Haemangiopericytoma of the trigeminal nerve

A 41-year-old man presented with a 4-year history of progressive right-sided diplopia on lateral gaze and right nasolabial paraesthesia. A CT revealed minor bone erosion of Meckel's cave and of the right petrous apex by a uniformly enhancing lesion at the base of the skull. Magnetic resonance imaging on three occasions over 2 years showed tumour, measuring 4 cm in diameter, with features suggestive of a trigeminal neuroma. At surgery the lesion had the macroscopic appearance of a giant schwannoma. Histopathological findings were that of a meningeal haemangiopericytoma (HPC) of the trigeminal nerve. Intracranial HPC are rare and aggressive tumours of the central nervous system. They usually arise from the falx, tentorium and dural sinuses. The present case is unique as it originates from a cranial nerve.     

罕少见脑胚胎性肿瘤患者的临床病理特征及其影像表现

目的 探讨几种罕少见的脑胚胎性肿瘤的临床病理特征及影像表现.方法 回顾性分析10例罕少见的经手术病理证实为脑胚胎性肿瘤患者的临床病理特征及MRI、CT表现.结果10例中,幕上原始神经外胚层肿瘤6例,室管膜母细胞瘤2例,髓上皮瘤1例,非典型性畸胎样或横纹肌样瘤1例,其中,4例为婴幼儿和儿童.各肿瘤的病理组织学表现具有一定特征性,是确诊的依据.肿瘤均位于幕上,体积较大,形态多不规则,呈分叶状,信号、密度不均匀,坏死囊变多见;肿瘤实质CT平扫多旱稍高密度,MRI表现为T2WI呈等或较高信号,T1WI呈较低信号,增强扫描显著强化.结论罕少见脑胚胎性肿瘤患者的MRI、CT表现无明显特异性,结合临床及病理组织学特征对其进行全面认识了解十分必要.     

Computed tomography of retroperitoneal paragangliomas

More than 10% of retroperitoneal paragangliomas are malignant. Histopathological appearance is unreliable in distinguishing benign from malignant paragangliomas. In this study the computed tomography (CT) features of retroperitoneal paragangliomas were analysed to determine if benign neoplasms could be distinguished from malignancy by their appearance at imaging. We reviewed the clinical profiles and CT scans of 27 benign and seven malignant retroperitoneal paragangliomas in 32 patients to determine the presence of any characteristic appearances of benign and malignant neoplasms. Extra-adrenal paragangliomas were more frequently malignant (50%) than adrenal neoplasms (12.5%). Benign lesions were generally smaller (average 6.1 cm) than malignant lesions (average 7.9 cm). Benign tumours were more likely to be homogeneous (46.2%) and have well-defined margins (92.3%) than malignant tumours (25 and 12.5% respectively). Larger tumours were more frequently necrotic. Malignant retroperitoneal paragangliomas infiltrated adjacent liver, pancreas, bowel, lymph nodes, blood vessels, or metastasized to bone and liver. Malignant retroperitoneal paragangliomas are frequently extra-adrenal, large and heterogeneous, with ill-defined margin and necrosis. CT is useful for delineating the location, extent and nature of these tumours. Infiltration of surrounding tissues or organs, metastases, and resectability are accurately assessed by CT.     

Various imaging modalities for the detection of salivary gland lesions: the advantages of 201Tl SPET

The aim of this study was to compare dual-isotope (99Tc(m) and 201Tl) SPET imaging with computed tomography (CT) and magnetic resonance imaging (MRI) in the differentiation of various lesions of the major salivary glands. Twenty-two patients underwent dual-isotope SPET imaging, of whom 12 also had CT and 15 also had an MRI study. The uptake ratio and retention index for 99Tc(m) and 201Tl were calculated by drawing regions of interest on the involved and normal glands. Both CT and MRI were interpreted by two radiologists. All malignant tumours were detected by all three modalities. Warthin's tumours were detected by dual-isotope SPET imaging; however, MRI failed to differentiate Warthin's tumour from pleomorphic adenoma. Of 13 other benign tumours, dual-isotope SPET correctly diagnosed 12. Of 16 tumours showing a cold defect on the 99Tc(m) images, parametric analysis with 201Tl gave an accuracy of 94%, whereas CT gave an accuracy of 70-90%. MRI was 73-91% accurate in differentiating between benign (Warthin's) and malignant tumours. We believe that dual-isotope SPET imaging (99Tc(m) and 201Tl), together with semi-quantitative analysis, is the method of choice for differentiating between various lesions of the major salivary glands.     

