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Mansoori B, Kosaraju V, Yoon J, Chalian H, Shomal Zadeh F, Vo KV, Shafiei M, Prabhakar R, Chalian M. Incidental osseous lesions on chest CT: an algorithmic approach for radiologists. Clin Imaging 2022; 91:69-96. [PMID: 36037551 DOI: 10.1016/j.clinimag.2022.08.015] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/19/2022] [Revised: 08/01/2022] [Accepted: 08/17/2022] [Indexed: 11/29/2022]
Abstract
Numerous osseous findings are commonly discovered incidentally at chest CTs in daily practice. A broad spectrum of these findings ranges from benign and do not touch lesions to ominous conditions requiring further imaging evaluation and/or intervention. Interpretation of these incidental musculoskeletal findings may constitute a diagnostic challenge to radiologists. This review provides a systematic, algorithmic approach to common osseous lesions on chest CT based on imaging findings with recommendations for proper next step management.
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Affiliation(s)
- Bahar Mansoori
- Division of Abdominal Imaging, Department of Radiology, University of Washington, Seattle, WA, United States of America
| | - Vijaya Kosaraju
- Division of Musculoskeletal Imaging, Department of Radiology, University Hospitals Cleveland Medical Center, Case Western Reserve University, Cleveland, OH, United States of America
| | - James Yoon
- Department of Radiology, UT Southwestern Medical Center, Dallas, TX, United States of America
| | - Hamid Chalian
- Division of Cardiothoracic Imaging, Department of Radiology, University of Washington, Seattle, WA, United States of America
| | - Firoozeh Shomal Zadeh
- Division of Musculoskeletal Imaging and Intervention, Department of Radiology, University of Washington, Seattle, WA, United States of America
| | - Kiet V Vo
- Division of Musculoskeletal Imaging and Intervention, Department of Radiology, University of Washington, Seattle, WA, United States of America
| | - Mehrzad Shafiei
- Division of Musculoskeletal Imaging and Intervention, Department of Radiology, University of Washington, Seattle, WA, United States of America
| | - Rajiah Prabhakar
- Cardiovascular Imaging Section, Department of Radiology, Mayo Clinic, Rochester, MN, United States of America
| | - Majid Chalian
- Division of Musculoskeletal Imaging and Intervention, Department of Radiology, University of Washington, Seattle, WA, United States of America.
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Hamartochondroma Pleural Lesion Mimicking Liposarcoma: A Case Report. Curr Oncol 2022; 29:3489-3493. [PMID: 35621671 PMCID: PMC9140095 DOI: 10.3390/curroncol29050281] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/30/2022] [Revised: 05/02/2022] [Accepted: 05/06/2022] [Indexed: 12/05/2022] Open
Abstract
Heterogeneous masses developing in the pleural cavity are most often malignant and can pose diagnostic challenges. Fibrous tumors of the pleura, liposarcoma, thymoma or lipoma most frequently affect this anatomic area. Surgical exploration and resection are often mandatory to make the definitive diagnosis. We report the case of a 54-year-old women who presented with an epigastric and right sub costal pain. A complete preoperative workup revealed a large tissular and fatty mass in the right costo-diaphragmatic angle suggestive of liposarcoma. Surgical resection resulted in the surprising diagnosis of hamartochondroma.
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Mansour J, Raptis D, Bhalla S, Heeger AP, Abbott GF, Parkar N, Hammer MM, Kiernan J, Raptis C. Diagnostic and Imaging Approaches to Chest Wall Lesions. Radiographics 2022; 42:359-378. [PMID: 35089819 DOI: 10.1148/rg.210095] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
Chest wall lesions are relatively uncommon and may be challenging once they are encountered on images. Radiologists may detect these lesions incidentally at examinations performed for other indications, or they may be asked specifically to evaluate a suspicious lesion. While many chest wall lesions have characteristic imaging findings that can result in an accurate diagnosis with use of imaging alone, other entities are difficult to distinguish at imaging because there is significant overlap among them. The interpreting radiologist should be familiar with the imaging features of both "do not touch" benign entities (which can be confidently diagnosed with imaging only, with no need for biopsy or resection unless the patient is symptomatic) and lesions that cannot be confidently characterized and thus require further workup. CT and MRI are the main imaging modalities used to assess the chest wall, with each having different benefits and drawbacks. Chest wall lesions can be classified according to their predominant composition: fat, calcification and ossification, soft tissue, or fluid. The identification or predominance of signal intensities or attenuation for these findings, along with the patient age, clinical history, and lesion location, can help establish the appropriate differential diagnosis. In addition, imaging findings in other organs, such as the lungs or upper abdomen, can at times provide clues to the underlying diagnosis. The authors review different chest wall lesions classified on the basis of their composition and highlight the imaging findings that can assist the radiologist in narrowing the differential diagnosis and guiding management. ©RSNA, 2022.
