Application value of contrast-enhanced ultrasound in differential diagnosis of complex renal cysts and clear renal cell carcinoma with cystic change / 中华超声影像学杂志

Objective@#To investigate the value of contrast-enhanced ultrasound(CEUS) in differential diagnosis of complex renal cysts and clear renal cell carcinoma with cystic change(CRCCC).@*Methods@#The ultrasonographic datas of 82 lesions in 82 patients with complicated renal cysts or CRCCC confirmed by pathology were analyzed. The characteristics of conventional ultrasound and CEUS were observed and evaluated. The lesions were graded according to Bosniak classification criteria.@*Results@#Pathological examination showed that 36 cases were complicated renal cysts and 46 cases were CRCCC. Routine ultrasound showed there were 9 cases (25.0%) with cystic masses and 27 cases (75.0%) with solid and cystic masses in complex renal cysts, of which 14 cases (38.9%) could detect color flow signals. In CRCCC, 2 cases (4.3%) were with cystic masses and 44 cases (95.7%) were with solid and cystic masses, of which 33 cases (75.0%) could detect color flow signals. CEUS showed that only 18 cases (50.0%) of the complex renal cysts showed enhancement of cystic wall or septum, with equal or low enhancement at the peak, 9 cases (50.0%) accompanied by decrease of renal cortex, 35 cases (97.2%) had thin and regular cystic wall, no enhancement of cystic wall in all lesions, and 33 cases (91.7%) had septal thickness less than 1 mm. Forty-five cases (97.8%) of CRCCC showed enhancement of cystic wall or septum, 40 cases (88.9%) showed equal or high enhancement at peak, 30 cases (66.7%) were faster than the decrease of renal cortex, 37 cases (80.4%) showed uneven thickness of cystic wall, 24 cases (52.2%) showed enhancement of cystic wall nodules, and 28 cases (60.9%) showed uneven thickness of septum. After CEUS, 33 cases (91.7%) of complex renal cysts were classified as grade Ⅰ and Ⅱ, while 42 cases (91.3%) of CRCCC were classified as grade Ⅲ and Ⅳ.@*Conclusions@#The CEUS manifestations of complex renal cysts are different from those of CRCCC. The application of Bosniak criteria in CEUS is helpful for the differential diagnosis of complex renal cysts and CRCCC.

Application value of contrast-enhanced ultrasound in differential diagnosis of complex renal cysts and clear renal cell carcinoma with cystic change / 中华超声影像学杂志

Objective To investigate the value of contrast-enhanced ultrasound(CEUS)in differential diagnosis of complex renal cysts and clear renal cell carcinoma with cystic change(CRCCC).Methods The ultrasonographic datas of 82 lesions in 82 patients with complicated renal cysts or CRCCC confirmed by pathology were analyzed.The characteristics of conventional ultrasound and CEUS were observed and evaluated.The lesions were graded according to Bosniak classification criteria.Results Pathological examination showed that 36 cases were complicated renal cysts and 46 cases were CRCCC. Routine ultrasound showed there were 9 cases (25.0％) with cystic masses and 27 cases (75.0％) with solid and cystic masses in complex renal cysts,of which 14 cases (38.9％) could detect color flow signals.In CRCCC,2 cases(4.3％)were with cystic masses and 44 cases(95.7％)were with solid and cystic masses, of which 33 cases(75.0％)could detect color flow signals.CEUS showed that only 18 cases(50.0％)of the complex renal cysts showed enhancement of cystic wall or septum,with equal or low enhancement at the peak,9 cases(50.0％) accompanied by decrease of renal cortex,35 cases (97.2％) had thin and regular cystic wall,no enhancement of cystic wall in all lesions,and 33 cases(91.7％)had septal thickness less than 1 mm.Forty-five cases (97.8％) of CRCCC showed enhancement of cystic wall or septum,40 cases(88.9％)showed equal or high enhancement at peak,30 cases(66.7％)were faster than the decrease of renal cortex,37 cases (80.4％) showed uneven thickness of cystic wall,24 cases (52.2％) showed enhancement of cystic wall nodules,and 28 cases (60.9％) showed uneven thickness of septum.After CEUS,33 cases(91.7％)of complex renal cysts were classified as grade Ⅰ and Ⅱ,while 42 cases(91.3％) of CRCCC were classified as grade Ⅲ and Ⅳ.Conclusions The CEUS manifestations of complex renal cysts are different from those of CRCCC.The application of Bosniak criteria in CEUS is helpful for the differential diagnosis of complex renal cysts and CRCCC.

Progressive Multiple Cystic Changes in Both Lungs in a Patient Treated with Gefitinib for Lung Adenocarcinoma with Multiple Lung Metastases

Gefitinib is regarded as a relatively safe agent for the treatment of an advanced non-small cell lung cancer (NSCLC). Pulmonary toxicity such as interstitial lung disease associated with gefitinib is uncommon with an estimated all time incidence around 1% worldwide. Moreover, a case of gefitinib associated with pulmonary cystic changes has not been reported yet. In this report we present a case of progressive multiple air cystic changes in both lungs in a patient with NSCLC and intrapulmonary metastases who underwent a gefitinib therapy.

