Benign lymphoepithelial parotid tumors in AIDS patients: CT and MR findings in nine cases

Benign lymphoepithelial parotid neoplasm with associated cervical adenopathy is a newly described head and neck manifestation of HIV infection, characterized previously as purely cystic masses on both CT and MR evaluations. The CT and MR findings in nine cases of surgically proved benign lymphoepithelial parotid lesions are presented. Five (56%) of the nine cases demonstrated masses that appeared other than cystic, reflecting a greater variety of radiologic appearances than previously reported. The majority of these cystic masses contained solid components and therefore could not be labeled as cysts; instead, they were considered to be benign lymphoepithelial parotid lesions. For patients with parotid gland enlargement, the lack of a characteristic CT/MR appearance of these lesions necessitates an evaluation of clinical history and a determination of whether cervical adenopathy is present in order to determine their underlying origin.     

Cystic tumors in the anterior mediastinum. Radiologic-pathological correlation

Anterior mediastinal neoplasms comprise a diverse group of tumors and occasionally manifest as a cystic lesion. We retrospectively reviewed computed tomography (CT) scans in 46 patients with pathologically proved cystic anterior mediastinal tumors. We categorize them into a pure cystic mass and a cystic tumor with a solid portion. In this pictorial essay, the radiologic appearances of cystic anterior mediastinal tumors are described with CT and illustrated with their gross and histopathological findings on resected specimen.     

Peritoneal mesothelioma. Radiologic appearances correlated with histology

Previous imaging reports of peritoneal mesothelioma have described a variety of radiologic appearances, but have not included its pathologic classification. We retrospectively reviewed 10 cases of peritoneal mesothelioma representing the following histologic categories: 7 epithelial, 2 sarcomatoid, and one biphasic. By imaging, epithelial mesotheliomas demonstrated diffuse thickening of the peritoneum and mesentery and/or multiple small nodules. The sarcomatoid-type appeared as a mass and the biphasic-type had radiologic and gross pathologic features of both sarcomatoid and epithelial types. We conclude that peritoneal mesothelioma presents with a wide spectrum of radiographic appearances and should therefore be included in the differential diagnoses of diffuse as well as localized peritoneal processes.     

卵巢颗粒细胞瘤的CT表现

目的：分析卵巢颗粒细胞瘤（OGCT）的CT征象,提高对本病的诊断水平。方法：回顾性分析19例经手术病理证实的卵巢颗粒细胞瘤的CT资料,其中11例为初发病例,8例为复发病例。结果：19例OGCT患者共有23个肿瘤,其中14个呈类圆形或圆形,9个呈不规则或分叶状,共有2个囊性肿块,15个囊实性肿块和6个实性肿块。囊性肿块在CT图像上以均匀低密度、无强化的囊性成分为主,囊壁、分隔或壁结节有强化;实性肿块CT表现为肿块大部分为实性,内有单发或多发灶性低密度坏死区;囊实性肿块CT表现为囊性与实性成分大致相等。所有病例增强扫描病灶实性部分呈轻度-中度强化。13例伴腹水,9例伴子宫内膜增厚,19例均无淋巴结肿大。结论：卵巢颗粒细胞瘤的CT表现有一定特征,结合临床和CT有助于对本病的诊断和鉴别诊断。     

Differential diagnosis of truly suprasellar space-occupying masses: synopsis of clinical findings,CT, and MRI

