Magnetic resonance imaging of intramuscular myxoma with histological comparison and a review of the literature

Objective To evaluate the magnetic resonance (MR) features of intramuscular myxoma (IM) compared with its pathological findings.Design Two radiologists retrospectively reviewed records and imaging studies of patients with histologically proven IM. Two radiologists also analyzed by consensus all the MR studies (pre- and post-contrast T1-weighted and T2-weighted sequences) and a pathologist reviewed the available histological material.Patients Seventeen patients with 18 histologically proven IM were reviewed. Histological samples of 11 of these 18 tumors were available for pathological analysis.Results There were 14 women and three men, with a mean age of 58.9 years. IM involved predominantly the thigh (n=10). MR imaging showed well-circumscribed intramuscular masses, hypointense on T1-weighted and hyperintense on T2-weighted images. Eleven masses were homogeneous and seven slightly heterogeneous due to fibrous septa. Enhanced MR imaging demonstrated three different patterns: peripheral enhancement (n=1), peripheral and patchy internal enhancement (n=7) or peripheral and linear internal enhancement (n=4). Intratumoral cysts were detected in four masses. MR imaging showed the presence of a pseudocapsule (n=12), fat around the lesion (n=16) and peritumoral edema (n=16). Histologically, all the tumors were hypocellular, hypovascular and myxoid. Peripheral areas of collagenous fibers formed a partial capsule and IM often merged into surrounding muscular fibers. More cellular tumors and those with scanty myxoid stroma tended to show a more prominent internal enhancement.Conclusion IM shows several recognizable MR features which suggest its diagnosis.     

Postprandial triacylglycerol in adolescent boys: a case for moderate exercise

PURPOSE: To compare the effects of 60-min bouts of intermittent moderate and vigorous exercise on postprandial plasma triacylglycerol (TAG) metabolism in eight healthy adolescent boys (mean +/- SD age: 13 +/- 0.3 yr). METHODS: Participants completed three conditions in a counterbalanced order. On day 1, they either rested for 110 min (CON), completed 6 x 10-min blocks of intermittent treadmill exercise at 53% peak V O2 (MOD), or 6 x 10-min blocks at 75% peak V O2 (VIG). On day 2 after a 12-h fast, a capillary blood sample was taken for [TAG] and [glucose] (mmol.L) and then a high-fat milkshake was consumed (1.50 g.kg fat, 1.22 g.kg CHO, and 0.22 g.kg protein; 80 kJ.kg). Further blood samples were taken every hour for a 6-h postprandial rest period for [TAG] and [glucose]. RESULTS: Estimated energy expenditure was 45% higher in VIG than in MOD (95% confidence interval [CI] 23-72%). Fasting [TAG] and [glucose] did not differ between the conditions. Average [TAG] for the postprandial period was lower by 24% in MOD (95% CI -47% to 9%, P = 0.06) and by 21% in VIG (95% CI -42% to 8%, P = 0.08) than CON, with no meaningful difference (4%; 95% CI -27% to 48%, P = 0.50) between MOD and VIG. The total area under the [TAG] versus time curve (mmol.L 6 h) was lower by 24% in MOD (95% CI -42% to 0%, P = 0.05) and by 20% in VIG (95% CI -37% to 0%, P = 0.07) than CON. MOD and VIG were not different from each other (4%; 95% CI -18% to 32%, P = 0.54). CONCLUSION: Both 60 min of moderate and vigorous intermittent exercises reduced postprandial [TAG]. However, the extra energy expended in the vigorous condition did not produce a dose-related reduction compared with the moderate-intensity condition.     

Methodological approach for the histological comparison between rickets and child abuse

Metaphyseal changes in rickets and child abuse-related fractures may be difficult to distinguish; therefore, it is important to follow a standardized procedure in order to detect mineralization defects of the skeleton and differentiate them from healing fractures. We present a typical post-mortem case of rickets in a 3.5-year-old boy where different diagnostic tools were applied to confirm this condition. At autopsy a rachitic rosary was seen. Vitamin D insufficiency found in laboratory analyses, metaphyseal fraying in radiography and an accumulation of non-mineralized bone (osteoid) in undecalcified histological preparations led to the correct diagnosis. This case shows that the appropriate methodology to use undecalcified bone preparations is of paramount importance to detect mineralization defects. Moreover, as in this case which involved a combination of rickets and child abuse, the situation is often more complex where neglect and abuse may lead to vitamin D insufficiency.     

