Case report. Sclerosing liver haemangioma with pericapillary smooth muscle proliferation: atypical CT and MR findings with pathological correlation

We report a case of sclerosing liver haemangioma with pericapillary smooth muscle proliferation in a 63-year-old man who presented with abdominal pain. Because the tumour showed atypical features on CT and MRI, a correct diagnosis could not be made until surgery. In this report, the atypical radiological findings are illustrated and correlated with pathological findings.     

Solitary fibrous tumor of the trachea: CT findings with a pathological correlation.

We present the multidetector CT findings with a pathologic correlation for the case of a solitary fibrous tumor located in the trachea. The MDCT revealed a well-circumscribed intraluminal mass arising from the trachea, with strong nodular enhancement in the periphery of the mass. The enhancement pattern of the mass corresponded histopathologically to a focal hypocellular area in the center and prominent blood vessels along the periphery of the mass. We also present volume-rendered and virtual bronchoscopic images of this rare submucosal tracheal tumor.     

Radiofrequency ablation of rabbit liver: correlation between CT findings and pathological findings

The purpose of this study was to present the time-related imaging findings and correlative pathological findings of irradiated regions in the rabbit liver. RF ablation was carried out on 16 rabbit livers. Irradiated regions were imaged at 3 days, 4 weeks, and 12 weeks. At 3 days, the regions showed a two-zone structure on plain CT and peripheral enhancement on the arterial phase. The regions presented a three-zone structure on pathological study. At 4 weeks, peripheral enhancement had almost disappeared, and a two-zone structure obscured on plain CT. The CT findings reflected pathological changes after RF ablation.     

Hydro-dynamic CT preoperative staging of gastric cancer: correlation with pathological findings. A prospective study of 107 cases

The aim of this study was to evaluate the accuracy of dynamic CT in the preoperative staging of gastric cancer. One hundred seven patients affected by gastric cancer diagnosed by endoscopic biopsy were prospectively staged by dynamic CT prior to tumor resection. After an oral intake of 400–600 ml of tap water and an intravenous infusion of a hypotonic agent, 200 ml of non-ionic contrast agent were administered by power injector using a biphasic technique. The CT findings were prospectively analyzed and correlated with the pathological findings at surgery. The accuracy of dynamic CT for tumor detection was 80 and 99 % in early and advanced gastric cancer, respectively, with overall detection rate of 96 % (103 of 107). Three early (pT1) and one advanced (pT2) cancers were undetected. Tumor stage as determined by dynamic CT agreed with pathological findings in 83 of 107 patients with an overall accuracy of 78 %. The accuracy of CT in detecting increasing degrees of depth of tumor invasion when compared with pathological TNM staging was 20 % (3 of 15) and 87 % (80 of 92) in early and advanced cancer, respectively. The sensitivity, specificity, and accuracy of CT in the preoperative staging (pT3–pT4 vs pT1–pT2) was 93, 90, and 91.6 %, respectively. The sensitivity, specificity, and accuracy of CT in assessing metastasis to regional lymph nodes was 97.2, 65.7, and 87 %, respectively. Computed tomography correctly staged liver metastases in 105 of 107 patients with an overall sensitivity of 87.5 % and specificity of 99 %. The sensitivity of peritoneal involvement was 30 % when ascites or peritoneal nodules were absent. Our findings show that dynamic CT can play a role in the preoperative definition of gastric cancer stage. The results can be used to optimize the therapeutic strategy for each individual patient prior to surgery, thus avoiding unnecessary intervention and allowing careful planning of extended surgery in eligible patients. Received: 29 June 1999, Revised: 20 October 1999, Accepted: 22 May 2000     

Case report: primary lymphoma of bone--MRI appearances with pathological correlation.

A case of primary lymphoma of bone involving the proximal tibia is presented. The magnetic resonance (MR) appearances were unusual for a primary malignant tumour, with predominantly low signal intensity on both T1- and T2-weighted images. This correlated with marked fibrosis on histology. These observations are discussed in the context of previous reports of MRI in bone lymphoma.     

