Cystic Change of Thyroid Mass: A Useful Sign in Differentiating Benign from Malignant Thyroid Lesions?

PURPOSE: To examine the usefulness of the cystic change of the thyroid mass in the diagnostic differentiation of benign from malignant thyroid lesions. MATERIALS AND METHODS: We retrospectively analyzed the ultrasonographic (US) findings of 65 benign (30 follicular adenomas and 35 nodular hyperplasias) and 206 malignant (202 papillary carcinomas and 4 follicular carcinomas) lesions that had been confirmed by surgery. The cystic change was graded as 0 (mass without cystic change), 1, 2, 3 and 4 (cystic change less than 25%, 25-50%, 51-75%, and more than 75% of the volume of the mass, respectively). The incidence and grades of the cystic change of the benign thyroid lesions were compared with those of the malignant lesions. We also evaluated the US features of the cystic change to evaluate any differences between benign and malignant lesions. Statistical significance was assessed by Chi-square test. RESULTS: Cystic change was present in 47/65 (72.3%) of benign thyroid lesions (21/30 [70%] of follicular adenomas and 26/35 [74.3%] of nodular hyperplasias) and 16/206 (7.8%) of malignant lesions (14/202 [6.9%] of papillary carcinomas and 2/4 [50%] of follicular carcinomas). The grades of cystic change were grade 1 in 29/47 (61.7%), 2 in 2/47 (4.3%), 3 in 2/47 (4.3%), and 4 in 14/47 (29.8%) for benign thyroid lesions, and grade 1 in 14/16 (87.5%) and 3 in 2/16 (12.5%) for malignant lesions. In regard to the US features of cystic change, a large cyst with polypoid projection less than 1 cm in size and a large cyst with a peripheral rind of solid component were exclusively found in the benign thyroid lesions. In contrast, malignant lesions frequently presented as a mass with irregularly mixed, solid and cystic components, a solid mass with multiple cystic components, or a solid mass with one or two cystic components. CONCLUSION: Cystic change was more common (p < 0.0001) and more prominent in benign than in malignant lesions. A large cyst with polypoid projection less than 1 cm in size and a large cyst with a peripheral rind of solid component were exclusively found in the benign thyroid lesions. The cystic change was evaluated to be a useful sign in the diagnostic differentiation of benign from malignant thyroid lesions, although the size of the lesion must also be taken into account.

Trapping of Massive Thrombus in an Inferior Vena Cava Filter: Treatment with Additional Filter Placement and Aspiration Thrombectomy

For the patients suffering from extensive deep vein thrombosis (DVT), the placement of an inferior vena cava (IVC) filter in conjunction with anticoagulant therapy has been used to prevent pulmonary embolisms. However, for the patients who anticoagulant is contraindicated or if this is complicated, the use of an IVC filter without concurrent anticoagulation may become the sole treatment for pulmonary embolisms. In this situation, the thrombi trapped in the IVC filter may cause significant clinical problems. We report here on a case of IVC filter thrombosis that was successfully treated by aspiration thrombectomy after placing another filter proximal to the previous filter.

Fish Bone as a Nidus for Stone Formation in the Common Bile Duct: Report of Two Cases

We report two cases of common bile duct stone formed around a fish bone which migrated from the intestinal tract, along with their characteristic imaging findings. Two patients who had no history of previous operation were admitted because of cholangitis. Percutaneous transhepatic biliary drainage (PTBD) was performed and the cholangiogram showed filling defects with an unusually elongated shape in the common bile duct. After improvement of the cholangitic symptoms, the stones were removed through the PTBD tract under fluoroscopic guidance. A nidus consisting of a 1.5 cm sized fish bone was found in each stone removed.

Glycogen-Rich Carcinoma of the Breast: A Case Report

Glycogen-rich carcinoma of the breast, defined as one in which more than 90% of neoplastic cells have abundant clear cytoplasm containing glycogen, is very rare. We report a case occurring in a 50-year old woman, and include the mammographic and ultrasonographic findings.

Congenital Bilateral Neuroblastoma (Stage IV-S): Case Report

Congenital neonatal neuroblastoma is not uncommon but bilateral adrenal neuroblastoma is rare, accounting for about ten percent of neuroblastomas in children. We report the US and MR findings of a stage IV-S congenital bilateral neuroblastoma occurring in a one-day-old neonate.

