Epithelioid hemangioendothelioma of the liver: MR and CT findings.

The MR imaging features in five patients with hepatic epithelioid hemangioendothelioma (EHE) were correlated with CT and pathologic findings. Two hemangioendotheliomas appeared as multiple nodular lesions with a predominantly peripheral location in the liver. In three more extensive cases, the tumors formed confluent peripheral lesions with macroscopic invasion of portal or hepatic veins (n = 3), signs of portal hypertension (n = 3), and nodular hypertrophy of uninvolved liver (n = 2). These findings, suggestive of EHE, were well demonstrated by MR imaging and CT. The internal architecture of the tumors was clearly depicted on T2-weighted MR images. Viable tumor peripheries appeared moderately hyperintense relative to liver. The center of the tumors consisted of one or several concentric zones. Hyperintense central zones were composed of loose, edematous connective tissue. Hypointense zones contained mainly coagulation necrosis, calcifications, and scattered hemorrhages. Except for the presence of calcifications, the internal architecture of EHE was better defined by MR imaging than by CT.     

Giant cavernous hemangioma of the liver: atypical CT and MR findings

The CT and MR appearance of giant cavernous hemangiomas can be confusing, and some atypical radiographic findings have been described. We report the CT and MR features of a giant cavernous hemangioma of the liver with atypical presentation. CT showed a large hypodense geographical lesion involving the majority of the liver and multiple scattered peripheral lesions. The T2-weighted MR images revealed a huge hyperintense lesion with multiple satellite nodules. Correspondence to: C. Valls     

Adenoid cystic carcinoma of the maxillary sinus: CT and MR imaging findings

Objective

The purpose of this study was to determine whether adenoid cystic carcinomas (ACCs) of the maxillary sinus have features on CT and MR imaging.

Materials and methods

Nine patients with histopathologically proved maxillary sinus ACCs were included. The growth pattern was classified as expansile or destructive types on the basis of CT images. CT images were also reviewed for adjacent bony defects and MR images were reviewed for tumor extension. Fluid accumulation in the ipsilateral maxillary sinus was also assessed.

Results

The tumors had caused adjacent bony expansion with minimal bony defects in 4 patients whereas those in the remaining 5 patients had caused extensive destruction of adjacent bones comprising the maxillary sinus walls. Nasal cavity invasion was observed in 7 patients, retroantral fat pad invasion in 5, pterygopalatine fossa invasion in 4, and orbital invasion in 3. All 4 expansile ACCs were accompanied by accumulation of a small amount of fluid in the surroundings of the tumors, which was revealed as hyperintensity on T1-weighted images.

Conclusion

The growth pattern of maxillary sinus ACCs can be classified into an expansile type with minimal bony defects and a destructive type with extensive bony defects.     

Elastofibroma: CT and MR findings

Two cases of elastofibroma of the chest wall are reported. Each patient was investigated with CT and, in 1 case, MR imaging was also performed. Elastofibroma appears like a mass in the subscapular region and often presents problems of differential diagnosis. The contribution of MR imaging is reported.     

Hepatocellular carcinoma in an ectopic liver: CT findings

Hepatocellular carcinoma (HCC) in an ectopic liver is very rare and its CT findings have never been reported. We present an ectopic HCC between the spleen and left diaphragm, mimicking a splenic neoplasm on the CT scan. A follow up CT at seven months postoperatively revealed multiple recurrent HCCs in the mother liver.     

Meningioangiomatosis: CT and MR findings.

Meningioangiomatosis (MA) is a rare hamartomatous lesion of the cerebral cortex; to date only 18 cases with imaging findings have been reported in the English literature. The origin of MA is probably malformative, with possible association with neurofibromatosis. These lesions frequently cause seizures in young patients. We report two new cases seen at our institution and present their CT and MR findings clearly illustrating MA cortex infiltration. Gd-DTPA used in one of the two cases failed to cause enhancement.     

