• Title/Summary/Keyword: Incidental findings

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Foramen transversarium enlargement caused by vertebral artery tortuosity: Diagnosis with cone-beam computed tomography and magnetic resonance angiography

  • Omami, Galal
    • Imaging Science in Dentistry
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    • v.51 no.3
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    • pp.329-332
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    • 2021
  • A markedly enlarged foramen transversarium was discovered incidentally on a cone-beam computed tomography scan of a 72-year-old male patient who was referred for dental implant placement. Further evaluation with magnetic resonance angiography revealed that the foramen enlargement was caused by a tortuosity in the course of the vertebral artery. This case report highlights the importance of recognizing significant incidental findings on diagnostic images and the potential need for additional imaging as part of the complete interpretative process.

Incidental Benign Parotid Lesions on FDG-PET: Prevalence and Clinico-pathologic Findings (FDG-PET 검사시 우연히 발견한 양성 이하선 병변: 유병율과 임상 및 병리 소견)

  • Lim, Il-Han;Lee, Won-Woo;Chung, Jin-Haeng;Park, So-Yeon;Kim, Sang-Hee;Kim, Yu-Kyeong;Kim, Sang-Eun
    • Nuclear Medicine and Molecular Imaging
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    • v.41 no.5
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    • pp.359-363
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    • 2007
  • Purpose: Incidental parotid lesions on F-18 FDG-PET can mimic distant metastasis of underlying malignancy. The prevalence and the clinico-pathologic findings of PET positive parotid lesions have not been known. We investigated how often incidental parotid lesions are found on clinical FDG-PET studies and what the clinico-pathologic characteristics of those parotid lesions are in the present study. Materials and Methods: We retrospectively reviewed 3,344 cases of FDG-PET which had been obtained in our hospital from May 2003 to Dec 2006. The indications of FDG-PET were: evaluation of known/suspected cancer (n= 3,212) or screening of cancer in healthy subjects (n=132). Incidental parotid lesion on FDG-PET was defined as an un-expected FDG uptake in one of parotid glands which was not primary target lesion of current FDG-PET. FDG uptake was represented by maximum standardized uptake value (maxSUV). Final diagnosis was made by pathologic analysis or clinical follow-up assessment. Results: Fifteen (0.45% = 15/3,344) incidental parotid lesions were found and they were all benign lesions. The maxSUV ranged from 1.7 to 8.6 (mean${\pm}$s.d. = $3.7{\pm}1.9$). Final diagnoses of the incidental parotid lesions were; Warthin's tumor (n=2), pleomorphic adenoma (n=1), other un-specified benign lesion (n=1), and benign lesions under bases of imaging studies (n=3) and of clinical follow-up (n=8). Conclusion: All of incidentally found parotid lesions in clinical FDG-PET studies were confirmed as benign lesions with prevalence of 0.45%. Close follow up using PET or CT might be a reasonable approach for determining the nature of incidentally found parotid lesions.

Normative Issues in Next Generation Sequencing Gene Testing

  • Na-Kyoung Kim
    • Development and Reproduction
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    • v.27 no.1
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    • pp.47-56
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    • 2023
  • Despite the commercialization of Next generation sequencing (NGS) gene testing, only a few studies have addressed the various ethical and legal problems associated with NGS testing in Korea Here, we reviewed the normative issues that emerged at each stage of the wet analysis and bioinformatics analysis of NGS gene testing. In particular, it was in mind to apply various international guidelines and the principles of bioethics to actual clinical practice. Considering the characteristics of NGS testing, wet analysis of additional testing can be justified if presumptive consent is recognized. Furthermore, the medical relationship between diseases needs to be established and it should be clear that the patient would have given consent if the patient had been aware of the correlation between genes. At the stage of bioinformatics analysis, the question of unsolicited findings arises. In case of unsolicited and relevant findings, according to American College of Medical Genetics and Genomics (ACMG), a recognized relationship between genes and diseases needs to be established. In case of unsolicited and not-relevant findings, it is almost impossible to determine whether knowing or not knowing the findings is more beneficial to the patient. However, it seems to be certain that the psychological harm an individual may suffer from such information is likely to be greater if the disease is severe and if there is no cure. The list of genes for which the ACMG guidelines impose reporting obligations is a good reference for judgment.

