• Title/Summary/Keyword: lesions

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McCune-Albright syndrome with acromegaly: A case report with characteristic radiographic features of fibrous dysplasia

  • Han-Gyeol, Yeom;Byung-Do, Lee
    • Imaging Science in Dentistry
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    • v.52 no.4
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    • pp.421-427
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    • 2022
  • McCune-Albright syndrome (MAS) is a rare multisystem disorder characterized by a clinical triad of polyostotic fibrous dysplasia (FD), skin pigmentation, and hyperfunctioning endocrinopathies. A 42-year-old man visited our medical hospital for the treatment of intermittent headaches and was diagnosed with MAS with acromegaly. This patient showed various clinical features of MAS, including pituitary adenoma, polyostotic FD, and hypogonadotropic hypogonadism. The FD lesions showed characteristic radiographic features, such as widespread, sclerotic bony lesions in the cranial bones, mixed radiolucent-radiopaque multilocular lesions in the mandible, and radiolucent lesions in the axial and appendicular skeleton. Over the years, the patient had been hospitalized multiple times due to accidental bony fractures associated with the fragile bony state of FD. This report presents a retrospective description of a case of MAS, with a review of the relevant literature.

The Incidental Pancreatic Cyst: When to Worry About Cancer

  • Danielle E. Kruse;Erik K. Paulson
    • Korean Journal of Radiology
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    • v.25 no.6
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    • pp.559-564
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    • 2024
  • Incidental pancreatic cystic lesions are a common challenge encountered by diagnostic radiologists. Specifically, given the prevalence of benign pancreatic cystic lesions, determining when to recommend aggressive actions such as surgical resection or endoscopic ultrasound with sampling is difficult. In this article, we review the common types of cystic pancreatic lesions including serous cystadenoma, intraductal papillary mucinous neoplasm, and mucinous cystic neoplasm with imaging examples of each. We also discuss high-risk or worrisome imaging features that warrant a referral to a surgeon or endoscopist and provid several examples of these features. These imaging features adhere to the latest guidelines from the International Consensus Guidelines, American Gastroenterological Association (2015), American College of Gastroenterology (2018), American College of Radiology (2010, 2017), and European Guidelines (2013, 2018). Our focused article addresses the imaging dilemma of managing incidental cystic pancreatic lesions, weighing the options between imaging follow-up and aggressive interventions.

The Study for Voice Onset Types in Benign Vocal Fold Lesions (양성성대질환에서의 발성시작유형에 관한 연구)

  • Kim, Seong-Tae;Ahn, Cheol-Min;Nam, Soon-Yuhl
    • Journal of the Korean Society of Laryngology, Phoniatrics and Logopedics
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    • v.20 no.2
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    • pp.131-135
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    • 2009
  • Background and Objectives: Benign vocal fold lesions have shown various voice onset types on phonation, however, they have not been documented yet. We studied to know the relationships between benign vocal fold lesions and voice onset types. Materials and Method: 114 subjects were evaluated by using videokymographic examinations. The subjects were classified into three types: normal, contact, and open types according to the patterns of voice onset types on phonation. Benign vocal fold lesions were investigated and voice onset types were compared between normal and disease groups. Voice parameters were obtained from and compared in all subjects to assess acoustic and aerodynamic factors. Results: The normal type among onset types were more than contact type or open type in both normal and disease groups. Disease group showed many contact and open types when. compared with normal group. Vocal nodule and vocal polyp were showed many normal and contact types, however, sulcus vocalis was almost showed open type among voice onset groups. The values of mean flow rate (MFR) of contact type were significantly higher compared to normal type in disease group (p<0.05). Shimmer of contact type was higher than normal type in diseasegroup, but the difference was not significant (p=0.057). Conclusion: Benign vocal fold lesions were related to the various types of voice onset. The various types of voice onset should be considered when benign vocal fold lesions were examined.

