Angioleiomyoma of the Extremities: Findings on Ultrasonography and Magnetic Resonance Imaging.

OBJECTIVES: The purpose of this study was to describe the features of angioleiomyomas of the extremities on ultrasonography (US) and magnetic resonance imaging (MRI). METHODS: We retrospectively reviewed the US and MRI findings of 29 pathologically confirmed cases of angioleiomyomas of the extremities in 29 patients. Twenty patients underwent only US; 7 patients underwent only MRI; and 2 patients underwent US and MRI. Clinical data and histopathologic specimens were reviewed. RESULTS: There were 19 women and 10 men. The mean patient age was 48.9 years (range, 23-80 years). On US, angioleiomyomas were located primarily in the subcutaneous fat layer (n = 20 [91%]), were oval (n = 17 [77%]), had well-circumscribed margins (n = 22 [100%]), had hypoechoic protrusions on one or both ends (n = 9 [41%]), had a homogeneous echo texture (n = 17 [ 77%]), had posterior acoustic enhancement (n = 20 [91%]), and had color Doppler flow (n = 20 [91%]). On MRI, the masses showed heterogeneous enhancement (n = 7 [88%]) and enhancing structures on one or both ends (n = 4 [50%]) on contrast-enhanced T1-weighted images. CONCLUSIONS: Angioleiomyoma of the extremities is usually a well-circumscribed oval mass with a homogeneous echo texture and occasionally hypoechoic protrusions on US and shows heterogeneous enhancement with occasionally enhancing structures on one or both ends of the mass on MRI. Therefore, it should be included in the differential diagnosis of a soft tissue mass that has protruding structures from one or both ends.

Chronic Vasitis After Mesh Herniorrhaphy: A Potential Cause of False Positive Results in 18F-FDG PET/CT Studies.

We report two cases of supra-scrotal vasitis incidentally detected in patients who had undergone mesh herniorrhaphy. PET/CT in patients undergoing lymphoma work-up and health check-up revealed hypermetabolic dilatation of vas deferens in the external iliac area. There were no symptoms, and blood test results did not indicate acute inflammation. Interestingly, both had undergone herniorrhaphy for inguinal hernia. Herniorrhaphy is reported to cause vasal complications such as obstruction or inflammation, although most are asymptomatic and probably under-reported. Chronic vasitis after herniorrhaphy may be a potential cause for false positive findings on F-FDG PET/CT in patients undergoing work-up for various oncological indications.

Reproducibility of coronary artery calcium measurements using 0.8-mm-thickness 256-slice coronary CT.

PURPOSE: Coronary artery calcium (CAC) measurement has been utilized as an important indicator of coronary artery disease and predictor of cardiovascular risk. The reproducibility of CAC measurements makes it clinically useful for the assessment of progression and regression of coronary atherosclerosis. This study assessed the reproducibility of the Agatston CAC score among patients undergoing 256-slice multidetector computed tomography (MDCT) scans using 0.8-mm slice thickness. MATERIALS AND METHODS: One hundred four patients (aged 62.8 ± 9.0 years, 56.7 % males) with CAC scores >0 on 256-slice MDCT underwent additional MDCT imaging at 2-week intervals. The CAC score was quantified using the Agatston score, which was measured independently by two radiologists. RESULTS: The variability between observers and MDCT scan measurements was determined by the mean value of absolute and percentage differences: inter-scan/inter-observer (14.45 ± 21.84, 12.51 ± 21.84 %), intra-scan/intra-observer (1.75 ± 5.85, 1.26 ± 3.69 %), intra-scan/inter-observer (3.3 ± 9.1, 4.8 ± 21.3 %), and inter-scan/intra-observer (13.45 ± 20.7, 10.04 ± 10.46 %). CONCLUSION: Reproducibility in CAC measurements using the 0.8-mm-thickness 256-slice MDCT showed low inter-scan/inter-observer variability. Therefore, this CT imaging has potential to be used in prospective, longitudinal CAC assessments.

Simultaneous occurrence of malignant fibrous histiocytoma and hepatocellular carcinoma in cirrhotic liver: A case report.

Primary hepatic malignant fibrous histiocytoma (MFH) is rarely encountered. There have been no reports to date of hepatic MFH associated with liver cirrhosis. The presence of liver cirrhosis is considered an adjunctive feature favoring sarcomatoid hepatocellular carcinoma (HCC) in the diagnosis of spindle cell tumors in liver. We describe here a 59-year-old man with liver cirrhosis due to hepatitis B virus infection 20 years ago. On abdominal computed tomography scanning, two distinct hepatic masses were identified in the background of cirrhosis, which had different radiological features from conventional HCC. He underwent segmentectomy for removal of the tumors. The pathological examination of surgically resected specimen revealed the large malignant spindle cell tumor and small conventional HCC. Additional tissue sampling and immunohistochemical stainings demonstrated that the spindle cell tumor was consistent with MFH. On the post-operative follow-up for 21 mo, a round mass showing similar radiological findings for the previous MFH was appeared on the surface of resection margin, suggesting the recurrence. Despite its rarity, hepatic MFH should be considered during differential diagnosis, even in cirrhotic patients, and extensive tissue sampling and immunohistochemical analyses are necessary in the diagnosis of hepatic spindle cell tumors.