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Liu LD, Ren RR, Zheng S, Cao JF, Deng M, Peng F, Chen R. Primary cardiac angiosarcoma: Imaging characterization. Echocardiography 2024; 41:e15826. [PMID: 38678584 DOI: 10.1111/echo.15826] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/26/2024] [Revised: 04/16/2024] [Accepted: 04/17/2024] [Indexed: 05/01/2024] Open
Abstract
This case report describes a 35-year-old female patient who presented with palpitations and shortness of breath. Imaging findings suggested a cardiac tumor, histopathology confirmed primary cardiac angiosarcoma. This tumor is highly aggressive, usually occurs in the right atrium, lacks specificity in clinical presentation, is prone to early metastasis, and has a poor prognosis. Echocardiography is the method of choice for early detection and is important in assessing tumor size, location, mode of attachment and whether cardiac function is impaired.
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Affiliation(s)
- Lian-di Liu
- Department of Ultrasound, Renmin Hospital, Hubei University of Medicine, Shiyan, China
| | - Run-Run Ren
- Department of Ultrasound, Renmin Hospital, Hubei University of Medicine, Shiyan, China
| | - Shuang Zheng
- Department of Ultrasound, Renmin Hospital, Hubei University of Medicine, Shiyan, China
| | - Jing-Fang Cao
- Department of Ultrasound, Renmin Hospital, Hubei University of Medicine, Shiyan, China
| | - Mao Deng
- Department of Cardiothoracic Vascular Surgery, Renmin Hospital, Hubei University of Medicine, Shiyan, China
| | - Fang Peng
- Department of Ultrasound, Renmin Hospital, Hubei University of Medicine, Shiyan, China
| | - Ran Chen
- Department of Ultrasound, Renmin Hospital, Hubei University of Medicine, Shiyan, China
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Zhang Y, Jiang X, Ye W, Sun J. Clinical features and outcome of eight patients with Chlamydia psittaci pneumonia diagnosed by targeted next generation sequencing. Clin Respir J 2023; 17:915-930. [PMID: 37552996 PMCID: PMC10500319 DOI: 10.1111/crj.13681] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/30/2023] [Revised: 06/29/2023] [Accepted: 07/23/2023] [Indexed: 08/10/2023]
Abstract
INTRODUCTION The clinical symptoms of Chlamydia psittaci pneumonia are still poorly understood. This study was designed to summarize the clinical features and outcome of eight C. psittaci pneumonia patients diagnosed by targeted next generation sequencing (tNGS). METHODS We included eight C. psittaci pneumonia patients admitted to our hospital from January 2021 to July 2022. The tNGS was performed to the samples collected from bronchoalveolar lavage fluid of each patient. Their clinical data were analysed, including baseline features, clinical symptoms, chest radiographic findings and laboratory examinations. RESULTS The tNGS sequence number for C. psittaci was in a range of 10 to 1722. The radiographic characteristics were mainly featured by patchy consolidation shadows, ground-glass density shadows, air bronchogram and slight pleural effusion. Within 1-3 days after hospitalization, most patients showed increased neutrophil ratio, C-reactive protein and erythrocyte sedimentation rate, and decreased lymphocyte count, total protein, albumin and prealbumin. Some patients showed increased glutamic-pyruvic transaminase, glutamic-oxaloacetic transaminase and lactate dehydrogenase levels. Three critically ill patients showed increased creatine kinase, creatine kinase isoenzyme and high-sensitivity troponin T (hs-TnT) levels. CONCLUSIONS A poultry or bird contact history, typical flu-like symptoms, patchy consolidation, ground-glass density shadow and air bronchogram may contribute to the diagnosis and treatment of C. psittaci pneumonia. Increase in creatine kinase, creatine kinase isoenzyme and hs-TnT may indicate a severe condition. Moxifloxacin and minocycline were effective in the management of C. psittaci pneumonia.
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Affiliation(s)
- Yanping Zhang
- Department of Respiratory MedicineShandong Provincial Third HospitalJinanP.R. China
| | - Xiangsen Jiang
- Imaging CenterShandong Provincial Third HospitalJinanP.R. China
| | - Wei Ye
- Department of Respiratory MedicineShandong Provincial Third HospitalJinanP.R. China
| | - Jinlin Sun
- Department of Respiratory MedicineShandong Provincial Third HospitalJinanP.R. China
- Department of Respiratory MedicineHui Ya Hospital of The First Affiliated Hospital, Sun Yat‐Sen UniversityHuizhouP.R. China
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Liu X, Wu R, Zhu S, Gu L, Tang Z. Imaging and pathological characteristics, treatment, and prognosis of pulmonary sequestration-A retrospective study of 13 cases. Clin Respir J 2023; 17:865-873. [PMID: 37533295 PMCID: PMC10500327 DOI: 10.1111/crj.13672] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/31/2023] [Revised: 07/11/2023] [Accepted: 07/17/2023] [Indexed: 08/04/2023]
Abstract
OBJECTIVE This study aimed to summarize and analyze the characteristics of pulmonary sequestration to improve our understanding of this disease. METHODS Between January 2019 and April 2023, the clinical data of 13 patients with pulmonary sequestration underwent surgical treatment at the First Affiliated Hospital of Gannan Medical University. RESULTS The male-to-female ratio was 4:9, the age was 0.5 to 60 years, and the average age was 38 ± 19 years. There were 10 and 3 cases of intralobar and extralobar pulmonary sequestration, respectively. Chest enhanced computed tomography (CT) and three-dimensional vascular reconstruction showed that the abnormal blood vessels were derived from the descending thoracic aorta in nine cases and from other blood vessels in four cases. Three patients underwent thoracoscopic lobectomy, two underwent thoracoscopic segmentectomy, and eight underwent thoracoscopic wedge resection. All the patients successfully completed the surgery and were discharged postoperatively. CONCLUSIONS Some patients with pulmonary sequestration exhibit no obvious symptoms. Patients with clinical symptoms are easily confused for pneumonia, bronchial cysts, lung abscesses, and lung tumors; therefore, patients with pulmonary sequestration are prone to missed diagnosis and misdiagnosis. Currently, enhanced chest CT combined with three-dimensional vascular reconstruction can accurately show the course, branches, and relationship with the mass of the feeding artery. Routine pathological examination is helpful to further clarify the diagnosis of pulmonary sequestration. Minimally invasive thoracoscopic surgery is the preferred treatment for patients with pulmonary sequestration. Surgical resection is safe and feasible, and satisfactory results are typically obtained.