Marchiafava-Bignami disease: CT and MR findings

We describe characteristic findings in a patient with Marchiafava-Bignami disease who was serially imaged with CT and MR. Involvement of the entire corpus callosum was visualized with both types of imaging. Following administration of gadolinium-DTPA, the lesion was clearly enhanced in the subacute stage. Correspondence to: S. Otake     

Intracranial hemangioblastomas: CT and MR findings

The CT and magnetic resonance (MR) findings in eight patients with 10 biopsy-proven intracranial hemangioblastomas were reviewed. Three of these patients had von Hippel-Lindau (VHL) syndrome. Nine tumors were infratentorial, seven were cystic, and five had well-defined mural nodules. The only three solid tumors, the only brain stem tumor, and the only supratentorial tumor in this series occurred in VHL patients. Magnetic resonance detected a single tumor missed by CT, and no lesion seen on CT was missed by MR. The tumor nodule, when present, was identified in every case using MR, although it was usually more apparent on contrast-enhanced CT. In three cases MR was better than CT in defining the margins of posterior fossa tumors. Serpentine vessels were well seen as flow voids against high signal cyst or tumor on T2-weighted images, but contrast-enhanced CT also demonstrated them. Magnetic resonance was found superior to CT for the detection of intracranial hemangioblastomas, and complementary in their characterization.     

Meningovascular syphilis: CT and MR findings

The radiologic findings in three cases of meningovascular syphilis are presented. Angiography demonstrated varying degrees of narrowing and ectasia of the supraclinoid carotid, basilar, and proximal anterior and middle cerebral arteries, as well as distal branches. Computed tomography (CT) showed multifocal infarction with variable enhancement. Similarly, in the one case studied with magnetic resonance (MR), several regions of high signal intensity on T2-weighted sequences were found, which were compatible with foci of ischemia. Although the radiologic findings are nonspecific, the diagnosis of meningovascular syphilis should be considered in patients with vasculitis of uncertain etiology.     

Macrodystrophia lipomatosa: CT and MR findings

Macrodystrophia lipomatosa is a congenital macrodactyly characterized by proliferation of all mesenchymal components, particularly fibroadipose tissue. We report imaging features of two such patients. MR imaging and CT scanning demonstrated proliferation of fatty tissue in the territory of the median nerve in the hands and forearms, characteristic of macrodystrophia lipomatosa.     

Hyperostotic esthesioneuroblastoma: CT and MR findings

Olfactory neuroblastoma is a malignant, slow growing, neurogenic tumor that originates in the olfactory mucosa of the upper nasal cavity. Its CT appearance, i.e., a soft tissue mass adherent to the cribriform plate usually with bone lysis, has been described. Two cases are presented in which this entity was associated with exuberant bony hyperostosis, a feature not previously reported. The differential diagnosis of nasoethmoid soft tissue masses with associated hyperostosis is reviewed.     

Lead encephalopathy: CT and MR findings

Lead is toxic to many organ systems, among them bone marrow, muscles, kidneys, endocrine glands, joints, and nervous system. Encephalopathy is a rare but severe complication of lead poisoning. Lead toxicity is much less common in adults. Adult lead poisoning results primarily from exposure by inhalation in the workplace. In this report, two cases of adult toxic encephalopathy due to lead poisoning are presented with CT and MR findings.     

Lhermitte-Duclos disease: CT and MR findings

The typical CT findings of Lhermitte-Duclos disease (dysplastic gangliocytoma of the cerebellum) are a hypodense nonenhancing unilateral posterior fossa mass, with or without adjacent occipital thinning, hydrocephalus, and calcification. Magnetic resonance (MR) has been found to be very helpful, and superior to CT, in delineating the margins of the lesion for determining the extent of surgical resection. Since recurrence is known, MR is important in the follow-up of these patients. To our knowledge this is the first reported case that included MR examination with administration of gadolinium. There was no enhancement of the lesion, consistent with previous reports of no contrast enhancement on CT.     

Sinus pericranii: CT and MR findings

A case of sinus pericranii communicating with the right transverse sinus is reported. The radiographic findings on CT, angiography, and magnetic resonance imaging are presented.     

Nasopharyngeal teratoma: CT and MR findings

Teratomas of the nasopharynx occur usually in neonates. We present a case of teratoma which was discovered in an adult, and which relapsed after 34 years. The conventional radiograms, CT, MR, and histologic appearances are described. Received 3 January 1996; Revision received 1 March 1996; Accepted 4 March 1996