Characteristic sonographic findings of Warthin's tumor in the parotid gland

PURPOSE: The aim of this study was to define the characteristic sonographic features of Warthin's tumors in the parotid gland, thus enhancing the ability to make a preoperative diagnosis of this disease process. METHODS: We retrospectively evaluated the sonograms of Warthin's tumors of the parotid gland that had been confirmed by histopathologic examination of surgically excised specimens from patients treated at our institution over a 2-year period. We recorded the echogenicity, shape, margin, and internal structure of the tumors and categorized them into 2 groups on the basis of size (< 5 cm versus > or =5 cm in the largest diameter). RESULTS: Eighteen patients (16 men and 2 women) with a mean age of 57 years (range, 29-82 years) were included in the analysis. One patient had 2 tumors (1 in each parotid gland); the other 17 patients each had only 1 tumor. Our review of the sonographic findings revealed that all 19 tumors were hypoechoic compared with the normal parenchyma of the affected parotid glands. Most of the tumors were ovoid, had well-defined margins, and contained multiple irregular, small, sponge-like anechoic areas. Tumors that were 5 cm or greater in diameter had a higher proportion of cystic content than smaller lesions had and in some cases were composed almost entirely of cystic material. CONCLUSIONS: Our evidence suggests that the sonographic appearance of a Warthin's tumor in the parotid gland is distinctive: a well-defined round or ovoid hypoechoic mass containing microcystic anechoic areas. These sonographic features constitute useful criteria in the preoperative diagnosis of Warthin's tumor in the parotid gland, although sonographically guided fine-needle aspiration biopsy may be needed to confirm the diagnosis.     

A case of primary intestinal Burkitt-like lymphoma: usefulness of sonographic diagnosis

A 55-year-old Japanese man presented with a fist-sized, nonremovable mass in the right lower abdomen. Transabdominal sonographic examination revealed extensive wall thickening without stratification in the distal ileum and cecum, whose echogenicity was homogeneous and extremely low. Some compressibility of the affected bowel was retained. Diagnostic findings obtained with other conventional modalities were consistent with intestinal malignant lymphoma. At surgery, 3 tumors were found in the ileocecal region and the ileum. Histopathological, immunophenotypic, and molecular cytogenetic analysis of resected specimens showed a diffuse Burkitt-like type of B-cell lymphoma.     

Primary peripheral T-cell lymphoma in subcutaneous tissue: sonographic findings

We describe the sonographic findings in a case of Lennert's lymphoma, a rare type of peripheral T-cell lymphoma, involving the subcutaneous tissues of the arm. The sonographic appearance was thought to be more helpful than MRI to establish the diagnosis.     

CXCL12 rs1801157 polymorphism in patients with breast cancer,hodgkin's lymphoma,and non‐hodgkin's lymphoma

Chemokines and their receptors regulate the trafficking of immune cells during their development, inflammation, and tissue repair. The single‐nucleotide polymorphism (SNP) rs1801157 (previously known as CXCL12‐A/ stromal cell‐derived factor‐1 (SDF1)‐3′A) in CXCL12/SDF1 gene was assessed in breast cancer, Hodgkin's lymphoma (HL), and non‐Hodgkin's lymphoma (NHL), since the chemokine CXCL12, previously known as SDF1, and its receptor CXCR4 regulate leukocyte trafficking and many essential biological processes, including tumor growth, angiogenesis, and metastasis of different types of tumors. Genotyping was performed by PCR‐RFLP (polymerase chain reaction followed by restriction fragment length polymorphism) using a restriction enzyme HpaII cleavage. No significant difference was observed in genotype distribution between breast cancer patients (GG: 57.3%; GA: 39.8%; AA: 2.9%) and healthy female controls (GG: 62.9%; GA: 33%; AA: 4.1%) nor between HL patients (GG: 61.1%; GA:27.8%; AA: 11.1%) and healthy controls (GG: 65.6%; GA: 28.9%; AA: 5.5%), whereas a significant difference was observed in genotype distribution between NHL patients (GG: 51.4%; GA: 47.1%; AA: 1.5%) and healthy controls (GG: 65.6%; GA: 28.9%; AA: 5.5%). Further studies will be necessary to elucidate the cancer chemokine network. However, this study suggests that CXCL12 rs1801157 polymorphism may have important implications in the pathogenesis of NHL. J. Clin. Lab. Anal. 23:387–393, 2009. © 2009 Wiley‐Liss, Inc.     