Spinal osteoblastoma: CT and MR imaging with pathological correlation

Objectives. To illustrate the CT and MRI features of spinal osteoblastomas and correlate the imaging with histological findings. Design. In a retrospective review the CT and MRI features of spinal osteoblastomas with respect to mineralisation, signal intensity (SI), adjacent reactive changes, enhancement following gadolinium-DTPA (5 cases) and adjacent soft tissue masses were compared and correlated with the histological findings including the degree of osteoid formation and matrix mineralisation, vascularity and surrounding reactive changes in bone and soft tissue. Patients. Eleven patients (7 males and 4 females; age range 8–43 years, mean age 19.5 years) with 12 osteoblastomas (1 patient suffered a recurrence) were studied. Results. All lesions showed classical features on CT with varying degrees of matrix mineralisation, whereas MRI identified mineralisation in only eight of 12 cases. MRI showed low signal intensity of the lesion on both T1- and T2-weighted sequences in several cases in the absence of heavy mineralisation. In these cases, histological examination revealed diffuse osteoid production by the tumour. All patients given gadolinium showed enhancement within the tumour on MRI. Reactive bone marrow changes were identified on MRI in 10 cases, and in five of these the changes were at multiple levels. An adjacent soft tissue mass was demonstrated in five cases, but extraosseous tumour was present histologically in only two of these. Conclusions. The MRI appearances of spinal osteoblastomas are varied and show no characteristic features. MRI may also overestimate the extent of the lesion due to extensive reactive changes and adjacent soft tissue masses. CT should continue to be the investigation of choice for the characterisation and local staging of suspected spinal osteoblastomas.     

Intracerebral haemorrhage and cerebral amyloid angiopathy: CT features with pathological correlation.

AIMS: To review the computed tomography (CT) features of intracerebral haemorrhage pathologically proven to be associated with cerebral amyloid angiopathy in order to facilitate recognition of the presence of cerebral amyloid angiopathy in life. METHODS: We prospectively collected the clinical and brain imaging records of patients dying following an intracerebral haemorrhage who underwent a post-mortem examination and were found to have cerebral amyloid angiopathy. We reviewed the brain imaging to highlight features of the haemorrhage and of the rest of the brain common to these cases. RESULTS: Seven patients aged 60-86 years were examined over a 30-month period. On CT, the notable features were that the haemorrhages appeared large, lobar, often extended through the cortex to the subarachnoid space or into the ventricles, and were multiple and recurrent in patients who survived the initial bleed. The high density (blood) within the haematoma tended to sediment posteriorly. CONCLUSIONS: There are features on CT of cerebral amyloid angiopathy associated with spontaneous intracerebral haemorrhage which should raise the possibility of this underlying diagnosis. We suspect this condition is under-recognized in life, and should perhaps be considered more widely.     

Radiofrequency ablation of rabbit liver: correlation between dual CT findings and pathological findings

PURPOSE: To present the time-related imaging findings and correlative pathologic findings of radiofrequency pulse-irradiated regions of the liver. MATERIALS AND METHODS: Radiofrequency (RF) ablation was performed in 22 rabbit livers with 15-gauge RF probes inserted percutaneously. Regions were imaged with dual-phase CT at 3 days (n = 6), 2 weeks (n = 6), 4 weeks (n = 6), and 12 weeks (n = 4) after RF ablation. RESULTS: At 3 days, the regions showed a two-zone structure on plain CT and peripheral enhancement. The regions presented a three-zone structure on pathological study. Hepatocytes appeared as acidophilic bodies, and nuclei were pyknotic at the inner necrotic zone. The middle whitish zone showed enlarged sinusoids. The marginal zone was a regenerative band. At 2 weeks, the two-zone structure was obscured on unenhanced CT. The region showed a two-zone structure on pathological study. At the inner zone, acidophilic degeneration had progressed, however, cell structure remained. The marginal zone showed fibrous tissue bundles. At 12 weeks, the region was obscured on plain CT. Nuclei and cell structures had disappeared almost completely at the inner zone. Collagen fiber had replaced the marginal zone. CONCLUSION: Zone structural CT findings reflect the pathological findings and time-related changes after RF ablation. Peripheral enhancement in the arterial phase reflects the granulation tissue layer, and its time-related decrease reflects replacement by fibrous tissue.     

