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Kanthawang T, Pattamapaspong N, Peh WCG, Hammami N, Bouaziz MC, Ladeb MF. Imaging of infra-thoracic tuberculosis. Br J Radiol 2024; 97:492-504. [PMID: 38288505 DOI: 10.1093/bjr/tqad051] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/03/2023] [Revised: 11/16/2023] [Accepted: 11/29/2023] [Indexed: 03/01/2024] Open
Abstract
Tuberculosis (TB) is a potentially curable disease that is a leading cause of death globally. While it typically affects the lungs, this disease may involve many extra-pulmonary sites, particularly in patients with risk factors. Extra-pulmonary TB often mimics a variety of different diseases, posing a diagnostic dilemma. Imaging aids in early diagnosis of TB, especially in patients with non-specific or atypical symptoms found at extra-pulmonary infra-thoracic locations. Imaging also helps guide appropriate laboratory investigation, monitor disease progress, and response to treatment. This review aims to highlight the imaging spectrum of TB affecting the infra-thoracic region, that is, gastrointestinal tract, abdominal lymph nodes, peritoneal cavity, intra-abdominal solid organs, and urogenital system.
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Affiliation(s)
- Thanat Kanthawang
- Department of Radiology, Faculty of Medicine, Chiang Mai University, Chiang Mai 50200, Thailand
| | - Nuttaya Pattamapaspong
- Department of Radiology, Faculty of Medicine, Chiang Mai University, Chiang Mai 50200, Thailand
| | - Wilfred C G Peh
- Department of Diagnostic Radiology, Khoo Teck Puat Hospital, Singapore 768828
| | - Nadia Hammami
- Department of Neuroradiology, National Institute of Neurology Mongi Ben Hamida, Tunis 1007, Tunisia
| | - Mouna Chelli Bouaziz
- Department of Radiology, Faculty of Medicine of Tunis, MT Kassab Institute of Orthopaedics, Tunis-El Manar University, Ksar Said, Tunis 2010, Tunisia
| | - Mohamed Fethi Ladeb
- Department of Radiology, Faculty of Medicine of Tunis, MT Kassab Institute of Orthopaedics, Tunis-El Manar University, Ksar Said, Tunis 2010, Tunisia
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Aldana JC, Rodríguez LC, Bastidas N, Vásquez A. Radiological features of nephrocalcinosis, a common but forgotten entity. Br J Radiol 2023; 96:20221096. [PMID: 37194990 PMCID: PMC10392641 DOI: 10.1259/bjr.20221096] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/21/2022] [Revised: 01/16/2023] [Accepted: 04/14/2023] [Indexed: 05/18/2023] Open
Abstract
Nephrocalcinosis refers to calcium deposition in the form of calcium oxalate or calcium phosphate in the renal parenchyma and tubules. After diagnosis, the cause of nephrocalcinosis must be established to carry out a comprehensive approach to this entity. Although this is a common finding, it can be underdiagnosed due to the lack of knowledge of the different presentation patterns that exist. Many causes have been described related to this disease.A pictorial review about the most common features of cortical and medullary nephrocalcinosis both in ultrasound and CT is presented in the present work as well as a review of its main causes and graphics to easily recognize each pattern.
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Affiliation(s)
| | - Laura C. Rodríguez
- Radiology Resident, University of la Sabana, Chía, Cundinamarca, Colombia
| | - Nicolás Bastidas
- Medical student, University of la Sabana, Chía, Cundinamarca, Colombia
| | - Andrés Vásquez
- Radiologist at Fundación Clínica Shaio, Bogotá, Colombia
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Genitourinary Tuberculosis: A Comprehensive Review of a Neglected Manifestation in Low-Endemic Countries. Antibiotics (Basel) 2021; 10:antibiotics10111399. [PMID: 34827337 PMCID: PMC8614939 DOI: 10.3390/antibiotics10111399] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/28/2021] [Revised: 11/02/2021] [Accepted: 11/12/2021] [Indexed: 12/15/2022] Open
Abstract
Genitourinary tuberculosis (GUTB) represents a disease often underestimated by urological specialists, particularly in settings such as the European one, where the pathology is less frequent. Similar to other uncommon diseases at these latitudes, GUTB is a neglected clinical problem. In this light, the aim of this review is to give a comprehensive overview of GUTB in order to provide a useful tool for urologists who seldomly manage this disease. A non-systematic review of genitourinary tuberculosis was performed on relevant articles published from January 1990 to July 2021 using PubMed, Scopus, and the Cochrane Central Register of Controlled Trials. GUTB represents up to a quarter of extrapulmonary tuberculosis (EPTB) cases. Diagnostic, therapeutic and surgical work-up have been deeply reviewed and summarized. The mass migration of refugees to Europe as well as the ease of international travel is gradually leading to an upsurge in urological diseases such as GUTB, which were previously only rarely encountered in some European countries. The poor TB knowledge of European urologists should be improved through medical education courses, webinars or telematic means.