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Affiliation(s)
- Joseph Mansour
- From the Mallinckrodt Institute of Radiology, Washington University School of Medicine, St Louis, Mo (J.M., D.R., S.B., C.R.); Department of Radiology, Massachusetts General Hospital, Boston, Mass (A.P.H., G.F.A.); Department of Radiology, Cleveland Clinic, Cleveland, Ohio (N.P.); Department of Radiology, Brigham and Women's Hospital, Boston, Mass (M.M.H.); and Department of Radiology, St Louis University Hospital, St Louis, Mo (J.K.)
| | - Demetrios Raptis
- From the Mallinckrodt Institute of Radiology, Washington University School of Medicine, St Louis, Mo (J.M., D.R., S.B., C.R.); Department of Radiology, Massachusetts General Hospital, Boston, Mass (A.P.H., G.F.A.); Department of Radiology, Cleveland Clinic, Cleveland, Ohio (N.P.); Department of Radiology, Brigham and Women's Hospital, Boston, Mass (M.M.H.); and Department of Radiology, St Louis University Hospital, St Louis, Mo (J.K.)
| | - Sanjeev Bhalla
- From the Mallinckrodt Institute of Radiology, Washington University School of Medicine, St Louis, Mo (J.M., D.R., S.B., C.R.); Department of Radiology, Massachusetts General Hospital, Boston, Mass (A.P.H., G.F.A.); Department of Radiology, Cleveland Clinic, Cleveland, Ohio (N.P.); Department of Radiology, Brigham and Women's Hospital, Boston, Mass (M.M.H.); and Department of Radiology, St Louis University Hospital, St Louis, Mo (J.K.)
| | - Allen P Heeger
- From the Mallinckrodt Institute of Radiology, Washington University School of Medicine, St Louis, Mo (J.M., D.R., S.B., C.R.); Department of Radiology, Massachusetts General Hospital, Boston, Mass (A.P.H., G.F.A.); Department of Radiology, Cleveland Clinic, Cleveland, Ohio (N.P.); Department of Radiology, Brigham and Women's Hospital, Boston, Mass (M.M.H.); and Department of Radiology, St Louis University Hospital, St Louis, Mo (J.K.)
| | - Gerald F Abbott
- From the Mallinckrodt Institute of Radiology, Washington University School of Medicine, St Louis, Mo (J.M., D.R., S.B., C.R.); Department of Radiology, Massachusetts General Hospital, Boston, Mass (A.P.H., G.F.A.); Department of Radiology, Cleveland Clinic, Cleveland, Ohio (N.P.); Department of Radiology, Brigham and Women's Hospital, Boston, Mass (M.M.H.); and Department of Radiology, St Louis University Hospital, St Louis, Mo (J.K.)
| | - Nadeem Parkar
- From the Mallinckrodt Institute of Radiology, Washington University School of Medicine, St Louis, Mo (J.M., D.R., S.B., C.R.); Department of Radiology, Massachusetts General Hospital, Boston, Mass (A.P.H., G.F.A.); Department of Radiology, Cleveland Clinic, Cleveland, Ohio (N.P.); Department of Radiology, Brigham and Women's Hospital, Boston, Mass (M.M.H.); and Department of Radiology, St Louis University Hospital, St Louis, Mo (J.K.)
| | - Mark M Hammer
- From the Mallinckrodt Institute of Radiology, Washington University School of Medicine, St Louis, Mo (J.M., D.R., S.B., C.R.); Department of Radiology, Massachusetts General Hospital, Boston, Mass (A.P.H., G.F.A.); Department of Radiology, Cleveland Clinic, Cleveland, Ohio (N.P.); Department of Radiology, Brigham and Women's Hospital, Boston, Mass (M.M.H.); and Department of Radiology, St Louis University Hospital, St Louis, Mo (J.K.)
