Subject(s)
Contusions , Respiratory Distress Syndrome , Thoracic Injuries , Wounds, Nonpenetrating , Humans , Intensive Care Units , Phenotype , Prognosis , SteroidsSubject(s)
Coronary Artery Disease , Fistula , Child , Coronary Vessels , Follow-Up Studies , HumansABSTRACT
The presence of pelvic lymph node metastases is without doubt the most significant prognostic factor that determines recurrences and survival of women with early-stage cervical cancer. To avoid the underdiagnosis of lymph node metastasis, pelvic lymphadenectomy procedure is routinely performed with radical hysterectomy procedure. However, the pelvic lymphadenectomy procedure may not be necessary in most of these women due to the relatively low incidence of pelvic lymph node metastasis. The removal of large numbers of pelvic lymph nodes could also render non-metastatic irreversible damages for these women, including vessel, nerve, or ureteral injuries; formation of lymphocysts; and lymphedema. Over the past decades, the concept of sentinel lymph node biopsy has emerged as a popular and widespread surgical technique for the evaluation of the pelvic lymph node status in gynecologic malignancies. The histological status of sentinel lymph node should be representative for all other lymph nodes in the regional drainage area. If metastasis is non-existent in the sentinel lymph node, the likelihood of metastatic spread in the remaining regional lymph nodes is very low. Further lymphadenectomy is therefore not necessary for a patient with negative sentinel lymph nodes. Since the uterine cervix has several lymphatic drainage pathways, it is a challenging task to assess the distribution pattern of sentinel lymph nodes in women with early-stage cervical cancer. This review article will adapt the methodology proposed in these studies to systematically review sentinel lymphatic mapping among women with early-stage cervical cancer.
Subject(s)
Lymph Nodes/pathology , Lymphatic Metastasis/pathology , Sentinel Lymph Node Biopsy , Uterine Cervical Neoplasms/pathology , Cervix Uteri/pathology , False Negative Reactions , Female , Humans , Lymph Node Excision/adverse effects , Lymph Node Excision/methods , Lymphedema/etiology , Neoplasm Staging , Pelvis , Sensitivity and Specificity , Sentinel Lymph Node Biopsy/methodsABSTRACT
INTRODUCTION: Differentiation of benign and malignant pulmonary tumor-like lesions is challenging but increasingly important. We evaluate the most common imaging features in benign lesions based on the frequency of their appearance and compare with corresponding frequencies in malignant tumors from literature. METHODS: Retrospective imaging review study in one center between 1 January 2012 and 30 June 2014. We reviewed the data from 2466 pathological examinations of lung specimens collected from the hospital. We excluded malignant or non-tumor-like lesions and identified 133 infection-related lesions for imaging review. The frequency of 11 benign imaging features was evaluated in the selected infection-related tumor-like pulmonary lesions and was compared with corresponding frequency in malignant tumors. RESULTS: Most of the evaluated lesions were seen to have one to four benign features. The two most common benign features are marginal ground glass or infiltrates (62.4%), followed by pleura-based wedge shape (50.4%). Features with significantly higher frequency in benign infection-related lung lesions than malignancy are calcification or hyperdensity, pleura-based wedge shape, adjacent clustered small nodules, and strongly or poorly enhanced soft tissue part. CONCLUSIONS: Infection-related lung lesions usually have one to four benign features and the common features with significantly higher frequency than malignant condition are pleura-based wedge shape, calcification or hyperdensity, adjacent clustered small nodules, and strongly or poorly enhanced soft tissue part.
Subject(s)
Lung Neoplasms/diagnostic imaging , Respiratory Tract Infections/diagnostic imaging , Tomography, X-Ray Computed , Biopsy , Diagnosis, Differential , Humans , Lung Neoplasms/pathology , Lung Neoplasms/surgery , Respiratory Tract Infections/pathology , Respiratory Tract Infections/surgery , Retrospective Studies , TaiwanABSTRACT
BACKGROUND: Diastolic dysfunction (DD), a precursor to clinical heart failure (HF), has traditionally been evaluated by means of echocardiography. Data regarding morphologic descriptions of pulmonary vein (PV) orifices in transition from DD to HF have been lacking. METHODS AND RESULTS: We retrospectively studied 124 subjects with computerized tomography (CT)-derived PV parameters and echocardiography-derived diastolic indices. We categorized our subjects as 1) non-DD, 2) DD, or 3) heart failure with preserved ejection fraction (HFpEF) and observed a graded enlargement for 4 PV orifice areas across these groups. Positive linear relationship between the 4 PV orifice areas, echocardiography-derived mean pulmonary capillary wedge pressure (PCWP), and velocity of propagation (VP) were observed. Finally, maximum areas of left superior pulmonary vein (LSPV) and left inferior pulmonary vein (LIPV) significantly increased clinical diagnosis of HFpEF (likelihood-ratio χ(2): from 42.92 to 50.75 and 54.67 for LSPV and LIPV, respectively) when superimposed on left ventricular mass index, PCWP, and left atrial volume. CONCLUSIONS: PV size measurements with the use of CT are feasible and further aid in diseases discrimination between preclinical DD and those progressed into HF, even with preserved global pumping. Our data suggest that CT-based PV measures may help to identify subjects at risk for HF.