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Affiliation(s)
- Xiangjin Liu
- First Clinical Medical CollegeThe Gannan Medical UniversityGanzhouChina
| | - Rongqian Wu
- First Clinical Medical CollegeThe Nanchang UniversityNanchangChina
| | - Shenyu Zhu
- Department of Thoracic SurgeryThe First Affiliated Hospital of Gannan Medical UniversityGanzhouChina
| | - Liang Gu
- Department of Thoracic SurgeryThe First Affiliated Hospital of Gannan Medical UniversityGanzhouChina
| | - Zhixian Tang
- Department of Thoracic SurgeryThe First Affiliated Hospital of Gannan Medical UniversityGanzhouChina
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Sideris SN, Falkner N, Porter G. The imaging appearances of non-calcified ductal carcinoma in situ: A pictorial essay. J Med Imaging Radiat Oncol 2023; 67:647-652. [PMID: 37454369 DOI: 10.1111/1754-9485.13558] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/30/2023] [Accepted: 06/27/2023] [Indexed: 07/18/2023]
Abstract
Non-calcified ductal carcinoma in situ (NCDCIS) presents as a heterogeneous entity on various imaging modalities, most frequently presenting symptomatically as a palpable lump. The combination of multiple modalities and knowledge of its potential radiological appearances are important in minimising misdiagnosis. Compared to conventional 2D mammography, both sonography and digital breast tomosynthesis show higher diagnostic accuracy in the detection of NCDCIS. Newer modalities of contrast-enhanced digital mammography and MRI have limited data at present, but early results indicate greater sensitivity for the detection of lesions that may be occult on ultrasound or mammography. Here, we present an illustrative study highlighting the varied appearances of NCDCIS on several imaging modalities including a brief review of the literature.
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Affiliation(s)
| | - Nathalie Falkner
- Department of Radiology, Sir Charles Gairdner Hospital, Perth, Western Australia, Australia
- BreastScreen WA, Perth, Western Australia, Australia
| | - Gareth Porter
- Department of Radiology, Sir Charles Gairdner Hospital, Perth, Western Australia, Australia
- BreastScreen WA, Perth, Western Australia, Australia
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Lei K, Wang X, Liu Y, Sun T, Xie W, Ma M. Diagnosis and surgical treatment of adrenal ganglioneuroma: a retrospective cohort study of 51 patients in a single center. Am J Transl Res 2022; 14:7528-7534. [PMID: 36398207 PMCID: PMC9641490] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/15/2022] [Accepted: 09/26/2022] [Indexed: 06/16/2023]
Abstract
OBJECTIVES To analyze the clinical features, imaging findings, and surgical results of 51 cases of adrenal ganglioneuroma (AGN) in our center to provide a clinical reference for its diagnosis and treatment. METHODS We retrospectively reviewed the clinical data of 51 AGN patients admitted to our hospital. We summarized the clinical and imaging characteristics and analyzed the effects of different surgical methods and tumor size on the perioperative outcome. RESULTS The mean tumor size was 6.1±2.4 cm. The mean computerized tomography (CT) value of tumors on the plain scan images was 29.9±4.3 Hounsfield units (HU), and 60.8% (20/45) of tumors showed delayed progressive enhancement on enhanced CT images. Pathologically, immunohistochemistry revealed a positive rate of 91.7% for S-100 (11/12) and 77.8% (7/9) for Vimentin. Of the 51 patients, 32 underwent laparoscopic adrenalectomy, and 19 underwent open adrenalectomy. The median postoperative follow-up time was 51.1 (2-125) months, and no tumor recurrence or metastasis occurred during the follow-up. The estimated blood loss (EBL) was reduced in the laparoscopic group compared to the open group (P=0.027). Larger tumors prolonged the operation time and postoperative hospital stay (both P<0.05). CONCLUSIONS This study reports the largest series of AGN patients to date. CT plays a guiding role in the preoperative diagnosis of AGN, but the pathologic results are the most reliable. Laparoscopic adrenalectomy may be safer than open surgery. Larger tumor volume is a risk factor for a longer operative time and postoperative hospital stay.
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Affiliation(s)
- Kunyang Lei
- Department of Urology, The First Affiliated Hospital of Nanchang UniversityNanchang 330006, Jiangxi, China
| | - Xu Wang
- Department of Pathology, The First Affiliated Hospital of Nanchang UniversityNanchang 330006, Jiangxi, China
| | - Yifu Liu
- Department of Urology, The First Affiliated Hospital of Nanchang UniversityNanchang 330006, Jiangxi, China
| | - Ting Sun
- Department of Urology, The First Affiliated Hospital of Nanchang UniversityNanchang 330006, Jiangxi, China
| | - Wenjie Xie
- Department of Urology, The First Affiliated Hospital of Nanchang UniversityNanchang 330006, Jiangxi, China
| | - Ming Ma
- Department of Urology, The First Affiliated Hospital of Nanchang UniversityNanchang 330006, Jiangxi, China
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Hou K, Li C, Su H, Yu J. Imaging Characteristics and Endovascular Treatment of Brain Arteriovenous Malformations Mainly Fed by the Posterior Cerebral Artery. Front Neurol 2021; 11:609461. [PMID: 33584508 PMCID: PMC7873489 DOI: 10.3389/fneur.2020.609461] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/23/2020] [Accepted: 12/14/2020] [Indexed: 11/23/2022] Open
Abstract
Background: A BAVM that is mainly supplied by the posterior cerebral artery (PCA) lies deeply in the middle of the bilateral posterior hemispheres. Few studies have investigated the imaging characteristics and endovascular treatment (EVT) of brain arteriovenous malformations (BAVMs) in this area. Methods: A retrospective study was performed for patients who were diagnosed with PCA-BAVMs from January 2015 to December 2019. The PCA-BAVMs were divided into type I and type II according to their feeding arteries. Type I PCA-BAVMs were supplied by the posterior choroidal artery (PchA) from the PCA. They could be further subdivided into type Ia and type Ib. Type II PCA-BAVMs were supplied by the temporal or occipital branch from the PCA. They could also be further subdivided into type IIa and IIb. Targeted embolization of the risk factors was the main aim of EVT. Results: Forty-two patients were identified, with age ranging from 6 to 63 years. Twenty-four cases belonged to type I (57.1%, 24/42), including 6 Ia cases and 18 Ib cases. Eighteen cases belonged to type II (42.9%, 18/42), including 7 IIa cases and 11 IIb cases. Immediate complete or nearly complete embolization was achieved in 17 (40.5%, 17/42) cases. Partial embolization was achieved in 25 (59.5%, 25/42) cases. Two (4.8%, 2/42) patients experienced intraoperative or postoperative bleeding. The GOS scores at discharge were 3, 4, and 5 in 2 (4.8%, 2/42), 2 (4.8%, 2/42), and 38 (90.4%, 38/42) cases, respectively. There was no statistical difference between patients in type I and type II groups regarding age, BAVM rupture, SM grade, immediate extent of obliteration, and prognosis. Deep venous drainage was more common in patients of the type I group (P < 0.001). Conclusions: Our classification of the PCA-BAVMs was based on the segmentation of the PCA, which is a reasonable approach and could guide the strategy of EVT. EVT is a reasonable option for the PCA-BAVMs. The main aim of EVT is to secure the weak structures. A targeted EVT aimed at the ruptured part of the BAVM can reduce the risk of early rebleeding.
