ABSTRACT
The purpose of our study was to develop a predictive model to rule out pheochromocytoma among adrenal tumours, based on unenhanced computed tomography (CT) and/or magnetic resonance imaging (MRI) features. We performed a retrospective multicentre study of 1131 patients presenting with adrenal lesions including 163 subjects with histological confirmation of pheochromocytoma (PHEO), and 968 patients showing no clinical suspicion of pheochromocytoma in whom plasma and/or urinary metanephrines and/or catecholamines were within reference ranges (non-PHEO). We found that tumour size was significantly larger in PHEO than non-PHEO lesions (44.3 ± 33.2 versus 20.6 ± 9.2 mm respectively; P < 0.001). Mean unenhanced CT attenuation was higher in PHEO (52.4 ± 43.1 versus 4.7 ± 17.9HU; P < 0.001). High lipid content in CT was more frequent among non-PHEO (83.6% versus 3.8% respectively; P < 0.001); and this feature alone had 83.6% sensitivity and 96.2% specificity to rule out pheochromocytoma with an area under the receiver operating characteristics curve (AUC-ROC) of 0.899. The combination of high lipid content and tumour size improved the diagnostic accuracy (AUC-ROC 0.961, sensitivity 88.1% and specificity 92.3%). The probability of having a pheochromocytoma was 0.1% for adrenal lesions smaller than 20 mm showing high lipid content in CT. Ninety percent of non-PHEO presented loss of signal in the "out of phase" MRI sequence compared to 39.0% of PHEO (P < 0.001), but the specificity of this feature for the diagnosis of non-PHEO lesions low. In conclusion, our study suggests that sparing biochemical screening for pheochromocytoma might be reasonable in patients with adrenal lesions smaller than 20 mm showing high lipid content in the CT scan, if there are no typical signs and symptoms of pheochromocytoma.
Subject(s)
Adrenal Gland Neoplasms , Lipids/blood , Models, Biological , Pheochromocytoma , Adrenal Gland Neoplasms/blood , Adrenal Gland Neoplasms/diagnostic imaging , Adult , Aged , Female , Humans , Male , Middle Aged , Pheochromocytoma/blood , Pheochromocytoma/diagnostic imaging , Retrospective Studies , Tomography, X-Ray ComputedABSTRACT
Pembrolizumab, a programmed death 1 inhibitor, has been shown to have clinically significant efficacy in different types of cancer, providing long-term survival benefit for patients with lung cancer. Herein, we report the development of a primary thyroid cancer in a lung cancer patient that was being treated with pembrolizumab. Primary thyroid malignancy (and not only metastatic disease or immunotherapy-induced thyroiditis) should be considered in patients with lung cancer being treated with immune checkpoint inhibitors who develop new incidental thyroid lesions on imaging studies.
Subject(s)
Antibodies, Monoclonal, Humanized/adverse effects , Carcinoma, Non-Small-Cell Lung/drug therapy , Immunotherapy/adverse effects , Lung Neoplasms/drug therapy , Thyroid Neoplasms/chemically induced , Antibodies, Monoclonal, Humanized/therapeutic use , Antineoplastic Agents, Immunological/adverse effects , Carcinoma, Non-Small-Cell Lung/diagnosis , Diagnosis, Differential , Humans , Lung Neoplasms/diagnosis , Male , Middle Aged , Positron-Emission Tomography , Thyroid Neoplasms/diagnosis , Tomography, X-Ray ComputedSubject(s)
Amino Acyl-tRNA Synthetases/immunology , Azathioprine/administration & dosage , Calcinosis , Lung Diseases, Interstitial , Myositis , Paraspinal Muscles , Prednisone/administration & dosage , Tomography, X-Ray Computed/methods , Autoantibodies/blood , Calcinosis/diagnostic imaging , Calcinosis/etiology , Female , Humans , Immunosuppressive Agents/administration & dosage , Lung Diseases, Interstitial/diagnostic imaging , Lung Diseases, Interstitial/etiology , Lung Diseases, Interstitial/therapy , Middle Aged , Myositis/diagnosis , Myositis/immunology , Myositis/physiopathology , Myositis/therapy , Paraspinal Muscles/diagnostic imaging , Paraspinal Muscles/pathologyABSTRACT
No disponible
Subject(s)
Humans , Male , Aged , Carcinoma, Bronchogenic/diagnostic imaging , Hernia, Hiatal/diagnostic imaging , Carcinoma, Bronchogenic/complications , Radiography, Thoracic , BronchoscopyABSTRACT
