ABSTRACT
The increasing interest in accurate pretreatment diagnosis of solid tumours by morphology, immunohistochemistry, genetics and molecular biology requires clinicians to obtain undamaged large core biopsies. Simultaneously, medical imaging and surgery give priority to minimal tissue injury, affordable technology and optimal patient compliance. A new large core soft tissue biopsy device has been developed to meet the above criteria. After intensive preclinical testing, 30 patients gave informed consent and 26 underwent the new diagnostic biopsy procedure. The sample was studied by morphology, immunohistochemistry and, where indicated, by molecular biology. Successful diagnosis was considered when in line with clinical follow-up and, as for all malignant lesions, when confirmed by open biopsy or surgery. No difficulties in the technique were encountered in 25 patients. In one patient the procedure was prematurely stopped because of anxiety. In all other 25 procedures a complete diagnosis was reached with regard to morphology, immunohistochemistry and molecular biology. A number of radiologists suggested some automation of the technique. This new large core soft tissue biopsy system performs well in the clinical context without injury to the breast parenchyma or artefacts in the harvested tissue specimen. The system meets almost all of the proposed technical and financial requirements. Automation is underway.
Subject(s)
Biopsy, Needle/methods , Soft Tissue Neoplasms/diagnosis , Soft Tissue Neoplasms/pathology , Artifacts , Automation , Biopsy, Needle/adverse effects , Diagnosis, Differential , Humans , ImmunohistochemistryABSTRACT
An abdominal ultrasound examination performed on two patients with abdominal pain showed segmental wall thickening of the colon that proved to be due to ischemic colitis. In one case, the typical "target lesion" was recognized. These findings could be confirmed with computed tomography, whereas a single contrast enema was unable to demonstrate the ischemic disease. In the second case, a typical five-layered structure of the bowel wall could be demonstrated. It is concluded that US can be useful in the early diagnosis of colonic ischemia.
Subject(s)
Colitis, Ischemic/diagnostic imaging , Cecum/blood supply , Cecum/diagnostic imaging , Colon, Sigmoid/blood supply , Colon, Sigmoid/diagnostic imaging , Female , Humans , Male , Middle Aged , Tomography, X-Ray Computed , UltrasonographyABSTRACT
A case of focal fatty infiltration of the liver (FFIL) with partly multinodular appearance and significant mass effect on computed tomography (CT) is presented. Mass effect in FFIL is sometimes seen with alcoholic liver disease and makes the differential diagnosis with malignant disease often difficult. Diagnosis of FFIL was confirmed on 1.5 T MR images.
Subject(s)
Fatty Liver, Alcoholic/diagnostic imaging , Liver Neoplasms/diagnostic imaging , Adult , Diagnosis, Differential , Fatty Liver, Alcoholic/diagnosis , Gadolinium , Humans , Liver Neoplasms/diagnosis , Magnetic Resonance Imaging , Male , Tomography, X-Ray ComputedABSTRACT
We present a case of duodenal leiomyosarcoma studied with computerized tomographic (CT) and magnetic resonance (MR) images. Some differential diagnostic remarks are mentioned. The topographic abilities of MR to determine the exact origin of the tumor are stressed. A stellar "scar", hypointense on T1 and hyperintense on T2-weighted images (1 Tesla) in association with gastrointestinal leiomyosarcoma was, at least to the best of our knowledge, never mentioned before in the literature.
Subject(s)
Duodenal Neoplasms/diagnosis , Leiomyosarcoma/diagnosis , Adult , Duodenal Neoplasms/diagnostic imaging , Duodenal Neoplasms/surgery , Female , Humans , Leiomyosarcoma/diagnostic imaging , Leiomyosarcoma/surgery , Magnetic Resonance Imaging , Tomography, X-Ray ComputedABSTRACT
The study of a 70-year-old woman with fibrosing pancreatitis, an uncommon variety of chronic pancreatitis, presenting as a discrete solid mass in the head of the pancreas, is reported. CT and US were non-diagnostic while ERCP and MR detected a focal anomaly. This case report stresses the sensitivity of MR in some pancreatic pathologies.
Subject(s)
Fibroma/diagnosis , Magnetic Resonance Imaging , Pancreatic Neoplasms/diagnosis , Pancreatitis/diagnosis , Aged , Cholangiopancreatography, Endoscopic Retrograde , Chronic Disease , Diagnosis, Differential , Female , Fibroma/surgery , Humans , Pancreatic Neoplasms/surgeryABSTRACT
We present the case of an 8-year-old male with intervertebral disc calcification at C2-C3. This uncommon entity has a very striking clinical and radiographic appearance. The course is mostly benign and therefore only needs conservative treatment.