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Clinical Results of Tarsal Tunnel Decompression in Case of Known Etiology (원인이 밝혀진 족근관 증후군의 수술적 치료의 결과)

  • Sung, Ki-Sun;Park, Se-Jun
    • Journal of Korean Foot and Ankle Society
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    • v.11 no.2
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    • pp.192-197
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    • 2007
  • Purpose: The purpose of this study is to present our clinical results after surgical treatment in tarsal tunnel syndrome due to space occupying lesions. Material and Methods: We performed surgical decompression for tarsal tunnel syndrome in 20 patients from July 2004 to February 2007. Out of them, thirteen cases were due to space occupying lesions around the tarsal tunnel. The average age at operation was 51.3 years old and the duration from symptom onset to surgery was 16.5 months. The operation included removal of space occupying lesions and tarsal tunnel decompression. The clinical parameters were pain visual analogue scale (VAS), AOFAS scale, and subjective satisfaction. Results: The ganglion cysts were the most frequent causes (ten cases) and synovial chondromatosis in 1 case, neurofibroma in 1 case, talocalcaneal coalition in 1 case. The average follow-up duration was 14.5 months. The AOFAS scale showed significant improvement from 77.8 to 92.7. The average VAS decreased from 6.4 to 2.2. Seven out of thirteen patients were satisfied with the results. The excellent results were shown in six patients, the good results in one patient, the fair result in three patients and the unsatisfactory results in three patients. Conclusion: Favorable results could be obtained in patients with known etiology. But not all cases with surgical decompression of space occupying lesions showed satisfactory results. We assume that the clinical results were related to the multiple factors, not only well performed surgery but also age, size lesions and duration of symptoms, ect.

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Clinical Benefits of Narrow Band Imaging Bronchoscopy in Central Lung Cancer (중심성 폐암 발견에 있어 협대역 내시경의 임상적 유용성)

  • Park, Jin-Kyeong;Jo, Young-Sun;Jang, Sae-Jin;Park, Young-Soo;Choi, Chang-Min
    • Tuberculosis and Respiratory Diseases
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    • v.68 no.1
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    • pp.16-21
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    • 2010
  • Background: Lung cancer is usually diagnosed at an advanced stage, resulting in a poor prognosis. The detection of these lesions at an earlier stage would be a clear benefit to patients. However, it is extremely difficult to detect carcinomatous lesions in the bronchial mucosal sites during a routine bronchoscopy. Methods: This study employed a novel optical technique, known as narrowband imaging (NBI), which allows noninvasive visualization of the microvascular structure of an organ's surface using reflected light. Results: Narrow band imaging was performed on 10 patients who were radiologically suspicious or had a high risk of lung cancer. The median age of the patients was 57.5 years (range, 44~81 years), and 80% of the patients were male. All lesions showed a microvascular proliferation pattern (dotted, tortuous and abruptly ending vessel) on the magnified NBI. Two lesions were confirmed histologically to be adenocarcinoma and the remaining lesions were squamous cell carcinomas. Two lesions were confirmed histologically to be a carcinoma in situ. Conclusion: NBI is a promising and potentially powerful tool for identifying carcinomas at an earlier stage or a central lesion during a routine bronchoscopy examination.

The Effects of Cystic Tyroid Lesions by Ethanol-Instillation (갑상선 낭종 환자에서 Ethanol 경화술의 효과)

  • Lee Hui-Seop;Kim Sang-Woon;Lee Soo-Jung;Shim Min-Chul;Kwun Koing-Bo
    • Korean Journal of Head & Neck Oncology
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    • v.11 no.1
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    • pp.18-23
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    • 1995
  • We analyzed the results of ethanol sclerotherapy in 47 patients with cystic thyroid lesion. Cytologic study showed all of the lesions to be benign. The patients were followed clinically and ultrasonically I month and 3 or more months after ethanol sclerotherapy. If the cystic lesions recurred, repeated treatment was offered. In 4 patients with pure cystic lesion, all of the patents had almost total resolution of the cystic lesions. In 43 patients with mixed cystic lesion, 16(37.2%) patients had almost total resolution of the cystic lesions, 10(23.3%) patients showed a decrease' in the cystic lesion of <50%, but 11(25.6%) patients it did not change in size. Overall, in 30(63.8%) patients the cystic lesion decreased in size. Eleven patients who were not effective by sclerotherapy or follicular proliferation by cytology were converted to surgery. Although no severe complication were observed, there were complication of severe pain in I patient and a drunken feeling in I patient. If the malignancy must be excluded by repeated cytologic examination of aspirated fluid, we consider instillation of ethanol into the cystic lesions of the thyroid to be a simple, safe, economical and effective treatment.

