rare bronchopulmonary malformation in adulthood: bronchial atresia

Bronchial atresia is a congenital anomaly characterized by focal obliteration of a part of the bronchus, which causes an accumulation of secretions and a bronchocele with absence of ventilation of the corresponding distal pulmonary area which is seen radiologically as hyperlucent. Approximately 50% of the patients are asymptomatic at the time of diagnosis, and this condition is more frequent in men than in women [ratio 2:1], and usually affects young people. Chest computed tomography is diagnostic, and makes it possible to differentiate between congenital anomalies, bronchiectasias and other types of bronchial obstruction. Treatment of asymptomatic patients is conservative, and surgery is only necessary if there should be symptoms such as recurrent respiratory infections, chronic cough or dyspnea. Herein we report a case of asymptomatic bronchial atresia with radiological features and differential diagnosis

Contribution of advanced magnetic resonance imaging techniques in diagnosis of breast lesions

To determine the diagnostic contribution of diffusion weighted imaging [DWI] and magnetic resonance spectroscopy [MRS] identified either with mammography, ultrasonography or conventional enhanced magnetic resonance imaging [MRI] to cases with palpable breast lesions or for routine control. Prospective study. Department of Radiology, Celal Bayar University, Turkey. Fifty female patients who applied to the clinic between November 2009 and April 2010 with different indications were included. We applied conventional breast MRI with the routine sequences. We added DWI and BREASE [MRS]. After MRI examination postprocessing applications were applied. Analysis of contribution of advanced techniques in breast lesions diagnosis. Determining the value of DWI and MRS of breast lesions, which may be useful in improving the specificity. Fifty-two breast lesions in 37 cases were evaluated. In DWI when cut off apparent coefficient diffusion [ACD] value was accepted as 1.44 xlO.3 mm[2]/sn, the sensitivity was found to be 91.3% and the specifity was 62.1% in discriminating malignant and benign lesions. When the lesions which have choline peak at 3.2 ppm were accepted as malignant and lesions which do not have choline peak were accepted as benign lesions in spectroscopic examination, the specifity was 80%, the sensitivity was 31.8%, negative predictive value [NPV] was 44.4% and positive predictive value [PPV] was found to be 70%. Our specifity was compatible with that in the literature but sensitivity and negative ppv were lower than reported in the literature. According to ADC values, the findings in our study were compatible with the literature

Diffusion-weighted MR imaging of the breast: comparison of apparent diffusion coefficient values of normal breast tissue with benign and malignant breast lesions

<p><b>INTRODUCTION</b>The specificity of conventional magnetic resonance (MR) imaging is lower than its high sensitivity. Diffusion-weighted imaging (DWI), based on alterations in the microscopic motion of water molecules, promises improved specificity for breast MR imaging. In this study, we aimed to determine the diagnostic potential of DWI to differentiate between benign and malignant breast lesions and normal breast tissue.</p><p><b>METHODS</b>Dynamic contrast-enhanced breast MR imaging and DWI were applied to 108 women. Apparent diffusion coefficient (ADC) values were obtained for normal breast tissue (n = 183), benign lesions (n = 66) and malignant lesions (n = 58). The results were compared with the patients' final diagnoses.</p><p><b>RESULTS</b>Mean ADC values for benign and malignant breast lesions were 1.04 × 10-3 ± 0.29 × 10-3 mm2/s and 2.00 × 10-3 ± 0.55 × 10-3 mm2/s, respectively (p = 0.001, Student's t-test), while that for normal breast tissue was 1.78 × 10-3 ± 0.33 × 10-3 mm2/s. With a cut-off value of 1.46 × 10-3 mm2/s for ADC in receiver operating characteristic analysis, 95% sensitivity and 85% specificity were achieved for differentiating between benign and malignant lesions.</p><p><b>CONCLUSION</b>DWI of the breast can help differentiate benign and malignant breast lesions from normal breast tissue. DWI, which can be easily introduced into standard breast MR imaging protocols without increasing imaging times, promises to increase the accuracy of breast MR imaging without contrast media. However, its clinical value will depend on the standardisation of b-values and other technical parameters in larger future study series.</p>

Giant Breast Involvement in Acute Lymphoblastic Leukemia: MRI Findings / 한국유방암학회지

Breast metastases in cases of leukemia are rare. We aimed to report the conventional-advanced magnetic resonance imaging (MRI) findings of unilateral breast involvement of acute lymphoblastic leukemia (ALL) and review the literature. A 32-year-old woman was first diagnosed with ALL in treated in 2004. She did not continue the follow-up after 2008. She was presented with a giant, progressive right breast palpable mass in 2010. Mass, contralateral breast tissue were evaluated with MRI, diffusion weighted imaging and MR spectroscopy. With MRI findings, lesion was evaluated as malignant, tru-cut biopsy revealed recurrence of ALL. Lymphoma, malignant melanoma, rhabdomyosarcoma are most common tumors metastase to breast. Breast metastases of leukemia are rare and occur primarily in patients with acute myeloid leukemia. Secondary ALL breast involvement is uncommon. In a patient with malignancy, any enlarging breast mass, even with benign radiologic appearance, should be investigated carefully and metastasis should not be forgotten.

Kidney metastasis of invasive ductal breast carcinoma mimicking renal cell carcinoma

A 56-year-old female patient was admitted to the urology outpatient clinic with severe macroscopic hematuria. She was diagnosed with right kidney cancer after clinical and radiological evaluations. Pathology reported a metastasis of invasive ductal breast carcinoma in the right kidney after laparoscopic radical right nephrectomy was performed. After physical and radiological evaluations, she was referred to the Department of General Surgery, and was treated with radical mastectomy and axillary lymph node dissection for breast cancer. She was later referred to the Department of Medical Oncology at our institute for chemotherapy. We aimed for clinicians to be more aware of metastasis to the kidney, and perform regular and thorough breast examination for women every year