Myomatous hepatic angiomyolipoma: imaging findings in 14 cases with radiological-pathological correlation and review of the literature.

OBJECTIVE: To display and analyse the imaging features of myomatous hepatic angiomyolipomas (MHAMLs). METHODS: The imaging features (CT = 9; MRI = 10; ultrasound = 10; contrast-enhanced ultrasound = 4) of 14 patients with pathologically proven MHAMLs were reviewed retrospectively. RESULTS: MHAMLs were surgically resected in the 14 patients (10 females and 4 males; age, 27-64 years; mean, 45 years), all of whom had negative hepatitis markers and were positive for the immunohistochemical stain homatropine methylbromide-45. The tumours were solitary and well defined, and ranged in size from 1.9 to 9.1 cm (mean, 5.7 cm). On dynamic contrast-enhanced CT, MRI and ultrasound scans, all tumours showed fast strong enhancement in the arterial phase and moderate washout in the portal venous and delayed phases, and the greater portions of the tumours were slightly lower than the surrounding hepatic parenchyma. In some cases, a small area of prolonged or increasing enhancement in the tumour was recognized in the delayed phase. Early draining vessels to the portal vein or hepatic vein could be seen in some cases. However, no capsular signs could be confidently identified in the delayed phase. Haemorrhagic cavities were recognized in two cases, and nodular low-intensity areas in the tumours on T2 weighted imaging that showed slow and faint enhancement on dynamic scans were seen in two cases. However, no necrosis was identified. CONCLUSION: Dynamic enhanced imaging studies revealed some specific features of MHAMLs that distinguish them from other hypervascular hepatic tumours, especially when combined with clinical features. Familiarity with imaging and clinical features of MHAMLs could avoid unnecessary surgical resection of these generally benign tumours. ADVANCES IN KNOWLEDGE: This article systematically describes the imaging features of MHAMLs.

[Cutaneous pili migrans]. / Pili migrans (poil migrant cutané).

INTRODUCTION: Cutaneous pili migrans, caused by a hair shaft or fragment embedded in the superficial skin, and occasionally in the middle dermis, is a rare condition characterized by creeping eruption with a black line at the advancing end, which resembles the lesion associated with cutaneous larva migrans. CASE REPORT: We present the case of a 38-year-old Chinese housewife with a 30-day history of painfully and slowly moving black linear eruption on the dorsal aspect of her left foot. The more she walked, the further the line extended and the more pain she felt, particularly on walking rapidly. A black hair shaft was removed from the lesion, which healed completely. DISCUSSION: Pili migrans is an extremely rare condition with only 22 cases being reported to date. The hair shaft penetrates into the superficial layers of the epidermis following injury or occasionally for no known reason. The spectacular clinical picture is similar to that seen in the interdigital spaces of hairdressers in whom there are only small hair fragments on occasion, with no movement of the lesion.

Aquagenic syringeal acrokeratoderma in an adult man: case report and review of the literature.

Aquagenic syringeal acrokeratoderma (ASA) is a rare acquired disorder that develops predominantly in young women. It is clinically characterized by a burning sensation and whitish discolouration on the hands and rarely on the soles after brief immersion in water, which resolves within a short time after drying. Topical aluminium chloride and salicylic acid are reportedly beneficial in some cases. In total, 20 female and 8 male patients with ASA have been reported previously. We present another male patient, who failed to respond to treatment with antihistamines and topical steroids, but responded well to formalin 3% in alcohol without any side-effects.

[Chest wall and mediastinum invasion by lung cancer--a CT and MRI evaluation].

CT and MRI manifestations of 52 peripheral lung cancers located close to the pleural surface or mediastinal structures were studied correlating with the surgical and pathologic findings. Rib destruction as shown by CT and T2 weighted MRI showing the encroachment of tumor upon the chest wall were crucial in demonstrating chest wall invasion. An obtuse chest wall intersecting angle and the length of the neighboring borders of the tumor and chest wall were of limited value. Local pleural thickening was observed near the tumor in 54% of cases, over half of them showed obtuse angle between the tumor and the chest wall but without tumor invasion. T2 weighted MRI was more reliable than CT by showing different signal intensities for pleural thickening, inflammation, localized pleural effusion or tumor invasion to chest wall soft tissue.