Ultrasound and MR Imaging Findings of Vulvar Leiomyoma: Case Report

Leiomyomas are common benign neoplasms that can occur at any anatomical site containing smooth muscle, though most originate in the female genital tract. Leiomyomas of the vulva or perineum are, however, very rare. We report the ultrasonographic (US) and MR imaging findings of a vulvar leiomyoma, and briefly review the literature.

Results of Renal Allograft in Recipient with Iliac Endarterectomy / 대한이식학회지

PURPOSE: Pretransplant peripheral vascular examination in renal transplant recipient is not common even though the uremic status is a risk factor of developing atherosclerosis. Since that kind of atherosclerotic stenosis is inadequate for renal artery anastomosis, surgeons should perform certain procedures in that area. Until now, we have no written report about the results of renal transplant recipient who have been done endarterectomy at anastomosing iliac artery. The aim of this paper is to review the results of renal allograft recepient whose anastomosed iliac artery is endarterectomized at the time of transplantation. METHODS: Among 161 living donor renal allografts which were performed between January 1993 through June 1998, 21 allografts needed recipient iliac artery endarterectomy before vascular anastomosis. Their graft survivals, serial changes of blood pressure, serum creatinine level, and ultrasonic measure of renal arterial diameter and peak systolic velocity with their wave patterns were compared between endarterectomy group and non-endarterectomy group (control group). Mean age of endarterectomy group was older than control group (45.4 vs 32.9). Endarterectomy was done at internal iliac artery in 18 patients and both common and external iliac arteries in 3 patients. RESULTS: One and 3 year graft survivals showed higher in endarterectomy group than control group (90.9% vs 82.3%). Uncontrolled hypertension of endarterectomy group was 6.3%, 11.5%, 27.3% in 12, 24, 36 months and that of control group was 18.9%, 23.6%, 25.1%, but there was no statistical significance between groups. Serial changes of serum creatinine level of endarterectomy group was maintained low until the end of 3 years compare to control group (1.2 0.9 mg/ml vs 1.9 1.1). There was no difference between groups in peak systolic velocity and wave pattern proximal and distal to the anastomotic site of renal artery, and also no difference in measured arterial diameter and resistance index. CONCLUSION: Endarterectomy of recipient iliac artery before transplant renal vascular anastomosis show no adverse effect on recipient blood pressure, renal allograft function, graft survival and renal artery restenosis at least up to 3 years after graft.

Radiological Findings of Congenital Lipoid Adrenal Hyperplasia: A Case Report

Congenital lipoid adrenal hyperplasia (CLAH) is a rare autosomal recessive disorder characterized by the marked accumulation of lipids and cholesterol in the adrenal cortex, and the failure of adrenal steroids to synthesise. We report the ultrasound (US), computed tomographic (CT), and magnetic resonance (MR) imaging findings in a four-day- old female neonate with CLAH.

MR Imaging Findings of Ovarian Epithelial Tumor: Emphasis on Borderline Malignancy

PURPOSE: To evaluate the role of MR in the diagnosis of borderline epithelial tumors of the ovary comparedwith that of benign and malignant tumors. MATERIALS AND METHODS: MR images of 42 ovarian epithelial tumors in 39patients were retrospectively analyzed, focusing on the morphologic characters distinguishing borderlineepithelial tumors from benign and malignant tumors. All images were obtained using a 1.5T imager 3-27 (mean, 12)days before surgery. The size, shape, internal signal intensity, wall and septal thickness, papillary nodule,solid component, and contrast enhancement of the tumor were evaluated. RESULTS: Histopathologic diagnoses were 16serous epithelial tumors [benign (SB) 3, borderline malignancy (SBM) 5, malignancy (SM) 8]; 24 mucinous epithelialtumors [benign (MB) 11, borderline malignancy (MBM) 9, malignant (MM) 4]; one endometrial carcinoma (EC), and oneclear cell carcinoma (CC). Mucinous epithelial tumors were multilocular in 23 of 24 tumors, while signal intensityof the locules varied in 22 of 24. Six of 16 serous epithelial tumors were unilocular, and 15 of 16 were ofhomogeneous signal intensity. Papillary projection was seen in 14 tumors (SB 1/3, SBM 5/5, SM 3/8, MB 2/11, MBM2/9, CC 1/1), but multiple (>10) projections were seen in SBM (5/5) and CC (1/1). Multiple irregular thick septawere found in 18 tumors (SM 3/8, MB 2/11, MBM 9/9, MM 4/4), while solid components were seen in ten (SM 6/8, MB1/11, MM 2/4, EC 1/1). CONCLUSION: Multiple (>10) papillary projections and multiple irregular thick septa withoutremarkable solid components are suggestive MR findings of ovarian SBM and MBM, respectively.