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Variables measured on three-dimensional computed tomography are preferred for predicting the outcomes of shock wave lithotripsy. World J Urol 2021; 40:569-575. [PMID: 34687343 DOI: 10.1007/s00345-021-03861-9] [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: 05/05/2021] [Accepted: 10/07/2021] [Indexed: 10/20/2022] Open
Abstract
PURPOSE Shock wave lithotripsy (SWL) is used to treat upper urinary tract stones. Recently, some volume analyzers have enabled preoperative assessment using three-dimensional computed tomography (3D-CT). We evaluated the efficacy of 3D-CT variables for predicting the outcomes of SWL. METHODS The study population included 193 patients who underwent SWL between November 2014 and August 2020. In addition to conventional two-dimensional computed tomography (2D-CT) assessments, 3D-CT assessments of targeted stones were retrospectively performed, and stone size and stone density (SD) were measured. The successful and unsuccessful treatment groups were compared and risk factors for an unsuccessful first SWL session were investigated. The predictive accuracy of variables measured on 3D-CT was evaluated by receiver operating characteristic curves and multivariate analyses. RESULTS The success rate of the first SWL session was 73.1%. Stone volume, mean SD and highest SD on 3D-CT were significantly higher in the unsuccessful group than in the successful group. Stone volume showed a higher area under the curve (AUC) than the estimated volumetric stone burden and stone diameter, which were measured on 2D-CT (0.729, 0.683, and 0.672, respectively). The AUCs of the mean SD and highest SD on 3D-CT were higher than those on 2D-CT (0.699, 0.680, 0.617, and 0.627, respectively). Multivariate analyses identified stone volume (≥ 0.29 ml), mean SD on 3D-CT (≥ 421 HU), and absence of hydronephrosis as independent predictive factors for unsuccessful SWL. CONCLUSION 3D-CT variables were promising predictors of the outcomes of SWL. Preoperative 3D-CT assessment is helpful for selecting favorable patients for SWL.
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An uncommon cause of nephrocalcinosis in an infant: Answers. Pediatr Nephrol 2021; 36:2097-2099. [PMID: 33528635 DOI: 10.1007/s00467-021-04942-y] [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: 12/14/2020] [Accepted: 01/08/2021] [Indexed: 10/22/2022]
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Zulfiqar M, Shetty A, Tsai R, Gagnon MH, Balfe DM, Mellnick VM. Diagnostic Approach to Benign and Malignant Calcifications in the Abdomen and Pelvis. Radiographics 2020; 40:731-753. [DOI: 10.1148/rg.2020190152] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
Affiliation(s)
- Maria Zulfiqar
- From the Mallinckrodt Institute of Radiology, Washington University School of Medicine, 510 S Kingshighway Blvd, St Louis, MO 63110
| | - Anup Shetty
- From the Mallinckrodt Institute of Radiology, Washington University School of Medicine, 510 S Kingshighway Blvd, St Louis, MO 63110
| | - Richard Tsai
- From the Mallinckrodt Institute of Radiology, Washington University School of Medicine, 510 S Kingshighway Blvd, St Louis, MO 63110
| | - Marie-Helene Gagnon
- From the Mallinckrodt Institute of Radiology, Washington University School of Medicine, 510 S Kingshighway Blvd, St Louis, MO 63110
| | - Dennis M. Balfe
- From the Mallinckrodt Institute of Radiology, Washington University School of Medicine, 510 S Kingshighway Blvd, St Louis, MO 63110
| | - Vincent M. Mellnick
- From the Mallinckrodt Institute of Radiology, Washington University School of Medicine, 510 S Kingshighway Blvd, St Louis, MO 63110
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Pathological Mineralization: The Potential of Mineralomics. MATERIALS 2019; 12:ma12193126. [PMID: 31557841 PMCID: PMC6804219 DOI: 10.3390/ma12193126] [Citation(s) in RCA: 24] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/27/2019] [Revised: 09/11/2019] [Accepted: 09/19/2019] [Indexed: 12/11/2022]
Abstract
Pathological mineralization has been reported countless times in the literature and is a well-known phenomenon in the medical field for its connections to a wide range of diseases, including cancer, cardiovascular, and neurodegenerative diseases. The minerals involved in calcification, however, have not been directly studied as extensively as the organic components of each of the pathologies. These have been studied in isolation and, for most of them, physicochemical properties are hitherto not fully known. In a parallel development, materials science methods such as electron microscopy, spectroscopy, thermal analysis, and others have been used in biology mainly for the study of hard tissues and biomaterials and have only recently been incorporated in the study of other biological systems. This review connects a range of soft tissue diseases, including breast cancer, age-related macular degeneration, aortic valve stenosis, kidney stone diseases, and Fahr’s syndrome, all of which have been associated with mineralization processes. Furthermore, it describes how physicochemical material characterization methods have been used to provide new information on such pathologies. Here, we focus on diseases that are associated with calcium-composed minerals to discuss how understanding the properties of these minerals can provide new insights on their origins, considering that different conditions and biological features are required for each type of mineral to be formed. We show that mineralomics, or the study of the properties and roles of minerals, can provide information which will help to improve prevention methods against pathological mineral build-up, which in the cases of most of the diseases mentioned in this review, will ultimately lead to new prevention or treatment methods for the diseases. Importantly, this review aims to highlight that chemical composition alone cannot fully support conclusions drawn on the nature of these minerals.