| | - Julia Kiernan
- From the Mallinckrodt Institute of Radiology, Washington University School of Medicine, St Louis, Mo (J.M., D.R., S.B., C.R.); Department of Radiology, Massachusetts General Hospital, Boston, Mass (A.P.H., G.F.A.); Department of Radiology, Cleveland Clinic, Cleveland, Ohio (N.P.); Department of Radiology, Brigham and Women's Hospital, Boston, Mass (M.M.H.); and Department of Radiology, St Louis University Hospital, St Louis, Mo (J.K.)
| | - Constantine Raptis
- From the Mallinckrodt Institute of Radiology, Washington University School of Medicine, St Louis, Mo (J.M., D.R., S.B., C.R.); Department of Radiology, Massachusetts General Hospital, Boston, Mass (A.P.H., G.F.A.); Department of Radiology, Cleveland Clinic, Cleveland, Ohio (N.P.); Department of Radiology, Brigham and Women's Hospital, Boston, Mass (M.M.H.); and Department of Radiology, St Louis University Hospital, St Louis, Mo (J.K.)
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Kolta MFF, El Rheem NKA, Ibrahim AF, El-Mageed MRA. The role of MRI in comparison between benign and malignant chest wall masses in correlation with pathology. THE EGYPTIAN JOURNAL OF RADIOLOGY AND NUCLEAR MEDICINE 2021. [DOI: 10.1186/s43055-021-00449-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
Abstract
Abstract
Background
Tumors that arise from the chest wall (including bone structures such as the sternum, clavicle, scapula, and ribs) or from adjacent soft tissues are less common than other parts of the body, and so the resulting unfamiliarity can make it difficult to limit the number of possible diagnoses. These tumors have a wide range of possibilities, including primary chest wall tumors arising from the bone or soft tissue, which are subdivided into malignant and benign tumors, and the secondary metastatic deposits. The aim of the study is to investigate the ability of MRI with diffusion sequence in differentiation between benign and malignant chest wall masses, which is subsequently reflected in the management of chest wall masses patients.
Main body
MRI has superior soft-tissue resolution and value for local assessment of primary tumors and accurate tissue characterization and plays a key role in preoperative staging to assess for multi-spatial and multi-compartment involvement. ADC values were obtained in 31 patients, and the mean ADC values of benign (13 patients) chest wall masses were 1.31 ± 0.50 × 10−3 mm2/s while the mean ADC values of the malignant (18 patients) chest wall masses were 0.98 ± 0.36 × 10−3 mm2/s. There was a statistically significant difference between the ADC values obtained from the malignant and benign chest wall masses (P < 0.001).
Conclusion
This study demonstrates that diffusion-weighted MR imaging is a growing imaging modality to predict the histopathological differentiation of malignant from benign chest wall masses.
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Solitary osteochondroma affecting the rib and adjacent vertebral body: a case with atypical radiology features. Radiol Case Rep 2021; 16:2038-2042. [PMID: 34158888 PMCID: PMC8203576 DOI: 10.1016/j.radcr.2021.05.023] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/30/2021] [Revised: 05/06/2021] [Accepted: 05/07/2021] [Indexed: 11/22/2022] Open
Abstract
Costal osteochondroma is an uncommon primary benign tumor. Thorough radiological and pathological examinations should be performed to avoid misdiagnosis. Herein, we describe a case of a surgically resected costal osteochondroma in 23-year-old man. The aim of this report is the value of cartilage cap on imaging, leading to a correct preoperative impression. We also present a brief review of existing literature on costal osteochondroma.