CT imaging of intrabiliary growth of colorectal liver metastases: a comparison of pathological findings of resected specimens

The objective of this study was to assess the usefulness of CT in the pre-operative evaluation of macroscopic intrabiliary tumour growth of colorectal liver metastases. 25 metastatic nodules of 18 patients who underwent an initial hepatectomy for colorectal liver metastasis were retrospectively evaluated. The CT appearance and pathological findings of the resected specimens were correlated. A number of unusual peritumoral features associated with intrabiliary tumour growth were detected by pre-operative CT. These were classified into three patterns: (1) thickened portal tract; (2) intrahepatic bile duct dilatation; and (3) a wedge-shaped area with enhancement. In 8 (32%) of the 25 nodules the portal tract was depicted as thicker than usual and these features were found proximal to the tumour in three instances, distal to the tumour in four instances, and both proximal and distal in one instance. All of the three intrabiliary tumours larger than 30 mm resulted in thickening of the portal tract. Intrahepatic bile duct dilatation was detected in association with 10 (40%) of 25 nodules. Bile duct dilatation was observed in more than one segment when intrabiliary tumour reached the hepatic hilus from the tumour. The presence of bile duct dilatation was not related to either the size of the tumour or the extent of intrabiliary tumour growth. An abnormally high density wedge-shaped area on contrast enhanced CT was another feature indicating intrabiliary tumour growth and was seen in association with four nodules. Such areas were seen in the liver parenchyma distal to the tumour on three occasions, or encompassing the tumour on one accasion. This wedge-shaped area appeared as a well demarcated dark red-brown region in the cut surface of the resected specimen. CT was useful for detecting the presence of intrabiliary tumour growth with these three patterns of radiological findings in patients with liver metastases from colorectal cancer     

Role of CT and US in the diagnosis of myelolipoma of the adrenal glands

The Computed Tomographic (CT) and Sonographic (US) features are reported of 3 adrenal myelolipomas, occasionally found in 3 patients. Even though US and CT are capable of detecting the majority of adrenal tumors, they are often limited in their ability to suggest specific histologic diagnosis. Adrenal myelolipoma represents an apparent exception to this limitation, since the myelolipomas large enough to be detected by CT or US often contain macroscopic fat. In some cases a myelolipoma containing macroscopic quantities of nonfatty material (blood, calcium, myeloid tissue) may have a non-specific CT/US appearance, due to the fat inside the lesion being shaded. In equivocal cases, needle biopsy may be needed to reach the correct diagnosis.     

Villous tumor of the colon: correlation of histologic, macroscopic, and radiographic features

Forty-six patients with villous or tubulovillous tumors of the colon were examined to study the correlation between histologic and macroscopic or radiographic features and to define more accurately villous tumors of the colon. There was good correlation between the histologic and macroscopic or radiographic features. As villous elements became more prominent on histologic studies, the macroscopic appearance was more villous and granular but less nodular on the surface. Reticular and/or granular patterns with a feathery margin were more frequently seen on radiographs in cases of dominant villous elements. The macroscopic and radiographic characteristics of villous tumor frequently appeared when villous elements composed over 75% of the whole tumor on histologic studies. The authors propose that villous tumor of the colon can be accurately diagnosed when villous elements compose over 75% of the tumor.     

Occipital osteosarcoma of a 33 years old man: a case report

Cranial localization of osteosarcoma is rare, representing only 0,7-3% of cranial primary tumours. The authors present the case of a 33 year old man with occipital osteosarcoma diagnosed by CT scan, MRI and angiography. The radiological features of this pathology are discussed.     

Case report: imaging of bile duct hamartomas.

A rare case of multiple bile duct hamartomas of the liver has been evaluated with ultrasound (US), computed tomography (CT), magnetic resonance imaging (MRI) and digital subtraction angiography (DSA). The CT and angiographic features of the hamartomas described here differ significantly from previously reported cases. In addition, the MR appearance of these tumours is reported for the first time.     