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8
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Urogenital tuberculosis - epidemiology, pathogenesis and clinical features. Nat Rev Urol 2019; 16:573-598. [PMID: 31548730 DOI: 10.1038/s41585-019-0228-9] [Citation(s) in RCA: 56] [Impact Index Per Article: 11.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/15/2019] [Indexed: 02/07/2023]
Abstract
Tuberculosis (TB) is the most common cause of death from infectious disease worldwide. A substantial proportion of patients presenting with extrapulmonary TB have urogenital TB (UG-TB), which can easily be overlooked owing to non-specific symptoms, chronic and cryptic protean clinical manifestations, and lack of clinician awareness of the possibility of TB. Delay in diagnosis results in disease progression, irreversible tissue and organ damage and chronic renal failure. UG-TB can manifest with acute or chronic inflammation of the urinary or genital tract, abdominal pain, abdominal mass, obstructive uropathy, infertility, menstrual irregularities and abnormal renal function tests. Advanced UG-TB can cause renal scarring, distortion of renal calyces and pelvic, ureteric strictures, stenosis, urinary outflow tract obstruction, hydroureter, hydronephrosis, renal failure and reduced bladder capacity. The specific diagnosis of UG-TB is achieved by culturing Mycobacterium tuberculosis from an appropriate clinical sample or by DNA identification. Imaging can aid in localizing site, extent and effect of the disease, obtaining tissue samples for diagnosis, planning medical or surgical management, and monitoring response to treatment. Drug-sensitive TB requires 6-9 months of WHO-recommended standard treatment regimens. Drug-resistant TB requires 12-24 months of therapy with toxic drugs with close monitoring. Surgical intervention as an adjunct to medical drug treatment is required in certain circumstances. Current challenges in UG-TB management include making an early diagnosis, raising clinical awareness, developing rapid and sensitive TB diagnostics tests, and improving treatment outcomes.
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Priante G, Ceol M, Gianesello L, Furlan C, Del Prete D, Anglani F. Human proximal tubular cells can form calcium phosphate deposits in osteogenic culture: role of cell death and osteoblast-like transdifferentiation. Cell Death Discov 2019; 5:57. [PMID: 30701089 PMCID: PMC6349935 DOI: 10.1038/s41420-019-0138-x] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/23/2018] [Revised: 12/18/2018] [Accepted: 12/21/2018] [Indexed: 12/12/2022] Open
Abstract
Nephrocalcinosis is a clinicopathological entity characterized by microscopic calcium crystals in the renal parenchyma, within the tubular lumen or in the interstitium. Crystal binding to tubular cells may be the cause underlying nephrocalcinosis and nephrolithiasis. Pathological circumstances, such as acute cortical necrosis, may induce healthy cells to acquire a crystal-binding phenotype. The present study aimed to investigate whether human renal proximal tubular cells (HK-2 cells) can form calcium phosphate deposits under osteogenic conditions, and whether apoptosis and/or osteogenic-like processes are involved in cell calcification. HK-2 cells were cultured in standard or osteogenic medium for 1, 5, and 15 days. Von Kossa staining and ESEM were used to analyze crystal deposition. Apoptosis was investigated, analyzing caspase activation by in-cell Western assay, membrane translocation of phosphotidylserine by annexin V-FITC/propidium iodide staining, and DNA fragmentation by TUNEL assay. qRT/PCR, immunolabeling and cytochemistry were performed to assess osteogenic activation (Runx2, Osteonectin, Osteopontin and ALP), and early genes of apoptosis (BAX, Bcl-2). HK-2 cell mineralization was successfully induced on adding osteogenic medium. Calcium phosphate deposition increased in a time-dependent manner, and calcified cell aggregates exhibited characteristic signs of apoptosis. At 15 days, calcifying HK-2 cells revealed osteogenic markers, such as Runx2, ALP, osteonectin and osteopontin. Monitoring the processes at 1, 5, and 15 days showed apoptosis starting already after 5 days of osteogenic induction, when the first small calcium phosphate crystals began to appear on areas where cell aggregates were in apoptotic conditions. The cell death process proved caspase-dependent. The importance of apoptosis was reinforced by the time-dependent increase in BAX expression, starting from day 1. These findings strongly support the hypothesis that apoptosis triggered HK-2 calcification even before any calcium phosphate crystal deposition or acquisition of an osteogenic phenotype.
