Supratentorial ependymomas: computed tomographic and pathologic correlations

Of a total of 52 cases of ependymomas, 38 were intracranial, with 15 being supratentorial and 23 infratentorial. Pre- and postoperative computed tomographic scans were correlated with surgical pathologic findings in four cases of supratentorial ependymomas. Pathologic specimens were analyzed from another four cases for which only postoperative scans were available. Seven cases had no computed tomographic studies, but pathology reports were available. Common computed tomography findings for these tumors included para- or intraventricular location, one or more cystic areas within the tumor, and calcifications within the lesion or around its periphery. Proven subependymal spread of tumor was evident by computed tomography in one case. Mixing of ependymoma with oligodendroglioma was present in four cases and with both oligodendroglioma and astrocytoma in two cases. Microscopic calcifications were more frequently seen in ependymomas that were mixed with oligodendroglioma.     

Temporomandibular joint and rheumatoid polyarthritis. X-ray computed tomographic aspects]

Direct coronal computed tomography (CT) examination of the temporomandibular joint (TMJ) was performed in 26 patients with rheumatoid arthritis (RA) and 26 control subjects. Changes in condylar shape, erosions and cysts of the mandibular condyle and condylar head resorption were more frequent among the RA group than the control group. Only the erosions and cysts of the mandibular condyle had a significantly higher frequency in the RA group than in the control group (p less than 0.05). Bone changes were bilateral in RA. Coronal view of the CT examination allow a clear visualization of the osseous elements of the TMJ but a control group is absolutely necessary to affirm with certainty the rheumatoid origin of the bone changes. The erosions and cysts of the mandibular condyle and their bilateral nature are the most specific features of RA on TMJ.     

Non-neoplastic gliotic cerebellar cysts: Clinical and computed tomographic correlations

Summary The clinical and CT findings in 3 patients with non-neoplastic gliotic cerebellar cyst are described. CT does not permit accurate preoperative differentiation of these lesions from neoplastic disorders.     

Retroperitoneal malignant fibrous histiocytoma: The angiographic and computed tomographic features of an unusual tumor

Malignant fibrous histiocytomas are uncommon retroperitoneal soft tissue tumors. We report a case of a malignant fibrous histiocytoma of the retroperitoneum that was angiographically hypervascular and indistinguishable from renal cell carcinoma. Computerized tomography of the abdomen demonstrated extensive psoas muscle infiltration by tumor. This feature may be useful in differentiating a renal cell carcinoma from a primary retroperitoneal sarcoma.     

The computed tomographic diagnosis of malignant pleural mesothelioma. A multicenter study]

CT features are described and accuracy of the method is discussed in the diagnosis of malignant pleural mesothelioma. Ninety-eight patients suffering from pleural disease mimicking mesothelioma were examined by means of III-generation CT scanners; according to the final diagnosis, 37 patients suffered from malignant pleural mesothelioma, 27 from other malignant pleural diseases and 34 from various benign diseases. In all patients a series of CT signs was evaluated: pleural thickening patterns, lesion spread and possible associated characters. In the diagnosis of mesothelioma CT showed 72.5% sensitivity, 63.8% specificity, 68.3% diagnostic accuracy, 68.5% positive predictive value and 68.2% negative predictive value. Some significant CT patterns in distinguishing malignant from benign pleural disease were identified, while the characterization of malignant disease (mesothelioma versus other neoplastic conditions) proved to be unreliable.     

Calcified renal metastases: their etiology, pathogenesis, computed tomographic aspects and differential diagnosis

PURPOSE: To describe CT findings of calcified renal metastases focusing on differential diagnosis problems. MATERIAL AND METHODS: We retrospectively reviewed abdominal CT scans of 8000 patients with tumor, performed from 1984 to 1998. Among the 58 renal metastases, 9 showed a calcific component. We evaluated the location, morphostructural pattern, histology of the primary lesion, the synchronous or metachronous character and the type of treatment. All the lesions were pathologically proved. RESULTS: The primary histotype of the 9 metastases was as follows: 4 mucin-producing adenocarcinomas of the large bowel, 1 gastric mucinous adenocarcinoma, 1 chondrosarcoma, 1 osteosarcoma, 1 melanoma, 1 papillary thyroid carcinoma. In all the cases the renal metastasis was unilateral and unifocal. Granular multiple calcifications were demonstrated within the metastases of mucin-producing adenocarcinoma of the large bowel (3), within the metastasis of chondrosarcoma (1) and of melanoma (1). Diffuse "star-like" calcifications were demonstrated in renal metastases of mucin-producing adenocarcinoma of the large bowel and of gastric mucinous adenocarcinoma (1). Peripheral "egg-shell" calcifications were demonstrated in renal metastasis from papillary thyroid carcinoma (1). Completely calcified monofocal calcification was demonstrated in renal metastasis from osteosarcoma (1). DISCUSSION AND CONCLUSIONS: Calcified renal metastases are rare lesions related to specific oncotypes. The differential diagnosis (carcinoma with calcifications, osteosarcoma, chondrosarcoma, nephrocalcinosis, granulomatosis, hydatidosis etc.) is particularly difficult because of the aspecificity of the morphostructural pattern. Diagnosis is based on a history of specific oncotypes (papillary and mucin-secreting carcinomas, osteosarcoma and chondrosarcoma), but in most cases it requires pathologic confirmation.     