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Poropat F, Bevacqua M, Giorgi R, Dibello D, Cattaruzzi E, Barbi E. Painful swelling of the clavicle. Arch Dis Child Educ Pract Ed 2019; 104:211-213. [PMID: 29973345 DOI: 10.1136/archdischild-2018-315417] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/28/2018] [Accepted: 06/09/2018] [Indexed: 11/03/2022]
Affiliation(s)
- Federico Poropat
- Institute for Maternal and Child Health, IRCCS Burlo Garofolo, Trieste, Italy
| | | | - Rita Giorgi
- Institute for Maternal and Child Health, IRCCS Burlo Garofolo, Trieste, Italy
| | - Daniela Dibello
- Institute for Maternal and Child Health, IRCCS Burlo Garofolo, Trieste, Italy
| | | | - Egidio Barbi
- Institute for Maternal and Child Health, IRCCS Burlo Garofolo, Trieste, Italy.,University of Trieste, Trieste, Italy
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Abstract
Primary chest wall neoplasms are uncommon and comprise a heterogeneous group of lesions that may be challenging to classify and diagnose. These tumors may be primary or secondary, malignant or benign, and arise from cartilaginous/osseous structures or soft tissues. The role of magnetic resonance (MR) imaging in the evaluation of chest wall tumors continues to expand given its superior soft tissue contrast relative to computed tomography. MR imaging can facilitate differentiation of neoplasms from normal chest wall structures and other disease processes due to infection and inflammation, and can fully characterize abnormalities by demonstrating the various internal components of complex lesions. It is important that radiologists be able to identify key features of primary chest wall neoplasms on MR imaging to provide focused differential diagnoses and guide patient management.
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Nummela MT, Bensch FV, Pyhältö TT, Koskinen SK. Incidence and Imaging Findings of Costal Cartilage Fractures in Patients with Blunt Chest Trauma: A Retrospective Review of 1461 Consecutive Whole-Body CT Examinations for Trauma. Radiology 2017; 286:696-704. [PMID: 29095676 DOI: 10.1148/radiol.2017162429] [Citation(s) in RCA: 25] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/16/2023]
Abstract
Purpose To assess the incidence of costal cartilage (CC) fractures in whole-body computed tomographic (CT) examinations for blunt trauma and to evaluate distribution of CC fractures, concomitant injuries, mechanism of injury, accuracy of reporting, and the effect on 30-day mortality. Materials and Methods Institutional review board approval was obtained for this retrospective study. All whole-body CT examinations for blunt trauma over 36 months were reviewed retrospectively and chest trauma CT studies were evaluated by a second reader. Of 1461 patients who underwent a whole-body CT examination, 39% (574 of 1461) had signs of thoracic injuries (men, 74.0% [425 of 574]; mean age, 46.6 years; women, 26.0% [149 of 574]; mean age, 48.9 years). χ2 and odds ratios (ORs) with 95% confidence intervals (CIs) were calculated. Interobserver agreement was calculated by using Cohen kappa values. Results A total of 114 patients (men, 86.8% [99 of 114]; mean age, 48.6 years; women, 13.2% [15 of 114]; mean age, 45.1 years) had 221 CC fractures. The incidence was 7.8% (114 of 1461) in all whole-body CT examinations and 19.9% (114 of 574) in patients with thoracic trauma. Cartilage of rib 7 (21.3%, 47 of 221) was most commonly injured. Bilateral multiple consecutive rib fractures occurred in 36% (41 of 114) versus 14% (64 of 460) in other patients with chest trauma (OR, 3.48; 95% CI: 2.18, 5.53; P < .0001). Hepatic injuries were more common in patients with chest trauma with CC fractures (13%, 15 of 114) versus patients with chest trauma without CC fractures (4%, 18 of 460) (OR, 3.72; 95% CI: 1.81, 7.64; P = .0001), as well as aortic injuries (n = 4 vs n = 0; P = .0015; OR, unavailable). Kappa value for interobserver agreement in detecting CC fractures was 0.65 (substantial agreement). CC fractures were documented in 39.5% (45 of 114) of primary reports. The 30-day mortality of patients with CC fractures was 7.02% (eight of 114) versus 4.78% (22 of 460) of other patients with chest trauma (OR, 1.50; 95% CI: 0.65, 3.47; P = .3371). Conclusion CC fractures are common in high-energy blunt chest trauma and often occur with multiple consecutive rib fractures. Aortic and hepatic injuries were more common in patients with CC fractures than in patients without CC fractures. © RSNA, 2017.