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Affiliation(s)
- Giovanna Priante
- Laboratory of Kidney Histomorphology and Molecular Biology, Clinical Nephrology, Department of Medicine-DIMED, University of Padova, Padova, Italy
| | - Monica Ceol
- Laboratory of Kidney Histomorphology and Molecular Biology, Clinical Nephrology, Department of Medicine-DIMED, University of Padova, Padova, Italy
| | - Lisa Gianesello
- Laboratory of Kidney Histomorphology and Molecular Biology, Clinical Nephrology, Department of Medicine-DIMED, University of Padova, Padova, Italy
| | - Claudio Furlan
- Center for ESEM and SEM analyses (CEASC), University of Padova, Padova, Italy
| | - Dorella Del Prete
- Laboratory of Kidney Histomorphology and Molecular Biology, Clinical Nephrology, Department of Medicine-DIMED, University of Padova, Padova, Italy
| | - Franca Anglani
- Laboratory of Kidney Histomorphology and Molecular Biology, Clinical Nephrology, Department of Medicine-DIMED, University of Padova, Padova, Italy
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Chen X, Scapa JE, Liu DX, Godbey WT. Cancer-specific promoters for expression-targeted gene therapy: ran, brms1 and mcm5. J Gene Med 2018; 18:89-101. [PMID: 27140445 DOI: 10.1002/jgm.2882] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/23/2015] [Revised: 04/20/2016] [Accepted: 04/22/2016] [Indexed: 12/24/2022] Open
Abstract
BACKGROUND To expand the library of promoters that can be used for expression-targeted gene delivery to cancer cells, the specificity and strength of expression of three cancer-related gene promoters was evaluated: RAS-related nuclear protein ((P) ran), breast cancer metastasis suppressor 1 ((P) brms1) and minichromosome maintenance complex component 5 ((P) mcm5). METHODS The expression of reporter genes under the control of these promoters demonstrated selectivity in cancer cell lines of breast, prostate and ovarian origins versus a panel of normal cell types. The (P) ran was next used to regulate the expression of a bioactive exon (a constitutively active form of human caspase 3) to induce apoptosis in cancer cells. Further evaluation was performed in an orthotopic model of murine bladder cancer. RESULTS The average strengths of reporter expression had relative intensities of 99.8% ((P) ran), 87.7% ((P) brms1) and 55.8% ((P) mcm5) versus the strong (P) cmv-driven positive control. Comparisons of expression-targeted reporter gene expression for these three promoters versus the clinically interesting promoter for the human telomerase reverse transcriptase gene ((P) hTERT) yielded an improvement of two- to 15-fold. Following transfection, cell death was evident from morphologic observations and viability assays performed on the cancer cells lines, with little (if any) effects seen when the same genes were delivered to normal cells. Cell viability was reduced by up to 60% after one treatment, with cell death via apoptosis implied by caspase 3 detection. During the in vivo preclinical study, reduced tumor burden, lack of mineralization and decreased inflammation were demonstrated after only three treatments. CONCLUSIONS The ran, brms1, and mcm5 promoters have the specificity and strength needed for cancer-specific expression-targeted gene therapy. (p) ran in particular produced exciting results when coupled with a version of the caspase 3 exon to treat bladder cancer. Copyright © 2016 John Wiley & Sons, Ltd.
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Affiliation(s)
- Xuguang Chen
- Department of Chemical and Biomolecular Engineering, Tulane University, New Orleans, LA, USA
| | - Jacqueline E Scapa
- Department of Comparative Medicine, Tulane University, New Orleans, LA, USA
| | - David X Liu
- Division of Comparative Pathology, Tulane National Primate Research Center, Covington, LA, USA
| | - W T Godbey
- Department of Chemical and Biomolecular Engineering, Tulane University, New Orleans, LA, USA
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11
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Stone heterogeneity index as the standard deviation of Hounsfield units: A novel predictor for shock-wave lithotripsy outcomes in ureter calculi. Sci Rep 2016; 6:23988. [PMID: 27035621 PMCID: PMC4817509 DOI: 10.1038/srep23988] [Citation(s) in RCA: 39] [Impact Index Per Article: 4.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/17/2015] [Accepted: 03/08/2016] [Indexed: 11/24/2022] Open
Abstract
We investigated whether stone heterogeneity index (SHI), which a proxy of such variations, was defined as the standard deviation of a Hounsfield unit (HU) on non-contrast computed tomography (NCCT), can be a novel predictor for shock-wave lithotripsy (SWL) outcomes in patients with ureteral stones. Medical records were obtained from the consecutive database of 1,519 patients who underwent the first session of SWL for urinary stones between 2005 and 2013. Ultimately, 604 patients with radiopaque ureteral stones were eligible for this study. Stone related variables including stone size, mean stone density (MSD), skin-to-stone distance, and SHI were obtained on NCCT. Patients were classified into the low and high SHI groups using mean SHI and compared. One-session success rate in the high SHI group was better than in the low SHI group (74.3% vs. 63.9%, P = 0.008). Multivariate logistic regression analyses revealed that smaller stone size (OR 0.889, 95% CI: 0.841–0.937, P < 0.001), lower MSD (OR 0.995, 95% CI: 0.994–0.996, P < 0.001), and higher SHI (OR 1.011, 95% CI: 1.008–1.014, P < 0.001) were independent predictors of one-session success. The radiologic heterogeneity of urinary stones or SHI was an independent predictor for SWL success in patients with ureteral calculi and a useful clinical parameter for stone fragility.
