Metaplastic Carcinoma of the Breast with Chondroid Calcification: A Case Report

Metaplastic carcinoma is a rare form of breast carcinoma in which a variety of metaplastic changes occur. These commonly involve squamous or spindle cells, but pure chondroid metaplasia is relatively uncommon. We report a case of metaplastic carcinoma of the breast which mainly involved chondroid metaplasia and in which chondroid calcifications were seen on mammograms.

Assessment of the Depth and Extent of Myometrial Invasion in Uterine Adenomyosis Using MRI

PURPOSE: To determine the detection rate of MRI in the diagnosis of adenomyosis and ascertain the accuracy of MRI in assessing the extent and depth of the myometrial invasion. MATERIALS AND METHODS: By retrospective analysis of MR images of the pelvis in 65 pathologically proven cases of uterine adenomyosis, we investigated the detection rate and differences of in the detection rate when this was based on (a) the extent, and (b) the depth of myometrial invasion. The condition was classified as diffuse or focal according to the extent of invasion, and mild, moderate, or severe according to its depth. RESULTS: Pathologically, there were 35 cases of focal adenomyosis (53.8%), and 30 of diffuse adenomyosis (46.2%). Among patients with the focal variety of this condition, 12 cases were mild, 14 were mild, 14 were moderate, and nine were severe, while among those with the diffuse variety, two were mild, ten were moderate and 18 were severe. A total of 48 cases (73.8%) were detected on MR images; the detection rate of focal adenomyosis was 60.0% (21/35) and that of diffuse adenomyosis was 90.0% (27/30). The detection rates of mild, moderate, and severe adenomyosis were 42.9%(6/14), 79.2%(19/24), and 85.2% (23/27), respectively. Among the 48 cases detected on MR images, the pathologic and MR findings were consistent with regard to both the extent and depth of myometrial invasion in 26(54.2%). For diffuse adenomyosis, the consistency rate was higher than for the focal variety (81.5%, 22/27; compared with 19%, 4/21). The extent of myometrial invasion was correctly evaluated in 32 cases (66.7%); the consistency rate for the diffuse form was higher than for the focal form [96.3% (26/27), compared with 28.6% (6/21)]. In 42 cases (87.5%), the depth of invasion was correctly evaluated, though differences in this depth were not significant. CONCLUSION: MR imaging was a useful imaging modality in the diagnosis of uterine adenomyosis. With regard to the extant of mymetrial invasion, the detection rate was higher among cases of the diffuse form than of the focal form, and with regard to depth, the rate was higher among moderate and severe cases than among mild ones. These findings may be useful for preoperative diagnosis based on clinical symptoms, and provide important yardstick for decisions as to whether hysterectony should be replaced by an alternative therapy.

Radiologic Findings of Cholangiolocellular Carcinoma: A Case Report

Cholangiolocellular carcinoma is a rare lesion, intermediate in type between hepatocellular and cholangio-cellular carcinoma. The radiologic findings of cholangiolocellular carcinomas have not been reported. We describe the ultrasound, CT, MR, and angiographic findings of a case of cholangiolocellular carcinoma not associated with liver cirrhosis.

Splenic Space Occupying Losion Observed in The Dual-Phase Bolus CT File

PURPOSE: To evaluate the dual-phase bolus CT findings and clinical significance of splenic S. O. L.(SpaceOccupying Lesion) basically included in abdominal CT but previously not considered important. MATERIALS AND METHODS: We retrospectively reviewed 64 splenic S.O.L.'s(0.94%) detected among 6842 patients who underwentdual-phase rapid sequence abdominal CT. Diffuse splenomegaly and heterogeneous enhancement during the arterialphase were excluded. Fifty-eight of 64 splenic S. O. L. cases were confirmed by surgery, biopsy, radiologic studyand follow up. RESULTS: In only eight patients(12.5%) were symptoms localized to the left upper quadrant. Therewere 21 cases of inflammatory and ischemic diseases(36.2%), 19 malignant tumors(32.8%), 12 benign cysts(20.7%),four benign tumors(6.9%), one metabolic disease and one hematoma(each 1.7%) ; six cases were not confirmed and inthese, S.O.L. was also found at other sites. Escept in the case of benign cysts and tumors, the early phase wasbetter than the late for the detection of S.O.L., though both were good for diagnosis. Among 21 inflammatory andischemic lesions there were eight cases of portal hypertensions, seven of pancreatitis, and one of tuberculosis ;five were due to other cauese. Among 19 patients with malignant tumors, metastases were most common(11 cases).Cases involving malignancy involved four lymphomas, two cases of leukemias and two angiosarcomas, which togetherrepresented only primary splenic malignancy. Two epidermoid and ten simple cysts were benign, while benign tumorsincluded three hemangiomas and one lymphangiomatosis ; these were difficult to differentiate from angiosarcoma.Gaucher's disease showed multiple low density lesions in the enlarged spleen and one hematoma was also present. CONCLUSION: Splenic S.O.L.'s are very rare and clinical symptoms directly related to splenic mass are uncommon.Benign and secondary lesions are more common than malignant and primary lesions, and cysts are also much rarerthan any other solid organs. Dual-phase CT especially during the early phase, is currently the modality of choicefor the evaluation of splenic S.O.L.