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Affiliation(s)
- Mari T Nummela
- From the Department of Radiology, HUS Medical Imaging (M.T.N., F.V.B.), and Department of Orthopedics and Traumatology (T.T.P.), Töölö Hospital, Helsinki University Hospital, PL 266, 00029 Helsinki, Finland; Department of Clinical Science, Intervention and Technology, Karolinska Institute, Stockholm, Sweden (S.K.K.); and Department of Radiology, Karolinska University Hospital Huddinge, Stockholm, Sweden (S.K.K.)
| | - Frank V Bensch
- From the Department of Radiology, HUS Medical Imaging (M.T.N., F.V.B.), and Department of Orthopedics and Traumatology (T.T.P.), Töölö Hospital, Helsinki University Hospital, PL 266, 00029 Helsinki, Finland; Department of Clinical Science, Intervention and Technology, Karolinska Institute, Stockholm, Sweden (S.K.K.); and Department of Radiology, Karolinska University Hospital Huddinge, Stockholm, Sweden (S.K.K.)
| | - Tuomo T Pyhältö
- From the Department of Radiology, HUS Medical Imaging (M.T.N., F.V.B.), and Department of Orthopedics and Traumatology (T.T.P.), Töölö Hospital, Helsinki University Hospital, PL 266, 00029 Helsinki, Finland; Department of Clinical Science, Intervention and Technology, Karolinska Institute, Stockholm, Sweden (S.K.K.); and Department of Radiology, Karolinska University Hospital Huddinge, Stockholm, Sweden (S.K.K.)
| | - Seppo K Koskinen
- From the Department of Radiology, HUS Medical Imaging (M.T.N., F.V.B.), and Department of Orthopedics and Traumatology (T.T.P.), Töölö Hospital, Helsinki University Hospital, PL 266, 00029 Helsinki, Finland; Department of Clinical Science, Intervention and Technology, Karolinska Institute, Stockholm, Sweden (S.K.K.); and Department of Radiology, Karolinska University Hospital Huddinge, Stockholm, Sweden (S.K.K.)
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Carter BW, Benveniste MF, Betancourt SL, de Groot PM, Lichtenberger JP, Amini B, Abbott GF. Imaging Evaluation of Malignant Chest Wall Neoplasms. Radiographics 2016; 36:1285-306. [PMID: 27494286 DOI: 10.1148/rg.2016150208] [Citation(s) in RCA: 37] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
Neoplasms of the chest wall are uncommon lesions that represent approximately 5% of all thoracic malignancies. These tumors comprise a heterogeneous group of neoplasms that may arise from osseous structures or soft tissues, and they may be malignant or benign. More than 50% of chest wall neoplasms are malignancies and include tumors that may arise as primary malignancies or secondarily involve the chest wall by way of direct invasion or metastasis from intrathoracic or extrathoracic neoplasms. Although 20% of chest wall tumors may be detected at chest radiography, chest wall malignancies are best evaluated with cross-sectional imaging, principally multidetector computed tomography (CT) and magnetic resonance (MR) imaging, each of which has distinct strengths and limitations. Multidetector CT is optimal for depicting bone, muscle, and vascular structures, whereas MR imaging renders superior soft-tissue contrast and spatial resolution and is better for delineating the full extent of disease. Fluorine 18 fluorodeoxyglucose (FDG) positron emission tomography (PET)/CT is not routinely performed to evaluate chest wall malignancies. The primary functions of PET/CT in this setting include staging of disease, evaluation of treatment response, and detection of recurrent disease. Ultrasonography has a limited role in the evaluation and characterization of superficial chest wall lesions; however, it can be used to guide biopsy and has been shown to depict chest wall invasion by lung cancer more accurately than CT. It is important that radiologists be able to identify the key multidetector CT and MR imaging features that can be used to differentiate malignant from benign chest lesions, suggest specific histologic tumor types, and ultimately guide patient treatment. (©)RSNA, 2016.