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Affiliation(s)
- Adam P Sweeney
- Department of Radiology, Wake Forest Baptist Medical Center, Wake Forest University School of Medicine, Medical Center Blvd., Winston-Salem, 27157, NC, USA.
| | - Raymond B Dyer
- Department of Radiology, Wake Forest Baptist Medical Center, Wake Forest University School of Medicine, Medical Center Blvd., Winston-Salem, 27157, NC, USA
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13
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Black JC, Dyer RB. The "staghorn" calculus. ABDOMINAL IMAGING 2015; 40:2908-2909. [PMID: 25962710 DOI: 10.1007/s00261-015-0450-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/04/2023]
Affiliation(s)
- Justin C Black
- Department of Radiology, Wake Forest Baptist Medical Center, Wake Forest University School of Medicine, Medical Center Blvd., Winston-Salem, NC, 27157, USA.
| | - Raymond B Dyer
- Department of Radiology, Wake Forest Baptist Medical Center, Wake Forest University School of Medicine, Medical Center Blvd., Winston-Salem, NC, 27157, USA
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Liang W, Xu S. Xp11.2 translocation renal cell carcinoma with egg-shell calcification mimicking a benign renal tumour: A case report. Oncol Lett 2015; 10:3191-3194. [PMID: 26722310 DOI: 10.3892/ol.2015.3718] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/04/2014] [Accepted: 08/20/2015] [Indexed: 01/12/2023] Open
Abstract
The present study reports the case of a 20-year-old female who was identified to have a left renal angiomyolipoma (AML) with hemorrhage. Following temporary conservative observation, the patient received continuous ultrasonic follow-up. Due to the rapid growth of the lesion, further examinations were performed. Computed tomography (CT) plain scans revealed a partly high-density mass with marginal egg-shell calcification. Enhanced CT revealed a solid tumor with a rich blood supply. Since no fats were detected, the possibility of a typical AML was excluded, but the diagnoses of epithelioid AML or renal cancer were considered. Finally, the left kidney was partially excised laparoscopically. The intraoperative frozen section indicated a diagnosis of renal cell carcinoma (RCC). The left kidney was subsequently radically excised. Routine histopathological and immunohistochemical tests confirmed that the lesion was an RCC with an Xp11.2 translocation. The present study introduces the pitfalls in the diagnosis of Xp11.2 translocation RCC, which is a rare RCC subtype accompanied with uncommon imaging manifestations. The study suggests that when a rapidly-growing AML is detected by ultrasound, renal cancer with marginal calcification should be considered. Moreover, although egg-shell calcification mostly occurs in benign renal lesions, further examinations, such as enhanced CT, are recommended for identifying the nature of the masses and excluding the possibility of malignant tumors.
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Affiliation(s)
- Wenjie Liang
- Department of Radiology, The First Affiliated Hospital, College of Medicine, Zhejiang University, Hangzhou, Zhejiang 310003, P.R. China
| | - Shunliang Xu
- Department of Radiology, The First Affiliated Hospital, College of Medicine, Zhejiang University, Hangzhou, Zhejiang 310003, P.R. China
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15
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Dystrophic calcification of the prostate after cryotherapy. Case Rep Urol 2014; 2014:471385. [PMID: 25548712 PMCID: PMC4273508 DOI: 10.1155/2014/471385] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/12/2014] [Revised: 11/21/2014] [Accepted: 11/22/2014] [Indexed: 11/25/2022] Open
Abstract
We present a previously undocumented complication of dystrophic calcification of the prostate after cryotherapy. An 87-year-old male presented with recurrent lower urinary tract infections and was found to have an obstructing large calcified mass in the right lobe of the prostate. Subsequently, he underwent transurethral resection of the prostate (TURP) and bladder neck with laser lithotripsy to remove the calculus. We propose that chronic inflammation and necrosis of the prostate from cryotherapy resulted in dystrophic calcification of the prostate. As the use of cryotherapy for the treatment of localized prostate cancer continues to increase, it is important that clinicians be aware of this scenario and the technical challenges it poses.