Verrucous Carcinoma of the Bladder Unassociated with Bilharzial Cystitis: A Case Report

Verrucous carcinoma that occurs only in the bladder is a very rare, well-differentiated squamous cell carcinoma. The tumor is a histologically and clinically distinctive variant of squamous cell carcinoma, and is almost exclusively associated with bilharzial infection. We report the radiologic findings of a case of verrucous carcinoma of the bladder unassociated with bilharzial infection.

Experimental Study on the Rim-Enhancing Lesion of Rabbit Brain Abscess: MR Imaging and Histopathologic Correlation

PURPOSE: To evaluate on the basis of histopathologic carrelation the MR findings of mature brain abscess inthe rabbit, with particular attention to rim-enhancing lesions. MATERIALS AND METHODS: The evolution of abscess formation was obtained by the direct inoculation of Staphylococcus aureus into the gray-white matter junctions ofthe brains of 16 rabbits. The stages of brain abscesses were divided into four : early cerebritis (days 1 to 5after inoculation of the organism) ; late cerebritis (days 6 to 14) ; early capsular (days 16 to 21) ; and latecapsular (days 22 to 28). The available MR images showed 14 cases at the stage of early cerebritis, seven at thelate cerebritis stage, three at the early capsular, and one at the late capsular stage. According to the known pathology of brain abscesses and on the basis of both MR imaging and histopathologic findings, the lesions weregrouped according to whether they were found in the central necrotic, border, or peripheral zone. We analyzed the patterns of rim-enhancement (completeness of the rim, thickness, and margin) and the signal intensities of theabscess walls on MR images at each stage. Histopathologic correlation was performed in one case of each stage. We evaluated the presence or absence and degree of infiltration by inflammatory granulation tissue, microhemorrhage, reticulin, collagen, and hemosiderin of the abscess walls. RESULTS: Rim-enhancing lesions were present in threeof 14 cases at the late cerebritis stage, in all three cases at the early capsular, in one at the late capsular, but in none at the early cerebritis stage. The enhancing pattern of the late cerebritis stage was irregular-margined incomplete rim-enhancement, with irregular thickness of the abscess walls (3/3). The enhancing pattern of the capsular stages was well-defined, complete rim-enhancement with uniform thickness of the abscess walls (3/4). The signal intensities of the abscess walls at the late cerebritis and early capsular stages were variable. The late capsular stage was characterized by hypointensity of the abscess wall on both T1- and T2-weighted images. Histopathologically, the capsular stages were distinguished from the late cerebritis stage bythe marked infiltration of reticulin and the presence of collagen in the abscess walls. The most conspicuous pathologic finding distinguishing the late from the early capsular stage was abundant infiltration of the abscess wall by collagen and hemosiderin. CONCLUSION: The enhancing pattern of a brain abscess with mature capsule formation was characterized by a well-defined, complete rim-enhancing abscess wall of uniform thickness. The mature abscess wall was hypointense on both T1- and T2-weighted images, may be explained by marked infiltration bymature collagen and hemosiderin.

Immature Teratoma of the Ovary: CT and US Findings

PURPOSE: To compare CT and US features of immature and mature teratomas of the ovary. MATERIALS AND METHODS: We retrospectively reviewed CT and US findings of 11 patients with immature teratoma and 18 patients(20 cases) with mature teratoma. The tumors were classified into three groups on the basis of image findings : predominantlycystic(type I), predominantly solid(type II), and mixed cystic and solid(type III). RESULT: All eleven cases of immature teratoma were of the mixed type(type III), showing multiple small(less than 2 cm) nodular and linear calcifications and fatty nodules within the solid component and adjacent to the septa of the cystic component of the masses. In contrast, mature teratomas were predominantly cystic in six cases, predominantly solid in eight,and mixed in six cases. In five of six mixed type mature teratomes, calcified fatty nodules were fewer and largerthan in immature teratomas. CONCLUSION: Immature teratoma may be diagnosed by the demonstration on CT or US ofmultiple small(less than 2cm) nodular and linear calcifications and fatty nodules in the solid and cystic components of the tumor.