Predictive factors for inadequate stem cell mobilization in Chinese patients with NHL and HL: 14-year experience of a single-center study

Background: Factors affecting progenitor cell mobilization in patients with non‐Hodgkin's lymphoma (NHL) and Hodgkin's lymphoma (HL) are incompletely understood. The aim of this retrospective study was to determine which factors are crucial for effective mobilization and collection of autologous peripheral blood stem cells (PBSC) prior to transplantation in Chinese patients. Patients and methods: A total of 239 patients with lymphoma (198 NHL and 41 HL patients) underwent PBSC collection after mobilization with granulocyte‐colony‐stimulating factor (G‐CSF) or G‐CSF plus chemotherapy priming. Results: Patient characteristics at diagnosis and transplant, including low Eastern Cooperative Oncology Group score (P = 0.013), lack of extranodal invasion (P = 0.034), previously administered radiotherapy regimens (P = 0.040), treatment with platinum prior to mobilization (P = 0.042), previous chemotherapy regimens (P = 0.001) and cycles (P < 0.001), and chemotherapy regimens (P < 0.001) were statistically significant for successful mobilization in multivariate analysis. Premobilization factors, including previous radiotherapy (P = 0.009), previous chemotherapy regimens (P = 0.043) and cycles (P = 0.039), low platelet count prior to mobilization (P = 0.042), and lower CD34+ cells in peripheral blood (PB) (P = 0.050) or bone marrow (BM) (P = 0.007) were considered possibly predictive of poor mobilization. We found the patients who had chemosensitive lymphoma had worse progress‐free survival (PFS) than the patients with initial treatment and high risks (P = 0.017). Conclusion: Our analysis showed that high amounts of chemotherapy, radiotherapy, low platelet count, chemosensitive recurrent patients, combination chemotherapy plus G‐CSF and low CD34+ cells in BM prior to mobilization could emerged as important predictive factors for mobilization failure in Chinese patients with NHL and HL. J. Clin. Apheresis, 2012. © 2012 Wiley Periodicals, Inc.     

Incidental sonographic detection of mucosa-associated lymphoid tissue lymphoma of the urinary bladder found in a very young woman: report of a case

We report a rare case of a mucosa-associated lymphoid tissue (MALT)-type lymphoma of the bladder, incidentally found on sonography in a 17-year-old girl during the workup of arterial hypertension. The diagnosis was established by a transurethral biopsy. Treatment consisted of transurethral resection of the bladder tumor and subsequent chemotherapy. To the best of our knowledge, this is the youngest patient with asymptomatic MALT-type lymphoma of the urinary bladder.     

Sonographic appearances of malignant lymphoma of the salivary glands.

PURPOSE: We undertook this retrospective study to describe the sonographic findings in patients with malignant lymphoma of the major salivary glands. METHODS: We reviewed the sonograms and medical records of 7 patients with histologically proven lymphoma of the parotid (3 patients) or submandibular glands (4 patients). RESULTS: Primary lymphoma was found in 1 parotid gland and 2 submandibular glands. The remaining 4 cases were secondary lymphomas. One patient had been diagnosed with Sj?gren's syndrome and had been followed up with sonography. In parotid glands, both parenchymal and intraparotid nodal lymphomas were found. All submandibular gland tumors were parenchymal. Intraparotid nodal involvement appeared as multiple small nodules with relatively smooth margins, whereas the parenchymal parotid and submandibular gland lymphomas were larger (25 to 45 mm in longitudinal diameter) and showed various degrees of margin irregularity. All tumors were hypoechoic relative to the normal parenchyma. The primary parotid lymphoma and intraparotid nodal lymphomas had a homogeneous echotexture; the secondary parotid lymphomas and submandibular gland lymphomas were heterogeneous. One submandibular gland lymphoma showed intratumoral echogenic stripes. Neither calcification nor cystic degeneration was observed within the lesions. CONCLUSIONS: Lymphomas of the salivary glands present a variety of sonographic appearances, ranging from multiple small, hypoechoic nodules to an irregularly shaped heterogeneous mass without cystic areas or calcifications.     