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Affiliation(s)
- Brett W Carter
- From the Department of Diagnostic Radiology, Division of Diagnostic Imaging, University of Texas MD Anderson Cancer Center, 1515 Holcombe Blvd, Unit 1478, Houston, TX 77030 (B.W.C., M.F.B., S.L.B., P.M.d.G., B.A.); Department of Radiology and Radiological Sciences, Uniformed Services University of the Health Sciences, Bethesda, Md (J.P.L.); and Department of Radiology, Massachusetts General Hospital, Boston, Mass (G.F.A.)
| | - Marcelo F Benveniste
- From the Department of Diagnostic Radiology, Division of Diagnostic Imaging, University of Texas MD Anderson Cancer Center, 1515 Holcombe Blvd, Unit 1478, Houston, TX 77030 (B.W.C., M.F.B., S.L.B., P.M.d.G., B.A.); Department of Radiology and Radiological Sciences, Uniformed Services University of the Health Sciences, Bethesda, Md (J.P.L.); and Department of Radiology, Massachusetts General Hospital, Boston, Mass (G.F.A.)
| | - Sonia L Betancourt
- From the Department of Diagnostic Radiology, Division of Diagnostic Imaging, University of Texas MD Anderson Cancer Center, 1515 Holcombe Blvd, Unit 1478, Houston, TX 77030 (B.W.C., M.F.B., S.L.B., P.M.d.G., B.A.); Department of Radiology and Radiological Sciences, Uniformed Services University of the Health Sciences, Bethesda, Md (J.P.L.); and Department of Radiology, Massachusetts General Hospital, Boston, Mass (G.F.A.)
| | - Patricia M de Groot
- From the Department of Diagnostic Radiology, Division of Diagnostic Imaging, University of Texas MD Anderson Cancer Center, 1515 Holcombe Blvd, Unit 1478, Houston, TX 77030 (B.W.C., M.F.B., S.L.B., P.M.d.G., B.A.); Department of Radiology and Radiological Sciences, Uniformed Services University of the Health Sciences, Bethesda, Md (J.P.L.); and Department of Radiology, Massachusetts General Hospital, Boston, Mass (G.F.A.)
| | - John P Lichtenberger
- From the Department of Diagnostic Radiology, Division of Diagnostic Imaging, University of Texas MD Anderson Cancer Center, 1515 Holcombe Blvd, Unit 1478, Houston, TX 77030 (B.W.C., M.F.B., S.L.B., P.M.d.G., B.A.); Department of Radiology and Radiological Sciences, Uniformed Services University of the Health Sciences, Bethesda, Md (J.P.L.); and Department of Radiology, Massachusetts General Hospital, Boston, Mass (G.F.A.)
| | - Behrang Amini
- From the Department of Diagnostic Radiology, Division of Diagnostic Imaging, University of Texas MD Anderson Cancer Center, 1515 Holcombe Blvd, Unit 1478, Houston, TX 77030 (B.W.C., M.F.B., S.L.B., P.M.d.G., B.A.); Department of Radiology and Radiological Sciences, Uniformed Services University of the Health Sciences, Bethesda, Md (J.P.L.); and Department of Radiology, Massachusetts General Hospital, Boston, Mass (G.F.A.)
| | - Gerald F Abbott
- From the Department of Diagnostic Radiology, Division of Diagnostic Imaging, University of Texas MD Anderson Cancer Center, 1515 Holcombe Blvd, Unit 1478, Houston, TX 77030 (B.W.C., M.F.B., S.L.B., P.M.d.G., B.A.); Department of Radiology and Radiological Sciences, Uniformed Services University of the Health Sciences, Bethesda, Md (J.P.L.); and Department of Radiology, Massachusetts General Hospital, Boston, Mass (G.F.A.)
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Skeletal muscle metastases on magnetic resonance imaging: analysis of 31 cases. Contemp Oncol (Pozn) 2016; 20:242-50. [PMID: 27647989 PMCID: PMC5013688 DOI: 10.5114/wo.2016.61568] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/08/2014] [Accepted: 11/19/2014] [Indexed: 12/21/2022] Open
Abstract
Aim of the study To investigate the magnetic resonance imaging (MRI) features of skeletal muscle metastases (SMM). Material and methods The records of 31 patients with proven SMM were retrospectively reviewed. Clinical history, type of primary malignancy, location of metastases, and MRI features of SMM were evaluated. Based on MRI findings, SMM were divided into three MRI types. The correlation between MRI types with ages and pathology category, between MRI types of SMM and ages, as well as MRI types of SMM and pathology category were analysed with Spearman's rho. Results The most common primary tumour was genital tumour (25.8%) and bronchial carcinoma (19.4%), and the most common cell type was adenocarcinoma (58.1%). SMM were located in the iliopsoas muscle (26.3%), paravertebral muscles (21.1%), and upper extremity muscles (18.4%). MRI features: (1) Type-I localised lesions (12.90%), round-like mass limited to local regions with heterogeneous iso-signal intensity in T1WI and heterogeneous hyper-intensity in T2WI; (2) Type-II diffuse lesions without bone destruction (35.48%), abnormal diffuse swelling of the muscle with irregular boundaries and slightly hypo- to iso-intensity in T1WI and hyper-intensity in T2WI; and (3) Type-III diffuse lesions with bone destruction (51.61%), distinct irregular lump with iso-intensity in T1WI and heterogeneous hyper-intensity in T2WI with adjacent bone invasion. There was positive correlation between MRI types and ages (r = 0.431, p < 0.05). There were no significant differences of MRI types with pathology category (p > 0.05). Conclusions SMM features on MRI can be broadly used to classify lesions, which is beneficial for SMM diagnosis.
