รายงานผลภาพเอกซเรย์คอมพิวเตอร์ของมะเร็งต่อมหมวกไตชนิดนิวโรบลาสโตมาในผู้ป่วยเด็กที่พบร่วมกับภาวะต่อมน้ำเหลืองโตในช่องท้องจำนวนมาก

            Neuroblastoma is the tumor of sympathetic nervous system that derives from primordial neural crest cells. Neuroblastoma is the third most common pediatric malignancy after leukemia and central nervous system tumors. This article reported atypical computed tomographic findings of neuroblastoma with massive intra-abdominal and retroperitoneal lymphadenopathy.            The authors reported a 2-year-old girl who presented with abdominal distension and fever. Ultrasonographic examination showed a large heterogeneous echogenic mass at right suprarenal region. Contrast enhanced computed tomography (CT) of the whole abdomen revealed an ill-defined inhomogeneous enhancing mass at right adrenal gland with internal calcification. There were massive intra-abdominal and retroperitoneal lymphadenopathy. Pathological diagnosis showed the poorly differentiated neuroblastic tumor.             This article reported atypical CT findings and reviews natural history, histological findings, biological features, and radiographic appearances.

Accuracy of multi-detector CT scan in pre-operative staging of renal cell carcinoma: Comparison of radiological and histopathological findings.

Objective: To evaluate the accuracy of pre-operative multi-detector CT scan (MDCT) compared to histopathology findings in tumor staging of renal cell carcinoma. Methods: Retrospective review of 29 renal cell carcinomas at Siriraj Hospital from 2004-2007. Two blinded radiologists evaluated the pre-operative MDCT images independently. Imaging findings were compared with surgical specimens and pathological findings. Results: A total of 29 renal cell carcinomas were proven on histopathology. The respective accuracy for overall staging of reader 1 and 2 were 0.75 and 0.65. The reader 1 and 2 reached a sensitivity of 75% and 87%, a specificity of 70% and 50% for perinephric involvement, and a sensitivity of 100% and 100%, a specificity of 63% and 54% for renal pelvis involvement. The kappa interobserver agreements for perinephric involvement and renal pelvis involvement were 0.67 and 0.83, respectively. Conclusion: False positive finding of perinephric involvement causes overstaging of Robson stage I disease or in T1-T2 disease of TNM classification. Perinephric stranding may not be reliable or specific findings, and a result of perinephric involvement in CT scan is still limited. MDCT is accurate in the pre-operative evaluation of renal cell carcinoma in Robson stage II-IV disease.