Role of elastosonography in the differentiation between benign and malignant neoformations of the breast and possibility of reducing the number of FNACS for tissue characterization.

INTRODUCTION: Background The aim of the paper is related to our experience defining the diagnostic accuracy of breast elastosonog-raphy. OBJECTIVE: The aim of our study is therefore to define the diagnostic accuracy of breast elastosonography in the differential diagnosis of nodular breast neoformations to improve the characterization of the solid lesion and reduce the number of needle aspiration unnecessary for benign formations. MATERIAL AND METHODS: A total of 88 patients were enrolled, who came to the Department with an ultrasound diagnosis of a breast lesion. Each lesion was subjected to mammography and B-mode ultrasonogra-phy with an evaluation of size, echogenicity, and vascularization pres-ence or absence. The use of the ultrasound machine and the respective probe has made it possible to make the measurements. All nodules were subjected to ultrasound-guided FNAC. These data were compared with the results of elastosonographic examination. RESULTS: FNAC results were as follows: CIN 1 in 18 nodules, CIN 2 in 22 nodules, CIN 3 in 36 nodules, CIN 4 in 6 nodules, and CIN 5 in 6 nodules. The sensitivity and specificity of elastosonography found in our case series reported values in line with data reported in the literature, confirming the method's high reliability. CONCLUSIONS: The elastosonography could become a complemen-tary technique to mammography and ultrasonography in the future, reducing the costs and risks of additional examinations. Therefore, we believe it is essential to contribute with this additional finding to increasingly accredit this pathway and reduce the discomfort to patients of more invasive methods.

Unusual presentation of metastatic thyroid cancer without a primary: role of diagnostic imaging in a daily clinical setting.

Papillary thyroid carcinoma (PTC) is the most common mali gnancy of the thyroid gland. In 21-90% of the patients occult lymph node metastases may occur. The case reported here describes a woman who underwent a total thyroidectomy for multinodular goiter and who presented an enlarged lymph node on the left side of the neck, which showed a metastasis from PTC. The patient underwent imaging investigation with CT and FNAB. The pathological examination diagnosed a papillary thyroid cancer metastases. The pT underwent a I131 total body scan, negative for secondary localization.

Deep vein thrombosis of the lower limb secondary to lumbar discal hernia compression: a rarity? Review of the literature.

This case report is about a 70-years-old female patient, suffering from discal hernia, with compression of the iliac vein, that led to the formation of deep vein thrombosis of the lower limbs. The angio-CT scan revealed the starting point of the L4- L5 compression where a voluminous discal hernia caused deep vein thrombosis, with the involvement the femoro-popliteal venous axis. Blood samples and PET-CT scans excluded other possible etiologic factors. This case demonstrates how a voluminous discal hernia can cause venous thrombosis.

An unusual case of bilateral granulomatous mastitis.

Idiopathic granulomatous mastitis (IGM) is an uncommon benign disorder of the breast. At clinical examination, IGM is characterized by an inflammatory process of the breast, usually unilateral. Possible clinical findings are palpable mass with erythematous skin, pain, sterile abscesses, fistula and nipple retraction. Mammography and ultrasound findings are not specific for IGM. Magnetic resonance imaging (MRI) is a useful tool for the differential diagnosis; it is also necessary to delineate the exact extension of the disease and to plan the correct treatment. Final diagnosis is histological. We described an unusual case of IGM with bilateral involvement in a patient with history of pacemaker implantation and IGM typical clinical symptoms. Mammography, ultrasound, and MRI examinations were performed to identify the inflammatory disorder and to plan the correct therapy. Imaging features were correlated with final histological diagnosis of IGM.