Fetal echocardiographic diagnosis of isolated ductus arteriosus aneurysm: a longitudinal study from 32 weeks of gestation to term.
(65/807)
OBJECTIVE: To investigate the echocardiographic characteristics of isolated fetal ductus arteriosus aneurysm (DAA) and the factors influencing its development. METHODS: Fetal echocardiograms for 509 low-risk singleton pregnancies were performed longitudinally from 32 weeks of gestation. The ventricular outflow tracts and great vessels were visualized, focusing on changes in the ductus arteriosus (DA), and fetuses with DAA or ductus arteriosus dilatation (DAD) were identified. Prenatal and perinatal findings were compared between those infants diagnosed postnatally with and those without neonatal DAA. RESULTS: Forty-one of the 509 fetuses (8.1%) studied had neonatal DAA; 2.2% (11/509) had DAA and 5.9% (30/509) DAD before delivery. The mean gestational age at the time of diagnosis of fetal DAA/DAD was 36.9 +/- 1.7 weeks. The mean maximal internal diameter of DAA/DAD was 8.0 +/- 0.8 mm at initial diagnosis, increasing to 10.8 +/- 1.6 mm before delivery. All cases originated from the aortic end of the DA. Compared with fetuses without neonatal DAA, the affected cases had a markedly more curved DA prior to diagnosis, and higher peak velocities at the aortic end of the DA (P < 0.05). Newborns with fetal DAA/DAD had a larger placental weight to birth body weight (BBW) ratio and were less likely to have a BBW appropriate for gestational age (P < 0.05). All cases of fetal DAA/DAD regressed spontaneously. CONCLUSION: Isolated neonatal DAA is a continuity of fetal DAA/DAD. The development of fetal DAA/DAD is likely to be related to the higher peak velocities in the more markedly curved DA occurring in the latter part of the third trimester. Fetal DAA/DAD usually initiates at the aortic end of the DA, followed by progression towards the pulmonary end. (+info)
Incidental finding of a large pulmonary valve fibroelastoma: a case report.
(66/807)
Papillary fibroelastoma (PFE) is an uncommon primary neoplasm of cardiac origin. They are solitary neoplasms that historically were an incidental finding at the time of autopsy. With the advent of two-dimensional echocardiography, symptomatic cases have been reported in current literature, thus causing a paradigm shift in the management of these tumors. Although the majority of PFE are benign, because of their potential risk for complication related to embolic and obstructive phenomena, they are now considered hazardous and require tumor excision even in asymptomatic patients. We report a case of an asymptomatic incidental large papillary fibroelastoma within the right ventricular outflow tract. (+info)
Hepatic B-cell non-Hodgkin's lymphoma of MALT type in the liver explant of a patient with chronic hepatitis C infection.
(67/807)
B-cell non-Hodgkin's lymphoma (B-NHL) is a well-documented complication of hepatitis C virus (HCV) infection. Marginal zone (mucosa-associated lymphoid tissue; MALT) lymphomas constitute a less common type of B-NHL. In this article, we report a case of liver MALT in a cirrhotic patient, incidentally discovered after liver transplantation (LT). We discuss pertinent diagnostic and management strategies in this clinical setting. (+info)
Littoral cell angioma of the spleen treated by laparoscopic splenectomy.
(68/807)
Massive splenomegaly due to multifocal littoral cell angioma was discovered incidentally in a 55-year-old man during a workup for an unrelated condition. The tumor was removed successfully by laparoscopic splenectomy. We report the second case of littoral cell angioma of the spleen treated laparoscopically. (+info)
Serum chromogranin-A assay in differential diagnosis of incidentally discovered adrenal masses.
