Solid Pseudopapillary Tumor of the Pancreas in Child: A Case Report

Solid pseudopapillary tumor of the pancreas is a very rare form of childhood pancreatic tumor. We report the case of an 11-year-old girl having a solid pseudopapillary tumor of the pancreas presenting with left upper abdominal pain. Imaging studies showed the lesion to be an ovoid solid mass arising from the body and the tail of the pancreas. The tumor was surgically resected and was histopathologically diagnosed as a solid pseudopapillary tumor.

A Case of Intrapancreatic Accessory Spleen Mistaken as a Pancreatic Mass due to Different Enhancing Pattern from Normal Spleen / 대한소화기학회지

Most cases of accessory spleen show similar features as normal spleen in imaging studies. However, some accessory spleen has unusual scan feature which can be misdiagnosed. We present a case of intrapancreatic accessory spleen that was discovered incidentally during a workup for abdominal pain in a 47-year-old woman. CT and MRI revealed a different enhancing pattern from that of the spleen. Further evaluation with endoscopic ultrasonography failed to identify the pancreatic mass. Therefore, it was surgically removed and diagnosed pathologically as an accessory spleen.

A case of gastric trichobezoar causing psychiatric problems / 소아과

Trichobezoar is characterized by the accumulation of hair in the gastrointestinal tract and usually occurs in those who have trichotillomania, other psychiatric disorders, or neurologic problems. Trichobezoar typically presents as gastric obstruction, including abdominal pain, vomiting, anorexia, and weight loss. A 9-year-old girl visited our clinic with the complaint of abdominal discomfort and vomiting. A review of her medical history revealed that she had trichophagia since the age of 5, and she felt that her parents had been strict with her. She underwent gastrotomy, during which a large trichobezoar was removed. This case highlights the importance of psychiatric and comprehensive approaches in patients with trichobezoar.

Hounsfield Number Measurement after a Uterine Fibroid Embolization: Significance as a Predictive Factor of Embolization Success

PURPOSE: To assess the usefulness of the Hounsfield number, measured by a non-contrast enhanced pelvic CT, after a uterine artery embolization as an index of the successful outcome of a uterine fibroid embolization (UFE). MATERIALS AND METHODS: The study subjects included 15 women (age range: 28-49 years, mean age: 36.4 years) diagnosed with symptomatic uterine myomas and seen from March 2003 to August 2005. A non-contrast enhanced pelvic CT scan was performed six hours after a uterine artery embolization. The global and maximal CT numbers were measured for each myoma. In addition, a pelvic MRI was performed to measure the volume of each myoma prior to and 6 months after the UFE. The relationship between fibroid volume reduction and the global CT number were prospectively analysed. RESULTS: The mean global CT number was 91.25 HU in Group I and 40.8 HU in Group II. Further, the mean fibroid volume reduction rate was 73% in Group I and 10% in Group II (p < 0.05). CONCLUSION: The global CT number measured by a non-contrast enhanced pelvic CT is a useful predictive factor of a successful uterine fibroid embolization.

Mucocele of the Remnant Appendix Following Incomplete Appendectomy: A Case Report

Appendiceal mucoceles are rare lesions. There has been only one report of a mucocele of the remnant appendix not communicating with the cecum. We report a remnant appendiceal mucocele following an incomplete incidental appendectomy, which presented as a lobulated cystic mass on ultrasonography and a cystic mass with an irregular wall on computed tomography. A borderline malignant mucinous tumor of the appendix was diagnosed.

High-Resolution Ultrasonography (US) of Appendiceal Specimens: Differentiation of Acute Non-perforated Appendicitis from Perforated Appendicitis

PURPOSE: To analyze surgical specimens from patients with acute non-perforated and perforated appendicitis using high-resolution ultrasonography (US), and to correlate the US features with the pathologic findings. MATERIALS and METHODS: One hundred and six surgical appendix specimens obtained from patients with suspected acute appendicitis were evaluated. The following US features were evaluated for differentiating acute non-perforated appendicitis from perforated appendicitis: circumferential loss of the echogenic submucosal layer, disruption of the serosal layer, asymmetrical wall thickening, the sum of opposing walls > or = 9 mm and the presence of appendicoliths. The sensitivity and specificity of the US findings for diagnosing perforated appendicitis were determined. RESULTS: All US features were detected significantly more often in the perforated appendicitis group of specimens. The disruption of the serosal layer was the most significant independent predictor of perforation (p or = 9 mm, and the presence of appendicoliths individually was 84.6%, 69.2%, 61.5%, 73.1% and 46.2%, respectively. The specificity for all of these findings was 86.3%, 98.7%, 95.0%, 85.0% and 85.0%, respectively. CONCLUSION: High-resolution US of appendiceal specimens was very useful for differentiating acute non-perforated from perforated appendicitis.

Nonpancreatic Pseudocyst with Fat-Fluid Level: A Case Report

Nonpancreatic pseudocyst is a rare lesion, with a specific fat-fluid level in the cyst. It is found among all age groups. The condition has been previously reported in foreign but not in domestic journals; we now describe one such case.