MRI诊断肌肉内黏液瘤三例

肌肉内黏液瘤是一种良性间叶组织肿瘤,可能为成纤维细胞产生大量的黏多糖所致,见于50～70岁的老年人,青壮年少见,儿童罕见~([1-2]).患者常以软组织肿块就诊.有关肌肉内黏液瘤MRI特征的报道较少.笔者报道3例有完整临床资料及手术病理证实的肌肉内黏液瘤MRI表现,并结合相关文献复习,旨在提高对本病的认识.     

Factor XIIa and triacylglycerol rich lipoproteins: responses to exercise intervention

OBJECTIVES: (a) To determine if factor XIIa (FXIIa) would be sensitive to change from exercise intervention in a group of previously sedentary/low active middle aged men and women; (b) to investigate further the previously reported relation between FXIIa and triacylglycerol (TAG) rich lipoproteins. METHODS: Thirty seven men (mean (SD) age 57 (7) years) and 60 women (mean age 54 (7) years) completed the study. Before the intervention, these subjects were randomly allocated to a group of walkers (n = 81) or controls (n = 16). Before and after an 18 week walking intervention, fasted blood samples were collected and analysed for FXIIa, TAG, total cholesterol (TC), low density lipoprotein cholesterol (LDL-C), high density lipoprotein cholesterol (HDL-C), and apolipoprotein (apo) B. RESULTS: Kruskal-Wallis analysis of data obtained before the intervention showed no significant differences (p>0.4) between the walking and control groups for age, height, body mass, gender, FXIIa, TAG, TC, HDL-C, or apo B, although the women did show significantly lower levels of TAG (p<0.04) and higher HDL-C (p<0.0001) than the men. General linear model analysis of data obtained after the intervention, using the baseline value as a covariate, showed significant reductions (p<0.0001) in FXIIa for the walkers compared with the controls. Pearson product-moment correlations also showed significant relations between the concentrations of FXIIa and TAG, TC, LDL-C, and apo B. CONCLUSIONS: The findings of this study suggest that FXIIa is sensitive to change from exercise intervention and support previous research showing an association between the concentrations of FXIIa and TAG rich lipoproteins.     

Anatomy of the lateral collateral ligament: a cadaver and histological study

This paper describes the anatomy of the lateral collateral ligament (LCL). The dimensions of the ligament and its femoral and fibular attachments are given. The relationships between the LCL and other anatomical structures are described, particularly the terminal fiber branches of the biceps femoris. The histological features of the ligament fibers and their osseous attachments are also described.     

Diffuse infiltrative neurofibroma: a clinical,radiological, and histological conundrum

Diffuse infiltrative neurofibroma is a rare clinical entity that can pose a diagnostic challenge not only due to its rarity but also due to its varied clinical, radiological, and histological features. Our case illustrates how this entity may be misdiagnosed on clinical and pathological examination. Radiological imaging plays a critical and collaborative role in guiding clinicians and pathologists when faced with this challenging diagnosis.     

Anatomical and histological approach to the radioraphic appearance of the breast (author's transl)]

The authors present first correlations between histology, anatomy and serial radiography of the breast, in order to establish a new understanding of the mammographic picture, with respect to the tridimensional histological structures. Several essential points are considered: - Mammographic pictures only show fibrous, connecting and fatty tissues. The epithelium of the galactophores is not shown, because of its low radio-opacity. Mammographic densities are due above all to fibrous connecting tissue, which has a high percentage of water. Benign or malignant breast tumors present with a proliferation of epithelium and connecting tissue, but only connecting tissue, more or less hydrated is shown on the mammographic picture. Many mammographic patterns are related to various superimposed fibrous strands, appearing as pseudotumoral opacities. The benign or malignant tumoral opacities are hidden or modified by multiple superimposed adjacent structures. - The mammographic patterns is related to the degree of hydratation and components of the connecting tissue.     