腹腔恶性纤维组织细胞瘤1例

患者男,40岁,工人。10余天前无明显诱因出现上腹部胀痛不适,以左上腹为重,进食后胀痛明显,无发热、恶心呕吐、腹泻等,当地医院行B超及CT检查显示左侧腹腔囊实性占位、腹水,为进一步诊治以＂腹腔内占位＂收入院。发病来饮食睡眠差,体重无明显减轻。查体：腹部平软,     

Post-traumatic aneurysmal dissection of the extracranial internal carotid artery; helical computed tomographic and angiographic aspects: a case]

A 20-year-old man presented with mild intracranial bleeding, a Horner's syndrome, and left neck swelling following head injury. Following noncontrast CT of the brain, a contrast-enhanced helical CT was performed through the neck that showed a hematoma in the poststyloid space (carotid sheath) with irregular diameter of the ICA. Selective digital subtraction angiography confirmed the presence of left cervical ICA dissection with pseudoaneurysm formation. The aneurysm was resected and an end-to-end anastomosis was done using an inverted saphenous graft. Histology confirmed a diagnosis of traumatic ICA dissection with pseudoaneurysm formation and there was no evidence of pre-existing pathology. Helical CT is a simple, widely available, and relatively non-invasive imaging technique that correlates well with angiography. It should be considered in the evaluation of patients with suspected cervical ICA dissection.     

Malignant Brenner tumor with transition from benign to malignant components: computed tomographic and magnetic resonance imaging findings with pathological correlation

We report computed tomographic and magnetic resonance findings of an ovarian malignant Brenner tumor with transition from benign to malignant components. The tumor was demonstrated as a cystic mass with solid mural components. The benign component contained dense calcifications on computed tomography and showed very low intensity on T2-weighted images, whereas the malignant component showed high intensity. The admixture of 2 components may well reflect the pathological feature and may be a diagnostic clue to malignant Brenner tumor.     

Hepatic Kaposi's sarcoma and AIDS. Ultrasonographic and x-ray computed tomographic aspects

AIDS-related Kaposi sarcoma is most often multicentric and extensive. Hepatic involvement is unusual and asymptomatic. An anicteric cholestasis may exist. Ultrasonography shows a pedicular echogenic infiltration and a heterogeneous parenchyma with small hyperechoic nodules. On CT, these hypodense lesions are related to the involvement of the hepatic pedicle. This is linked to angiosarcomatous tumorous tissue infiltration of the liver evolving along portal branches. In a patient suffering from cutaneous or digestive Kaposi sarcoma lesions, these radiological aspects are suggestive of hepatic involvement.     

Agenesis of an internal carotid artery: Angiographic,tomographic and computed tomographic correlation

Summary Congenital absence of one internal carotid artery was found by angiography in a woman of 52 years who had subarachnoid hemorrhage. The absence of the bony carotid canal on the affected side substantiated the congenital nature of this rare vascular anomaly. We believe this to be the first report of absence of the bony carotid canal and the intracavernous portion of the internal carotid artery confirmed by computed tomography and cavernous sinography.     

恶性胃间质瘤1例的超声表现

患者女,30岁。1年前无明显诱因黑便,1次/日,乏力感,略头晕,无恶心、呕吐、无呕血。外院实验室检查:大便潜血 ,血色素正常。胃镜示反流性胃炎、息肉,自行缓解。4天前无诱因再现黑便就诊。上腹不适,乏力,实验室检查:大便潜血 ,血Hb 87g/L,无发热、返酸、嗳气。初诊:消化道出血,返流性胃炎、息肉,失血性贫血(中度)。彩超检查:左上腹腔内见实性低回声肿物,大小约6·5 cm×8·3 cm,形态不图1左上腹分叶状稍低回声实性肿块规整,CDFI:肿块周边及内部均可见丰富血流信号,走行纡曲,分布杂乱,其中多为动脉样血流信号。腹腔未探及明显肿大淋巴结。饮…     

Venous calcifications associated with cavernous transformation of the portal vein: computed tomographic and angiographic correlations.

A case of rare venous calcifications involving cavernous transformation of the portal vein and spontaneous splenocaval shunt is presented. Findings were obtained with plain abdominal radiography, computed tomography, and angiography. Inflammation of the portal vein with subsequent occlusion could account for splenomegaly and hypertrophy of the splenic artery and vein with atheromatous calcifications due to turbulence and sclerosis. Angiography is essential prior to surgical intervention in order to select the appropriate shunt.