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Vasogenic Edema in Experimental Cerebral Fat Embolism

  • Park Byung-Rae;Koo Bong-Oh
    • Biomedical Science Letters
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    • v.11 no.1
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    • pp.31-36
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    • 2005
  • To evaluate the magnetic resonance imaging and electron microscopic findings of the hyperacute stage of cerebral fat embolism in cats and the time needed for the development of vasogenic edema. Magnetic resonance imaging was performed at 30 minutes (group 1, n=9) and at 30 minutes and 1, 2, 4, and 6 hours after embolization with triolein (group 2, n= 10). As a control for group 2, the same acquisition was obtained after embolization with polyvinyl alcohol particles (group 3, n=5). Electron microscopic examination was done in all cats. In group 1, the lesions were iso- or slightly hyperintense on T2-weighted (T2W) and diffusion-weighted (DWIs) images, hypointense on the apparent diffusion coefficient (ADC) map image, and markedly enhanced on the gadolinium-enhanced T1-weighted images (Gd-T1WIs). In group 2 at 30 minutes, the lesions were similar to those in group 1. Thereafter, the lesions became more hyperintense on T2WIs and DWIs and more hypoinfense on the ADC map image. In group 3, the lesions showed mild hyperintensity on T2WIs at 6 hours but hypointensity on the ADC map image from 30 minutes, with a tendency toward a greater decrease over time. Electron microscopic findings revealed discontinuity of the capillary endothelial wall, perivascular and interstitial edema, and swelling of glial and neuronal cells in groups 1 and 2. The lesions were hyperintense on T2WIs and DWIs, hypointense on the ADC map image, and enhanced on Gd-T1WIs. On electron microscopy, the lesions showed cytotoxic and vasogenic edema with disruption of the blood-brain barrier.

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Immunohistochemical Observation of Plasma Cell Granuloma in Intraoral Chronic Inflammatory Lesions (구강내 만성염증병소에서 보이는 형질세포육아종의 면역조직화학적 관찰)

  • Kim, Yeon-Sook;Lee, Suk-Keun
    • Maxillofacial Plastic and Reconstructive Surgery
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    • v.33 no.1
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    • pp.26-31
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    • 2011
  • Purpose: Chronic inflammatory gingival lesions occur as pyogenic granulomas or non-specific chronic suppurative lesions. Methods: Of the 59 chronic inflammatory gingival lesions examined, plasma cell granuloma (n=14), which showed an intense antibody-mediated immune reaction with the increased infiltration of plasma cells, was observed as a pseudotumor-like gingival overgrowth and myofibroblastic or fibrohistiocytitc proliferation of stromal cells with a heavy collection of plasma cells. The levels of CD3, CD20, CD31, CD68, RANKL, cathepsin G, cathepsin K, lysozyme, TNF${\alpha}$, MMP-2, and MMP-9 in the 14 cases of gingival plasma cell granuloma with immunohistochemical detection were measured to determine the pathogenetic progresses of the plasma cell granuloma compared to the common pyogenic granuloma (n=45) in the gingiva. Results: The gingival lesions of the plasma cell granuloma could be divided into three histological types, plasma cell predominant type (PPT, n=8), mixed inflammatory cell type (MICT, n=2), and sclerosed fibrosis type (SFT, n=4). The PPT showed a condensed infiltration of plasma cells into the perivascular spaces of the granulomatous lesion with frequent formation of Russel's body in their cytoplasm. The MICT showed the concomitant infiltration of many macrophages together with plasma cells, resulting in the diffuse destruction of stromal fibrous tissue. The SFT showed granulomatous lesions replaced gradually by thick collagenous fibrous tissue, resembling an inflammatory pseudotumor. The SFT expressed strongly the lymphocytic markers, CD3 and CD20, and the macrophage/monocyte markers, CD31 and CD68, but showed reduced expression of common inflammatory markers, TNF${\alpha}$, cathepsin G, lysozyme, MMP-2, and MMP-9, as well as the reduced expression of osteoclastogenic markers, RANKL and cathepsin K. Conclusion: These results suggest that a gingival plasma cell granuloma shows variable gene expression for cell-mediated immunity and stromal tissue degeneration, undergoing sclerotic fibrosis with a persistent inflammatory reaction.