This review demonstrates the features of truly suprasellar masses in modern imaging based on the clinical, CT, and MRI findings of 42 patients with suprasellar masses in correlation to the histologic findings. The radiologic examinations were evaluated retrospectively to determine if diagnosis can be made based on specific imaging patterns. The most frequent clinical findings of space-occupying suprasellar masses were visual disturbances, diabetes insipidus, and symptoms and signs of occlusive hydrocephalus. There were no clinical features specific for any of the observed masses. Craniopharyngiomas were the most frequent tumors. They appeared in two different forms, as cystic and as solid enhancing masses. The cystic tumors could not be differentiated from cystic hamartomas or cystic gliomas by CT or MRI. The solid craniopharyngiomas were similar to meningiomas and hamartomas. In craniopharyngiomas of adults calcifications were not common. In CT and especially in MRI gliomas were characterized by the diffuse infiltration of the adjacent brain tissue or optic nerve. Except for meningiomas, all lesions were highly variable in appearance, making a reliable characterization by CT and MRI difficult in many cases. However, administration of contrast media in some cases resulted in a better tumor delineation. Compared with unenhanced MRI the enhanced scans did not increase diagnostic efficacy for neoplasms, but were helpful in the differentiation from inflammatory diseases. The MRI technique was superior to CT in demonstrating the anatomic relationships, thus facilitating evaluation of origin and extent of the lesions. The CT technique, of course, was more reliable in the detection of calcifications. Both CT and MRI are not tissue-specific, however,and suprasellar tumors as well as many other neoplasms cannot be classified using only one of these imaging techniques.To optimize the diagnostic strategy both imaging modalities should be used with close regard to patient history, physical examination, and clinical parameters. Correspondence to: J. Reul     

低度恶性腹膜囊性间皮瘤的影像与病理

探讨低度恶性腹膜囊性间皮瘤的影像学表现与病理基础 ,回顾性分析经病理证实的 14例低度恶性腹膜囊性间皮瘤的X线、CT或MRI影像表现特点。本组 14例腹膜低度恶性囊性间皮瘤以中年女性多见 ,男女之比为 3∶11。主要症状为腹部疼痛或不适 ,10例CT或MRI检查发现 3例为局限性单发囊性肿块 ,5例为多发囊性结节 ,6例为弥漫性囊性结节。大多数低度恶性腹膜囊性间皮瘤的X线、CT或MRI显示有一定的特征性改变 ,从而可获得诊断     

CT and MR appearances of parotid pseudotumors in Sj?gren syndrome.

The radiologic findings in eight patients with parotid pseudotumors associated with Sj?gren syndrome (CT in eight; MRI in two) were retrospectively analyzed and compared with the findings in three cases with malignant lymphomas. Diagnosis of pseudotumor was obtained by surgery in six cases and by fine-needle aspiration biopsy and radiologic follow-up in the remaining cases. Six cases (75%) had advanced disease and the remaining had early disease. Both solid (75%) and cystic (38%) masses were seen in the patients with pseudotumors. The masses were solitary in 25%, multiple in 75%, unilateral in 25%, and bilateral in 75%. All three lymphomas were solid masses. The lymphomatous masses were not reliably distinguished from the solid pseudotumors.     

恶性局限性腹膜间皮瘤的CT诊断与病理基础

目的 探讨恶性局限性腹膜间皮瘤的CT诊断价值。方法 分析4例恶性局限性腹膜间皮瘤的CT表现特点及其病理基础。结果 4例恶性局限性腹膜间皮瘤的CT表现均为巨大孤立性肿块,瘤径平均大小为13cm。其中3例为囊实性,以多囊性为主;1例为实性,内见不规则坏死。增强扫描,4例肿瘤实质区均显著强化,密度增高最大者达106HU, 平均76HU。无远处转移及腹水。结论 恶性局限性腹膜间皮瘤CT表现具有多囊变、实性部分显著强化及无地锭处转移等特征。     

Diagnosis of peritoneal mesothelioma: computed tomography, sonography, and fine-needle aspiration biopsy

The diagnosis of peritoneal mesothelioma was made prospectively and noninvasively in four patients with the use of sonography, computed tomography, and sonographically guided fine-needle aspiration biopsy. The imaging methods revealed information similar to the operative findings, with clear superiority of computed tomography over sonography. These noninvasive methods may be used as screening tools, especially among groups or in regional areas with a high risk for asbestos exposure. The findings included soft-tissue masses with invariable involvement of the omentum; small intraperitoneal nodules; thickened peritoneum, mesentery, and bowel wall; pleural plaques; and usually minimal, if any, ascites. Since the differential diagnosis from peritoneal carcinomatosis may be difficult, sonographically (or CT) guided aspiration biopsy is needed to produce diagnostic cytologic specimens. The use of this type of biopsy should obviate surgical exploration.     

