US and MDCT diagnosis of a rare cause of haematuria in children: Posterior nutcracker syndrome

Posterior nutcracker syndrome is caused by compression of the left renal vein between the abdominal aorta and the vertebral column. We present the case of a 14-year-old girl with vague left loin pain, mild haematuria and proteinuria. Diagnosis of this rare syndrome was achieved using color Doppler US and multidetector computed tomography (MDCT) angiography.

Is pattern III as evidenced by US color-Doppler useful in predicting thyroid nodule malignancy? Large-scale retrospective analysis

OBJECTIVE

To evaluate whether pattern III of color Doppler Ultra-sound may identify malignant nodules.

MATERIALS AND METHODS

We have retrospectively analyzed data pertaining to 1090 patients of both genders (230 males, 860 females), with an average age of 53 years (min 17 years, max 81 years), who underwent thyroidectomy in Department of Surgical Sciences of Sapienza University of Rome since January 2003 through June 2009. We correlated color-Doppler characteristics and histological features through statistical analysis so as to verify statistical correlation between them.

RESULTS

Our study showed that 164/273 (60.1%) patients with malignant disease were associated with vascularization pattern III. Regarding benign disease, 152/268 (56.7%) patients showed a pattern of vascularization 3 at ultrasonography. The statistical analysis was not able to show any correlation between pattern III and malignancy.

CONCLUSION

Pattern III cannot be used to predict malignancy with confidence, and FNA is still mandatory to rule out the nature of the nodule.

Vascular leiomyoma presenting as medial joint line pain of the knee

Vascular leiomyoma or angioleiomyoma is a rare benign solitary smooth muscle tumor that occurs mostly in the extremities. Most of these tumors are composed of venous vessels, but in some reports small arteries have been detected in the tumors.We present a rare case of a 60-year-old man with a subcutaneous vascular leiomyoma of the right knee. Clinical findings, ultrasound (US), magnetic resonance (MR), and histopathologic features are reported, and the literature is reviewed. The knowledge of specific imaging findings allows to include vascular leiomyoma in the differential diagnosis of lower extremity subcutaneous masses and to achieve an early accurate diagnosis.

A case of subfascial lipoma in the lateral space of neck: US and CT findings

Lipomas in the head and neck region usually occur in the immediate subcutaneous tissue. They are extremely rare under the muscular band of neck. We present a case of a 53-year-old woman with a subfascial lipoma located in the anterior lateral space of neck. The diagnosis of the lesion was reached by clinical examination and confirmed by ultrasonography (US) and computed tomography (CT) imaging. The lesion with surrounding capsule formation and lipofibromatous changes underwent open surgery.

Cysts of the canal of Nuck: ultrasound and magnetic resonance imaging findings

Cyst of the canal of Nuck is a rare cause of inguinal swelling in woman. We report a case of a cyst of the canal of Nuck in which sonography showed a tubular cystic structure with internal septae localized within the inguinal canal. Magnetic resonance examination demonstrated that the mass was hypointense on T1-weighted and hyperintense on T2-weighted series and that there were fine hypointense septae inside the mass on the T2-weighted sequence. Diagnosis of cyst of the canal of Nuck was confirmed by surgery and subsequent histopathologic evaluation.