Primary Mucosa-Associated Lymphoid Tissue (MALT) Lymphoma of Thyroid Gland Arising from Coexisting Hashimoto's Thyroiditis: A Case Report

We report herein on a case of primary mucosa-associated lymphoid tissue (MALT) lymphoma of the thyroid gland in a 57-year-old woman with coexisting Hashimoto's thyroiditis, and we include its characteristic imaging, histopathologic and immunohistochemical findings.

A Case of Blastomycosis after Traveling around Non-Endemic Area / 결핵및호흡기질환

Blastomycosis is a systemic pyogranulomatous disease that is caused by a thermally dimorphic fungus, Blastomyces dermatitidis. it's the disease is endemic in the south-eastern and south central states of the USA, which border the Mississippi and Ohio Rivers, the mid-western states and Canadian provinces bordering the Great Lakes as well as in a small area of New York and Canada adjacent to the St. Lawrence River.1 We encountered a case of blastomycosis, representing as a pulmonary manifestation after traveling around a non-endemic area and report it with a brief review of the relevant literature.

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.

Cervical Carcinoma vs Endometrial Carcinoma, Involving Both Corpus and Cervix: Comparison of Growing Pattern with MR Imaging

PURPOSE: To evaluate the growth pattern depicted by MR imaging and used to differentiate between uterine cervcal and endometrial carcinoma where the mass involves both the uterine corpus and cervix. MATERIALS AND METHODS: The tumor growth pattern observed on MR images obtained between November 1989 and January in 1999 in 37 of 784 cervical carcinomas and 9 of 47 endometrial carcinomas in which the tumor involved both the uterine corpus and cervix was analysed. The histologic type was squamous (n=29), adenocarcinomatous (n=6) or adenosquamous (n=2) in cervical carcinoma, and carcinomatous (n=8) or adenosquamous (n=1) in endometrial carcinoma. A 1.5-T (Magnetom Vision, Siemens, Germany) and a 2.0-T unit (Spectro-20000, Goldstar, Korea) were used to obtain T1-and T2-weighted axial, T2-weighted sagittal and Gdenhanced images. Tumor involvement of the uterine cervix was classified as either partial(Cp) or total(Ct), and partial involvement(Cp) was subclassified as Cp-n, Cp-x, or Cp-b according to involvement of the endocervix, exocervix or both. Tumors of the uterine corpus were classified as involving the mucosa(U-mu), myometrium(U-my) or serosa(U-se). RESULTS: In 37 cases of cervical carcinoma, all three involving the endocervix(Cp-n) invaded the endometrium(U-mu), three involving both the endo- and exocervix(Cp-b) invaded the endometrium(U-mu, 1 case), myometrium(U-my, 1 case), or serosa(U-se, 1 case), and 31 involving the full-thickness of the uterine cervix(Ct) invaded the endometrium (U-mu, 6 cases) or serosa(U-se, 25 cases). In nine cases of endometrial carcinoma, three involving the endometrium(U-mu) and five involving the myometrium(U-my) invaded the endocervix(Cp-n), and one involving the serosa(U-se) invaded the full-thickness of the uterine cervix(Ct). CONCLUSION: Cervical carcinoma tended to involve the entire cervix and the full thickness of the uterine corpus, but endometrial carcinoma tended to involve the endometrium or myometrium of the uterine corpus and endocervix.

A Case of Systemic Sclerosis Sine Scleroderma Presenting as Pulmonary Interstitial Fibrosis / 결핵

Lung involvement in systemic sclerosis(SSC) is common but usually occurs late in the course. Skin changes usually occur before the pulmonary findings. In this report, a patient who developed pulmonary interstitial fibrosis without skin changes is presented. A diagnosis of SSC lung involvement was made histologically. The a nti-scl-70 antibody test was positive. Esophageal manometry revealed a lower amplitude in the lower two-third of the esophagus and pressure in the lower esophageal sphincter. Here we report a case of wystemic sclerosis sine scleroderma presenting as pulmonary interstitial fibrosis with a review of the relevant literatures.

HRCT Finding of Pulmonary Cryptococcosis in Immune Competent Patients

PURPOSE: To determine the HRCT finding of pulmonary cryptococcosis in immunocompetent patients. MATERIALS AND METHODS: The HRCT scans and chest radiographs of five patients with pulmonary cryptococcosis were retrospectively reviewed, the diagnosis being proven by the presence of the organism in histopathologic specimens obtained during CT-guided biopsy (n = 4) or medistinoscopic biopsy (n = 1). All patients were immunocompetent. HRCT scans and chest radiographs were characterized according to morphology [consoli-dation, nodule, ground-glass opacity (GGO), interstitial thickening], location, airbronchogram, and the pres-ence or absence of mediastinal or hilar lymphadenopathy. RESULTS: Consolidation was present in three of five patients, and in two of the three, ill-defined, spiculated nodules were also present. One patient had multiple, small, well-defined nodules. One had diffuse interstitial thickening (GGO, nodular thickening of bronchovascular bundles and interlobular septa), with massive mediastinal and right hilar lymphadenopathy. The location of the consolidation and nodules was mainly peripheral, and in three patients with consolidation, the presence of air bronchograms was noted. CONCLUSION: The HRCT findings of pulmonary cryptococcosis in immunocompetent patients are peripheral consolidation with airbronchogram and/or ill defined nodules.

