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2.
Radiol Case Rep ; 14(5): 584-587, 2019 May.
Artigo em Inglês | MEDLINE | ID: mdl-30891107

RESUMO

Extramedullary plasmacytoma of the breast (EPB), a manifestation of multiple myeloma (MM), is very rare. It is important to recognize the imaging findings of EPB because it may be the first manifestation of relapsed MM. An 85-year-old woman presented with a lump in her right breast 4 years after the complete remission of MM. She underwent mammography and ultrasonography, which showed an oval circumscribed mass and an irregular circumscribed heterogeneous solid mass, respectively. Following ultrasound-guided vacuum-assisted breast biopsy, this lesion was confirmed to be EPB. Whole-body computed tomography showed multiple new osteolytic lesions and other multiple extramedullary lesions in addition to EPB in the right breast. The final diagnosis was relapsed MM with multiple extramedullary plasmacytoma.

3.
Jpn J Radiol ; 36(11): 629-640, 2018 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-30194586

RESUMO

The internal mammary lymph node (IMLN) chain is a pathway through which breast lymphatic drainage flows. The internal mammary lymphatic vessel runs around the internal mammary artery and veins with IMLN in the parasternal intercostal spaces. IMLN metastasis, which forms a part of clinical TNM staging, may negatively affect the prognosis of primary breast cancer patients. IMLN metastasis is clinically detected using ultrasound, computed tomography, magnetic resonance imaging, and 18F-deoxyglucose positron emission tomography computed tomography. The uptake of radioactive tracers in IMLN with clinically negative axillary lymph nodes is often identified using sentinel lymph node mapping (SLNM) in primary breast cancer patients. The indication for IMLN biopsy or resection that is clinically detected or visualized using SLNM is controversial. The clinically suspicious IMLN may be considered for ultrasound-guided fine-needle aspiration. First IMLN recurrence needs to be biopsied. Irradiation of the breast, chest wall, and/or regional nodal irradiation, including IMLN, following lumpectomy or postmastectomy is recommended. Although radiation therapy for IMLN recurrence may improve clinical outcomes, it is also associated with pulmonary and cardiac toxicities. This review covers the local anatomy of IMLN, lymph drainage and image findings of IMLN with a discussion.


Assuntos
Neoplasias da Mama/patologia , Diagnóstico por Imagem/métodos , Linfonodos/diagnóstico por imagem , Metástase Linfática/diagnóstico por imagem , Adulto , Mama/diagnóstico por imagem , Mama/patologia , Feminino , Humanos , Linfonodos/anatomia & histologia , Linfonodos/patologia , Artéria Torácica Interna/diagnóstico por imagem , Pessoa de Meia-Idade , Biópsia de Linfonodo Sentinela
4.
Eur J Radiol ; 91: 116-123, 2017 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-28629557

RESUMO

OBJECTIVE: To assess the value of contrast-enhanced MRI, apparent diffusion coefficient (ADC) measurement, and CA-125 measurement for differentiating borderline ovarian tumors (BOTs) from stage I malignant epithelial ovarian tumors (MEOTs). MATERIAL AND METHODS: This retrospective study included 43 patients with BOTs and 43 patients with stage I MEOTs who underwent contrast-enhanced MRI with DWI and CA-125 analysis. Two radiologists evaluated the MRI findings in consensus. Univariate and multivariate analyses were performed to detect the best predictor variables for MEOTs. RESULTS: Mixed cystic/solid and predominantly solid appearances, as well as thickened irregular septa, were more frequent in MEOTs. A papillary architecture and internal branching (PA&IB) pattern was more frequent in BOTs. MEOTs had thicker walls and septa, larger solid components, and higher CA-125 values. The mean ADC value of solid components (ADCmean) and minimum ADC value of whole lesions (ADCmin) were lower in MEOTs. Multivariate analysis revealed that ADCmin and maximum diameter of the solid components were independent indicators of MEOTs with an AUC, sensitivity, and specificity of 0.86, 81%, and 84%, respectively. CONCLUSION: ADCmin and maximum diameter of solid components were useful for differentiating BOTs from MEOTs.


Assuntos
Imageamento por Ressonância Magnética/mortalidade , Neoplasias Ovarianas/diagnóstico , Diagnóstico Diferencial , Feminino , Humanos , Modelos Logísticos , Neoplasias Ovarianas/patologia , Estudos Retrospectivos , Sensibilidade e Especificidade
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