Tuberculosis of the parotid gland: sonographic manifestations and sonographically guided aspiration.

OBJECTIVE: Involvement of the parotid gland by tuberculosis (TB) is rare. If treated properly, the prognosis of TB of the parotid gland is good. In this retrospective study, we report our experience with sonography and sonographically guided aspiration in the diagnosis of parotid TB. METHODS: Over 12 years, 9 adults (mean age, 48 years) with parotid gland TB had been examined with high-resolution sonography and color Doppler sonography for their clinical problems of swelling on the mandibular angle. Sonographically guided fine-needle aspiration was done for cytologic study, stains for acid-fast bacilli, and cultures for mycobacterium. RESULTS: The sonographic patterns were classified as chiefly the parenchymal type (4 patients) and chiefly the periparotid type (5 patients). The parenchymal type appeared as a diffusely enlarged, comparatively hypoechoic gland (compared with the contralateral asymptomatic gland), with or without focal intraparotid nearly anechoic zones, which might have a cavity or cavities within it. The periparotid type appeared as hypoechoic nodules located in the peripheral zone of the hyperechoic parotid gland, consistent with enlarged periglandular lymph nodes. The diagnosis of parotid TB was made in 8 of 9 patients on the basis of sonographically guided aspiration for acid-fast bacilli stains, cytologic study, and cultures for mycobacterium. CONCLUSIONS: Sonographic examination contributes substantially in the diagnosis of parotid TB infection. In the presence of diffuse parotid echo pattern changes with periparotid lymphadenopathy, and with or without focal hypoechoic zones, TB infection should be differentiated. Sonographically guided fine-needle aspiration may provide further diagnostic information by means of stains, cultures, and cytologic study.     

Primary follicular lymphoma of colon: A case series and review of literature

Follicular lymphoma of the colon is rare, accounting for 1% to 2% of cases in the gastrointestinal tract. Despite the absence of randomized clinical trials, NCCN stage III and IV colonic follicular lymphomas are routinely treated with chemotherapy with good clinical response. We present 2 cases of advanced stage follicular lymphoma of colon that were effectively treated with bendamustine‐based chemotherapy regimens.     

Unusual presentation of a clinically isolated temporal region mass: Non‐Hodgkin lymphoma

Non‐hodgkins lymphoma is a systemic disease that may present in multiple sites, rarely does it present primarily as a temporal fossa swelling. Only four cases have been reported in the English literature. We report a case of a patient who presented with a rapidly progressive swelling of the temporal fossa.     

Intussusception induced by villous tumor of the colon: sonographic findings.

We report a case of intussusception caused by a villous tumor of the ascending colon in an 82-year-old man. Abdominal sonography showed intussusception in the ascending colon, with a transverse scan demonstrating a multiple concentric ring sign. Color Doppler sonography showed blood flow signals in a mass, which was considered to be the lead point of the intussusception. A spontaneous reduction of the intussusception occurred during the examination; sonography then showed a mildly echogenic, mass. The graded compression method revealed that the mass was soft and immobile. Colonoscopy confirmed the diagnosis of villous tumor. Sonography helped to make an early diagnosis, allowing successful conservative management of the tumor and the intussusception.     