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Affiliation(s)
- Kun Hou
- Department of Neurosurgery, The First Hospital of Jilin University, Changchun, China
| | - Chao Li
- Department of Neurology, The First Hospital of Jilin University, Changchun, China
| | - Han Su
- Department of Neurosurgery, The First Hospital of Jilin University, Changchun, China
| | - Jinlu Yu
- Department of Neurosurgery, The First Hospital of Jilin University, Changchun, China
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Zang ST, Han X, Cui Q, Chang Q, Wu QJ, Zhao YH. Imaging characteristics of coronavirus disease 2019 (COVID-19) in pediatric cases: a systematic review and meta-analysis. Transl Pediatr 2021; 10:1-16. [PMID: 33633932 PMCID: PMC7882282 DOI: 10.21037/tp-20-281] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/17/2022] Open
Abstract
BACKGROUND The confirmed coronavirus disease 2019 (COVID-19) cases, caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), have exceeded 21 million (with more than 775,000 fatalities), and the number of children with COVID-19 is also increasing. This study aimed to summarize the chest imaging characteristics of pediatric COVID-19 cases and provide a reference for the diagnosis and control of pediatric COVID-19. METHODS The study protocol was registered in PROSPERO, number CRD42020177391. Studies related to pediatric COVID-19 imaging manifestations were accessed from PubMed, Web of Science, and the Cochrane library databases, without language limitations. The publication date was limited to April 1, 2020, and it was updated on May 1 and May 27, 2020. Data normalization was determined with the Freeman-Tukey double arcsine transformation. Summarized incidences with 95% confidence intervals of various imaging manifestations were assessed by random-effects models. Heterogeneity was assessed with meta-regression and subgroup analyses, robustness with sensitivity analyses; and publication biases with Egger's test. RESULTS Twenty-three with 517 cases were included in this study. The summarized incidence of chest computed tomography abnormalities in pediatric COVID-19 cases was 70%, which was lower than what has been seen in adults. The incidence of halo signs in pediatric COVID-19 cases was 26%, which is rarely seen in adult COVID-19 cases. The incidences of ground-glass opacities (GGOs), GGOs and consolidations, consolidations, reverse halo signs, crazy paving signs, pleural effusion, bronchopneumonia-like signs, air bronchograms, and increased lung markings were 40%, 25%, 10%, 2%, 4%, 1%, 15%, 12%, and 31%, respectively. Pericardial effusions were found in the computed tomography images of adult COVID-19 cases but were scarcely seen in the computed tomography images of pediatric COVID-19 cases. The incidences of bilateral lesions, unilateral lesions, and peripheral lesions were 35%, 22%, and 26%, respectively. CONCLUSIONS Chest computed tomography imaging of pediatric COVID-19 cases resulted in various abnormalities that were milder than those of adults. This study will hopefully provide a reference to help identify pediatric COVID-19 cases.
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Affiliation(s)
- Si-Tian Zang
- Department of Clinical Epidemiology, Shengjing Hospital of China Medical University, Shenyang, China.,Clinical Research Center, Shengjing Hospital of China Medical University, Shenyang, China
| | - Xu Han
- Department of Pathology, the First Hospital of China Medical University, Shenyang, China
| | - Qi Cui
- Department of Clinical Epidemiology, Shengjing Hospital of China Medical University, Shenyang, China.,Clinical Research Center, Shengjing Hospital of China Medical University, Shenyang, China
| | - Qing Chang
- Department of Clinical Epidemiology, Shengjing Hospital of China Medical University, Shenyang, China.,Clinical Research Center, Shengjing Hospital of China Medical University, Shenyang, China
| | - Qi-Jun Wu
- Department of Clinical Epidemiology, Shengjing Hospital of China Medical University, Shenyang, China.,Clinical Research Center, Shengjing Hospital of China Medical University, Shenyang, China
| | - Yu-Hong Zhao
- Department of Clinical Epidemiology, Shengjing Hospital of China Medical University, Shenyang, China.,Clinical Research Center, Shengjing Hospital of China Medical University, Shenyang, China
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Nawabi J, Morotti A, Wildgruber M, Boulouis G, Kraehling H, Schlunk F, Can E, Kniep H, Thomalla G, Psychogios M, Hamm B, Fiehler J, Hanning U, Sporns P. Clinical and Imaging Characteristics in Patients with SARS-CoV-2 Infection and Acute Intracranial Hemorrhage. J Clin Med 2020; 9:jcm9082543. [PMID: 32781623 PMCID: PMC7464657 DOI: 10.3390/jcm9082543] [Citation(s) in RCA: 30] [Impact Index Per Article: 7.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/11/2020] [Revised: 07/29/2020] [Accepted: 08/05/2020] [Indexed: 01/08/2023] Open
Abstract
BACKGROUND AND PURPOSE Intracranial hemorrhage has been observed in patients with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection (COVID-19), but the clinical, imaging, and pathophysiological features of intracranial bleeding during COVID-19 infection remain poorly characterized. This study describes clinical and imaging characteristics of patients with COVID-19 infection who presented with intracranial bleeding in a European multicenter cohort. METHODS This is a multicenter retrospective, observational case series including 18 consecutive patients with COVID-19 infection and intracranial hemorrhage. Data were collected from February to May 2020 at five designated European special care centers for COVID-19. The diagnosis of COVID-19 was based on laboratory-confirmed diagnosis of SARS-CoV-2. Intracranial bleeding was diagnosed on computed tomography (CT) of the brain within one month of the date of COVID-19 diagnosis. The clinical, laboratory, radiologic, and pathologic findings, therapy and outcomes in COVID-19 patients presenting with intracranial bleeding were analyzed. RESULTS Eighteen patients had evidence of acute intracranial bleeding within 11 days (IQR 9-29) of admission. Six patients had parenchymal hemorrhage (33.3%), 11 had subarachnoid hemorrhage (SAH) (61.1%), and one patient had subdural hemorrhage (5.6%). Three patients presented with intraventricular hemorrhage (IVH) (16.7%). CONCLUSION This study represents the largest case series of patients with intracranial hemorrhage diagnosed with COVID-19 based on key European countries with geospatial hotspots of SARS-CoV-2. Isolated SAH along the convexity may be a predominant bleeding manifestation and may occur in a late temporal course of severe COVID-19.