CT Finding of Transfusional Hemosiderosis in Patients with Chronic Renal Failure: Clinical Correlation

PURPOSE: To evaluate whether there is any correlation between the CT features of hemosiderosis and clinical findings in patients with chronic renal failure who have received multiple blood transfusions. MATERIALS AND METHODS: Among chronic renal failure patients who had undergone long-term dialysis and received multiple blood transfusions, CT findings in 16 cases in which increased liver attenuation was seen on images obtained for other purpose, were analyzed by three radiologic specialists. The attenuation values of liver, spleen and pancreas compared with that of back muscle were correlated with the amount and duration of transfusion, and blood ferritin level. RESULTS: In 15 of these 16 case, blood ferritin level was examined; 14 showed more than 300ng/ml. Increased attenuation of the spleen was noted in 11 cases, and of the pancreas, in six. All these six also showed increased value for the spleen; the amount of blood transfusion was less than 40 units in three case and more than 40 units in the other three. None showed glucose intolerance. Between the two groups, there were no statistically significant difference in the amount and duration of transfusion, or blood ferritin level. CONCLUSION: There is no correlation between the CT features of hemosiderosis and clinical findings. In patients with chronic renal failure and no clinical symptoms, the status of iron overload was relatively easily detected on CT. Close observation of CT findings is thus thought to prevent significant permanent functional deformity of organs in patients with chronic renal failure who have received multiple blood transfusions.

Pulmonary Tuberculosis with Airspace Consolidation vs Mycoplasma Pneumonia in Adults: High-Resolution CT Findings

PURPOSE: To analyse and compare high-resolution CT findings of pulmonary tuberculosis with consolidation and mycoplasma pneumonia. MATERIALS AND METHODS: Twenty patients with pulmonary tuberculosis [confirmed by sputum culture (n=9) and bronchoscopic biopsy (n=11)] and airspace consolidation on high-resolution CT and 17 patientswith mycoplasma pneumonia, confirmed by serologic test, were included in this study. High-resolution CT findings were analyzed in terms of ground-glass opacities, distribution of consolidation, type of nodules, cavities, interlobular septal thickening, bronchial dilatations, bronchial wall thickening and pleural effusion. RESULTS: In patients with tuberculsis, average age was 33.5 years (range, 20-67) ; in those with mycoplasma pneumonia it was 32.5 years (range, 17-74). Segmental and subsegmental distributions were most common in both diseases ; the preferred site of consolidation was different, however ; for tuberculosis it was the upper lobes (13 cases, 65% ; bilateral involvement, 7 cases) ; for mycoplasma pneumonia it was the lower lobes (11 cases, 64.7%). Non-segmental (diffuse and random) distribution of ground-glass opacities were seen in two patients(11.8%) with mycoplasma pneumonia. Centrilobular nodules, branching linear opacities and alveolar nodules were not different in both diseases, but there were nodules above 10mm in 14 cases of tuberculosis and in only one case of mycoplasma pneumonia. Tree-in-bud appearances were seen in five cases of tuberculosis. Cavities without air-fluid level were noted in ten cases of tuberculosis. Other interlobular septal thickening, bronchial wall thickening, bronchial dilatation and pleural effusion were not different in both diseases. CONCLUSION: There was considerable overlap between high resolution CT findings of tuberculosis with airspace consolidation and those of mycoplasma pneumonia. The location of consolidation, type of nodules, and the presence of tree-in-bud appearance and cavities help in the differentiation of the two diseases, however.

Comparison of High-Resolution CT Findings between Asthmatic and Control Subjects

PURPOSE: The purpose of this study was to compare high-resolution CT(HRCT) findings of asthmatic and control subjects, and to evaluate the relationship between HRCT findings and clinical features in asthmatic subjects. MATERIALS AND METHODS: Using HRCT, we studied 16 asthmatic and 16 control subjects. We analyzed the ratio of bronchial wall thickeness, the frequency of bronchial dilatation, the presence of emphysema, centrilobular nodule, and pulmonary infiltration in two groups. In addition, we assessed HRCT findings of asthmatic patients for correlation with clinical findings and the pulmonary function test. RESULTS: The ratio of bronchial wall thickness of 16 asthmatic subjects (0.48 +/-0.08) and 16 control subjects(0.40 +/-0.08) was significantly different in statistical analysis (P<0.001). Bronchial dilatation was seen in 53(32%) of 165 bronchi in the asthmatic group and in 16(13%) of 119 bronchi in the control group, which was statistically significant (p<0.01). Among 16 asthmatic patients, there were eight cases of emphysema, two of centrilobular nodule, and four of pulmonary infiltration. The ratio of bronchial wall thickeness of eight asthmatic subjects with emphysema(0.47 +/-.08) and eight such subjects without emphysema(0.49 +/-0.09) was not significantly different when statistically analysed. In asthmatic patients, HRCT findings did not correlate with clinical findings and the pulmonary function test. CONCLUSION: On high-resolution CT, the ratio of bronchial wall thickness and the frequency of bronchial dilatation between asthmatic and control subjects are significantly different.

Ultrasonographic and Mammographic Findings of Gynecomastia

PURPOSE: The purpose of this study is to evaluate the radiologic features and clinical utility of ultrasonography and mammography in cases of gynecomastia. MATERIALS AND METHODS: This study involved 40 men inwhom gynecomastia had been pathologically diagnosed by surgical incision. In 21 cases, a retrospective analysis of ultrasonographic and mammographic findings was performed. RESULTS: Causative factors of gynecomastia among the 40 pathologically-proven cases were idiopathic or pubertal in 33 cases, related to male hormone deficiency in three cases and to chronic liver disease in four. Bilateral involvement was seen in 14 cases, and unilateral involvementin 26 ; among unilateral cases, right side was involved in 10 cases, and the left side in 16. Mammographically, asubareolar discoid lesion was present in 12 cases, diffuse increased breast density was seen in five cases and dendritic marginated subareolar lesion without microcalcification in one. Ultrasonographically, a round smooth marginated low echogenic lesion in the subareolar region was seen in five cases, a diffuse hyperechogenic pattern without definite mass in two cases and an ill defined low echogenic lesion in one. CONCLUSION: The male breast is small, so in cases of gynecomastia, ultrasonography is an effective diagnostic modality. Mamography will, however, be helpful in the detection of microcalcification in cases of gynecomastia seen on sonography.