• Title/Summary/Keyword: Cystic mass

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Large Duct Pancreatic Ductal Adenocarcinoma: A Morphological Variant of Pancreatic Ductal Adenocarcinoma With Distinct CT and MRI Characteristics

  • Se Jin Choi;Sung Joo Kim;Dong Wook Kim;Seung Soo Lee;Seung-Mo Hong;Kyung Won Kim;Jin Hee Kim;Hyoung Jung Kim;Jae Ho Byun
    • Korean Journal of Radiology
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    • v.24 no.12
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    • pp.1232-1240
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    • 2023
  • Objective: To investigate the imaging characteristics of large duct pancreatic ductal adenocarcinoma (LD-PDAC) on computed tomography (CT) and magnetic resonance imaging (MRI). Materials and Methods: Thirty-five patients with LD-PDAC (63.2 ± 9.7 years) were retrospectively evaluated. Tumor morphology on CT and MRI (predominantly solid mass vs. solid mass with prominent cysts vs. predominantly cystic mass) was evaluated. Additionally, the visibility, quantity, shape (oval vs. branching vs. irregular), and MRI signal intensity of neoplastic cysts within the LD-PDAC were investigated. The radiological diagnoses rendered for LD-PDAC in radiology reports were reviewed. Results: LD-PDAC was more commonly observed as a solid mass with prominent cysts (45.7% [16/35] on CT and 37.1% [13/35] on MRI) or a predominantly cystic mass (20.0% [7/35] on CT and 40.0% [14/35] on MRI) and less commonly as a predominantly solid mass on CT (34.3% [12/35]) and MRI (22.9% [8/35]). The tumor morphology on imaging was significantly associated with the size of the cancer gland on histopathological examination (P = 0.020 [CT] and 0.013 [MRI]). Neoplastic cysts were visible in 88.6% (31/35) and 91.4% (32/35) of the LD-PDAC cases on CT and MRI, respectively. The cysts appeared as branching (51.6% [16/35] on CT and 59.4% [19/35] on MRI) or oval shapes (45.2% [14/35] on CT and 31.2% [10/35] on MRI) with fluid-like MRI signal intensity. In the radiology reports, 10 LD-PDAC cases (28.6%) were misinterpreted as diseases other than typical PDAC, particularly intraductal papillary mucinous neoplasms. Conclusion: LD-PDAC frequently appears as a solid mass with prominent cysts or as a predominantly cystic mass on CT and MRI. Radiologists should be familiar with the imaging features of LD-PDAC to avoid misdiagnosis.

Laparoscopic Extirpation of the Term Sized Huge Ovarian Cyst (만삭 크기 거대 난소 낭종의 복강경 적출술)

  • Koh, Min-Whan;Choo, Hyun-Cheol;Kwon, Oh-Jin;Kim, Jeong-Sook
    • Journal of Yeungnam Medical Science
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    • v.21 no.1
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    • pp.108-113
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    • 2004
  • A 23 years old single nulligravida woman underwent laparoscopic removal of a huge cystic adnexal mass that occupied her entire abdomen, giving the appearance of a full term pregnancy. After anesthesia, a vertical infra-umbilical incision, 1 cm long, was made and a telescope was introduced through the port to determine the status of the intra-abdomen and the surface contour of the mass. A needle tipped with a laparoscopic suction apparatus was inserted into the cyst through the infra-umbilical port, directly under the mass. Subsequently, 3,200 ml of cystic fluid was aspirated without spillage. A huge cyst, reaching to the level of the xyphoid process was effectively excised through the operative laparoscopy after prelaparoscopic drainage. Operation time was 140 minutes and hospital stay was 2 days. There were no complications during hospital stay and after discharge. It seems the size of the cyst is not a criteria for the contraindication of laparoscopic surgery.

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Primary sinonasal mucosal melanoma simulated as cystic lesions: a case report

  • Shin, Sung-Ho;Seok, Hyun;Kim, Seong-Gon;Hong, Seong-Doo
    • Journal of the Korean Association of Oral and Maxillofacial Surgeons
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    • v.44 no.1
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    • pp.29-33
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    • 2018
  • Sinonasal mucosal melanoma (SNMM) in the maxillary sinus is a rare disease condition. Compared to oral mucosal melanoma, SNMM has a bulky, exophytic, and polypoid appearance, is weakly pigmented, and associated with unspecific symptoms. Due to these features, SNMM in the maxillary sinus has been misdiagnosed as nasal polyps and chronic sinusitis. In this case report, we described SNMM occurring in the right maxillary sinus simulated as a cystic or benign lesion. Cortical bone thinning and expansion were observed around the mass. The excised soft mass was encapsulated and weakly pigmented. The mass was clearly excised and covered with a pedicled buccal fat pad graft. Diagnosis using immunohistochemistry with S-100 and homatropine methylbromide-45 (HMB-45) is critical for proper treatment.