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Affiliation(s)
- Jawed Nawabi
- Department of Radiology (CCM), Charité-Universitätsmedizin Berlin, Campus Mitte, Humboldt-Universität zu Berlin, Freie Universität Berlin, 14195 Berlin, Germany; (E.C.); (B.H.)
- Correspondence: ; Tel.: +49-17-7874-9156
| | - Andrea Morotti
- Neurology Unit, ASST Valcamonica, Esine, 25040 Brescia, Italy;
| | - Moritz Wildgruber
- Klinik und Poliklinik für Radiologie, Klinikum der Universität (LMU), 81377 Munich, Germany;
| | - Gregoire Boulouis
- Pediatric Radiology Department, Necker Enfants Malades & GHU Paris, Sainte-Anne Hospital, Institut de Psychiatrie et Neurosciences de Paris (IPNP), UMR S1266, INSERM, Université de Paris, 75015 Paris, France;
| | - Hermann Kraehling
- Department of Radiology, University Hospital Muenster, 48149 Muenster, Germany;
| | - Frieder Schlunk
- Department of Neuroradiology, Charité—Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, 14195 Berlin, Germany;
| | - Elif Can
- Department of Radiology (CCM), Charité-Universitätsmedizin Berlin, Campus Mitte, Humboldt-Universität zu Berlin, Freie Universität Berlin, 14195 Berlin, Germany; (E.C.); (B.H.)
| | - Helge Kniep
- Department of Diagnostic and Interventional Neuroradiology, University Medical Center Hamburg Eppendorf, 20251 Hamburg, Germany; (H.K.); (J.F.); (U.H.); (P.S.)
| | - Götz Thomalla
- Department of Neurology, University Medical Center Hamburg-Eppendorf, 20251 Hamburg, Germany;
| | - Marios Psychogios
- Department of Neuroradiology, Clinic for Radiology and Nuclear Medicine, University Hospital Basel, 4031 Basel, Switzerland;
| | - Bernd Hamm
- Department of Radiology (CCM), Charité-Universitätsmedizin Berlin, Campus Mitte, Humboldt-Universität zu Berlin, Freie Universität Berlin, 14195 Berlin, Germany; (E.C.); (B.H.)
| | - Jens Fiehler
- Department of Diagnostic and Interventional Neuroradiology, University Medical Center Hamburg Eppendorf, 20251 Hamburg, Germany; (H.K.); (J.F.); (U.H.); (P.S.)
| | - Uta Hanning
- Department of Diagnostic and Interventional Neuroradiology, University Medical Center Hamburg Eppendorf, 20251 Hamburg, Germany; (H.K.); (J.F.); (U.H.); (P.S.)
| | - Peter Sporns
- Department of Diagnostic and Interventional Neuroradiology, University Medical Center Hamburg Eppendorf, 20251 Hamburg, Germany; (H.K.); (J.F.); (U.H.); (P.S.)
- Department of Neuroradiology, Clinic for Radiology and Nuclear Medicine, University Hospital Basel, 4031 Basel, Switzerland;
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Abstract
RATIONALE Giant synovial osteochondromatosis of the thigh is a highly unusual disease without standard diagnosis and curative managements so far. Our focus is to report a very rare case of giant synovial osteochondromatosis successfully operated by surgical treatment. The management of these unique cases has certain educational significance in clinical practice. PATIENT CONCERNS A 63-year-old previously healthy man presented to our institution with a 4-year history of continuous progressive hip pain and local numbness of right side in January 2018. One month ago, the patient felt that the above symptoms were aggravated, and the right hip and proximal thigh were significantly swollen. DIAGNOSIS Computed tomography and magnetic resonance imaging of the hip revealed the irregular mass in his right thigh. Post-operative pathology confirmed the diagnosis of synovial osteochondromatosis of the thigh. INTERVENTIONS Considering the large volume of the mass and possibility of malignancy, the patient underwent surgical exploration and complete tumor resection. OUTCOMES The patient's neurological deficits and symptoms improved significantly after the surgery, and the postoperative period was uneventful at the 1-year follow-up visit. There were no complications associated with the operation during the follow-up period. LESSONS Taken together, the lesion's clinical features, imaging results, and pathological characteristics are unique. Synovial osteochondromatosis of the thigh, although rare, should be part of the differential diagnosis when the patient presents with local pain, numbness, swelling or other symptoms. We recommend surgical treatment for the occupying lesion when the tumor has caused symptoms or neurological deficits.