Usefulness of Dynamic Magnetic Resonance Imaging in Pituitary Microadenomas

PURPOSE: To investigate the usefulness of dynamic MR imaging in the diagnosis of pituitary microadenomas. MATERIALS AND METHODS: Dynamic MR imaging was performed in 31 patients with suspicious pituitary microadenoma. The MR examination was performed on a 2.0T or 1.5T superconductive MR unit using spin echo(SE) technique with arepetition time of 200m sec, echo time of 15 m sec, 128 x 256 matrix and one excitation. Actual sampling time perimage was 26 seconds. The field of view was 25cm and a section thickness of 3mm with 2mm gap was chosen. After arapid hand injection(2-3ml/sec) of Gd-DTPA(0.1 mmol/kg of body weight), dynamic coronal plane MR images were obtained every 20-30 seconds for 3-5 minutes. Between never and ten serial images were usually obtained. After dynamic MR imaging, routine SE T1-weighted images(T1WI) were obtained in the same plane as dynamic images, and detection rates of pituitary microadenoma using dynamic MR imaging and using routine enhanced T1WI, were retrospectively compared. RESULTS: On early dynamic images(30|90 seconds), 23 of 31 adenomas(74.2%) were well visualized, with a clear border ; of particular note is the fact that 11 of the 31 were well visualized at 30-second dynamic image. On late dynamic images(120-180 seconds), six microadeomas(19.4%) were well-visualized and; two(6.5%) were well-visualized throughout on all dynamic images. Meanwhile, 12 of 31 microadenomas(38.7%) were well-visualized on routine Gd-DTPA enhanced T1WI. CONCLUSION: Dynamic MR imaging with Gd-DTPA bolus injection was the most useful technique for the detection of pituitary microadenomas, especially on early-phase dynamic images.

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.

MR Patterns of Bone Marrow of Calvarium and Vertebral Body in Normal Subjects; Pattern Analysis According to Age Distribution

PURPOSE: The purpose of this study is to illustrate MR patterns of bone marrow of calvarium and vertebral body in normal subjects according the age distribution and to understand the course of the fatty replacement from red marrow. METHODS AND MATERIAL: We retrospectively evaluated MR examinations of the calvaria(n=71), cervical spine(n=71), thoracic spine(n=65), Imbar spine(n =68) in subjects without bone marrow abnormality whose age ranged 3 weeks to 74 years. Three distinctive patterns were categorized on Tl-weighted images of the skull. In pattern 1, uniformly low signal intensity with or without very small areas of high intensity in frontal and occipital bones is noted. In pattern 2, frontal and occipital bones have uniformly high signal intensity, and patchy area of high intensity appears in parietal bone. In pattern 3, the entire skull has uniformly high signal intensity. In the spine, four patterns were categorized on Tl-weighted MR images. In pattern 1, the vertebral body has uniformly low signal intensity except for linear areas of high intensity superior and inferior to basivertebral vein. In pattern 2, bandlike and triangular areas of high signal intensity are found in the periphery. Pattern 3 and 4 have diffusely distributed areas of high signal intensity; pattern 3 consist of numerous indistinct dots measuring a few millimeter or less, and pattern 4 consist of fairly well marginated areas ranging in size from 5 to 1.5cm. RESULT:In the calvaria, 73% of pattern 1 were younger than 20 years, pattern 2 were evenly distributed, and 86% of pattern 3 were older than 40 years. In the spine, 87% of pattern 1 were younger than 40 years, 72% of pattern 3 were in 40 to 50 years, and 87% of pattern 4 were older than 50 years. Pattern 2 were evenly distributed in the cervical and thoracic spine, but in the thoracic spine 62% were younger than 30 years. CONCLUSION:It is concluded that younger age group shows mainly pattern 1, whereas elderly group has pattern 3 or 4 in the calvarial and vertebral body marrow. This suggests that conversion to fatty marrow begin locally and progress diffusely with age.

Ir-192 Brachytherapy Planning of Brain Tumor / 대한치료방사선과학회지

Although widely used in external beam treatment planning, computed tomography scans are infrequent in incranial tumors by implanting of Radioactive isotope. This incranial brachytherapy has only become possible by using CT scans and stereotaxic operation methods. The coincidence of single source and tumor axes in brachytherapy is very important to determine the therapeutic dosages. Eventhough using the CT scan, according to spatial location of tumor lying, the section of tumor will be seen enlargement, cause the tumor will be cut off with slight angle to its axes. Correct analysis of tumor size from source is required for rotated axes in analytical geometry.