Intracranial cysts: radiologic-pathologic correlation and imaging approach

Cysts and cystic-appearing intracranial masses have a broad imaging and pathologic spectra. The authors review the pathologic findings, origin, radiologic appearance, and differential diagnosis of many different intracranial cysts. A diagnostic algorithm based on most common anatomic locations is presented that helps narrow the differential diagnosis.     

Uncommon adrenal masses: CT and MRI features with histopathologic correlation

Adrenal glands are common sites of diseases. With dramatically increased use of computed tomography (CT) and magnetic resonance (MR) imaging, more and more uncommon adrenal masses have been detected incidentally at abdominal examinations performed for other purposes. In this article, uncommon adrenal masses are classified as cystic masses (endothelial cysts, epithelial cysts, parasitic cysts, and pseudocysts), solid masses (ganglioneuroma, ganglioneuroblastoma, extramedullary plasmacytoma (EMP), neurilemmoma, and lymphoma), fat-containing masses (myelolipoma, teratoma), and infectious masses (tuberculoma), and the imaging features of these uncommon masses are demonstrated. Although most of these lesions do not have specific imaging features, some fat-containing masses and cystic lesions present with characteristic appearances, such as myelolipoma, teratoma, and hydatid. Combination with histopathologic characteristic of these uncommon masses of adrenal gland, radiological features of these lesions on CT and MR imaging can be accurately understood with more confidences. Moreover, CT and MRI are highly accurate in localization of uncommon adrenal masses, and useful to guide surgical treatments.     

Cystic Lesions of the Gastrointestinal Tract: Multimodality Imaging with Pathologic Correlations

The cystic lesions of the gastrointestinal (GI) tract demonstrate the various pathologic findings. Some lesions may present a diagnostic challenge because of non-specific imaging features; however, other lesions are easily diagnosed using characteristic radiologic features and anatomic locations. Cystic masses from the GI tract can be divided into several categories: congenital lesions, neoplastic lesions (cystic neoplasms, cystic degeneration of solid neoplasms), and other miscellaneous lesions. In this pictorial review, we describe the pathologic findings of various cystic lesions of the GI tract as well as the radiologic features of GI cystic lesions from several imaging modalities including a barium study, transabdominal ultrasound (US), computed tomography (CT), and magnetic resonance (MR) imaging.     

多层螺旋CT对腹膜假性黏液瘤的诊断价值

目的 探讨腹膜假性黏液瘤的MSCT表现.方法 搜集经手术、病理证实的腹膜假性黏液瘤11例,回顾性分析其CT表现.结果 腹膜假性黏液瘤的MSCT平扫见腹腔不规则囊实性肿块,CT值18.5～27.6 HU;肝脾等实质脏器边缘扇贝样或结节状压迹,脏器周围、网膜间隙、腹腔、盆腔见大量黏液性腹水;腹膜、大小网膜弥漫性不规则增厚;增强扫描显示囊实性病变仅见囊壁、网膜、腹膜轻度强化,囊内病灶无明显强化.结论 MSCT检查对该病的诊断及鉴别诊断具有重要的价值.     

CT appearance of cystic adenomatoid malformations

Four pediatric patients with cystic adenomatoid malformation (CAM) are reported to illustrate the CT appearances of this lesion. Two patients presented in infancy with respiratory distress and two in later childhood with superimposed infection. Multilocular cystic masses with thin walls were seen by CT in the neonate and small infants with uninfected CAM, while infected CAM appeared as a complex lesion on CT, with an admixture of solid and cystic tissue and with variable definition of margins.     

Granulosa cell tumor of the ovary: common findings and unusual appearances on CT and MR

PURPOSE: The purpose of this article was to demonstrate CT and MR findings of granulosa cell tumor of the ovary. METHODS: MR (n = 7) and CT (n = 6) images of 11 tumors were analyzed. Uterine changes were also assessed. RESULTS: Multiseptated cystic mass (n = 4; mean, 14.5 cm) and unlobulated solid mass with internal cysts (n = 4; mean, 5.3 cm) were two common forms. Hemorrhage was found in five on MRI. Three tumors showed unusual appearances (an unilocular cystic mass, a lobulated solid mass with nonhemorrhagic cysts, and an entirely solid mass) and were not accompanied by any abnormal uterine changes, whereas all the tumors of common forms were associated with uterine changes explainable by hormonal stimuli in the postmenopausal patients. CONCLUSIONS: Large multiseptated cystic mass and medium solid mass with internal cysts were two common forms. Hemorrhage was a common MR finding. Uterine changes were frequently associated with the tumors with these common findings.     

