Purpose: The purpose of our study was to evaluate the CT findings of malarial spleens. Materials and Methods: We reviewed the patient records of 44 patients with malaria during a recent 3.5-year period and we selected 18 patients who underwent an abdominal CT scan. We retrospectively evaluated the CT findings of the malarial spleens and we compared then with those of a control group of 18 men. We analyzed the splenic size, whether or not there was mottled striped splenic enhancement during the arterial phase and the differences of splenic attenuation and the attenuation between the liver and spleen during the precontrast phase, the arterial phase and the portal phase between the two groups. Results: In malarial patients, the spleen was enlarged in all cases (p
The purpose of this study was to define the optimal scoring method for identifying benign intrapulmonary lymph nodes.Subjects for this study were selected from the COPDGene study, a large multicenter longitudinal observational cohort study. A retrospective case-control analysis was performed using identified nodules on a subset of 377 patients who demonstrated 765 pulmonary nodules on their baseline computed tomography (CT) study. Nodule characteristics of 636 benign nodules (which resolved or showed <20% growth rate at 5 y follow-up) were compared with 51 nodules that occurred in the same lobe as a reported malignancy. Two radiologists scored each pulmonary nodule on the basis of intrapulmonary lymph node characteristics. A simple scoring strategy weighing all characteristics equally was compared with an optimized scoring strategy that weighed characteristics on the basis of their relative importance in identifying benign pulmonary nodules.A total of 479 of 636 benign pulmonary nodules had the majority of lymph node characteristics, whereas only 1 subpleural nodule with the majority of lymph node characteristics appeared to be malignant. Only 279 of 479 (58%) of benign pulmonary nodules with the majority of lymph node characteristics were intrafissural or subpleural. The optimized scoring strategy showed improved performance compared with the simple scoring strategy with average area under the curve of 0.80 versus 0.55. Optimized cutoff scores showed negative likelihood values for both readers of <0.2. A simulation showed a potential reduction in CT utilization of up to 36% for Fleischner criteria and up to 5% for LUNG-RADS.Nodules with the majority of lymph node characteristics, regardless of location, are likely benign, and weighing certain lymph node characteristics greater than others can improve overall performance. Given the potential to reduce CT utilization, lymph node characteristics should be considered when recommending appropriate follow-up.
Purpose: We wanted to evaluate the imaging findings of fibrous hamartoma of infancy (FHI). Materials and Methods: We retrospectively reviewed the clinical presentation and the sonographic (n = 5) and CT (n = 3) findings of 5 cases of surgically/pathologically confirmed FHI. The sonographic findings were evaluated according to the location, size, internal echogenicity and vascularity. The CT findings were evaluated according to the attenuation of the mass on both the pre- (n = 3) and postcontrast (n = 2) scans. The image findings were correlated with the pathologic findings. Results: The mean age was 14.8 months (range, 7 months - 3 years). The location of lesions was all in the fatty layer of the back (n = 4) and upper arm (n = 1). All the lesions demonstrated-hypertrichosis on the overlying skin. The lesions measured 31.2 mm in the longest diameter (range: 18 mm - 50 mm). The sonographic findings were purely solid, heterogeneously hyperechoic and hypovacular for all the cases. The internal architecture revealed a ‘layering’ appearance (n = 3). The CT findings demonstrated isoattenuation, as compared to the adjacent muscle on both the pre- and postcontrast CT scans. The pathologic correlation demonstrated a characteristic ‘organoid’ mixture of fibrous, mucoid and fatty tissues in all cases. Conclusion: The diagnosis of FHI can be suggested by the sonographic findings of a superficially located, heterogeneous solid mass with a ‘layering’ appearance in the fatty layer of the back or arms of infants with local hypertrochosis on the overlying skin.
Giant cell tumor of bone is a benign, but potentially aggressive lesion that can show local recurrence and metastases. We report here on a case of a 29-year-old man who presented with an incidentally found mediastinal mass. Chest radiography and computed tomography showed a huge mediastinal mass with bilateral pulmonary nodules and the diagnosis of giant cell tumor with benign pulmonary metastasis was confirmed. To the best of our knowledge, this is the first reported case of primary thoracic spinal giant cell tumor manifesting as a huge mediastinal mass with pulmonary metastases.
Follicular thyroid carcinoma (FTC), which is the second common malignancy of the thyroid gland following papillary thyroid carcinoma (PTC), is usually diagnosed histologically by capsular and/or vascular invasion on permanent section. Meanwhile, it is more likely to metastasize to distant organs rather than to regional lymph nodes. The FTC may present with metastatic disease and the diagnosis can be made by histological examination of the metastatic disease (1). It is now well-known that the eggshell calcification of the thyroid nodule occurs in various benign and malignant diseases of the thyroid gland. Our review of the literature yielded four cases of FTC with eggshell calcification, with three of them presenting with distant metastasis and one with thyroid incidentaloma (2, 3). We report here of a case of FTC in a 74-year-old male, with the interrupted eggshell calcification, presenting with renal and bony metastases along with the findings of primary and metastatic lesions at gray-scale, power Doppler ultrasonography (PD US), and CT scan.
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