MR Imaging of Lipomatous Soft Tissue Tumor: Histopathologic Correlation

PURPOSE: The purpose of this study to access MR findings of the lipomatous soft tissue tumor based on histopathologic correlation and its predictability of the histopathologic diagnosis. MATERIALS AND METHODS: We retrospectively analyzed the MR findings and photomicrographs of 9 patients with histopathologically proven lipomatous soft tissue tumors as follows;classic lipoma(4), fibrolipoma(1), lipoblastoma(2), atypical l ipoma(1) and well-differentiated liposarcoma(1). RESULTS: All cases of lipoma showed the same signal intensities as subcutaneous fat which is composed of mature fat cells. Linear low signal intensity lesions corresponded to fibrous connective tissues within lipomas. Two cases of lipoblastoma showed heterogeneous signal intensity with areas of high signal intensity brighter than subcutaneous fat on T2WI, corresponding to myxoid matrix of cytoplasm of immature lipoblasts, and the areas of myxoid degeneration within tumors. Both atypical lipoma and liposarcoma showed heterogeneous signal intensity with ill-defined margins due to presence of lipoblasts and infiltration to adjacent muscle bundles. CONCLUSION: MR image findings were well correlated with histopathologic findings of lipomatous soft tissue tumor, especially with maturity of fat cells and the signal intensity of mesenchymal components within the tumors. MR may predict the pathologic diagnosis of lipoblastoma by presence of myxoid degeneration within Ihe tumor, but atypical lipoma and liposarcoma revealed similar MR findings.

Ultrasound measurement of pouch to perineum distance as a guide in determination of high or low imperforate anus

No abstract available.

Value of ultrasonography in the diagnosis of acute appendicitis

During a 12-month period high-resolution, real-time ultrasonography (US) with graded compression was performed on 268 consecutive patients with clinically suspected acute appendicitis and its complication. US visualization of a fluid-filled, non-compressed appendix or a decompressed, thick-walled appendix was the primary criterion for a diagnosis of acute appendicitis. The sonographic findings were correlated with surgical-pathologic outcome in 92 cases and with the findings of clinical follow-up in the remainder. US was found to be accurate in the diagnosis of acute appendicitis and its complication with a sensitivity of 93.3%, a specificity of 98.9%, and an accuracy of 97%. The predictive value of a positive test was 97.7%; that of a negative test was 96.7%. There were two false-positive examination in patients with a thick-walled appendix or periapperdiceal abscess, which were surgically confirmed as appendiceal adenocarcinoma and perforated cecal diverticulitis respectively. There were six false-negative examination in patients with a sonographically no-visible appendix, which were confirmed surgically as acute appendicitis(n=5) and perforated appendicitis(n=1). Our results show that high-resolution, real-time US is an accureate imaging modality in the diagnosis of acute appendicitis and the evaluation of its complication.

Interventional treatment of symptomatic lymphoceles following renal transplantation / 대한이식학회지

No abstract available.

Therapeutic effect of suppressive therapy for solitary thyroid nodule / 대한내분비학회지

No abstract available.

UD diagnosis of idiopathic pyloris stenosis

No abstract available.

Ultrasound and computed tomographic findings of pulmonary sequestration

The pulmonary sequestration is rare congenital anomaly characterized by the presence of a part of lung tissuewhich is supplied by an aberrant systemic artery from the aorta or its branch and usually has no communicationwith the normal bronchial tree. The authors present 3 cases of intralobar pulmonary sequestration, studied by CTand /or US. Typical CT features of intralobar pulmonary sequestration are homogenous or unhomogeneous, relativelylow density lung mass near the diaphragm, having feeding artery from the aorta or branching vessels within themass during bolus injection or dynamic CT.

Computed tomographic findings of the gastrointestinal lymphoma

Although conventional barium study has been used for diagnosis of gastrointestinal lymphoma, CT is superior tobarium study in the evaluation of its extent and relationship to the bowel, lymph node enlargement, and distantmetastasis. The authors analyzed CT features of 21 cases of pathologically proven gastrointestinal lymphoma forrecent 5 years. The results were as follows: 1. In a total 21 cases of gastrointestinal lymphomas, 13 cases wereprimary gastrontestinal lymphoma and others were secondary. But there was no difference in CT featurs betweenthem. 2. Male predominates over female(17:4), and type age ranged from 5 to 73 years old, most common