Clival lesion incidentally discovered on cone-beam computed tomography: A case report and review of the literature

  • Jadhav, Aniket B.;Tadinada, Aditya;Rengasamy, Kandasamy;Fellows, Douglas;Lurie, Alan G.
    • Imaging Science in Dentistry
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    • v.44 no.2
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    • pp.165-169
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    • 2014
  • An osteolytic lesion with a small central area of mineralization and sclerotic borders was discovered incidentally in the clivus on the cone-beam computed tomography (CBCT) of a 27-year-old male patient. This benign appearance indicated a primary differential diagnosis of non-aggressive lesions such as fibro-osseous lesions and arrested pneumatization. Further, on magnetic resonance imaging (MRI), the lesion showed a homogenously low T1 signal intensity with mild internal enhancement after post-gadolinium and a heterogeneous T2 signal intensity. These signal characteristics might be attributed to the fibrous tissues, chondroid matrix, calcific material, or cystic component of the lesion; thus, chondroblastoma and chondromyxoid fibroma were added to the differential diagnosis. Although this report was limited by the lack of final diagnosis and the patient lost to follow-up, the incidental skull base finding would be important for interpreting the entire volume of CBCT by a qualified oral and maxillofacial radiologist.

Intracranial ipoma : CT and MRI Findings

  • Lee, Jong-Deok;Choi, Chang-Min
    • Journal of Physiology & Pathology in Korean Medicine
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    • v.19 no.3
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    • pp.830-833
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    • 2005
  • Intracranial lipomas are rare lesions, which are believed to be congenital malformations. They are usually asymptomatic incidental findings and localized in the midline. However, they may occasionally produce neurological symptoms such as seizure, headache, mental changes, paresis. Currently, diagnosis of intracranial lipomas is made on based of imaging modalities, particularly Magnetic resonance imaging(MRI). Because Lipomas are strongly adherent to the surroundings and typically enclose both vessels and nerves, Surgical approach is rarely indicated.

Whole-exome sequencing analysis in a case of primary congenital glaucoma due to the partial uniparental isodisomy

  • Zavarzadeh, Parisima Ghaffarian;Bonyadi, Morteza;Abedi, Zahra
    • Genomics & Informatics
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    • v.20 no.3
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    • pp.28.1-28.7
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    • 2022
  • We described a clinical, laboratory, and genetic presentation of a pathogenic variant of the CYP1B1 gene through a report of a case of primary congenital glaucoma and a trio analysis of this candidate variant in the family with the Sanger sequencing method and eventually completed our study with the secondary/incidental findings. This study reports a rare case of primary congenital glaucoma, an 8-year-old female child with a negative family history of glaucoma and uncontrolled intraocular pressure. This case's whole-exome sequencing data analysis presents a homozygous pathogenic single nucleotide variant in the CYP1B1 gene (NM_000104:exon3:c.G1103A:p.R368H). At the same time, this pathogenic variant was obtained as a heterozygous state in her unaffected father but not her mother. The diagnosis was made based on molecular findings of whole-exome sequencing data analysis. Therefore, the clinical reports and bioinformatics findings supported the relation between the candidate pathogenic variant and the disease. However, it should not be forgotten that primary congenital glaucoma is not peculiar to the CYP1B1 gene. Since the chance of developing autosomal recessive disorders with low allele frequency and unrelated parents is extraordinary in offspring. However, further data analysis of whole-exome sequencing and Sanger sequencing method were applied to obtain the type of mutation and how it was carried to the offspring.