Primary central nervous system Hodgkin's lymphoma: a case report

Primary central nervous system Hodgkin''s lymphoma (CNS-HL) is extremely rare. This current case report describes a 60-year-old male patient that presented with numbness of the left lower extremity and worsening headache. After a full range of investigations and a partial resection of the right cerebellum, external ventricular drainage reservoir placement and cranioplasty, he was diagnosed with primary CNS-HL. The patient was treated with 3 g/m² methotrexate (intravenous [i.v.], once a day, day 1) and 1 g/m² cytarabine (i.v., every 12 h, days 2 + 3), followed by anti-programmed cell death protein 1 antibodies (200 mg sintilimab, i.v., once a day, day 1, every 3 weeks). After six courses of treatment with intrathecal injections of 50 mg cytarabine (once a day, day 1) and 5 mg dexamethasone (once a day, day 1), there was no residual lesion on cranial magnetic resonance imaging. No significant drug-related adverse events were observed. The patient has been followed up every 3 months and no relapse has occurred.     

子宫直肠陷凹恶性外周神经鞘瘤1例

患者女,46岁,下腹隐痛伴尿频、尿急及肛门坠胀感10天.查体:子宫后方触及直径6.0 cm包块,表面结节感,压痛明显,活动度差.经阴道超声:阴道与直肠肛管间5.8cm×4.8cm囊实性肿物,紧邻宫颈后壁及阴道后壁,以实性中等回声为主;CDFI见其内星点状血流信号(图1A).腹部MRI:直肠右前方5.6 cm×6.8 c...     

Bifocal primary pancreatic Burkitt's lymphoma in a 4‐year‐old child

Pancreatic tumors are uncommon in children and rarely result in biliary obstruction. Primary pancreatic Burkitt's lymphoma is an exceptionally rare entity with only a few cases described in the literature. We present a case of a bifocal primary pancreatic Burkitt's lymphoma in a 4‐year‐old child presenting with jaundice. © 2016 Wiley Periodicals, Inc. J Clin Ultrasound 45 :171–174, 2017     

Correlation of computerized gray-scale sonographic findings with thyroid function and thyroid autoimmune activity in patients with Hashimoto's thyroiditis

PURPOSE: The objective of this study was to retrospectively assess whether computerized gray-scale sonography can allow objective measurement of thyroid echogenicity in patients with Hashimoto's thyroiditis (HT) at various functional stages of the disease. METHODS: Of the 77 patients with HT who were included in our study, 28 had been euthyroid, 20 had had subclinical hypothyroidism, and 29 had had clinical hypothyroidism. Of those with clinical hypothyroidism, 6 had been untreated and 23 had been receiving L-thyroxine substitution therapy. Fifty volunteers without thyroid disease served as a control group. Thyroid echogenicity was evaluated by computerized gray-scale sonography as mean tissue density (MTD) +/- standard deviation; the echogenicity of the prethyroid muscles served as a control of the system variability. RESULTS: The MTD was significantly lower for the patients with HT (15.9 +/- 4) than for the control subjects (24.3 +/- 3; p < 0.05). Moreover, a significant difference was found between the MTD values of euthyroid patients with HT (18.9 +/- 3.4) and hypothyroid patients with HT analyzed either as a group (14.3 +/- 3.8) or separately for subclinical hypothyroidism (14.9 +/- 3.8) and clinical hypothyroidism (13.9 +/- 3.7; p < 0.05). The lowest MTD was found in patients with untreated clinical hypothyroidism (11.1 +/- 4.3), with a significant difference (p < 0.05) compared to all other groups of patients. Untreated patients with clinical hypothyroidism also showed the highest mean anti-thyroid peroxidase autoantibody levels (1,286 +/- 177 IU/ml versus 570 +/- 489 IU/ml for L-thyroxine-treated patients; p < 0.05), although no correlation between the MTD values and anti-thyroid peroxidase autoantibody levels was found in any group of patients. CONCLUSIONS: Computerized gray-scale sonography provides an objective measure of thyroid hypoechogenicity, which correlates well to the clinical stages of HT. Use of this modality may prove beneficial in the diagnosis and follow-up of patients with HT.     

Gray-scale and color Doppler sonographic findings in a case of mesenteric Castleman's disease incidentally detected in a patient with Graves' disease

We report a case of localized Castleman's disease of mesentery, studied with sonography, that was incidentally detected as an abdominal mass in a patient with Graves' disease. Its lymphatic nature and mesenteric origin was indicated preoperatively on the basis of gray-scale and color Doppler sonographic features.