ABSTRACT
Syphilitic proctitis is a rare presentation of sexually transmitted infection that poses a diagnostic challenge as it mimics rectal cancer clinically, radiologically and endoscopically. We report a case of a 66-year-old male patient with a background of HIV infection presenting with obstructive bowel symptoms and initial diagnosis of rectal cancer on CT. Sigmoidoscopy and histopathology were non-diagnostic. A diagnosis of secondary syphilis was suspected after obtaining sexual history and diagnostic serology, avoiding planned surgical intervention.
Subject(s)
HIV Infections , Intestinal Obstruction , Penicillins/administration & dosage , Proctitis/diagnosis , Rectal Neoplasms/diagnosis , Rectum , Treponema pallidum , Aged , Anti-Bacterial Agents/administration & dosage , Diagnosis, Differential , HIV Infections/complications , HIV Infections/therapy , Humans , Intestinal Obstruction/diagnosis , Intestinal Obstruction/etiology , Male , Proctitis/etiology , Proctitis/physiopathology , Proctitis/therapy , Rectum/diagnostic imaging , Rectum/microbiology , Rectum/pathology , Sexually Transmitted Diseases/diagnosis , Sexually Transmitted Diseases/therapy , Sigmoidoscopy/methods , Syphilis/complications , Syphilis/diagnosis , Syphilis/therapy , Tomography, X-Ray Computed/methods , Treponema pallidum/immunology , Treponema pallidum/isolation & purificationABSTRACT
Advances in the early detection and treatment of esophageal cancer have meant improved survival rates for patients with esophageal cancer. Accurate pretreatment and post-neoadjuvant treatment staging of esophageal cancer is essential for assessing operability and determining the optimum treatment plan. This article reviews the multimodality imaging approach in the diagnosis, staging, and assessment of treatment response in esophageal cancer.
Subject(s)
Diagnostic Imaging , Esophageal Neoplasms/diagnostic imaging , Esophageal Neoplasms/therapy , Esophageal Neoplasms/pathology , Humans , Neoadjuvant Therapy , Neoplasm StagingABSTRACT
The prognosis and preferred management of breast implant-associated anaplastic large cell lymphoma is dependent on whether lymphoproliferative cells are confined to within the fibrous capsule, in an effusion or lining the fibrous capsule, or if there is spread beyond the capsule in the form of a mass lesion. We describe a case where 18F-fludeoxyglucose positron emission tomography-CT was used to confirm localized disease and guide management decisions.
ABSTRACT
We report a case of a patient who was found to have a uterine lipoleiomyoma on ultrasound and MRI, which was later confirmed with histological evidence. Uterine lipoleiomyomas are rare benign tumours that are often misdiagnosed on imaging, leading to unnecessary invasive procedures. Increased awareness of the tumour and its characteristics on imaging can aid future preoperative diagnosis.
Subject(s)
Diagnostic Imaging/methods , Leiomyoma/diagnosis , Lipoma/diagnosis , Uterine Neoplasms/diagnosis , Biopsy, Needle , Endosonography/methods , Female , Follow-Up Studies , Humans , Hysteroscopy/methods , Immunohistochemistry , Leiomyoma/pathology , Leiomyoma/surgery , Lipoma/pathology , Lipoma/surgery , Magnetic Resonance Imaging/methods , Middle Aged , Treatment Outcome , Uterine Neoplasms/pathology , Uterine Neoplasms/surgeryABSTRACT
Menstrual complaints are common and include pain, abnormal bleeding, and menstrual irregularity. The etiology is wide-ranging and includes endometriosis, fibroids, adenomyosis, pelvic congestion syndrome, pelvic inflammatory disease, endometrial hyperplasia, and polyps. Polycystic ovarian syndrome and some congenital uterine anomalies may present with menstrual disturbance and have been included in this review. Transvaginal ultrasound is widely used as first-line investigation. Magnetic resonance imaging is used increasingly with high diagnostic accuracy and confidence. Its multiplanar capacity and superior tissue contrast resolution enable accurate presurgical mapping of fibroids, deep pelvic endometriosis, and adenomyosis. Similarly, accurate differentiation of congenital uterine anomalies depends on multiplanar imaging with either 3-dimensional ultrasound or magnetic resonance imaging. Recent advances in imaging and radiological intervention, combined with an understanding of the underlying causes of menstrual dysfunction, therefore aid in accurate diagnosis and optimal treatment planning.
Subject(s)
Genital Diseases, Female/diagnosis , Magnetic Resonance Imaging/methods , Menstruation Disturbances/diagnosis , Ultrasonography, Interventional/methods , Uterine Diseases/diagnosis , Diagnosis, Differential , Dysmenorrhea/complications , Dysmenorrhea/diagnosis , Endometrial Hyperplasia/complications , Endometrial Hyperplasia/diagnosis , Endometriosis/complications , Endometriosis/diagnosis , Female , Genital Diseases, Female/complications , Genitalia, Female/diagnostic imaging , Genitalia, Female/pathology , Humans , Imaging, Three-Dimensional/methods , Leiomyoma/complications , Leiomyoma/diagnosis , Menstruation Disturbances/complications , Pelvic Inflammatory Disease/complications , Pelvic Inflammatory Disease/diagnosis , Pelvis/blood supply , Polycystic Ovary Syndrome/complications , Polycystic Ovary Syndrome/diagnosis , Polyps/complications , Polyps/diagnosis , Sensitivity and Specificity , Uterine Diseases/complications , Uterine Diseases/congenital , Uterine Hemorrhage/complications , Uterine Hemorrhage/diagnosis , Vascular Malformations/complications , Vascular Malformations/diagnosisABSTRACT
The purpose of this retrospective medical audit was to evaluate the effect of discontinuing routine administration of oral contrast material to oncology patients undergoing follow-up multidetector computed tomography (CT) on reader evaluation of study adequacy. Analysis of 100 patients' experience of CT shows that positive oral contrast material was their least pleasant experience (P < .0001). Abandoning the routine use of positive oral contrast material for follow-up scans in general oncology patients undergoing multidetector CT, with section reconstruction thickness of 2.5 mm, was audited for 447 patents and included 5-13-month follow-up. The patient satisfaction study and clinical audit were performed according to local institutional audit guidelines. Since this was a clinical audit project, ethical approval was not required under UK National Health Service research governance arrangements. No patient needed to be recalled, no related diagnostic error has been reported, and follow-up CT, available in 285 of 447 cases (64%), revealed no error on the audited scan. We conclude that the routine use of positive oral contrast material is unnecessary for follow-up multidetector CT for general oncology indications.