7 Cases of Incidental Radionuclide Uptake in the Gabtrointestinal Tract During $^{99m}Tc$-Methylene Diphosphonate Bone Scintigraphy ($^{99m}Tc$-MDP 골 스캔 중 발견된 위 및 장관의 섭취증가 7예)

  • Son, Tae-Yong;Kim, Hyung-Gun;Yuh, Young-Jin;Lee, Sang-Goo;Cheon, Eun-Mee;Lim, Sang-Moo;Hong, Sung-Woon
    • The Korean Journal of Nuclear Medicine
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    • v.27 no.2
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    • pp.315-318
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    • 1993
  • We experienced 7 cases of patients who were performed $^{99m}Tc$-methylene diphosphonate bone scintigraphy for the evaluation of diseases they had. Their bone scintigrams showed incidental radionuclide uptake in the gastrointestinal tracts and they had no special symptom or sign attributable to the findings. Case 1 showed radionuclide uptake in the stomach and both lung and the patient had suffered from hypercalcemia and azotemia. Case 3 and case 6 showed diffuse radionuclide uptake in the stomach and intestinal tract. Others showed diffuse or regional radionuclide uptake in the intestinal tracts. Radionuclide uptake in the gastrointestinal tract by $^{99m}Tc$-methylene diphosphonate is caused by a certain pathologic lesion but also can be seen in the normal gastrointestinal tract. So, one who reads bone scintigrams should be alert for the pathologic lesion in the gastrointestinal tract although one must interpretate with the concept of this normal variations.

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Incidental findings of temporomandibular joint osteoarthritis and its variability based on age and sex

  • Alzahrani, Adel;Yadav, Sumit;Gandhi, Vaibhav;Lurie, Alan G.;Tadinada, Aditya
    • Imaging Science in Dentistry
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    • v.50 no.3
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    • pp.245-253
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    • 2020
  • Purpose: This study investigated the prevalence of temporomandibular joint osteoarthritis (TMJ-OA) using the Research Diagnostic Criteria for Temporomandibular Disorders image analysis criteria, assessed the severity of incidental osteoarthritic changes affecting the TMJ, and evaluated the correlations of sex and age with the prevalence and severity of TMJ-OA. Materials and Methods: This retrospective study assessed 145 randomly selected cone-beam computed tomography scans (261 TMJs) from the authors' institutional maxillofacial radiology archive following the application of inclusion and exclusion criteria. The criteria described by Ahmad et al. were used to determine whether each TMJ was affected by OA, and the severity of the osteoarthritic changes was scored for each joint based on the method described by Alexiou et al. The chi-square, McNemar, Bhapkar chi-square, and Stuart-Maxwell chi-square tests were applied to evaluate the significance of the relationships between variables(age and sex). Results: Sixteen TMJs (6.1%) had no OA, 74 (28.6%) were indeterminate for OA, and 171 (65.5%) had OA. Flattening and sclerosis were observed in 86.6% and 12.3% of cases, respectively, while resorption was observed in 7.3% of the joints. Only 21 (8.1%) of the examined TMJs had subchondral cysts. Erosion of the articular eminence was observed in 58 (22.1%) cases, while sclerosis and resorption were found in 68 (25.9%) and 16 (6.1%) TMJs, respectively. Conclusion: Female patients had a higher prevalence and severity of TMJ-OA than male patients. The prevalence and severity of TMJ-OA increased with age, with peaks in the fifth and seventh decades of life.

Is Target Oriented Surgery Sufficient with Borderline Ovarian Tumors? - Role of Accompanying Pathologies

