ABSTRACT
Background: mpMRI assesses prostate lesions through their PI-RADS score. The primary goal of this prospective study was to demonstrate the correlation of PI-RADS v2 score and the volume of a lesion with the presence and clinical significance of prostate cancer (PCa). The secondary goal was to determine the extent of additionally PCa in inconspicuous areas. Methods: All 157 patients underwent a perineal MRI/TRUS-fusion prostate biopsy. Targeted biopsies as well as a systematic biopsy were performed. The presence of PCa in the probes was specified by the ISUP grading system. Results: In total, 258 lesions were biopsied. Of the PI-RADS 3 lesions, 24% were neoplastic. This was also true for 36.9% of the PI-RADS 4 lesions and for 59.5% of the PI-RADS 5 lesions. Correlation between ISUP grades and lesion volume was significant (p < 0.01). In the non-suspicious mpMRI areas carcinoma was revealed in 19.7% of the patients. Conclusions: The study shows that the PI-RADS v2 score and the lesion volume correlate with the presence and clinical significance of PCa. However, there are two major points to consider: First, there is a high number of false positive findings. Second, inconspicuous mpMRI areas revealed PCa.
Subject(s)
Multiparametric Magnetic Resonance Imaging , Prostatic Neoplasms , Humans , Image-Guided Biopsy , Magnetic Resonance Imaging , Male , Prospective Studies , Prostate/diagnostic imaging , Prostatic Neoplasms/diagnostic imaging , Prostatic Neoplasms/pathologyABSTRACT
We report a case of a 77-year old female patient with abdominal pain in the upper right part. In the computertomography we had the suspicion of a rare small bowel diverticulitis which was confirmed in laparoscopic and histopathologic diagnostics. After surgical excision the patient was free of symptoms.
Subject(s)
Abdominal Pain/etiology , Cholecystectomy , Diverticulitis/diagnosis , Intestinal Diseases/diagnosis , Intestine, Small , Postoperative Complications/etiology , Aged , Diagnosis, Differential , Female , Humans , Intestinal Mucosa/pathology , Intestine, Small/pathology , Multidetector Computed Tomography , Postoperative Complications/diagnosis , Radiographic Image EnhancementSubject(s)
Breast Neoplasms/radiotherapy , Carcinoma, Lobular/radiotherapy , Hemangiosarcoma/diagnosis , Hemangiosarcoma/etiology , Aged , Breast Neoplasms/diagnosis , Breast Neoplasms/etiology , Breast Neoplasms/pathology , Breast Neoplasms/surgery , Carcinoma, Lobular/pathology , Carcinoma, Lobular/surgery , Female , Hemangiosarcoma/surgery , Humans , Lymph Node Excision , Magnetic Resonance Imaging , Time FactorsABSTRACT
Resection of the manubrium including both sternoclavicular joints is occasionally performed in the case of sternal tumours. Sternoclavicular joints are the only true joints connecting the axial skeleton to the upper extremity. Therefore, they play an important role in shoulder function. However, data on their reconstruction are lacking. Here, we described the case of a sternal reconstruction including both sternoclavicular joints using a mesh-bone cement sandwich. The mechanical properties of the construct mimicked those of the original sternoclavicular joints and could therefore restore shoulder strength allowing the patient to perform overhead work.
Subject(s)
Bone Cements , Plastic Surgery Procedures/methods , Sternoclavicular Joint/surgery , Sternum/surgery , Surgical Mesh , Thoracic Surgical Procedures/methods , Chondrosarcoma/surgery , Humans , Male , Middle Aged , Thoracic Neoplasms/surgeryABSTRACT
Solitary vertebral chordoma presents as an intra- and extraosseous tumour with typical bright signal on T2-weighted images and moderate inhomogeneous enhancement on T1 postcontrast images. The diffusion weighted imaging (DWI) characteristics of this histologically proven third lumbar vertebra chordoma are reported for the first time. The DWI hyperintensity with increased apparent diffusion coefficient (ADC) values strongly supports the preoperative diagnosis of a vertebral chordoma, allows for careful preoperative planning of the surgical procedure, and helps to narrow the differential diagnosis.
Subject(s)
Back Pain/etiology , Chordoma/complications , Chordoma/diagnosis , Diffusion Magnetic Resonance Imaging/methods , Lumbar Vertebrae/pathology , Spinal Neoplasms/complications , Spinal Neoplasms/pathology , Adult , Back Pain/diagnosis , Diagnosis, Differential , Humans , MaleABSTRACT
Barrett's mucosa is a risk factor for esophageal adenocarcinoma and should be detected at an early stage. It is defined by the presence of columnar epithelium with goblet cells in the lower esophagus, but histologic diagnosis can be uncertain in the absence of distinct goblet cells. We investigated 55 biopsies from 48 patients with endoscopically plain Barrett's esophagus and performed immunohistochemistry for CDX2 and MUC2. In addition, alcian blue (pH 2,5)/PAS staining was done. In histologically unequivocal Barrett's mucosa, nuclear expression of CDX2 in goblet cells and many columnar cells, as well as cytoplasmic positivity for MUC2 in goblet cells, could be observed. Alcian blue (pH 2,5)/PAS stained acidic mucins in goblet cells and in some non-goblet columnar cells. In six cases, no definite Barrett's mucosa was present, and no expression of MUC2 could be observed. In these biopsies, there was granular cytoplasmic and/or focal nuclear staining for CDX2 in non-goblet columnar epithelial cells, indicating their intestinal differentiation. We suggest that this peculiar mucosa is the precursor of unequivocal Barrett's mucosa and would designate it early Barrett's mucosa. Alcian blue for acidic mucins is inconsistent in this epithelium and does not reliably indicate early intestinal differentiation.