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Pillai N, Latha Gullapudi VR, Ford H, Warnock N, Roy A, Jones CH. Quiz page June 2014: a 45-year-old woman with acute anuria. Am J Kidney Dis 2014; 63:A19-22. [PMID: 24856622 DOI: 10.1053/j.ajkd.2013.10.063] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/06/2013] [Accepted: 10/16/2013] [Indexed: 11/11/2022]
Affiliation(s)
- Natasha Pillai
- York Teaching Hospitals NHS Trust, The York Hospital, York, United Kingdom; Hull and East Yorkshire Teaching Hospitals NHS Trust, Hull Royal Infirmary, Hull, United Kingdom
| | | | - Helen Ford
- York Teaching Hospitals NHS Trust, The York Hospital, York, United Kingdom; Hull and East Yorkshire Teaching Hospitals NHS Trust, Hull Royal Infirmary, Hull, United Kingdom
| | - Niall Warnock
- York Teaching Hospitals NHS Trust, The York Hospital, York, United Kingdom
| | - Anu Roy
- Hull and East Yorkshire Teaching Hospitals NHS Trust, Hull Royal Infirmary, Hull, United Kingdom
| | - Colin H Jones
- York Teaching Hospitals NHS Trust, The York Hospital, York, United Kingdom.
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Raman spectroscopic documentation of Oligocene bladder stone. Naturwissenschaften 2013; 100:789-94. [DOI: 10.1007/s00114-013-1078-6] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/13/2013] [Revised: 06/14/2013] [Accepted: 06/20/2013] [Indexed: 10/26/2022]
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Rodrigues JCL, Gandhi S. Don't get caught out! A rare case of a calcified urachal remnant mimicking a bladder calculus. J Radiol Case Rep 2013; 7:34-8. [PMID: 23705044 DOI: 10.3941/jrcr.v7i3.1230] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
Computer tomography through the kidneys, ureters and bladder (CT KUB) is the mainstay investigation of suspected renal tract calculi. However, several pathologies other than renal tract calculi can cause apparent urinary bladder calcification. We describe the case of a 45 year old man who presented with left sided renal colic. Prone CT KUB performed on admission revealed a calcified urachal remnant mimicking a urinary bladder calculus in the dependent portion of the urinary bladder, confirmed by reviewing the multi-planar reformatted images. This is the first reported case in the literature of this phenomenon. We discuss the importance of using multi-planar reformatted images (MPR) and maximum intensity projection images (MIP), as well as careful review of previous imaging, in making the correct diagnosis. We also discuss the differential diagnoses that should be considered when presented with urinary bladder calcification.
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Abstract
We present a case of primary renal angiosarcoma. We focus on the characteristic striated pattern of the tumor on T2-w MR sequence as well as on other radiological features and correlate them with the pathologic findings. A review of the imaging characteristics of cases published in the literature was subsequently performed.
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Shebel HM, Elsayes KM, Abou El Atta HM, Elguindy YM, El-Diasty TA. Genitourinary schistosomiasis: life cycle and radiologic-pathologic findings. Radiographics 2012; 32:1031-46. [PMID: 22786992 DOI: 10.1148/rg.324115162] [Citation(s) in RCA: 42] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
Genitourinary schistosomiasis is produced by Schistosoma haematobium, a species of fluke that is endemic to Africa and the Middle East, and causes substantial morbidity and mortality in those regions. It also may be seen elsewhere, as a result of travel or immigration. S haematobium, one of the five fluke species that account for most human cases of schistosomiasis, is the only species that infects the genitourinary system, where it may lead to a wide spectrum of clinical symptoms and signs. In the early stages, it primarily involves the bladder and ureters; later, the kidneys and genital organs are involved. It rarely infects the colon or lungs. A definitive diagnosis of genitourinary schistosomiasis is based on findings of parasite ova at microscopic urinalysis. Clinical manifestations and radiologic imaging features also may be suggestive of the disease, even at an early stage: Hematuria, dysuria, and hemospermia, early clinical signs of an established S haematobium infection, appear within 3 months after infection. At imaging, fine ureteral calcifications that appear as a line or parallel lines on abdominopelvic radiographs and as a circular pattern on axial images from computed tomography (CT) are considered pathognomonic of early-stage schistosomiasis. Ureteritis, pyelitis, and cystitis cystica, conditions that are characterized by air bubble-like filling defects representing ova deposited in the ureter, kidney, and bladder, respectively, may be seen at intravenous urography, intravenous ureteropyelography, and CT urography. Coarse calcification, fibrosis, and strictures are signs of chronic or late-stage schistosomiasis. Such changes may be especially severe in the bladder, creating a predisposition to squamous cell carcinoma. Genital involvement, which occurs more often in men than in women, predominantly affects the prostate and seminal vesicles.