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Affiliation(s)
- Shuzhong Liu
- Department of Orthopedic Surgery, Peking Union Medical College Hospital, Peking Union Medical College and Chinese Academy of Medical Sciences
| | - Xi Zhou
- Department of Orthopedic Surgery, Peking Union Medical College Hospital, Peking Union Medical College and Chinese Academy of Medical Sciences
| | - An Song
- Department of Endocrinology, Key Laboratory of Endocrinology, National Health and Family Planning Commission
| | - Zhen Huo
- Department of Pathology, Peking Union Medical College Hospital, Chinese Academy of Medical Science & Peking Union Medical College, Beijing, China
| | - Yipeng Wang
- Department of Orthopedic Surgery, Peking Union Medical College Hospital, Peking Union Medical College and Chinese Academy of Medical Sciences
| | - Yong Liu
- Department of Orthopedic Surgery, Peking Union Medical College Hospital, Peking Union Medical College and Chinese Academy of Medical Sciences
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Wu X, Liu G, Zhou W, Ou A, Liu X, Wang Y, Zhou S, Luo W, Liu B. Outcome prediction for patients with anterior circulation acute ischemic stroke following endovascular treatment: A single-center study. Exp Ther Med 2019; 18:3869-3876. [PMID: 31641377 PMCID: PMC6796376 DOI: 10.3892/etm.2019.8054] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/26/2019] [Accepted: 08/21/2019] [Indexed: 12/28/2022] Open
Abstract
Previous studies have identified various factors associated with the outcomes of acute ischemic stroke (AIS) but considered only 1 or 2 predictive factors. The present study aimed to use outcome-related factors derived from biochemical, imaging and clinical data to establish a logistic regression model that can predict the outcome of patients with AIS following endovascular treatment (EVT). The data of 118 patients with anterior circulation AIS (ACAIS) who underwent EVT between October 2014 and August 2018 were retrospectively analyzed. The patients were divided into 2 groups based on the modified Rankin Scale score at three months after surgery, where 0–2 points were considered to indicate a favorable outcome and 3–6 points were considered a poor outcome. Non-conditional logistic stepwise regression was used to identify independent variables that were significantly associated with patient outcome, which were subsequently used to establish a predictive statistical model, receiver operating characteristic (ROC) curve was used to show the performance of statistical model and analyze the specific association between each factor and outcome. Among the 118 patients, 47 (39.83%) exhibited a good and 71 (60.17%) exhibited a poor outcome. Multivariate analysis revealed that the predictive model was statistically significant (χ2=78.92; P<0.001), and that the predictive accuracy of the model was 83.1%, which was higher compared with that obtained using only a single factor. ROC curve analysis shows the area under curve of the statistical model was 0.823, the analysis of diagnostic threshold for prognostic factors indicated that age, diffusion-weighted imaging lesion volume, glucose on admission, National Institutes of Health Stroke Scale score on admission and hypersensitive C-reactive protein were valuable predictive factors for the outcome of EVT (P<0.05). In conclusion, a predictive model based on non-conditional logistic stepwise regression analysis was able to predict the outcome of EVT for patients with ACAIS.
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Affiliation(s)
- Xiao Wu
- The Second Clinical College of Guangzhou University of Chinese Medicine, Guangzhou, Guangdong 510405, P.R. China
| | - Guoqing Liu
- Department of Radiology, The Second Clinical College of Guangzhou University of Chinese Medicine, Guangzhou, Guangdong 510120, P.R. China
| | - Wu Zhou
- The Medical Imaging Laboratory, School of Medical Information Engineering, Guangzhou University of Chinese Medicine, Guangzhou, Guangdong 510006, P.R. China
| | - Aihua Ou
- Department of Statistics and Epidemiology, The Second Clinical College of Guangzhou University of Chinese Medicine, Guangzhou, Guangdong 510120, P.R. China
| | - Xian Liu
- Department of Radiology, The Second Clinical College of Guangzhou University of Chinese Medicine, Guangzhou, Guangdong 510120, P.R. China
| | - Yuhan Wang
- The Second Clinical College of Guangzhou University of Chinese Medicine, Guangzhou, Guangdong 510405, P.R. China
| | - Sifan Zhou
- The Second Clinical College of Guangzhou University of Chinese Medicine, Guangzhou, Guangdong 510405, P.R. China
| | - Wenting Luo
- The Second Clinical College of Guangzhou University of Chinese Medicine, Guangzhou, Guangdong 510405, P.R. China
| | - Bo Liu
- Department of Radiology, The Second Clinical College of Guangzhou University of Chinese Medicine, Guangzhou, Guangdong 510120, P.R. China
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Miglani A, Lal D, Weindling SM, Wood CP, Hoxworth JM. Imaging characteristics and clinical outcomes of biphenotypic sinonasal sarcoma. Laryngoscope Investig Otolaryngol 2019; 4:484-488. [PMID: 31637290 PMCID: PMC6793931 DOI: 10.1002/lio2.305] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/26/2019] [Revised: 07/22/2019] [Accepted: 08/20/2019] [Indexed: 12/26/2022] Open
Abstract
Objectives Biphenotypic sinonasal sarcoma (BSS) is a new, rare tumor characterized by concomitant neural and myogenic differentiation. The aim of this study is to describe the imaging characteristics and clinical outcomes of this neoplasm. Methods A retrospective review of BSS patients surgically treated within a tertiary academic health care system was performed. Imaging characteristics and clinical outcomes were reviewed. Results Five patients underwent surgical resection of BSS tumors. Negative surgical margins were achieved in four (80%) patients. There were no deaths but two (40%) patients developed local recurrences during the postoperative follow‐up period (median follow‐up 31.4 months). Review of imaging characteristics revealed a median tumor size of 3.8 cm in greatest dimension. All tumors were unilateral and centered within the nasoethmoidal region. In all cases, the tumors extended to the nasal septum, lamina papyracea, and anterior skull base with variable degrees of erosion through these structures. On CT, involved bony structures demonstrated mixed lytic and sclerotic pattern, with definitive hyperostotic bone identified in four (80%) cases. On MRI, tumors were isointense‐to‐mixed iso/hypointense on both T1‐ and T2‐weighted sequences with one tumor demonstrating mixed T2 hyperintensity. All cases demonstrated gadolinium contrast enhancement. Conclusions BSS is a locally aggressive tumor with a low risk of regional or distant metastases but has a significant rate of recurrence even with adequate resection. Despite its rarity, BSS should be considered in the differential diagnosis when imaging demonstrates a unilateral nasoethmoidal mass that is predominantly isointense to cerebral gray matter on T2‐weighted MRI and is hyperostotic on CT. Level of Evidence 4
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Affiliation(s)
- Amar Miglani
- Department of Otolaryngology-Head & Neck Surgery Mayo Clinic Phoenix Arizona U.S.A
| | - Devyani Lal
- Department of Otolaryngology-Head & Neck Surgery Mayo Clinic Phoenix Arizona U.S.A
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12
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Sun F, Xi J, Zhan C, Yang X, Wang L, Shi Y, Jiang W, Wang Q. Ground glass opacities: Imaging, pathology, and gene mutations. J Thorac Cardiovasc Surg 2018; 156:808-813. [PMID: 29753514 DOI: 10.1016/j.jtcvs.2018.02.110] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/18/2017] [Revised: 02/14/2018] [Accepted: 02/23/2018] [Indexed: 10/17/2022]
Abstract
BACKGROUND Lung cancer can be detected in its early stages with computed tomography (CT). Early lung adenocarcinoma often is displayed as ground glass opacity (GGO), an entity that has been well studied over the past decade. However, few studies have focused on the correlation between CT characteristics and pathologic subtype of GGO. We aimed to explore the correlation between CT characteristics, pathologic subtype, and gene mutation associated with GGO in an effort to aid in the treatment of lung adenocarcinoma. METHODS In this retrospective study, patients with GGO who underwent surgery in our institution between 2013 and 2016 were included. Patients were divided into 2 groups on the basis of CT characteristics: group 1, diameter <20 mm and solid component <50%; and group 2, diameter ≥20 mm or solid component ≥50%. Differences in pathologic subtype and gene mutation pattern between groups were compared using the χ2 test. The correlation between pathologic subtype and epidermal growth factor receptor (EGFR) mutation was also tested using the χ2 test. RESULTS A total of 1018 cases (408 in group 1, 610 in group 2) were included; of these, 544 were tested for the EGFR gene mutation. There was a significant difference in predominant subtype (P < .001) and all included subtypes (P = .044) between the groups. Of 59 cases with the pathologic subtype of micropapillary or solid, 57 were in group 2. The EGFR gene mutation rate was significantly higher in group 2 than group 1 (P < .001) and significantly correlated with pathologic subtype (P < .001); adenocarcinoma in situ was the lowest (31.4%) and papillary was the highest (85.7%). EGFR mutation subtype did not significantly differ between groups (P = .499). CONCLUSIONS CT characteristics of GGO significantly correlated with pathologic subtype and gene mutation rate. The EGFR mutation rate differed significantly among pathologic subtypes. GGOs with a diameter of <20 mm and with a solid component <50% seldom contain subtypes with poor prognosis (micropapillary and solid) and the EGFR mutation rate was significantly lower.