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Lee RKL, Griffith JF, Ng AWH, Sitt JCM. Sonography of the chest wall: A pictorial essay. JOURNAL OF CLINICAL ULTRASOUND : JCU 2015; 43:525-537. [PMID: 26265305 DOI: 10.1002/jcu.22286] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/07/2015] [Accepted: 05/25/2015] [Indexed: 06/04/2023]
Abstract
Ultrasound (US) is increasingly being used as the first-line imaging modality for investigating the chest wall for soft tissue and bony lesions. This article describes the technique used for the US examination, the relevant chest-wall anatomy, and the appearances on US scanning of pathologic entities either unique to or common in the region of the chest wall.
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Affiliation(s)
- Ryan Ka Lok Lee
- Department of Imaging and Interventional Radiology, Prince of Wales Hospital, Hong Kong
- The Chinese University of Hong Kong, Hong Kong
| | - James Francis Griffith
- Department of Imaging and Interventional Radiology, Prince of Wales Hospital, Hong Kong
- The Chinese University of Hong Kong, Hong Kong
| | - Alex Wing Hung Ng
- Department of Imaging and Interventional Radiology, Prince of Wales Hospital, Hong Kong
- The Chinese University of Hong Kong, Hong Kong
| | - Jacqueline Ching Man Sitt
- Department of Imaging and Interventional Radiology, Prince of Wales Hospital, Hong Kong
- The Chinese University of Hong Kong, Hong Kong
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Abstract
OBJECTIVE This article reviews the imaging and histopathologic findings of various axillary diseases and suggests management guidelines for radiologists based on imaging findings with clinical correlation. CONCLUSION Although axillary diseases may reveal nonspecific imaging findings, a knowledge of the characteristic radiologic manifestations of specific diseases according to anatomic origin (nodal, accessory breast, adipocytic, fibrous, nerve, vascular, stromal, and dermal) and postsurgical lesions aids in establishing an appropriate differential diagnosis and determining whether intervention is necessary.
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David EA, Marshall MB. Review of chest wall tumors: a diagnostic, therapeutic, and reconstructive challenge. Semin Plast Surg 2012; 25:16-24. [PMID: 22294939 DOI: 10.1055/s-0031-1275167] [Citation(s) in RCA: 49] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/16/2022]
Abstract
Chest wall tumors are a heterogeneous group of lesions that provide an interesting diagnostic and therapeutic challenge for surgeons. They make up less than 5% of thoracic malignancies and vary widely in pathology as they arise from all anatomic structures of the chest wall. In general, treatment is wide local excision, the margins for malignant disease are necessarily wider, and adjuvant radiation is typically given for those with positive margins. Chemotherapy is rarely effective. Local control is the most important prognostic factor. Disease-free survival for malignant disease is limited by positive margins; therefore full oncologic resection with 4-cm margins should be attempted. For small lesions, the resection and reconstruction is usually straightforward. For more advanced disease or those lesions that require significant functional loss, preoperative planning using a multidisciplinary approach, incorporating thoracic surgery, plastic surgery, neurosurgery, radiation medicine, oncology, and physical medicine and rehabilitation, may be essential.
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Restrepo R, Lee EY. Updates on Imaging of Chest Wall Lesions in Pediatric Patients. Semin Roentgenol 2012; 47:79-89. [DOI: 10.1053/j.ro.2011.07.007] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
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