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Affiliation(s)
- Haytham M Shebel
- Department of Radiology, Urology and Nephrology Center, Mansoura University, Mansoura, Egypt
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What the Radiologist Needs to Know About Urolithiasis: Part 1???Pathogenesis, Types, Assessment, and Variant Anatomy. AJR Am J Roentgenol 2012; 198:W540-7. [DOI: 10.2214/ajr.10.7285] [Citation(s) in RCA: 29] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
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Khandelwal N, Sodhi KS, Virmani V, Sharma N. Primary Hyperoxaluria. ANNALS OF THE ACADEMY OF MEDICINE, SINGAPORE 2010. [DOI: 10.47102/annals-acadmedsg.v39n1p70] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/01/2023]
Affiliation(s)
| | | | - Vivek Virmani
- Postgraduate Institute of Medical Education and Research, Chandigarh, India
| | - Navneet Sharma
- Postgraduate Institute of Medical Education and Research, Chandigarh, India
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Jeon SW, Park YK, Chang SG. Dystrophic calcification and stone formation on the entire bladder neck after potassium-titanyl phosphate laser vaporization for the prostate: a case report. J Korean Med Sci 2009; 24:741-3. [PMID: 19654962 PMCID: PMC2719192 DOI: 10.3346/jkms.2009.24.4.741] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/19/2007] [Accepted: 04/08/2008] [Indexed: 11/20/2022] Open
Abstract
Dystrophic calcification can be defined as a calcification that occurs in degenerated or necrotic tissue. It is associated with multiple clinical conditions, such as collagen vascular diseases. It involves the deposition of calcium in soft tissues despite no generalized disturbance in the calcium or phosphorus metabolism, and this is often seen at sites of previous inflammation or damage. Potassium-titanyl phosphate (KTP) laser vaporization of the prostate is safe and relatively bloodless procedure that results in a shorter catheterization, immediate symptomatic improvement, and less severe postoperative irritative symptoms. However, longer follow-up studies or reports about complications are lacking. Here in we report a case of dystrophic calcification and stone formation on the entire bladder neck after performing KTP laser vaporization of benign prostate hyperplasia. That was treated by lithotripsy and transurethral resection.
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Affiliation(s)
- Sang-Wohn Jeon
- Department of Urology, School of Medicine, Kyung Hee University, Seoul, Korea
| | - Yong-Koo Park
- Department of Pathology, School of Medicine, Kyung Hee University, Seoul, Korea
| | - Sung-Goo Chang
- Department of Urology, School of Medicine, Kyung Hee University, Seoul, Korea
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Abstract
Hematuria may have a number of causes, of which the more common are urinary tract calculi, urinary tract infection, urinary tract neoplasms (including renal cell carcinoma and urothelial tumors), trauma to the urinary tract, and renal parenchymal disease. This article discusses the current status of imaging of patients suspected of having urologic causes of hematuria. The role of all modalities, including plain radiography, intravenous urography or excretory urography, retrograde pyelography, ultrasonography, and multidetector computed tomography (MDCT) in evaluation of these patients is discussed. The article highlights the current status of MDCT urography in imaging of patients with hematuria, and discusses various-often controversial-issues, such as optimal protocol design, accuracy of the technique in imaging of the urothelium, and the significant issue of radiation dose associated with MDCT urography.
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Affiliation(s)
- Owen J O'Connor
- Department of Radiology, Cork University Hospital, Wilton, Cork, Ireland
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Abstract
The language of radiology is rich with descriptions of imaging findings, often metaphorical, which have found common usage in the day-to-day practice of genitourinary radiology. These "classic signs" give us confidence in our diagnosis. Some of the signs have become so familiar to us that they are referred to as an "Aunt Minnie." When the sign is invoked, or an Aunt Minnie is recognized, it often brings an impression of the image to mind, and it may have specific diagnostic and pathologic implications. The article uses classic signs accumulated from the literature to review a variety of pathologic conditions in the urinary tract.
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Affiliation(s)
- Raymond B Dyer
- Department of Radiology, Wake Forest University School of Medicine, Medical Center Blvd, Winston-Salem, NC 27157, USA.
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Symes A, Kalsi V, Rickards D, Allen C, Choong S, Philp T. Dystrophic ureteral calcification associated with Churg-Strauss vasculitis. Urology 2005; 64:1231.e9-11. [PMID: 15596209 DOI: 10.1016/j.urology.2004.06.036] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/10/2004] [Accepted: 06/23/2004] [Indexed: 12/20/2022]
Abstract
Churg-Strauss syndrome is an uncommon systemic vasculitis affecting small blood vessels. Renal involvement is typical; however, calcinosis of the urinary tract has not previously been described. Dystrophic calcification in the urinary tract is rare, although it is occasionally associated with schistosomiasis, tuberculosis, and polyarteritis nodosa. We report the case of a 19-year-old man with newly diagnosed Churg-Strauss syndrome who presented to us with dystrophic calcification in both ureters causing bilateral obstruction.
