic cysts, hemangiomas, and focal fatty infiltration; 63–78.7% of these lesions were solitary, and first-line imaging by US was sufficient for diagnosis of 66.1–98.2% of cases. Analysis of lesion evolution over more than 5 years revealed modifications in 17% of hemangiomas, 23.9% of nonparasitic cysts, and 75% of cases of focal fatty infiltration. Systematic pretherapy liver sonography can be proposed owing to the high frequency of benign liver lesions that can create diagnostic problems during follow-up of cancer patients. Correspondence to: J. N. Bruneton     

Synovial haemangioma of the knee: a frequently misdiagnosed lesion

Objective The objective of this study was to assess the contribution of magnetic resonance (MR) imaging in the diagnosis and surgical planning of five cases of synovial haemangioma of the knee.Patients and Methods The clinical, radiological and arthroscopic features of five pathologically proven synovial haemangiomas of the knee were retrospectively reviewed.Results A diagnostic delay, on average of 8 years, had occurred in four of the cases. Plain films were unremarkable, except for one case with arthropathy mimicking haemophilia, Arteriography, performed in three patients, was normal in one. CT, performed in three patients, showed the lesion, but the extent of the latter was better demonstrated with MR imaging. Synovial haemangiomas had a high signal intensity on T2-weighted images, without any extensive mass effect. Fibrofatty septa within the lesion were observed in three cases and muscular and/or fatty invasion in two. Arthroscopy allowed diagnosis of the lesion in two cases, but showed only non-specific synovitis in another two.Conclusion This study emphasizes the valuable contribution of MR imaging in the diagnosis and surgical planning of synovial haemangiomas.     

血管瘤不同治疗方法的疗效评价

目的　评价四种不同方法治疗血管瘤远期疗效。方法　取 1992～ 1998年共七年间我院门诊及住院分别患有毛细血管瘤、海绵状血管瘤、蔓状血管瘤病人 2 33例 ,分别采取血管瘤营养血管结扎 平阳霉素注射、5 %鱼肝油酸钠注射、平阳霉素 强的松龙注射、平阳霉素 5 %鱼肝油酸钠注射 4种治疗方法 ,并对上述 4种方法血管瘤注射后进行随访及疗效评定。结果　血管瘤营养血管结扎 平阳霉素注射组总有效率及显效率均较其余 3组高 ,而单纯应用鱼肝油酸钠血管瘤注射组较其余 3组无论是总有效率或显效率均低。结论　联合用药较单一用药治疗血管瘤效果好 ,而血管瘤远期疗效与药物在瘤体内存留时间长短有关 ,停留时间愈长 ,其有效率愈高 ,而缝扎血管瘤营养血管后无疑为药物在血管瘤内长时间停留提供条件。     

Selective arterial embolization in the treatment of aneurysmal bone cyst and angioma of bone

Nineteen aneurysmal bone cysts and five angiomas of bone were treated by selective arterial embolization. The median follow-up was 22 months. In 17 patients healing occurred with complete relief of symptoms; in 11 of these almost complete ossification of the lesion resulted. In the remaining cases, little or no ossification was apparent but ossification may take 1 year or more to occur. No recurrence was observed in any of these cases. Recurrence occurred only in two cases. In one, growth of the recurrence stopped after a second embolization, and the X-rays showed no change. Selective arterial embolization represents a treatment of choice in aneurysmal bone cyst and angioma of bone especially of the spine, sacrum, or pelvis. In these sites embolization replaces surgery which might be hazardous due to intraoperative bleeding.Supported in part with Rizzoli Research Funds     

匍行性血管瘤1例

患者女,37岁,左侧躯干及上下肢弥漫性红色斑片30余年,无不适。皮肤科情况:左侧躯干及上下肢可见泛发不规则红色斑片,右腰背部可见小面积受累,边界清楚,压之退色,其间可见不规则片状正常皮肤。皮损组织病理示:表皮大致正常,真皮乳头内可见扩张的管腔,腔内充满红细胞,管壁由单层内皮细胞组成,部分内皮细胞肿胀。诊断:匍行性血管瘤。     

脾脏窦岸细胞血管瘤一例报告及文献复习

目的:探讨脾脏窦岸细胞血管瘤(LCA)的临床病理特征和鉴别诊断。方法:对1例脾脏LCA患者的肿瘤组织进行临床病理学、免疫组化分析并复习相关文献。结果:脾脏LCA由互相吻合的血管性腔隙组成,表面衬覆单层内皮样细胞,细胞无异型,部分细胞可见嗜伊红小体,部分细胞内见含铁血黄素颗粒。免疫组化示肿瘤细胞CD8阴性(-)、CD31阳性(+)、CD34阴性(-)、溶菌酶(Lys)阳性(+)。结论:脾脏LCA是一种较少见的肿瘤,其诊断和鉴别诊断依赖于病理学检查和免疫组化标记。     

Prenatal thoracoabdominal tumor mimicking pulmonary sequestration: a diagnosis dilemma

Thoracoabdominal masses are among the many congenital anomalies being detected in fetus. The differential diagnosis of such anomalies include cystic adenomatoid malformation, pulmonary sequestration, neuroblastoma, lymphangioma, congenital diaphragmatic hernia, and bronchial atresia. We report a fetal thoracoabdominal mass that proved to be an angioma that was treated by partial embolization. Complete regression was observed. Received: 2 November 1999 Revised: 3 April 2000 Accepted: 4 April 2000