No disponible
Subject(s)
Humans , Male , Middle Aged , Brachytherapy/methods , Pulmonary Embolism/diagnostic imaging , Prostatic Neoplasms/therapy , Neoplasm Staging , Pulmonary Embolism/pathology , Dyspnea/complications , Cough/etiology , Pneumonia/complicationsSubject(s)
Brachytherapy/adverse effects , Foreign-Body Migration/diagnostic imaging , Lung/diagnostic imaging , Prostatic Neoplasms/etiology , Prostatic Neoplasms/radiotherapy , Tomography, X-Ray Computed , Brachytherapy/instrumentation , Cough/etiology , Diagnosis, Differential , Dyspnea/etiology , Foreign-Body Migration/diagnosis , Foreign-Body Migration/etiology , Humans , Lung/surgery , Male , Middle Aged , Pneumonia/diagnosisSubject(s)
Hernia, Hiatal/diagnostic imaging , Lung Neoplasms/diagnostic imaging , Aged , Diagnosis, Differential , Humans , MaleSubject(s)
Carcinoma, Squamous Cell/diagnostic imaging , Lung Neoplasms/diagnostic imaging , Pulmonary Artery/diagnostic imaging , Pulmonary Embolism/diagnostic imaging , Aged, 80 and over , Carcinoma, Squamous Cell/complications , Carcinoma, Squamous Cell/pathology , Humans , Lung Neoplasms/complications , Lung Neoplasms/pathology , Male , Positron Emission Tomography Computed Tomography , Pulmonary Artery/pathology , Pulmonary Embolism/etiologyABSTRACT
An 81-year-old woman who had undergone total hip arthroplasty 12 years earlier presented with a painful spontaneous hematoma in the proximal left thigh. A left hip radiograph showed a displaced cement fragment from the acetabular component of the hip prosthesis. Computed tomography confirmed an extruded cement fragment causing a large pseudoaneurysm of the deep femoral artery. The patient underwent successful percutaneous embolization of the pseudoaneurysm with coils.
Subject(s)
Aneurysm, False/etiology , Arthroplasty, Replacement, Hip/adverse effects , Bone Cements/adverse effects , Femoral Artery , Foreign-Body Migration/etiology , Aged, 80 and over , Aneurysm, False/diagnostic imaging , Aneurysm, False/therapy , Angiography, Digital Subtraction , Computed Tomography Angiography , Embolization, Therapeutic/instrumentation , Female , Femoral Artery/diagnostic imaging , Foreign-Body Migration/diagnostic imaging , Foreign-Body Migration/therapy , Humans , Time Factors , Treatment OutcomeSubject(s)
Cardiac Pacing, Artificial/adverse effects , Coronary Vessels/diagnostic imaging , Coronary Vessels/pathology , Medical Errors/adverse effects , Pacemaker, Artificial/adverse effects , Aged, 80 and over , Atrioventricular Block/therapy , Coronary Sinus/diagnostic imaging , Coronary Sinus/pathology , Heart Ventricles/diagnostic imaging , Humans , Male , Tomography, X-Ray ComputedABSTRACT
No disponible
Subject(s)
Humans , Male , Adult , Pulmonary Edema/etiology , Ventilators, Negative-Pressure/adverse effects , Intervertebral Disc Displacement/surgeryABSTRACT
No disponible
Subject(s)
Humans , Female , Middle Aged , Brachiocephalic Veins , Venous Thrombosis/complications , Mesenteric Vascular Occlusion/complications , Spinal Neoplasms/diagnosis , Diagnosis, Differential , Neoplasm Metastasis/diagnosisSubject(s)
Adenocarcinoma/pathology , Lung Diseases/pathology , Lung Neoplasms/pathology , Neuroendocrine Cells/pathology , Adenocarcinoma/surgery , Adenocarcinoma of Lung , Aged , Female , Humans , Hyperplasia/diagnostic imaging , Hyperplasia/pathology , Lung Diseases/diagnostic imaging , Lung Neoplasms/surgery , Pneumonectomy/methods , Thoracic Surgery, Video-Assisted , Tomography, X-Ray ComputedABSTRACT
No disponible
Subject(s)
Humans , Female , Adult , Bronchiolitis/etiology , Hematopoietic Stem Cell Transplantation/adverse effects , Tomography, X-Ray Computed/methods , Leukemia, Myeloid, AcuteSubject(s)
Brachiocephalic Veins/diagnostic imaging , Breast Neoplasms , Hyperemia/diagnostic imaging , Spinal Neoplasms/diagnostic imaging , Spinal Neoplasms/secondary , Venous Thrombosis/diagnostic imaging , Collateral Circulation , Diagnosis, Differential , Female , Humans , Hyperemia/complications , Middle Aged , Radiographic Image EnhancementABSTRACT
No disponible