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Affiliation(s)
- Fenghao Sun
- Department of Thoracic Surgery, Zhongshan Hospital, Fudan University, Shanghai, China
| | - Junjie Xi
- Department of Thoracic Surgery, Zhongshan Hospital, Fudan University, Shanghai, China
| | - Cheng Zhan
- Department of Thoracic Surgery, Zhongshan Hospital, Fudan University, Shanghai, China
| | - Xiaodong Yang
- Eight-year Program Clinical Medicine, Grade of 2010, Shanghai Medical College, Fudan University, Shanghai, China
| | - Lin Wang
- Department of Thoracic Surgery, Zhongshan Hospital, Fudan University, Shanghai, China
| | - Yu Shi
- Department of Thoracic Surgery, Zhongshan Hospital, Fudan University, Shanghai, China
| | - Wei Jiang
- Department of Thoracic Surgery, Zhongshan Hospital, Fudan University, Shanghai, China.
| | - Qun Wang
- Department of Thoracic Surgery, Zhongshan Hospital, Fudan University, Shanghai, China.
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13
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Papayiannis V, Tsaousis KT, Kouskouras CA, Haritanti A, Diakonis VF, Tsinopoulos IT. Investigation into the quantitative and qualitative characteristics of choroidal melanoma through magnetic resonance imaging and B-scan ultrasound. Clin Ophthalmol 2017; 11:1557-1564. [PMID: 28860706 PMCID: PMC5573043 DOI: 10.2147/opth.s130009] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/03/2023] Open
Abstract
OBJECTIVE To investigate the homogeneity and vascularity of choroidal melanoma through magnetic resonance imaging (MRI) and brightness modulation (B-mode) ultrasound scan and their correlation with dimensions of tumor, as well as to measure the sensitivity of both modalities in retinal detachment (RD) detection. MATERIALS AND METHODS This retrospective chart review included patients diagnosed with choroidal melanoma. All these patients underwent MRI scans using T2-weighted (T2-WI) and T1-weighted (T1-WI) sequences, before and after an intravenous injection of paramagnetic contrast material. The patients were also examined using a B-mode ultrasound scan, and the results from both modalities were compared (tumor homogeneity, tumor height, tumor base diameter, and tumor vascularity). RESULTS Forty-two patients (mean age=65.33±12.51 years) with choroidal melanoma were included in the study. Homogeneity was confirmed in 16 patients through ultrasound scan, in 19 patients through T1-WI sequence, in 21 patients through T2-WI sequence, and in 25 patients through T1-WI sequence + contrast (gadolinium). Patients with homogenous tumors presented with lower (P=0.0045) mean height than that of those with nonhomogenous tumors, whereas no statistically significant difference was found for base diameter measurements (P=0.056). Patients with tumors of high vascularity presented with greater mean height (P=0.000638) and greater mean base diameter compared with those with tumors of low vascularity (P=0.019543). RD was detected in 26 patients through T1-WI sequence, in 13 patients through T2-WI sequence, in 26 patients through T1-WI sequence + contrast, and in 32 patients through ultrasound scan, which proved to be the most sensitive modality. CONCLUSION The height of choroidal melanoma was positively correlated with tumor's homogeneity. Melanomas of greater height were found to be less homogenous, due to increased degeneration and higher occurrence of intratumoral hemorrhage. In addition, choroidal melanoma's height was also positively correlated with the level of its vascularity. Finally, ultrasound scan was found to be more sensitive than MRI in the detection of RD.
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Affiliation(s)
| | - Konstantinos T Tsaousis
- Department of Ophthalmology, Aristotle University of Thessaloniki, Thessaloniki, Greece.,John A Moran Eye Center, University of Utah, Salt Lake City, UT, USA
| | | | - Afroditi Haritanti
- Department of Radiology, AHEPA Aristotle University Hospital of Thessaloniki, Thessaloniki, Greece
| | - Vasilios F Diakonis
- Bascom Palmer Eye Institute, Miller School of Medicine, University of Miami, Miami, FL, USA
| | - Ioannis T Tsinopoulos
- Department of Ophthalmology, Aristotle University of Thessaloniki, Thessaloniki, Greece
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14
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Ai CJ, Jabar NA, Lan TH, Ramli R. Mandibular Canal Enlargement: Clinical and Radiological Characteristics. J Clin Imaging Sci 2017; 7:28. [PMID: 28781925 PMCID: PMC5523564 DOI: 10.4103/jcis.jcis_28_17] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/06/2017] [Accepted: 05/29/2017] [Indexed: 11/25/2022] Open
Abstract
Enlargement of the mandibular canal is a rare radiological finding. Clinically, it may or may not be associated with sensory deficits. We report four cases of widening of the mandibular canal observed with various methods of imaging with different clinical characteristics. We describe this unique radiological finding and elaborate the importance of quality assessment of the imaging that is vital for accurate diagnosis and treatment planning. Clinicians should be mindful when assessing the imaging whenever the size of the mandibular canal is implicated. The case ranged from a benign tumor to malignancy, radiological errors, and artifacts. A more superior imaging or treatment modality was necessary to ascertain the diagnosis.
