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Vernuccio F, Lombardo FP, Cannella R, Panzuto F, Giambelluca D, Arzanauskaite M, Midiri M, Cabassa P. Thromboembolic complications of COVID-19: the combined effect of a pro-coagulant pattern and an endothelial thrombo-inflammatory syndrome. Clin Radiol 2020; 75:804-810. [PMID: 32829885 PMCID: PMC7402367 DOI: 10.1016/j.crad.2020.07.019] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/12/2020] [Accepted: 07/28/2020] [Indexed: 02/07/2023]
Abstract
Coronavirus disease 2019 (COVID-19) is a newly emerging human infectious disease that has quickly become a worldwide threat to health, mainly causing severe acute respiratory syndrome. In addition to the widely described respiratory syndrome, COVID-19 may cause life-treating complications directly or indirectly related to this infection. Among these, thrombotic complications have emerged as an important issue in patients with COVID-19 infection, particularly in patients in intensive care units. Thrombotic complications due to COVID-19 are likely to occur due to a pro-coagulant pattern encountered in some of these patients or to a progressive endothelial thrombo-inflammatory syndrome causing microvascular disease. In the present authors' experience, from five different hospitals in Italy and the UK, imaging has proved its utility in identifying these COVID-19-related thrombotic complications, with translational clinical relevance. The aim of this review is to illustrate thromboembolic complications directly or indirectly related to COVID-19 disease. Specifically, this review will show complications related to thromboembolism due to a pro-coagulant pattern from those likely related to an endothelial thrombo-inflammatory syndrome.
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Affiliation(s)
- F Vernuccio
- Department of Health Promotion, Mother and Child Care, Internal Medicine and Medical Specialties, University Hospital of Palermo, Via del Vespro 129, 90127, Palermo, Italy; University Paris Diderot, Sorbonne Paris Cité, Paris, France; I.R.C.C.S. Centro Neurolesi Bonino Pulejo, Contrada Casazza, SS113, 98124, Messina, Italy; Section of Radiology - BiND, University Hospital "Paolo Giaccone", Via del Vespro 129, 90127, Palermo, Italy.
| | - F P Lombardo
- Department of Radiology, ASST Valtellina ed Alto Lario, Ospedale "E. Morelli", Via Zubiani 33, 23035, Sondalo (SO), Italy
| | - R Cannella
- Section of Radiology - BiND, University Hospital "Paolo Giaccone", Via del Vespro 129, 90127, Palermo, Italy
| | - F Panzuto
- Department of Radiology, ASST Lariana, Ospedale "S.Anna", Via Ravona, 20, 22042, San Fermo della Battaglia (CO), Italy
| | - D Giambelluca
- Department of Radiology, ASST Franciacorta, Azienda Ospedaliera M.Mellini, Viale Mazzini 4, 25032, Chiari (BS), Italy
| | - M Arzanauskaite
- Radiology and Imaging Department, Liverpool Heart and Chest Hospital, Liverpool, UK; Cardiovascular Program ICCC, IR, HSCiSP, IIB-Sant Pau, Barcelona, Spain
| | - M Midiri
- Section of Radiology - BiND, University Hospital "Paolo Giaccone", Via del Vespro 129, 90127, Palermo, Italy
| | - P Cabassa
- Department of Radiology, ASST Franciacorta, Azienda Ospedaliera M.Mellini, Viale Mazzini 4, 25032, Chiari (BS), Italy
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Purpura PP, Bignone R, Lombardo FP, Giannone G, Lo Casto A. A bump in the neck. Myositis ossificans of the omohyoid muscle: Imaging findings. Clin Ter 2020; 171:e185-e188. [PMID: 32323703 DOI: 10.7417/ct.2020.2211] [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] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
Myositis ossificans is a benign ossifying soft-tissue mass that occurs in muscle. In the majority of cases it is related to trauma but rarely observed in the neck. A 54 year-old-man with history of minor trauma and anticoagulant drug assumption for V Leiden mutation, was referred to our institution for a painless mass in the right supraclavicular fossa. On CT plan study a mass with negative attenuation values located in the posterior triangle of the neck, into the inferior belly of the right omohyoid muscle was evident. On MRI the lesion appears as an ovalar mass, with smooth borders, isointense to muscles on T1 images, isointense to fat on T2 images, intensely enhancing after i.v. Gd administration. After surgical removal the pathologist concluded for the nature of myositis ossificans. This is the first case, as far as we know, reported in the literature of a myositis ossificans arising in the inferior belly of the omohyoid muscle in a patient treated with dicumarol.
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Affiliation(s)
- P P Purpura
- Diagnostica per immagini - Fondazione Istituto G.Giglio di Cefalù
| | - R Bignone
- Sezione di Scienze radiologiche - BIND, Università degli Studi di Palermo
| | - F P Lombardo
- Sezione di Scienze radiologiche - BIND, Università degli Studi di Palermo
| | - G Giannone
- Dipartimento Promozione della Salute, Materno-Infantile, di Medicina Interna e Specialistica di Eccellenza "G.D'Alessandro" - U.O.C. di Anatomia e Istologia Patologica, Palermo, Italy
| | - A Lo Casto
- Sezione di Scienze radiologiche - BIND, Università degli Studi di Palermo
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Megibow AJ, Lombardo FP, Guarise A, Carbognin G, Scholes J, Rofsky NM, Macari M, Balthazar EJ, Procacci C. Cystic pancreatic masses: cross-sectional imaging observations and serial follow-up. Abdom Imaging 2001; 26:640-7. [PMID: 11907731 DOI: 10.1007/s00261-001-0024-9] [Citation(s) in RCA: 86] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
Abstract
BACKGROUND We retrospectively reviewed the imaging features of a series of patients with cystic pancreatic masses, the majority of whom underwent imaging surveillance. METHODS Imaging data from 30 patients with known cystic pancreatic masses were reviewed. Nine patients had surgical and/or cytologic classification. Of the 21 who were not operated on, all underwent serial imaging surveillance. Of these, five had corroborative endoscopic retrograde cholangiopancreatography and 16 were followed by only computed tomography and/or magnetic resonance imaging. RESULTS In the nonoperated group, mean follow-up time was 30 months (3-144 months). Two patients demonstrated growth, and the remainder remain stable. In the patients who underwent surgery, invasive carcinoma was found in those with lesions larger than 4 cm, involvement of the main pancreatic duct, or visible solid components on the imaging study. Smaller lesions were benign. CONCLUSION In patients with suspected cystic pancreatic neoplasms, surveillance might be possible if lesions are smaller than 2.5 cm, spare the main pancreatic duct, and demonstrate no solid components.
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Affiliation(s)
- A J Megibow
- Department of Radiology, NYU Medical Center, New York, NY 10016, USA
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Lombardo FP, Hertford DE, Tan LK, Kazam E, Ramirez de Arellaro E. Epidermoid cyst of the liver complicated by microscopic squamous cell carcinoma: CT, ultrasound, and pathology. J Comput Assist Tomogr 1995; 19:131-4. [PMID: 7822529 DOI: 10.1097/00004728-199501000-00025] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/27/2023]
Abstract
Though cystic hepatic lesions may have features that help characterize them by noninvasive imaging modalities, these findings are often nonspecific and may be unable to establish the presence of malignancy. This is illustrated here by describing an epidermoid cyst of the liver containing microscopic foci of squamous cell carcinoma. The importance of totally resecting an epidermoid cyst of the liver is emphasized.
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Affiliation(s)
- F P Lombardo
- Department of Radiology, New York Hospital-Cornell Medical Center, NY 10021
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