Congenital Melanocytic Nevus Combined with Cystic Change due to Recurrent Folliculitis / 대한피부과학회지

Nevus with cyst is defined as a single lesion in which there is the coexistence of an epidermoid cyst and a melanocytic nevus. Similar clinical and histopathologic changes can be observed when a hair follicle ruptures and subsequent folliculitis with supprative granulomatous reaction occurs beneath a melanocytic nevus. This cystic change due to inflammation is a different pathologic phenomenon from the formation of an epidermal cyst. Hence, it is necessary to differentiate between these two conditions. We report here on a case of congenital melanocytic nevus combined with cystic change due to inflammation in a 39-year-old man.

A Case of Fibrous Dysplasia with Secondary Cystic Change

PURPOSE: Fibrous dysplasia is an uncommon, benign bony disease of unknown etiology which typically presents in children or young adults. Fibrous dysplasia of the head mainly affects the maxillary bone and rarely affects the orbit. The authors report a case of fibrous dysplasia with secondary cystic change of the orbit that was incidentally discovered in an adult. Literature review is also included. METHODS: A 49-year-old man presented for evaluation of tumor of the right orbit. The orbital tumor was found incidentally on a brain MRI, which was carried out to evaluate the patient's symptom of dizziness. Computed tomography showed a cystic mass-like lesion in the right orbit with bony erosion. Tumor excision with lateral orbitotomy was performed. RESULTS: The pathologic result was consistent with the diagnosis of fibrous dysplasia with secondary cystic change.

Intrauterine Intraventricular Hemorrhage in Premature Infants / 소아과

PURPOSE: To determine incidence, characteristics and risk factors associated with intrauterine intraventricular hemorrhage(IU-IVH) among premature infants. METHODS: The medical records of infants with intraventricular hemorrhage(IVH) admitted to the neonatal intensive care unit of Asan Medical Center from January 1999 to June 2003 were reviewed retrospectively. Infants whose IVH with cystic change were detected within five days of life were defined as the IU-IVH group. The control group included those without any IVH. Various maternal and neonatal factors were evaluated between the IU-IVH and control groups, and risk factors for IU-IVH were identified using multiple logistic regression analysis. RESULTS: The incidence of IU-IVH was 49/1024(15.9%). Mothers who are younger, primiparous, use less antenatal steroid, and neonates with greater incidence of neonatal respiratory distress syndrome, had higher incidences of IU-IVH compared to neonates with normal neurosonography. Risk factors associated with IU-IVH included neonatal respiratory distress syndrome and placenta infarct by placenta biopsy. Most infants with IU-IVH were > or =1,501 g, > or =34 weeks gestational age and had low grade IVH. The size of the cysts associated with IU-IVH remained the same or disappeared in 96 %. IU-IVH does not seem to affect short-term neurodevelopmental outcome although a longer period of follow-up is needed. Conculusion:IU-IVH occurred mostly in > or =1,501 g, > or =34 weeks infants with grade I IVH without developmental delays. However, the high incidence of total IVH merits more attention in terms of awareness of its existence as an unusual IVH among premature infants.

Pseudosarcomatous Metaplastic Carcinoma of the Breast with Extensive Cystic Change: A case report

Metaplastic carcinomas (carcinomas with metaplasia) of the breast are difficult to accurately diagnose and classify because of their rarity and varied histologic patterns. Cystic change can be encountered in mammary carcinoma, especially in carcinoma with squamous metaplasia, but are rare in pseudosarcomatous metaplastic carcinoma. We recently experienced a case of pseduosarcomatous metaplastic carcinoma in a 69-year-old female who had an extensive cystic change in radiologic and histopathologic findings. The precise cell type that gives rise to metaplastic carcinomas remains uncertain. Immunohistochemical findings raised the possibility of the myoepithelial nature of the tumor.

Cystic Hepatocellular carcinoma: a case report / 한국간담췌외과학회지

Cystic hepatocellular carcinoma is unusal, and visualization of the cystic components within hepatic mass lesion have suggested that the lesions were metastatic tumors, primary cystic tumors such as biliary cystadenocarcinoma or cystic papillary cholangiocarcinoma. Although hepatic lesions can be well characterized by noninvasive imaging modalities, findings are often nonspecific. Even for cystic hepatic lesions a considerable diagnostic differential exists. The diagnosis of cystic hepatocellular carcinoma was difficult before the microscopic examination of the biopsy speciemen because of very rare. Then we report an unusual of cystic hepatocellular carcinoma without liver cirrhosis.

A Case of Cervical Endometriosis with Cystic Change / 대한산부인과학회잡지

Cervical endonetriosis with cystic change is extremely rare lesion. We experienced onecase of cervical endometriosis in 33 year old woman, who had no symptoms, so we reprot thecase and brief review of literatures.

A Case of Cystic Germinoma in Bilateral Frontal Region

The authors present a case of germinoma in corpus callosum extending to the both frontal lobes with cystic change, in a 27-year-old male. Bilaterallity and cystic change simulated a cystic astrocytoma or a butterfly glioblastoma. The interest in this case is due to the unusual location and the nature of the tumor.