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Affiliation(s)
- Chong Jun Ai
- Department of Oral Diagnostic and Surgical Sciences, Faculty of Dentistry, International Medical University, Kuala Lumpur, Malaysia
| | - Nazimi Abd Jabar
- Department of Oral and Maxillofacial Surgery, Faculty of Dentistry, UKM and UKM Medical Centre, Kuala Lumpur, Malaysia
| | - Tan Huann Lan
- Department of Oral and Maxillofacial Surgery, Faculty of Dentistry, UKM and UKM Medical Centre, Kuala Lumpur, Malaysia
| | - Roszalina Ramli
- Department of Oral and Maxillofacial Surgery, Faculty of Dentistry, UKM and UKM Medical Centre, Kuala Lumpur, Malaysia
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15
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Cannon RB, Wiggins RH, Witt BL, Dundar Y, Johnston TM, Hunt JP. Imaging and Outcomes for a New Entity: Low-Grade Sinonasal Sarcoma with Neural and Myogenic Features. J Neurol Surg Rep 2017; 78:e15-e19. [PMID: 28229035 PMCID: PMC5319202 DOI: 10.1055/s-0037-1598198] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/03/2023] Open
Abstract
Objectives Low-grade sinonasal sarcoma with neural and myogenic features (LGSSNMF) is a new, rare tumor. Our goal is to describe the imaging characteristics and surgical outcomes of this unique skull base malignancy. Design Retrospective case series. Setting Academic medical center. Participants There were three patients who met inclusion criteria with a confirmed LGSSNMF. Main Outcome Measures Imaging and histopathological characteristics, treatments, survival and recurrence outcomes, complications, morbidity, and mortality. Results Patients presented with diplopia, facial discomfort, a supraorbital mass, and nasal obstruction. Magnetic resonance imaging and computed tomography imaging in all cases showed an enhancing sinonasal mass with associated hyperostotic bone formation that involved the frontal sinus, invaded the lamina papyracea and anterior skull base, and had intracranial extension. One patient underwent a purely endoscopic surgical resection and the second underwent a craniofacial resection, while the last is pending treatment. All patients recovered well, without morbidity or long-term complications, and are currently without evidence of disease (mean follow-up of 2.1 years). One patient recurred after 17 months and underwent a repeat endoscopic skull base and dural resection. Conclusions The surgical outcomes and imaging of this unique, locally aggressive skull base tumor are characterized.
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Affiliation(s)
- Richard B Cannon
- Division of Otolaryngology - Head & Neck Surgery, Department of Surgery, University of Utah School of Medicine, Salt Lake City, Utah, United States; Department of Radiology, University of Utah School of Medicine, Salt Lake City, Utah, United States
| | - Richard H Wiggins
- Division of Otolaryngology - Head & Neck Surgery, Department of Surgery, University of Utah School of Medicine, Salt Lake City, Utah, United States
| | - Benjamin L Witt
- The Huntsman Cancer Institute, Salt Lake City, Utah, United States; Department of Pathology, University of Utah School of Medicine, Salt Lake City, Utah, United States
| | - Yusuf Dundar
- The Huntsman Cancer Institute, Salt Lake City, Utah, United States
| | - Tawni M Johnston
- The Huntsman Cancer Institute, Salt Lake City, Utah, United States
| | - Jason P Hunt
- Division of Otolaryngology - Head & Neck Surgery, Department of Surgery, University of Utah School of Medicine, Salt Lake City, Utah, United States; The Huntsman Cancer Institute, Salt Lake City, Utah, United States
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16
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Patel TA, Puppala M, Ogunti RO, Ensor JE, He T, Shewale JB, Ankerst DP, Kaklamani VG, Rodriguez AA, Wong STC, Chang JC. Correlating mammographic and pathologic findings in clinical decision support using natural language processing and data mining methods. Cancer 2016; 123:114-121. [PMID: 27571243 DOI: 10.1002/cncr.30245] [Citation(s) in RCA: 34] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/04/2016] [Revised: 07/01/2016] [Accepted: 07/13/2016] [Indexed: 11/12/2022]
Abstract
BACKGROUND A key challenge to mining electronic health records for mammography research is the preponderance of unstructured narrative text, which strikingly limits usable output. The imaging characteristics of breast cancer subtypes have been described previously, but without standardization of parameters for data mining. METHODS The authors searched the enterprise-wide data warehouse at the Houston Methodist Hospital, the Methodist Environment for Translational Enhancement and Outcomes Research (METEOR), for patients with Breast Imaging Reporting and Data System (BI-RADS) category 5 mammogram readings performed between January 2006 and May 2015 and an available pathology report. The authors developed natural language processing (NLP) software algorithms to automatically extract mammographic and pathologic findings from free text mammogram and pathology reports. The correlation between mammographic imaging features and breast cancer subtype was analyzed using one-way analysis of variance and the Fisher exact test. RESULTS The NLP algorithm was able to obtain key characteristics for 543 patients who met the inclusion criteria. Patients with estrogen receptor-positive tumors were more likely to have spiculated margins (P = .0008), and those with tumors that overexpressed human epidermal growth factor receptor 2 (HER2) were more likely to have heterogeneous and pleomorphic calcifications (P = .0078 and P = .0002, respectively). CONCLUSIONS Mammographic imaging characteristics, obtained from an automated text search and the extraction of mammogram reports using NLP techniques, correlated with pathologic breast cancer subtype. The results of the current study validate previously reported trends assessed by manual data collection. Furthermore, NLP provides an automated means with which to scale up data extraction and analysis for clinical decision support. Cancer 2017;114-121. © 2016 American Cancer Society.