卵巢囊性肿瘤的多层螺旋CT分析

目的探讨卵巢囊性肿瘤的CT表现和诊断价值。方法回顾性分析28例共30个经手术病理确诊的卵巢囊性肿瘤的CT表现。CT平扫28例,同时增强扫描26例。结果 28例卵巢囊性肿瘤中,囊腺瘤10例(浆液性囊腺瘤7例、黏液性囊腺瘤3例),囊性畸胎瘤3例,囊腺癌8例(浆液性囊腺癌3例、黏液性囊腺癌5例),卵黄囊瘤4例,kruken-berg瘤1例,透明细胞癌2例。各种肿瘤因其性质(良、恶性)不同而具有相应特征性CT表现,与手术病理对照,准确地定性诊断24例(85.7%),误诊4例(14.3%),准确定位27例(96.4%),错误定位1例(3.5%)。结论卵巢囊性肿瘤的CT表现有一定特征性,CT对卵巢囊性肿瘤的诊断及鉴别诊断具有一定帮助。     

唾液腺黏液表皮样癌CT表现与病理对照研究

目的分析唾液腺黏液表皮样癌的 CT 表现,探讨 CT 在唾液腺黏液表皮样癌中的诊断价值.资料与方法回顾性分析经病理证实的23例唾液腺黏液表皮样癌的 CT 征象,包括病灶部位、形态、边界、密度、均匀度、有无坏死及临近组织侵袭,以及增强方式,其中9例行增强扫描,并与病理结果进行对照.结果组织病理学分型中,低、中及高级黏液表皮样癌分别10、7、6例.CT 表现:各腺体部位:7例边界清楚,16例边界不清;9例轮廓规则,14例轮廓不规则;5例密度均匀,18例密度不均匀;9例发生坏死,14例未发生坏死;9例邻近组织受侵,14例邻近组织未受侵;1例发生淋巴结转移;9例行增强扫描均显著强化.结论唾液腺黏液表皮样癌的 CT 表现具有一定特征性,可为临床诊断提供帮助.     

64层螺旋CT在肋骨骨折诊断中的应用价值

目的：探讨64层螺旋CT及其后重建技术在肋骨骨折诊断中的临床应用价值。方法：对35例临床怀疑肋骨骨折而常规X线平片显示阴性的病例,应用64层螺旋CT扫描并行薄层重建及曲面重组观察。结果：应用64层螺旋CT及其后重建技术,35例胸部外伤患者共确诊98处肋骨骨折。结论：临床怀疑肋骨骨折而常规X线平片显示阴性的病例,应用64层螺旋CT扫描并行薄层重建及曲面重组观察,具有较高的临床应用价值。     

A rare case of urachal mucinous adenocarcinoma detected by 18F-FDG PET/CT and MRI

Urachal adenocarcinomas are rare cancers of the urinary bladder. Both CT and MRI are useful imaging modalities for the diagnosis and evaluation of urachal adenocarcinoma. Unlike CT or MR, there have been variable FDG PET findings with urachal tumours potentially due to considerable variation in their hypermetabolism. We present the case of a 24 year-old female patient who was diagnosed with urachal mucinous adenocarcinoma with characteristic features on CT and MRI which also exhibit moderately increased FDG avidity.     

Computed tomography of odontogenic myxoma

OBJECTIVES: The purpose of this study was to clarify the CT features of odontogenic myxoma. METHODS: CT appearances were analysed in 17 patients with histologically verified odontogenic myxoma collected from five dental hospitals in Japan. RESULTS: On the CT images, tumour borders were generally well defined with a smooth margin both for bony and soft tissue structures in all patients. Cortical status was clearly evaluated using CT and the continuity was interrupted in nine patients. Intralesional trabeculations were observed in 13 patients. Of these 13, 6 patients showed the characteristic appearance of angular or straight trabeculations within the tumour. The trabeculations were frequently observed at the peripheral portion of the tumour. In three maxillary tumours, soft tissue margins were observed beyond the cortical margin and/or intralesional trabeculations. In 10 of the 13 lesions evaluated, the majority of the whole tumour area showed relatively lower density compared with surrounding muscles. CONCLUSION: CT clearly demonstrated characteristic features of odontogenic myxoma. CT analysis may contribute to establishing a consensus regarding the interpretation of conventional radiographic appearances in odontogenic myxoma.     

CT evaluation of gastrointestinal leiomyomas and leiomyosarcomas

Computed tomographic (CT) features in 29 patients with gastrointestinal leiomyomas and leiomyosarcomas were analyzed and compared. Features evaluated included size, shape, homogeneity, response to intravenous contrast material, and presence of calcification. The sarcomas were larger (average, 12 cm) than the myomas (average, 4.8 cm), had an irregular shape, and had a nonhomogeneous appearance both before and after contrast enhancement. Gross features depicted on CT are compared with gross pathologic criteria. Analysis of the CT appearance suggested malignancy in two cases in which microscopic examination was interpreted as benign.     