Mediastinal Cavernous Hemangioma (상대정맥에 발생한 해면상 혈관종 -1례 보고-)

  • 김동원;이재영;배철영;신원선;맹대현;곽영태;이신영
    • Journal of Chest Surgery
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    • v.31 no.1
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    • pp.69-72
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    • 1998
  • Mediastinal hemangioma is a rare tumor and only few cases have been reported in the literatures. We have experienced one case of cavernous hemangioma occuring at the superior vena cana. The patient was a thrity-five year old female with no specific symtoms except palpable cystic mass in the right cervical area. A routine chest radiography showed an upper mediastinal mass. Computed Tomography showed about 4$\times$5 cm sized cystic mass communicating to the superior vena cava 2 cm above of the veno-atrial junction. After the evaluation, surgical excision was performed and the pathologic diagnosis was confirmed to cavernous hemangioma. Postoperative course was uneventful and the patient has been followed up without any problems.

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Eruption of a venous malformation through an iliac bone harvesting site after trauma

  • Kono, Tatsuki;Saiga, Atsuomi;Tamagawa, Keiichi;Katsuki, Kensuke;Nomura, Misako;Hokazono, Toshinori;Uchida, Yuuki
    • Archives of Plastic Surgery
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    • v.45 no.6
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    • pp.588-592
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    • 2018
  • Harvesting grafts from the anterior iliac bone has been associated with various complications. A 50-year-old woman presented to our department with a chief complaint of right inguinal swelling and pain. Autologous bone grafts had been harvested on two previous occasions from the right anterior iliac crest for use in the reconstruction of multiple facial fractures. Computed tomography and magnetic resonance imaging revealed a full-thickness bone defect in the right anterior iliac crest. A mass was noted in the right gluteus minimus, while a multilocular cystic mass extended from the right iliac crest defect to the right inguinal region. Both the inguinal mass and gluteal mass were removed under general anesthesia. Following histopathological analysis, the gluteal mass was diagnosed as a venous malformation (VM). Based on the patient's clinical course, iliac bone graft harvesting and trauma to the gluteal region triggered hemorrhaging from the VM. Blood components leaked out from the fragile portion of the iliac bone defect, forming a cystic lesion that developed into the inguinal mass. In this case, a coincidental VM resulted in a rare complication of iliac bone graft harvesting. These sequelae could have been avoided by planning for more appropriate ways to collect the grafts.

A Case of Late Presentation of Congenital Cystic Adenomatoid Malformation of the Lung (14세 여아에서 발견된 선천성 낭종성 선종성 기형 1예)

  • Lee, Myung In;Sohn, So Hee;Lee, Dae Joon;Ha, Dong Yul;Jee, Young Koo;Lee, Kye Young;Kim, Keun Youl;Choi, Young Hi;Cho, Jeong Hi;Seo, Pil Weon;Kim, Sam Hyun
    • Tuberculosis and Respiratory Diseases
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    • v.43 no.5
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    • pp.805-811
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    • 1996
  • Congenital cystic adenomatoid malformation of the Lung(CCAM) is characterized by anomalous fetal development of terminal respiratory structures, resulting in an adenomatoid proliferation of bronchiolar elements and cystic formation. CCAM was first described and differentiated from other cystic lung disease in the English literature by Ch'in and Tang in 1949. CCAN is a rare, potentially lethal form of congenital pulmonary cystic disease and the salient features of lesion are an irregular network of terminal respiratory bronchiole-like structures and macrocysts variably lined by pseudostratified ciliated columnar epithelium and simple cuboidal epithelium. Adult presentation of CCAM of the lung is so rare that only 9 cases have been reported in the literature of date. The pathogenesis of CCAM remains disputed and reseachers have variously proposed that the lesion represents a developmental anomaly, hamartoma, or a fonn of pulmonary dysplasia. Van Dijk and Wagenvoort divided CCAM into three subtypes : cystic, intermediated, and solid. These correspond to types I, II, and III of Stocker. In adults, the evaluation of cystic or multi cystic lung disease requires consideration of a differential diagnosis including the acquired lesions of lung abscess, cavitary neoplasm or inflammatory mass, bullous disease, bronchiectasis, and postionflammatory pneumatocele. Congenital lesions such as sequestration, bronchopulmonary-foregut anomalies, and bronchogenic cyst are also encounted. The definitive treatment for CCAM is complele removal of the involved lobe. Panial lobectomy leads to multiple complications, including severe post-operative infection. We report a case of CCAM in a 14-year-old female presentated with a pneumothorax and large bullae, who was treated by surgical remove of the involved lobe.

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A late onset solitary mediastinal cystic lymphangioma in a 66-year-old woman who underwent kidney transplantation

  • Lee, Jung Mo;Lee, Sang Hoon;Park, Youngmok;Kim, Chi Young;Goag, Eun Kyoung;Lee, Eun Hye;Park, Ji Eun;Lee, Chang Young;Kim, Se Kyu
    • Journal of Yeungnam Medical Science
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    • v.32 no.2
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    • pp.155-158
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    • 2015
  • Lymphangioma is a congenital abnormality of the lymphatic system detected primarily in early childhood. There are rare reports of mediastinal lymphangioma in older adults. We hereby report on a 66-year-old female patient who underwent kidney transplantation 20 years previously and who developed pathologically confirmed solitary mediastinal lymphangioma 1 year ago. Chest radiography showed a mediastinal nodule, which was not observed 2 year previously, therefore she was referred to the pulmonary division. She had no symptoms, and chest computed tomography demonstrated a 25-mm, well-defined, low-density nodule located at the anterior mediastinum. The size of the nodule had increased from 25 mm to 34 mm 1 year later, and it was completely resected via video-assisted thoracic surgery. The histological diagnosis was cystic lymphangioma. Therefore, we recommend that clinicians consider cystic lymphangioma as a possible diagnosis even in older patients with a mediastinal cystic mass that shows progressive enlargement.