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Affiliation(s)
- Tejal A Patel
- Houston Methodist Cancer Center, Houston, Texas.,Cancer Research Program, Houston Methodist Research Institute, Houston, Texas.,Department of Medicine, Weill Cornell Medicine, New York, New York
| | - Mamta Puppala
- Department of Informatics Development, Houston Methodist Hospital, Houston, Texas.,Department of Systems Medicine and Bioengineering, Houston Methodist Research Institute, Houston, Texas
| | - Richard O Ogunti
- Department of Informatics Development, Houston Methodist Hospital, Houston, Texas.,Department of Systems Medicine and Bioengineering, Houston Methodist Research Institute, Houston, Texas
| | - Joe E Ensor
- Houston Methodist Cancer Center, Houston, Texas.,Cancer Research Program, Houston Methodist Research Institute, Houston, Texas
| | - Tiancheng He
- Department of Informatics Development, Houston Methodist Hospital, Houston, Texas.,Department of Systems Medicine and Bioengineering, Houston Methodist Research Institute, Houston, Texas
| | - Jitesh B Shewale
- Department of Epidemiology, Human Genetics & Environmental Sciences, University of Texas School of Public Health, Houston, Texas
| | - Donna P Ankerst
- Department of Urology, University of Texas Health Science Center at San Antonio, San Antonio, Texas.,Department of Mathematics, Technical University of Munich, Garching, Germany
| | - Virginia G Kaklamani
- Division of Hematology Oncology CTRC, University of Texas Health Science Center San Antonio, San Antonio, Texas
| | - Angel A Rodriguez
- Houston Methodist Cancer Center, Houston, Texas.,Cancer Research Program, Houston Methodist Research Institute, Houston, Texas.,Department of Medicine, Weill Cornell Medicine, New York, New York
| | - Stephen T C Wong
- Cancer Research Program, Houston Methodist Research Institute, Houston, Texas.,Department of Informatics Development, Houston Methodist Hospital, Houston, Texas.,Department of Systems Medicine and Bioengineering, Houston Methodist Research Institute, Houston, Texas.,Department of Radiology, Neurology, and Neuroscience, Weill Cornell Medicine, New York, New York.,Department of Pathology and Laboratory Medicine, Weill Cornell Medicine, New York, New York
| | - Jenny C Chang
- Houston Methodist Cancer Center, Houston, Texas.,Cancer Research Program, Houston Methodist Research Institute, Houston, Texas.,Department of Medicine, Weill Cornell Medicine, New York, New York
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17
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Kato S, Mori H, Zakimi M, Yamada K, Chinen K, Arashiro M, Shinoura S, Kikuchi K, Murakami T, Kunishima F. Epidermoid Cyst in an Intrapancreatic Accessory Spleen: Case Report and Literature Review of the Preoperative Imaging Findings. Intern Med 2016; 55:3445-3452. [PMID: 27904107 PMCID: PMC5216141 DOI: 10.2169/internalmedicine.55.7140] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
An epidermoid cyst arising within an intrapancreatic accessory spleen (ECIAS) is rare, and also difficult to correctly diagnose before surgery. It is mostly misdiagnosed as a cystic tumor, such as a mucinous cystic neoplasm or as a solid tumor with cystic degeneration, such as a neuro endocrine tumor. We herein report a case of ECIAS and also perform a literature review of 35 reports of ECIAS. Although the preoperative diagnosis of ECIAS using conventional imaging is relatively difficult to make, careful preoperative examinations of the features on computed tomography and magnetic resonance imaging could lead to a correct preoperative diagnosis of ECIAS which might thereby reduce the number of unnecessary resections.
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Affiliation(s)
- Shin Kato
- Department of Gastroenterology, Okinawa Prefectural Chubu Hospital, Japan
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18
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Cheng KJ, Wang SQ, Zhou SH. A case report of an inflammatory myofibroblastic tumor of the neck: A focus on the computed tomography and magnetic resonance imaging findings. Oncol Lett 2015; 10:518-522. [PMID: 26171061 DOI: 10.3892/ol.2015.3168] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/26/2014] [Accepted: 04/09/2015] [Indexed: 11/06/2022] Open
Abstract
Inflammatory myofibroblastic tumors (IMTs) of the neck are rare, with only a few patients reported in the literature. The present study discusses the clinical manifestations, radiographic characteristics and management of these tumors, with a focus on imaging modalities. A case of IMT of the neck is presented and the associated literature is reviewed. In total, seven patients in seven English-language studies, including the present case, and one patient in one Chinese-language study were found. On CT scans, all tumors appeared as soft-tissue densities. Upon magnetic resonance imaging (MRI), all tumors displayed a heterogeneous hypointense-isointense signal on T1-weighted sequences and an isointense-hyperintense signal on T2-weighted sequences. All tumors showed enhancement on enhanced CT and MR images. The imaging features of the neck IMTs can be summarized as follows: i) When enhanced, the tumor displays enhancement on CT and MR images; ii) MRI is superior to CT scans in the differential diagnosis of this disease; iii) in general, the lesion displays a hypointense-isointense signal on T1-weighted sequences and an isointense-hyperintense signal on T2-weighted sequences; iv) due to the fibrous tissue in the tumor, delayed enhancement may be observed on gadolinium-enhanced MR images; and v) due to its benign or intermediate features, the tumor is usually a well-defined mass.
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Affiliation(s)
- Ke-Jia Cheng
- Department of Otolaryngology, The First Affiliated Hospital, College of Medicine, Zhejiang University, Hangzhou, Zhejiang 310003, P.R. China
| | - Shen-Qing Wang
- Department of Otolaryngology, The First Affiliated Hospital, College of Medicine, Zhejiang University, Hangzhou, Zhejiang 310003, P.R. China
| | - Shui-Hong Zhou
- Department of Otolaryngology, The First Affiliated Hospital, College of Medicine, Zhejiang University, Hangzhou, Zhejiang 310003, P.R. China
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19
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Gatlin JL, Hosch R, Khan M. Dermatofibrosarcoma protuberans of the scalp with fibrosarcomatous degeneration and pulmonary metastasis. J Clin Imaging Sci 2011; 1:55. [PMID: 22267990 PMCID: PMC3261608 DOI: 10.4103/2156-7514.90482] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/15/2011] [Accepted: 11/26/2011] [Indexed: 11/12/2022] Open
Abstract
Dermatofibrosarcoma protuberans is a rare locally aggressive cutaneous tumor of intermediate malignancy. It is a slow-growing neoplasm with a marked propensity to recur after resection. Head and neck involvement is unusual and distant metastases are quite rare but tend to be more frequent in tumors that undergo fibrosarcomatous degeneration. We present the imaging and corresponding histopathology in a case of dermatofibrosarcoma protuberans of the scalp demonstrating fibrosarcomatous degeneration and lung metastasis.
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Affiliation(s)
- Joseph L Gatlin
- Department of Radiology-Division of Neuroradiology, University of Mississippi School of Medicine, 2500 North State St, Jackson, MS, USA
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