(69/807)
Adrenal incidentalomas are defined as asymptomatic adrenal masses occasionally discovered during high-resolution imaging procedures such as computed tomography (CT) or magnetic resonance (MR). Pheochromocytoma, a potentially lethal chromaffin tumour, must be excluded before any invasive diagnostic procedures to avoid massive catecholamines release. Chromogranin A (CgA) is a member of the granin family contained in secretory vescicles of chromaffin adrenal cells. Consequently, serum CgA increases in patients affected by pheochromocytoma and other diseases of the chromaffin system. This study investigated the performance of serum CgA assay in diagnosis of pheochromocytoma among patients affected by adrenal incidentaloma. Additionally, we evaluated the role of the CgA assay in selection of patients for 123I-metaiodobenzyl-guanidine (MIBG) scintigraphy, a very accurate but high-cost and time-consuming imaging procedure. We enrolled 104 patients affected by adrenal incidentally discovered masses and 100 healthy blood donors as controls. Serum CgA was assayed by a specific immunoradiometric method (IRMA) and 123I-MIBG scan was performed in all patients. A cytological or histological diagnosis was obtained in all cases. Circulating CgA assay was positive in 12 out of 12 patients with pheochromocytoma and negative in 92 out of 92 patients with non-chromaffin adrenal nodules. Serum levels of CgA clearly increased from blood donors and patients with non-chromaffin adrenal nodules to patients with pheochromocytoma (p<0.0001). All patients with negative CgA assay showed a negative 1231-MIBG scan. Serum CgA assay is effective in evaluating the presence of chromaffin tumour among patients with adrenal incidentaloma. A negative serum CgA assay rules out successive 123I-MIBG imaging. (+info)
Incidental radiological diagnosis of rickets.
(70/807)
Rickets fortunately remains rare in the United Kingdom, although its actual incidence is currently undetermined.1 Many still consider it to be a disease of poverty prevalent during the Victorian era. However, a number of recent articles have highlighted concern among British health professionals about the number of cases still being diagnosed in this country. These cases have nearly all involved non-Caucasian children who are considered to be at high risk due to skin colour, prolonged breast feeding, and low maternal vitamin D levels. Their presentations are variable ranging from failure to thrive, bone deformities, seizures, and even stridor. The diagnosis is usually made in babies and toddlers.We present a series of patients attending our accident and emergency (A&E) department, over a five month period, where the diagnosis of rickets was primarily a radiological diagnosis. (+info)
A metachronous, atypical, multifocal renal oncocytoma with a concomitant renal cell carcinoma of the contralateral side and bilateral multifocal oncocytomas: two case reports and review of literature.
(71/807)
We present one case of a metachronous, atypical, multifocal renal oncocytoma with a concomitant chromophobe renal cell carcinoma (RCC) of the contralateral side and one case of bilateral and multifocal oncocytomas. Oncocytomas are benign renal tumours that rarely appear bilateral or multifocal or with coexisting RCC. A common pathogenic denominator of oncoytomas and RCC is being discussed. The first case was a 63 years old patient presenting with a history of nephrectomy for a pT1 G1 pN0 R0 papillary RCC 4 years prior to presentation, showed two tumours of a singular kidney. Upon nephron-sparing surgery one typical and one atypical oncocytoma with an invasion of the perinephric fat were found. Comparative genomic hybridisation was performed. Both tumours revealed genetic alterations with loss of genetic material on chromosome 1p. The second case was a 62 years old patient presenting with multifocal and bilateral renal tumours of undeclared dignity upon imaging. During open exploration all tumours could be removed by nephron-sparing surgery and were identified as oncocytomas. Again comparative genomic hybridisation was performed. All 4 tumours revealed genetic alterations with loss of genetic material on chromosome 1p, one of the tumours an additional loss of chromosome 10. (+info)
Synchronous primary neoplasms detected on 18F-FDG PET in staging of patients with esophageal cancer.
(72/807)
Because of improvements in diagnostic technology, the incidental detection of synchronous primary tumors during the preoperative work-up of patients with esophageal cancer has increased. The aim of this study was to determine the rate and clinical relevance of synchronous neoplasms seen on (18)F-FDG PET in staging of esophageal cancer. METHODS: From January 1996 to July 2004, 366 patients with biopsy-proven malignancy of the esophagus underwent (18)F-FDG PET for initial staging. This series of patients was retrospectively reviewed for the detection of synchronous primary neoplasms. RESULTS: Twenty synchronous primary neoplasms (5.5%) were identified in 366 patients. Eleven neoplasms were in the colorectum, 5 in the kidney, 2 in the thyroid gland, 1 in the lung, and 1 in the gingiva. One of the thyroid lesions and the lung lesion were erroneously interpreted as metastases, leading to incorrect upstaging of the esophageal tumor. CONCLUSION: (18)F-FDG PET detected unexpected synchronous primary neoplasms in 5.5% of patients with esophageal cancer. Sites of pathologic (18)F-FDG uptake should be confirmed by dedicated additional investigations before treatment, because synchronous neoplasms may mimic metastases. (+info)