A clinicoradiological study of odontogenic carcinomas and their impact on clinical diagnosis

Objectives

To investigate the clinical and radiological characteristics of odontogenic carcinomas (OCs) and evaluate their impact on early clinical diagnosis.

Methods

The clinical and radiological features of all patients with OCs in our pathology record from January 1988 to December 2009 were retrospectively reviewed. The impact on a tentative diagnosis before final histological examination of clinical, panoramic and CT features was investigated.

Results

Of 474 cases with malignant jaw tumours, 417 (88%) were gingival squamous cell carcinomas (SCCs) and 27 (6%) were OCs. The average age of the patients with OCs was significantly lower than that of those with gingival SCCs. 20 OCs were in the mandible and 7 were in the maxilla. 22 OC patients (81%) had pain and/or swelling as an initial symptom of the disease. Although the majority of OCs showed irregularly contoured radiolucency, one-third of the cases showed cyst-like radiolucency totally or partially surrounded by a sclerotic rim on panoramic radiography. Permeative or gross cortical bone destruction and mass extension outside the jaw bone were found on CT and a diagnosis of malignant tumour was more common. Mass extension outside the cortex had a significant influence on malignant diagnosis. However, 22% of the patients were still clinically diagnosed as having osteomyelitis after CT.

Conclusions

Although CT was useful to obtain a diagnosis of malignant tumour in OC patients, 22% of patients were clinically diagnosed as having osteomyelitis even after CT. When an osteomyelitis case is resistant to conventional therapy and gross bone destruction and/or mass extension is found on CT, a histopathological examination should be done.     

Osteosarcoma of the jaws: demographic and CT imaging features

Objective

The aim of this study was to evaluate the patient demographic and CT imaging findings of primary osteosarcoma of the jaws.

Methods

88 primary osteosarcomas of the jaws histopathologically diagnosed during 1997–2007 were reviewed. 21 cases of CT images were reviewed.

Results

Of 88 patients, 51 (58%) had tumours in the mandible and 37 (42%) in the maxilla. The mean age was 37.8 years (range 9–80 years). The male-to-female ratio was 1.32:1. The mean age of patients with mandibular lesions was 41.04 years and in those with maxillary lesions it was 33.3 years. CT imaging findings were available in 21 patients. In the maxilla (n = 9), all tumours (100%) arose from the alveolar ridge. In the mandible (n = 12), most tumours (9 cases, 75%), arose from the ramus and/or condyle. All except two lesions had the epicentrum within the medullary cavity of the involved bone. The presence of periosteal reaction was demonstrated in 13 cases (62%). Soft-tissue extension was present in 18 lesions (86%), with calcification identified in 13 (72%).

Conclusions

This study provides age, sex distribution, location and CT imaging features of primary osteosarcoma of the jaws.     

糖尿病并发脓肿的CT表现

目的：探讨糖尿病并发脓肿的CT表现特征。方法：回顾性分析26例糖尿病患者合并脓肿的CT表现。结果：并发脓肿的26例糖尿病患者中,25例病灶内出现气体,24例未出现液体,仅2例出现少量液体。结论：糖尿病并发脓肿在CT平扫上具有明显的特征,大多数不需要增强就可以明确诊断。     

The fibromatoses: CT-pathologic correlation

Although CT has been used in the evaluation of benign fibroblastic tumors (fibromatoses), data are lacking on radiologic-histopathologic correlation. In an attempt to explain the variable CT appearance of these lesions, a retrospective analysis was carried out of CT findings and histopathologic features in nine patients with fibromatoses. In three of four patients who had precontrast CT scans, the tumors were hyperdense relative to muscle, whereas in one patient the lesion was hypodense. The postenhancement appearance was variable. The pathologic specimens were analyzed and graded for collagen content, cellular content, tumor necrosis, and tumor vascularity. No consistent relationship could be established between the CT appearance of these lesions and their histologic appearance.     

Computed tomography characteristics of primary pulmonary lymphoepithelioma-like carcinoma

Primary pulmonary lymphoepithelioma-like carcinoma is a very rare subtype of lung cancer. This report documents the CT features of 16 Chinese patients diagnosed with primary pulmonary lymphoepithelioma-like carcinoma from January 1999 to December 2005. A pre-treatment CT was used to assess the tumour site, size, borders, pleural and vascular involvement, and the presence of lymph node involvement. The majority of the patients were female non-smokers with centrally located tumours. Lymph node involvement and bronchial and vascular encasement were frequent. In an Epstein-Barr virus endemic area, primary pulmonary lymphoepithelioma-like carcinoma is an important differential diagnosis to consider.