  • Gungor, Tayfun;Cetinkaya, Nilufer;Yalcin, Hakan;Ozdal, Bulent;Ozgu, Emre;Baser, Eralp;Yilmaz, Nafiye;Caglar, Mete;Zergeroglu, Sema;Erkaya, Salim
    • Asian Pacific Journal of Cancer Prevention
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    • v.15 no.16
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    • pp.6749-6754
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    • 2014
  • Background: There are limited data in the literature related to concomitant genital or extra-genital organ pathologies in patients with borderline ovarian tumors (BOTs). The aim of this study was to evaluate our experience with 183 patients to draw attention to the accompanying organ pathologies with BOTs. Materials and Methods: One hundred eighty-three patients with BOTs, diagnosed and/or treated in our center between January of 2000 and March of 2013 were evaluated retrospectively. Data related to age, tumor histology, lesion side, disease stage, accompanying incidental ipsilateral and/or contralateral ovarian pathologies, treatment approaches, and follow-up periods were investigated. Incidental gynecologic and non-gynecologic concomitant organ pathologies were also recorded. Results: The mean age at diagnosis was 40.6 years (range: 17-78). Ninety-five patients (51%) were ${\leq}40$ years. A hundred and forty-seven patients (80%) were at stage IA of the disease. The most common type of BOT was serous in histology. Non-invasive tumor implants were diagnosed in 4% and uterine involvement was found 2% among patients who underwent hysterectomies. There were 12 patients with positive peritoneal washings. Only 17 and 84 patients respectively had concomitant ipsilateral and concomitant contralateral incidental ovarian pathologies. The most common type of uterine, appendicular and omental pathologies were chronic cervicitis, lymphoid hyperplasia and chronic inflammatory reaction. Conclusions: According to our findings most of accompanying pathologies for BOT are benign in nature. Nevertheless, there were additional malignant diseases necessitating further therapy. We emphasize the importance of the evaluation of all abdominal organs during surgery.

Incidental Abnormal FDG Uptake in the Prostate on 18-fluoro-2-Deoxyglucose Positron Emission Tomography-Computed Tomography Scans

  • Kang, Pil Moon;Seo, Won Ik;Lee, Sun Seong;Bae, Sang Kyun;Kwak, Ho Sup;Min, Kweonsik;Kim, Wansuk;Kang, Dong Il
    • Asian Pacific Journal of Cancer Prevention
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    • v.15 no.20
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    • pp.8699-8703
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    • 2014
  • 18-fluoro-2-deoxyglucose positron emission tomography-computed tomography ($^{18}F$-FDG PET/CT) scans are commonly used for the staging and restaging of various malignancies, such as head and neck, breast, colorectal and gynecological cancers. However, the value of FDG PET/CT for detecting prostate cancer is unknown. The aim of this study was to evaluate the clinical value of incidental prostate $^{18}F$-FDG uptake on PET/CT scans. We reviewed $^{18}F$-FDG PET/CT scan reports from September 2009 to September 2013, and selected cases that reported focal/diffuse FDG uptake in the prostate. We analyzed the correlation between $^{18}F$-FDG PET/CT scan findings and data collected during evaluations such as serum prostate-specific antigen (PSA) levels, digital rectal examination (DRE), transrectal ultrasound (TRUS), and/or biopsy to confirm prostate cancer. Of a total of 18,393 cases, 106 (0.6%) exhibited abnormal hypermetabolism in the prostate. Additional evaluations were performed in 66 patients. Serum PSA levels were not significantly correlated with maximum standardized uptake values (SUVmax) in all patients (rho 0.483, p=0.132). Prostate biopsies were performed in 15 patients, and prostate cancer was confirmed in 11. The median serum PSA level was 4.8 (0.55-7.06) ng/mL and 127.4 (1.06-495) ng/mL in the benign and prostate cancer groups, respectively. The median SUVmax was higher in the prostate cancer group (mean 10.1, range 3.8-24.5) than in the benign group (mean 4.3, range 3.1-8.8), but the difference was not statistically significant (p=0.078). There was no significant correlation between SUVmax and serum PSA, prostatic volume, or Gleason score. $^{18}F$-FDG PET/CT scans did not reliably differentiate malignant or benign from abnormal uptake lesions in the prostate, and routine prostate biopsy was not usually recommended in patients with abnormal FDG uptake. Nevertheless, patients with incidental prostate uptake on $^{18}F$-FDG PET/CT scans should not be ignored and should be undergo further clinical evaluations, such as PSA and DRE.