Diffuse lymphangiomatosis of bone

Two cases of lymphangiomatosis of bone, a very rare systemic condition characterized by both skeletal and parenchymal lesions, are presented. The skeletal changes have an appearance similar to haemangiomas in the spine, and soap-bubbly lesions in the flat bones. One case carried the diagnosis of eosinophilic granuloma for 18 years. The findings on MRI, which have not been previously well-established, are discussed.     

Diffuse pulmonary lymphangiomatosis: imaging findings

Diffuse pulmonary lymphangiomatosis is a rare pulmonary disorder affecting the lymphatic channels from the mediastinum to the pleura. The disease usually occurs in children and young adults and frequently ends with death due to progressive course. Imaging findings of the disease are based on lymphatic involvement which appear as mediastinal soft tissue infiltration and thickening of pulmonary peribroncovascular bundles and interlobular septae. In this report, spiral and high-resolution computed tomography, and ultrasonography findings of severe form of this rare disease are presented. Furthermore, some lymphatic disorders, which are called with similar name but different appearances on imaging, are discussed.     

Diffuse bone metastases in a case of astrocytoma

Presented is an unusual case of astrocytoma with diffuse multiple bony metastases in bone imaging. The classification, spread, and prognosis of astrocytoma are briefly reviewed.     

Diffuse bone marrow involvement of Hodgkin lymphoma mimics hematopoietic cytokine-mediated FDG uptake on FDG PET imaging

Whole-body fluorine-18 fluorodeoxyglucose (F-18 FDG) positron emission tomography (PET) has been useful in the management of a variety of malignancies. In patients with chemotherapy followed by bone marrow stimulants such as granulocyte colony-stimulating factor and granulocyte-macrophage colony-stimulating factor, the bone marrow will have diffuse, increased FDG accumulation. Therefore, diffuse bone marrow FDG uptake is commonly attributable to the effect of hematopoietic cytokines. However, diffuse bone marrow FDG uptake can also be caused by bone marrow involvement by malignancy. The authors report a patient with diffuse bone marrow involvement of Hodgkin disease that appears indistinguishable from hematopoietic cytokine-mediated FDG bone marrow uptake.     

符合探测显像中放射性浓度和病灶大小对病灶/本底比值的影响

目的 探讨双探头SPECT符合探测显像中病灶／本底(L/B)比值的影响因素及其校正方法。方法 ①模型研究：分析模型的符合探测显像中不同^18F—脱氧葡萄糖(FDG)对比度(即阳模区或病灶与本底^18F—FDG放射性浓度之比)、不同直径大小阳模柱体对应的L/B比值；②临床研究：分析8例患者29个良、恶性病灶的L/B比值，井探讨其校正方法。结果 ^18F—FDG对比度和物体直径大小均会影响L/B比值测定，校正病灶大小可明显提高诊断准确性。结论 在双探头SPECT符合探测显像中，应充分考虑病灶大小对L/B比值的影响，必要时应加以校正。     

Diphosphonate intestinal activity seen on two bone images in neuroblastoma

Neuroblastoma is well recognized as a cause of soft tissue uptake of Tc-99m MDP. Two cases of neuroblastoma arising in the midline from the celiac axis are reported. Bone imaging performed on two separate days showed not only typical soft tissue uptake, but also the appearance of the radiopharmaceutical in the bowel. At surgery, a midline upper abdominal neuroblastoma was found in both patients without evidence of involvement of the liver, kidneys, bowel, gallbladder or mesentery. It became apparent with delayed images in the second patient that this activity was in the bowel and moving around the abdomen in a typical large bowel pattern. Bowel activity was not seen in other patients having bone scans at this time. Follow-up bone imaging on the first patient after resection of the tumor did not demonstrate diphosphonate activity in the bowel. These authors have never seen or read of this finding previously in this condition, and report it in these two patients.     

Diffuse pancreatic ductal adenocarcinoma: characteristic imaging features

PURPOSE: To evaluate imaging findings of diffuse pancreatic ductal adenocarcinoma. MATERIALS AND METHODS: We included 14 patients (4 men and 10 women; mean age, 64.5 years) with diffuse pancreatic ductal adenocarcinoma on the basis of retrospective radiological review. Two radiologists retrospectively reviewed 14 CT scans in consensus with respect to the following: tumor site, peripheral capsule-like structure, dilatation of intratumoral pancreatic duct, parenchymal atrophy, and ancillary findings. Eight magnetic resonance (MR) examinations with MR cholangiopancreatography (MRCP) and seven endoscopic retrograde cholangiopancreatography (ERCP) were also reviewed, focusing on peripheral capsule-like structure and dilatation of intratumoral pancreatic duct. RESULTS: CT revealed tumor localization to the body and tail in 11 (79%) patients and peripheral capsule-like structure in 13 (93%). The intratumoral pancreatic duct was not visible in 13 (93%). Pancreatic parenchymal atrophy was not present in all 14 patients. Tumor invasion of vessels was observed in all 14 patients and of neighbor organs in 8 (57%). On contrast-enhanced T1-weighted MR images, peripheral capsule-like structure showed higher signal intensity in five patients (71%). In all 11 patients with MRCP and/or ERCP, the intratumoral pancreatic duct was not dilated. CONCLUSION: Diffuse pancreatic ductal adenocarcinoma has characteristic imaging findings, including peripheral capsule-like structure, local invasiveness, and absence of both dilatation of intratumoral pancreatic duct and parenchymal atrophy.