Topical effects of molten salt on rat integument: a histological and photometric assessment

The topical effects of the molten salt 1-methyl-3-ethylimidazolium tetrachloroaluminate (melt) and its organic component, the organic salt 1-methyl-3-ethylimidazolium chloride were tested on rat integument. Evaluation was accomplished using standard histological techniques supplemented with digital analysis using the microscope photometer. Two groups of animals were treated with 1.5 ml of either the melt or the organic salt for 10 consecutive days. A third group treated with the melt had the treated area flushed with running water 5 min after each application (wash). Significant treatment effects were observed in rats treated with the melt and wash preparations while the effects of the organic salt were unremarkable. The melt induced an ulcerative dermatitis with acanthosis while the wash produced only mild acanthosis and dermatitis. This damage appears to result from the penetration of aluminum chloride in the melt through the skin and its toxic effects on the cells of the dermis and epidermis.     

Ultrasound-guided, histological, fine-needle biopsy from suspect parathyroid tumours: success-rate and reliability of histological diagnosis

Ultrasound-guided, fine-needle tissue biopsies were performed in 60 suspected parathyroid tumours in 55 consecutive patients with biochemically proven hyperparathyroidism. The specimens were randomly arranged and re-read "blind" by two pathologists. The interobserver agreement, corrected for chance agreement, was 0.92 (= kappa coefficient). Twenty-three of the 60 suspect parathyroid tumours were verified histologically following surgery. No diagnostic errors were seen but the percentage of insufficient biopsies from suspect parathyroid tumours or surgically verified parathyroid tumours was high (45 and 47%, respectively). We conclude that a reliable tissue diagnosis can be made by ultrasound-guided, fine-needle tissue biopsy. However, when the material is insufficient for histological diagnosis, we recommend the additional use of ultrasound-guided, fine-needle aspiration for cytology or parathyroid hormone determination.     

Drug-induced lung disease: high-resolution CT and histological findings

AIM: To compare the parenchymal high-resolution computed tomography (HRCT) appearances with histological findings in patients with drug-induced lung disease and to determine the prognostic value of HRCT. MATERIALS AND METHODS: Drug history, HRCT features, histological findings and outcome at 3 months in 20 patients with drug induced-lung disease were reviewed retrospectively. The HRCT images were assessed for the pattern and distribution of abnormalities and classified as most suggestive of interstitial pneumonitis/fibrosis, diffuse alveolar damage (DAD), organizing pneumonia (OP) reaction, or a hypersensitivity reaction. RESULTS: On histopathological examination there were eight cases of interstitial pneumonitis/fibrosis, five of DAD, five of OP reactions, one of hypersensitivity reaction and one of pulmonary eosinophilia. The most common abnormalities on HRCT were ground-glass opacities (n = 17), consolidation (n = 14), interlobular septal thickening (n = 15) and centrilobular nodules (n = 8). HRCT interpretation and histological diagnosis were concordant in only nine (45%) of 20 patients. The pattern, distribution, and extent of HRCT abnormalities were of limited prognostic value: all eight patients with histological findings of OP, hypersensitivity reaction, or eosinophilic infiltrate improved on follow-up compared to only five of 13 patients with interstitial pneumonitis/fibrosis or DAD. CONCLUSION: In many cases of drug-induced lung injury HRCT is of limited value in determining the histological pattern and prognosis.     

Chemical-shift imaging: a hybrid approach

The hybrid technique of projection-reconstruction echo-planar (PREP) imaging for obtaining chemical-shift images is demonstrated experimentally using a fluorine sample. The technique which is a variation on echo-planar imaging (EPI) relies on a multipass procedure. It is nevertheless quite efficient and consequently chemical-shift images may be produced in a few minutes. The method produces images in 64 chemical-shift regions, each region mapped spatially by 64 X 64 pixels. The imaging time was just over 4 min. These 64 chemical-shifted images can be straightforwardly added together to form an undistorted image of the complete object. In addition the chemical-shift spectrum can be extracted and the various chemical-shift images can be unambiguously assigned to the spectral peaks.     

Arterial injuries: a sonographic approach

Acute arterial emergencies can arise from direct traumatic injury to the artery or be spontaneous. This article emphasizes the various presentations of arterial emergencies. These include acute arterial occlusions; excessive bleeding; and hematoma formation caused by penetrating arterial wall injuries, pseudoaneurysms, and arteriovenous fistulas. The broad category of arterial occlusions includes traumatic lacerations, embolizations, and arterial dissections. Modern ultrasound equipment is a rapid and convenient imaging approach in many of these clinical scenarios. In combination with MR angiography and CT angiography, these noninvasive tests can diagnose the presence of most arterial injuries, and be used to measure their impact.