Occurrence, clinical signs, postmortem lesions and etiology of enterotoxaemia in Black Bengal goats

  • Islam, K.B.M. Saiful;Rahman, Md. Siddiqur;Ershaduzzaman, Md.;Taimur, M.J.F.A.;Song, Hee-Jong
    • Korean Journal of Veterinary Service
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    • v.31 no.4
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    • pp.475-484
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    • 2008
  • A year round study was carried out to investigate the etiology, clinical signs, postmortem lesions and occurrence of naturally occurring enterotoxaemia in Black Bengal goats. Sixteen goats of different age and sex died in different seasons with sigh associated with enterotoxaemia made the materials of this study. Accidental access to large amount of concentrate was noted as one of the predisposing factors although few cases were reported to occur without known diet change. Younger animals(50%) and males(62.50%) were found more prone to the disease and it was likely to be more prevalent during winter(50%) followed by at rainy season(31.25%) and summer(18.75%). Diarrhoea(81.25%), dullness(56.25%), drooping of the ears(50%), anorexia(43.75%) were recorded as major clinical signs whereas enterocolitis(100%), lung edema(87.50%), fluid filled intestines(87.50%), enlarged mesenteric lymph nodes(56.52%) etc. were most common post mortem lesions found. A few cases showed lesions on heart(31.25%), brain(25%) and/or liver/spleen(18.75%) but no lesion was found on kidney. Thus the so called 'pulpy kidney' lesion was absent. Intestinal contents were subjected to conventional bacteriological culture based methods to identify the causal agents. Based on the morphological, cultural and biochemical properties the causal agent was identified as Clostridium perfringens. Despite the study was carried out at certain area it showed a clear picture of goat enterotoxaemia in terms of etiology, clinical signs, postmortem lesions and occurrence of goat enterotoxaemia in Bangladesh.

Locations and Clinical Significance of Non-Hemorrhagic Brain Lesions in Diffuse Axonal Injuries

  • Chung, Sang Won;Park, Yong Sook;Nam, Taek Kyun;Kwon, Jeong Taik;Min, Byung Kook;Hwang, Sung Nam
    • Journal of Korean Neurosurgical Society
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    • v.52 no.4
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    • pp.377-383
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    • 2012
  • Objective : Detection of focal non-hemorrhagic lesion (NHL) has become more efficient in diffuse axonal injury (DAI) patients using an MRI. The aims of this study are to find out the radiological distribution, progress of NHL and its clinical significance. Methods : Between September 2005 and October 2011, 32 individuals with NHLs on brain MRI were enrolled. NHLs were classified by brain location into 4 major districts and 13 detailed locations including cortical and subcortical, corpus callosum, deep nuclei and adjacent area, and brainstem. The severity of NHL was scored from grades 1 to 4, according to the number of districts involved. Fourteen patients with NHL were available for MRI follow-up and an investigation of the changes was conducted. Results : Thirty-two patients had 59 NHLs. The most common district of NHL was cortical and subcortical area; 15 patients had 20 NHSs. However the most common specific location was the splenium of the corpus callosum; 14 patients had 14 lesions. The more lesions patients had, the lower the GCS, however, this was not a statistically meaningful difference. On follow-up MRI in 14 patients, out of 24 lesions, 13 NHLs resolved, 5 showed cystic change, and 6 showed atrophic changes. Conclusion : NHLs were located most commonly in the splenium and occur frequently in the thalamus and the mesial temporal lobe. Because most NHS occur concomitantly with hemorrhagic lesions, it was difficult to determine their effects on prognosis. Since most NHLs resolve completely, they are probably less significant to prognosis than hemorrhagic lesions.