Imaging findings of abdominal peripheral primitive neuroectodermal tumor: report of four cases with pathological correlation

Peripheral primitive neuroectodermal tumors (peripheral PNETs) are rare in the abdomen. We report the imaging findings of four peripheral PNETs arising in the abdomen. Three were ill-demarcated tumors and one was a well-demarcated tumor, with extensive local invasion and lymph node metastasis in two cases, respectively. The tumors are of inhomogeneous attenuation and heterogeneous enhancement after intravenous administration of contrast materials. Although their imaging manifestations cannot distinguish them from other sarcomas, recognition of these imaging features may be helpful in suggesting the possibility of peripheral PNETs in some cases.     

Multicystic cavernous haemangioma of the liver: ultrasonography, CT, MR appearances and pathological correlation

Among the hepatic haemangiomas with atypical features when studied radiologically, the multicystic type is extremely rare. We report a case of multicystic hepatic haemangioma in a 62-year-old woman, which was found incidentally during ultrasound screening. Because the tumour showed atypical features on ultrasonography, CT and MRI, the correct diagnosis was not made until the surgery. In this report, the atypical radiological findings are illustrated and correlated with pathological findings.     

CT and MRI findings with pathological correlation of an intracerebral malignant fibrous histiocytoma (MFH): a case report

The CT and MRI findings in a case of an intracranial malignant fibrous histiocytoma are reported. Pathological correlation was demonstrated and tumour vascularization was best seen at angiography. Despite its low incidence in brain. MFH is of special interest because of its ubiquitous location and poor prognosis.Correspondence to: C. Berchtenbreiter     

Periportal low attenuation associated with liver metastasis from colorectal cancer: evaluation using multi-detector-row CT with pathological correlation

Objectives

Periportal low attenuation (PPLA) associated with metastatic liver cancer is occasionally seen on multi-detector-row CT (MDCT). The purpose of this study was to investigate the MDCT patterns of the PPLA and to correlate it with pathological findings.

Methods

We retrospectively reviewed the MDCT images of 63 patients with metastatic liver cancers from colorectal adenocarcinoma. On MDCT scans, PPLA associated with liver metastasis was visualized in six patients with colorectal cancer. In these six patients who had undergone surgical resection, the radiologic-pathologic correlation was analyzed. All patients underwent a single contrast-enhanced MDCT within 1 month before surgical resection. The six liver cancers were pathologically proven to be moderately differentiated adenocarcinoma. We assessed the PPLA on MDCT concerning the distribution patterns and contrast enhancement with pathological correlation.

Results

In five of the patients, the PPLA extended to the hilar side from metastatic liver cancer. Pathologically, there was no cancer invasion into the intra-hepatic periportal area; however, massive lymphedema and fibrosis occurred in all six cases.

Conclusions

PPLA on the hilar and peripheral sides of hepatic metastasis from colorectal cancer may be present suggesting lymphedema and fibrosis of portal tracts not always indicating cancer infiltration.

     

肝脏血管肉瘤的多层螺旋CT表现及其相关病理基础

肝脏血管肉瘤是罕见肿瘤,笔者回顾性分析了经手术或穿刺活检证实的7例肝脏血管肉瘤CT影像资料,结合文献分析其CT影像特征及其病理基础,期望对该病的诊断提供帮助.     

CT findings of synovial sarcomas of the kidney with pathological correlation

PurposeTo describe computed tomography (CT) findings of primary synovial sarcoma of the kidney with pathological correlation.MethodsCT findings of four cases of pathologically confirmed synovial sarcoma of the kidney were retrospectively viewed and correlated with pathologic features.ResultsThe four synovial sarcomas presented as soft tissue masses with multiple smooth wall cysts. Pathologically, entrapped and dilated renal tubules formed the smooth wall cysts lined by hobnail tubular epithelium.ConclusionPrimary renal synovial sarcoma might manifest as a renal mass with multiple smooth wall cysts. The cysts are consistent with entrapped dilated renal tubular and are lined with hobnail tubular epithelium.     

Meningeal leiomyoma in an adult with AIDS: CT and MRI with pathological correlation

We describe the imaging features of a meningeal leiomyoma with pathological correlation in an adult with AIDS. On CT the tumour showed a central low-attenuation area and an enhancing peripheral ring. It gave low signal on T1 weighting and on T2-weighted images a central high-signal area was surrounded by a markedly low-signal band, which showed contrast enhancement. As far as we know, this is the first report of this condition in the radiological literature. Received: 19 January 1998 Accepted: 24 December 1998