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Affiliation(s)
- A Symes
- Stone Unit, Institute of Urology, University College London Hospitals, Middlesex Hospital, London, United Kingdom
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Diallo O, Janssens F, Hall M, Avni EF. Type 1 primary hyperoxaluria in pediatric patients: renal sonographic patterns. AJR Am J Roentgenol 2005; 183:1767-70. [PMID: 15547226 DOI: 10.2214/ajr.183.6.01831767] [Citation(s) in RCA: 29] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
Abstract
OBJECTIVE Our aim was to review the sonographic features of type I primary hyperoxaluria in children and to correlate the sonographic patterns with the clinical development of end-stage renal disease (ESRD). MATERIALS AND METHODS We performed a retrospective analysis of the clinical and imaging files of 13 patients with type I primary hyperoxaluria who were treated in one institution and of the sonographic patterns and the clinical follow-up reports. RESULTS We encountered the following two sonographic patterns: medullary nephrocalcinosis in eight patients and cortical nephrocalcinosis in five patients. The sonographic appearance of cortical nephrocalcinosis is quite specific: a hyperechoic peripheral renal cortex with acoustic shadowing behind it. Medullary nephrocalcinosis is less specific because there are many other causes of hyperechoic pyramids. All patients with medullary nephrocalcinosis developed lithiasis during the course of the disease. All patients with cortical nephrocalcinosis but only two of eight with medullary nephrocalcinosis developed ESRD. CONCLUSION Sonography can be used differentiate the two patterns of type 1 primary hyperoxaluria. The cortical nephrocalcinosis type carries a higher risk of developing ESRD.
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Affiliation(s)
- Ousséini Diallo
- Department of Pediatric Imaging, Queen Fabiola Children's Hospital, Av. J.J. Crocq, Brussels 1020, Belgium
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Choi JH, Jeong YY, Shin SS, Lim HS, Kang HK. Primary calcified T-cell lymphoma of the urinary bladder: a case report. Korean J Radiol 2004; 4:252-4. [PMID: 14726643 PMCID: PMC2698104 DOI: 10.3348/kjr.2003.4.4.252] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/28/2022] Open
Abstract
Primary malignant lymphoma of the urinary bladder is extremely rare, and to our knowledge, no case described in the radiologic literature has been accompanied by calcification. We report a case in which the condition was associated with calcification, and describe the pelvic CT and MR imaging findings.
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Affiliation(s)
- Jun Ho Choi
- Department of Diagnostic Radiology, Chonnam National University Medical School, Gwangju, Korea
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Doudier B, Parola P, Dales JP, Linzberger N, Brouqui P, Delmont J. Schistosomiasis as an unusual cause of appendicitis. Clin Microbiol Infect 2004; 10:89-91. [PMID: 14759233 DOI: 10.1111/j.1469-0691.2004.00805.x] [Citation(s) in RCA: 13] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
Millions of people originating from tropical areas now live outside the country of their birth. As a consequence, the number of cases of diseases imported from the tropics and being seen by European physicians in immigrants is growing. As an example of such diseases, schistosomal appendicitis is a specific trait of infection with Schistosoma haematobium and is an uncommon cause of appendicitis in non-endemic areas. Treatment requires anti-schistomal medication in addition to surgery. Physicians, including surgeons, need to be aware of the possibility of seeing atypical presentations of parasitic diseases in immigrant patients.
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Affiliation(s)
- B Doudier
- Service des Maladies Infectieuses et Tropicales, Center Hospitalo-Universitaire Nord, Marseille, France
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Abstract
Computed tomography (CT) plays an important role in evaluation and management of primary renovascular disease. Nonenhanced CT is useful for demonstrating renal hemorrhage, renal parenchymal or vascular calcifications, and masses. Contrast material-enhanced CT is essential to identify global or regional nephrographic abnormalities resulting from the vascular process (eg, renal infarcts, ischemia secondary to renal artery stenosis, arteriovenous communications). In addition, renal manifestations of a systemic disease (eg, vasculitis, thromboembolic disease) can be seen at CT. In trauma, occlusion of the main renal artery can be accurately diagnosed with contrast-enhanced CT. In cases of spontaneous renal hemorrhage without an apparent cause (eg, vasculitis, coagulopathy), a careful CT study should be performed to exclude renal cell carcinoma. The presence of fat in a hemorrhagic renal mass larger than 4 cm in diameter is characteristic of angiomyolipoma complicated by hemorrhage. Acute renal vein thrombosis appears as a clot in a distended renal vein, whereas renal vein retraction with collateral vessels is highly indicative of chronic thrombosis. Helical CT, especially with multiplanar two-dimensional and three-dimensional reconstruction following an intravenous injection of iodinated contrast material, has greatly improved our ability to directly image the proximal renal arteries and detect vascular lesions.
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Affiliation(s)
- A Kawashima
- Department of Radiology, University of Texas Medical School, Houston 77026, USA.
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