Fecal Calprotectin and Phenotype Severity in Patients with Cystic Fibrosis: A Systematic Review and Meta-Analysis

  • Talebi, Saeedeh;Day, Andrew S.;Rezaiyan, Majid Khadem;Ranjbar, Golnaz;Zarei, Mitra;Safarian, Mahammad;Kianifar, Hamid Reza
    • Pediatric Gastroenterology, Hepatology & Nutrition
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    • v.25 no.1
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    • pp.1-12
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    • 2022
  • Inflammation plays an important role in the outcome of patients with cystic fibrosis (CF). It may develop due to cystic fibrosis transmembrane conductance regulator protein dysfunction, pancreatic insufficiency, or prolonged pulmonary infection. Fecal calprotectin (FC) has been used as a noninvasive method to detect inflammation. Therefore, the aim of the current meta-analysis was to investigate the relationship between FC and phenotype severity in patients with CF. In this study, searches were conducted in PubMed, Science Direct, Scopus, and Embase databases up to August 2021 using terms such as "cystic fibrosis," "intestine," "calprotectin," and "inflammation." Only articles published in English and human studies were selected. The primary outcome was the level of FC in patients with CF. The secondary outcome was the relationship between FC and clinical severity. Statistical analysis was performed using Comprehensive Meta-Analysis software. Of the initial 303 references, only six articles met the inclusion criteria. The mean (95% confidence interval [CI]) level of FC was 256.5 mg/dL (114.1-398.9). FC levels were significantly associated with pancreatic insufficiency (mean, 243.02; 95% CI, 74.3 to 411.6; p=0.005; I2=0), pulmonary function (r=-0.39; 95% CI, -0.58 to -0.15; p=0.002; I2=60%), body mass index (r=-0.514; 95% CI, 0.26 to 0.69; p<0.001; I2=0%), and Pseudomonas colonization (mean, 174.77; 95% CI, 12.5 to 337.02; p=0.035; I2=71%). While FC is a reliable noninvasive marker for detecting gastrointestinal inflammation, it is also correlated with the severity of the disease in patients with CF.

A Case of Cavitated Uterine Mass from Müllerian duct in a Mixed Breed Dog

  • Park, Chul-Ho;Son, Chang-Ho
    • Journal of Veterinary Clinics
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    • v.35 no.6
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    • pp.279-281
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    • 2018
  • This report describes a case of newly recognized congenital $M{\ddot{u}}llerian$ duct anomaly in a bitch. A fourteen-year-old, mixed breed bitch was presented with mild hematuria and mammary gland tumor. Complementary examinations were performed and abdominal ultrasonography revealed distended uterine horns and uterine tumor-like mass around the right ovarian area. Macroscopic examination showed the mass to be on the level of insertion of the right round ligament. The mass was cystic in nature, and had no communication with the uterine cavity. Histopathologically, the mass was identified as an accessory cavity lined by functional endometrium, which confirmed the diagnosis of accessory and cavitated uterine mass.

A CASE REPORT OF BRANCHIAL CLEFT CYST IN THE NECK (경부에 발생한 새열낭 (branchial cleft cyst)의 증례보고)

  • Lee Young-Mi;Choi Soon-Chul;Park Tae-Won;You Dong-Soo
    • Journal of Korean Academy of Oral and Maxillofacial Radiology
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    • v.23 no.2
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    • pp.365-372
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    • 1993
  • Branchial cleft cyst is the most common lateral neck cyst; the vast majority are of the second branchial cleft origin. This presumably reflects the greater depth and longer persistence of the second cleft, compared with the first, third, and fourth clefts. We experienced a 49-year-old male whose chief complaint was a abnormal mass of the left parotid gland area and neck. As a result of careful analysis of clinical, radiological, and histopathological findings, we diagnosed it as a second branchial cleft cyst in the neck and obtained results as follows: 1. In clinical examination, there was a 10×15㎝ sized, fluctuant painful mass in the left neck and parotid area. 2. In radiographic examination, a low echogenic mass with internal cystic change in the inferior parotid gland area was noted sonographically. Computed tomograph showed a 3×4㎝ sized, well-defined cystic mass with heterogenous solid component in the anterior border of sternocleidomastoid muscle. MRI revealed 5×6㎝ sized, well-marginated multi separated mass in the same area. 3. In histopathological examination, lining of cyst was stratified squamous epithelium with typical lymph node pattern and inflammatory cell infiltration.

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