Acinic cell carcinoma of the head and neck: radiologic-pathologic correlation

OBJECTIVE: To describe and correlate the imaging and pathologic findings of acinic cell carcinoma (ACC) in the head and neck. METHODS: We reviewed the radiologic findings of 12 patients with pathologically proven ACC in the head and neck. They were 6 males and 6 females (ages: 5-75 years, mean 36 years) who undergoing computed tomography (CT, n=9) and CT with magnetic resonance (MR) imaging (n=3). RESULTS: The lesions in the superficial lobe of the parotid gland were solid (n=7), cystic (n=1), and cystic mass with mural nodule (n=1) on CT. A parapharyngeal lesion was cystic mass with mural nodule, and a submandibular and a palate tumor were cystic lesions on CT. All solid masses in the parotid gland (n=7) included focal low-attenuating portions on CT, which were microcyst, hemorrhage, or necrosis on pathologic examination. We could not find intratumoral calcifications or metastatic lymphadenopathy on imaging and histologic studies in all 12 cases. Internal hemorrhage on the MR images was seen in a parapharyngeal and a parotid lesion. CONCLUSION: Although ACC appears to have nonspecific imaging findings, familiarity with some imaging features can be helpful for differential diagnosis of head and neck tumors.     

腹膜转移瘤的影像学诊断

目的探讨腹膜转移瘤的影像学表现特点。方法回顾性分析经手术及穿刺活检证实的35例腹膜转移瘤的影像学表现,并与手术结果对照,35例做CT平扫及增强扫描,5例行MR I检查。结果(1)腹膜转移瘤常表现为大量腹水(22/35);(2)腹膜结节状增厚(23/35);(3)大网膜饼形增厚(16/35)和大网膜污垢样改变(12/35);(4)肠系膜污垢样改变(12/35)及结节状改变(9/35);(5)腹腔单发或多发囊性改变,有占位效应(4/35)。结论CT/MR I是发现腹膜转移灶的重要影像学方法。     

Primary serous papillary carcinoma of the peritoneum: CT findings

AIM: To describe the computed tomography (CT) findings of primary serous papillary carcinoma of the peritoneum. MATERIAL AND METHODS: The clinical data and imaging studies of 36 women aged 37-85 years with primary papillary serous carcinoma of the peritoneum were retrospectively evaluated. Twenty-seven patients presented with general abdominal complaints; all had elevated levels of CA-125. Thirty-two women were post-menopausal, four had had bilateral salpingo-oophorectomy. RESULTS: The most common findings on pre-operative abdominal CT, performed in 30 patients, were a variable amount of ascites (n = 29), omental involvement (n = 28), irregular parietal peritoneum thickening (n = 22) and mural thickening of the sigmoid colon (n = 10). Thoracic findings included enlarged cardiophrenic nodes (n = 15) and pleural effusion (n = 11). Six patients had unilateral or bilateral adnexal masses of soft tissue density, which proved to be surface serous papillary carcinoma. CONCLUSION: Diffuse peritoneal disease on CT in patients with normal-sized ovaries or following bilateral salpingo-oophorectomy, with elevated level of serum CA-125, but without an identifiable primary tumour, should suggest the diagnosis of primary serous papillary carcinoma of the peritoneum. Associated adnexal masses or focal bowel wall thickening may be seen, representing surface involvement by this tumour.     

Imaging of cystic or cyst-like neck masses

Cystic or cyst-like neck masses form a unique category within head and neck radiology with unique differential diagnoses. The precise anatomical location and imaging appearances are important for accurate diagnosis and formulating the differential diagnoses of cystic lesions in the neck. In vast majority of cases ultrasound, sometimes supplemented by fine-needle aspiration cytology (FNAC), is adequate for pre-treatment assessment. For large, deep-seated lesions assessment using magnetic resonance imaging (MRI) or computed tomography (CT) often provides useful supplementary information. Radiologists should be aware of imaging findings of common cystic neck masses to help in their appropriate management.