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Hepatic sclerosing hemangioma (HSH) is a rare benign tumor that is considered fibrosis and hyaline change caused by degenerative changes of cavernous angioma, and changes in pathological features cause the changes in imaging features, making this atypical hemangioma easily misdiagnosed as primary or metastatic malignant tumor. Although there are many studies on the imaging findings of this disease, it is still difficult to diagnose and most patients underwent resection since it is misdiagnosed as malignant tumor. There is still a low rate of confirmed diagnosis before surgery. This article elaborates on the etiology, clinical manifestations and pathological features, imaging findings, diagnosis, and treatment of HSH, in order to provide a reference for the diagnosis and treatment of this disease.
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Objective:To compare ultrasound (US) guided versus computed tomography (CT) guided radiofrequency ablation (RFA) in treatment of early hepatocellular carcinoma (HCC).Methods:The data of 133 patients with early HCC treated by RFA in the Department of Hepatobiliary Surgery of Shandong Provincial Hospital from February 1, 2015, to January 31, 2017, was analyzed retrospectively. These patients were divided into two groups: the US-guided group and the CT-guided group. The clinical data was collected and the factors affecting prognosis were analyzed.Results:Compared with the CT-guided group, the operation time of the US-guided group was significantly shorter [(29.0±12.0)min vs. (55.0±19.0)min, P<0.05], but the number of ablation sessions per tumor was significantly less [(1.1±0.3) vs. (2.0±0.6), P<0.05]. There was no significant difference in the complete ablation rates, postoperative complication rates and postoperative length of hospital stay between the two groups ( P>0.05). The CT-guided group was superior to the US-guided group in the local tumor recurrence and progression-free survival rates ( P<0.05). On multivariate analysis, CT-guided RFA was an independent protective factor for local tumor recurrence ( HR=0.266, 95% CI: 0.073-0.967, P<0.05) and progression-free survival ( HR=0.415. 95% CI: 0.213-0.806, P<0.05), while AFP >20 ng/ml ( HR=4.821, 95% CI: 1.714-13.560, P<0.05) was an independent risk factor for progression-free survival. Conclusion:CT-guided percutaneous RFA was superior to US-guided RFA in local treatment of early HCC, probably related to more needle placements and longer ablation time under CT guidance.
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Objective To improve our knowledge of primary benign tracheobronchial tumors and increase the early diagnosis rate. Method The clinical and imaging features of 22 patients with benign tracheobronchial tumors were retrospectively analyzed. The lesions were surgically or pathologically confirmed as schwannomas(n=2),lipomas(n=3),hamartomas(n=3),leiomyomas(n=9),inflammatory myofibroblastoma(n=1),and pleomorphic adenomas(n=2).The early symptoms were concealed and atypical,accompanied by misdiagnoses at different time points.The tumors were located at trachea in 5 patients and at bronchus in 17 patients.All lesions manifested as intraluminal growth with mild to moderate enhancement,without thickening of the tracheobronchial wall.They had smooth margins and wide basements.The lesions were cast-shaped and occluded the lumen in 3 cases;in the remaining 19 cases,the lesions appeared as round or oval nodules. Conclusions Primary benign tracheobronchial tumors are rare.Patients with repeated cough and expectoration that respond poorly to treatment should be screened for benign tracheobronchial tumors.On CT,the benign tracheobronchial tumors are small intraluminal nodules with the smooth surface and wide basement,without thickening of the wall.
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Humans , Bronchi , Diagnostic Imaging , Pathology , Bronchial Neoplasms , Diagnostic Imaging , Retrospective Studies , Tomography, X-Ray Computed , Trachea , Diagnostic Imaging , PathologyABSTRACT
Objective To summarize the experiences in the diagnosis and treatment of the hepatic hereditary hemorrhagic telangiectasia (HHHT).Methods The clinical data of 15 HHHT patients who were admitted to the Qilu Hospital,People's Hospital of Mengyin,People's Hospital of Liaocheng,Henan Provincial People's Hospital,the Second Hospital of Hebei Medical University,First Affiliated Hospital of Zhejiang University were retrospectively analyzed.The clinical manifestation,features of imaging and laboratory examination were summarized,and the diagnosis,treatment and prognosis of the disease were investigated.Results HHHT patients had nonspecific symptoms in the early stage,and some patients presented with right upper quadrant discomfort,shortness of breath,anemia and liver bruit.The condition of HHHT patients could be worsened by liver cirrhosis or portal hypertension rapidly.The results of color doppler ultrasound and computed tomography showed intrahepatic telangiectasia,arteriovenous fistula and hepatic artery aneurysm in the 15 patients.Digital subtraction angiography was not clear enough for 2 HHHT patients with more than 1 enlarged hepatic arteries,but computed tomographic angiography was feasible.According to the degree and stages of the HHHT,all the 15 patients were divided into asymptomatic HHHT,simple HHHT and complex HHHT.Among the 6 patients who underwent surgical treatment,5 received ligation or banding of the enlarged hepatic arteries with subsequent disappearance of symptoms.Three patients received interventional treatment,and the treatment for 1 patient with complex HHHT was failed,and the patient died 30 months after medical treatment.Six patients were treated by conservative treatment,2 patients of them had no symptoms at the beginning,then they suffered from hepatic dysfunction and ascites at 21 and 35 months,respectively,and 1 of them died 6 months later.Four patients received medical treatment,and the results of color doppler ultrasound and computed tomography showed the pathological changes were aggravated gradually.Conclusions Telangiectasia,intrahepatic arteriovenous fistula and hepatic artery aneurysm are the main imaging characteristics of HHHT,and imaging diagnosis has significant value in the diagnosis of HHHT.HHHT is a progressive disease,early,active and individualized treatment is beneficial to the patients.The outcome of ligation or banding of the hepatic arteries is satisfactory.