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Objective:To explore the clinical, imaging manifestations, treatment methods and prognosis of primary angiosarcoma of longbone, with the aim of improving the diagnosis and treatment.Methods:During April 2014 to April 2018, 5 patients with histopathologically-proven primary angiosarcoma of longbone were enrolled in this retrospective study, clinicaland imagingcharacteristics wereanalysiaed. Thetreatment and follow-up results werediscussed.There were 3 males and 2 females; the age ranged from 27 to 79 years and an average age of 45.2±3.5 years. Theproximal humeruswas1case. Thedistal humeruswas1case.The proximalfemur was 2 cases.Thediatalfemur was 1case. Pathological fracturewas2case.According to the tumor site and the presence or absence of pathological fractures, lesion curettage and large-scale resection were taken separately. Adjuvant treatment was given according to the patient's condition after surgery. The length of the lesion wasmeasured and recorded. The X-ray, CT, MRI and nuclear medicine imaging features of the tumor and its characteristics were recorded and analyzed. The pathological characteristics of the tumor were recorded and analyzed. The treatment of the tumor and treatment effect and prognosis were analyzed.Results:The clinical manifestations of angiosarcoma of long bone are non-specific,local pain and swelling. The imaging manifestationsin X-ray, CT and MRI imaging have certain characteristics, such as osteolytic bone destruction in bone marrow cavity and/orcorti-calmostly,without scleroticrim, soft tissue mass, centripetal non-progressive filling and unevenenhancement or nodules gradual enhancement. The length of the tumor lesion is usually larger, the size is about 6.6±1.2 cm. The expression of CD31 and CD34 inosteoangio sarcoma lesions was higher, and the positiverate of ERG expression was about 100%. The survival time of 2 patients who underwent adjuvant chemotherapy after surgery was15 months, 37 months with median survival time was28 months. One patient who survived radiotherapy survived for 40 months. The survival time of 2 patients who underwent surgery alone was 8 months, 30 months, and the median survival time was19 months.Conclusion:Imaging finding scan beused as adjunctive diagnois of the primary angio sarcoma of bone. ERG is the most specific and sensitive marker in the pathological diagnosis of osteoangiosarcoma. Surgical resectionis still the first choice of treatment for long bone angiosarcoma. Surgical combined with radiotherapy can appropriately extend the survival time, and this program can be used as a treatment method chosen by doctors and patients.
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Objective To explore the image quality of gastric cancer improved by dual-energy CT,and to evaluate the clinical utility in staging gastric cancers.Methods 55 patients suspected gastric cancers were included in the study.Patients underwent dual-phasic scans using dual-energy CT with a dual-source scanner.The relationships image quality parameters in 100 kV,120 kV and 70 keV images were evaluated.Image quality parameters comprised mean density,signal-to noise ratio (SNR) and objective noise.The 120 kV and 70 keV images were compared in TNM staging.Results In arterial and portal phase,the attenuation was significantly higher at 70 keV and 100 kV compared to 120 kV images (P＜0.001).In arterial phase,the SNR were higher at 120 kV and 70 keV in comparison to 100 kV(P＜0.01).In portal phase,the SNR were higher at 70 keV in comparison to 120 kV and 100 kV(P＜0.01).Overall accuracy in assessment of tumor invasion of the gastric wall (T stage) was 83.7％ with 70 keV images and 72.1％ with 120 kV images,this difference was not significant (P=0.25);Overall accuracy for lymph node (N) staging was significantly better with 70 keV images(74.4％) than with 120 kV images(62.8％) (P＜0.05).Conclusion The image quality of gastric cancers using dual-energy CT can be improved by optimizing the energy level.The 70 keV images may be used to improve the N-staging accuracy.
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Objective To analyze the correlations of clinical characteristics,CT and pathology features of peripheral primitive neuroectrodermal tumors (pPNET)in abdomen-pelvis region,and to improve the understanding of the disease.Methods The clinical information,CT and pathological features of 23 confirmed pPNET patients in abdomen-pelvis region were analyzed retrospectively.Results (1)All patients had preoperative clinical and imaging data integrallty.(2)23 cases showed soft tissue masses with fuzzy boundary and the average diameter were 10.72 cm.Among all,9 cases showed with varying degrees of sac necrosis,while 2 cases showed with platelet hemorrhage and 4 cases with speckled calcifications.Most showed slight-to-moderate heterogeneous enhancement and the necrosis and cystic are-as showed more obvious.12 cases showed with different degree of recurrence,invasion or distant metastasis.5 cases combined with tumor emboli and 4 cases with tumor feeding vessels.(3)Immunohistochemical examination showed CD99 expressed in 1 9 patients, CD56 in 11,vimentin(Vim)in 12,synaptophysin(Syn)in 11,neuron specific enolase(NSE)in 4,FLI-1 in 4 and epithelial membrane antigen (EMA)in 4 patients.Conclusion pPNET is common among young patients with a high degree of malignancy.CT features include large mass with invasive growth,commonly combined heterogenous density,necrosis and cystic changes.Persistent enhancement is observed during nephrographic phase.
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Objective To explore the relationship between Graves disease and hypokalemic periodic paralysis or thymus hyperplasia.Methods Sixty-two patients with Graves disease were enrolled in this study.Thirty-three patients without thymus hyperplasia were selected as group A and other 29 patients were group B.In addition,30 healthy volunteers served as control group.Results There were no significant difference between group A and group B in terms of sex,age,illness course,thyroid enlargement,exophthalmos,periodic paralysis and the levels of free triiodothyronine (FT3),free thyroxin (FT4),thyroid stimulating hormone (TSH) (P ＞ 0.05).The incidence rate of hypokalemic periodic paralysis in male Graves disease with thymus hyperplasia was 62％ (8/13),higher than that in female patients (6％ (1/16),x2 =10.24,P ＜ 0.05).The incidence rate of hypokalemic periodic paralysis in male Graves patients was 62％ (16/26),higher than in female Graves patients (6％ (2/36),x2 =22.96,P ＜ 0.05).There was no significant relationship between Graves disease patients combined with thymus hyperplasia and sex,age,illness course,thyroid enlargement,exophthalmos,periodic paralysis and the levels of FY3,FT4,TSH.Conclusion The incidence rate of hypokalemic periodic paralysis in male Graves disease patients combind with thymus hyperplasia is higher than in female,and therefore it should pay more attention of male Graves patients in case misdiagnosis.
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Objective To investigate the correlation of spiral CT features with expression of E-cadherin(E-cad) in peripheral lung cancer.Methods Spiral CT scans were performed in 58 patients with peripheral lung cancer confirmed by pathology.Expression of E-cad in 58 cases were detected with SP immunohistochemical techniques.Spiral CT findings were compared with expression of E-cad.Results The abnormal expression of E-cad was showed in 32 cases(55.17%).The positive rates of E-cad expression were 40.63% in I-II cell differentiation group and 73.08% in III-IV cell differentiation group,and the difference was significant(P＜0.05).The abnormal expression of E-cad was associated with the CT features,such as lymph node metastasis,pleural invasion and the size of tumor(P＜0.05),but not the cavity sign,spicular sign and vessel convergence sign(P＞0.05).Conclusion E-cad gene over expression may play an important role in the pathogenesis and CT appearances of lung cancer.