• Title/Summary/Keyword: Lesions

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Osteochondral Lesions of the Talus (거골의 골연골 병변)

  • Lee, Keun-Bae
    • Journal of Korean Foot and Ankle Society
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    • v.16 no.1
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    • pp.9-18
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    • 2012
  • Osteochondral lesions of the talus are isolated cartilage and/or bone lesions that are known cause of chronic ankle pain. They can occur as the result of a single acute ankle injury or from repetitive loading of the talus. Technical development in radiologic imaging and ankle arthroscopy have improved diagnostic capabilities for detecting osteochondral lesions. Characteristics which are important in assessing an osteochondral lesions include: the size, the type (chondral, subchondral, cystic), the stability, the displacement, the location, and the containment of lesion. Nonoperative treatment involving period of casting and non-weight-bearing is recommended for acute, non-displaced osteochondral lesions in select pediatric and adolescent patients. Operative treatment is recommended for unstable lesions or failed conservative management. Marrow stimulation techniques (abrasion chondroplasty, multiple drilling, microfracture), osteochondral autograft or allograft, autologous chondrocyte implantation, are frequently employed. The purpose of this article is to review the historical background, etiology, classification systems, diagnostic strategies, and to describe a systematic approach to management of osteochondral lesions of the talus.

Arachnoid Granulations Mimicking Multiple Osteolytic Bone Lesions in the Occipital Bone

  • Park, Seong-Hyun;Park, Ki-Su;Hwang, Jeong-Hyun
    • Brain Tumor Research and Treatment
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    • v.6 no.2
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    • pp.68-72
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    • 2018
  • We report a rare case of arachnoid granulations mimicking multiple osteolytic bone lesions. A 66-year-old woman was admitted to a local clinic for a regular checkup. Upon admission, brain CT showed multiple osteolytic lesions in the occipital bone. These needed to be differentiated from multiple osteolytic bone tumor. Subsequent brain MRI revealed that the osteolytic lesions were isointense to cerebrospinal fluid, hyperintense on T2-weighted image, hypointense on T1-weighted image, and with subtle capsules around the osteolytic lesions that were visible after gadolinium injection. A bone scan revealed no radiotracer uptake. The lesions were in both the transverse sinuses and the torcular herophili. With typical radiological appearances of the lesions, the osteolytic lesions were diagnosed as multiple arachnoid granulations. No further treatment was planned. A 1-year follow-up brain CT scan revealed no change. We should consider the possibility of arachnoid granulations when multiple osteolytic lesions are observed in the occipital bone.

Role of contrast-enhanced harmonic endoscopic ultrasonography (EUS) and EUS elastography in pancreatic lesions

  • Yasunobu Yamashita;Masayuki Kitano
    • Clinical Endoscopy
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    • v.57 no.2
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    • pp.164-174
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    • 2024
  • Pancreatic cancers have a poor prognosis, and their incident rates have risen. Endoscopic ultrasonography (EUS) is an efficient and reliable diagnostic modality for pancreatic lesions, providing high spatial resolution. However, while EUS helps to detect minor pancreatic lesions, nearly all solid pancreatic lesions are hypoechoic, which creates difficulty in making differential diagnoses of pancreatic lesions. When diagnosing pancreatic lesions, the performance of image-enhanced EUS techniques is essential, such as EUS elastography or contrast-enhanced harmonic EUS (CH-EUS). CH-EUS diagnosis is based on assessing the vascularity of lesions, whereas tissue elasticity is measured via EUS elastography. Elastography is either strain or shear-wave, depending on the different mechanical properties being evaluated. The usefulness of enhanced EUS techniques is demonstrated in this review for the differential diagnosis of pancreatic lesions, including solid and cystic lesions, and pancreatic cancer staging.

A CLINICO-RADIOLOGIC STUDY OF THE VARIOUS LESIONS IN THE ORAL AND MAXILLOFACIAL REGION OF CHILDREN (소아의 구강악안면 영역에서 발생된 각종 병변의 임상방사선학적 연구)

  • Choi Soon-Chul;Lee Young-Ho;Park Tae-Won;You Dong-Soo
    • Journal of Korean Academy of Oral and Maxillofacial Radiology
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    • v.25 no.2
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    • pp.513-520
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    • 1995
  • Two thousand-two hundred-forty-three cases of various lesions of the oral and maxillofacial region in children under 16 years of age were reviewed. The lesions were classified by 10 groups; osteomyelitis, cysts, benign tumors, malignant tumors, fibro-osseous lesions, developmental disturbances, antral lesions, TMJ lesions, salivary gland lesions, and other lesions. The obtained results were as follows; 1. Developmental disturbances, especially cleft alveolus and palate, was the most common lesions (25.7%), followed by cysts (22.5%), antral lesions (12.7%), benign tumors (11.9%) and osteomyelitis (9.3%). 2. With the time, the incidence of osteomyelitis and malignant tumors has been decreased, but that of developmental disturbances, cysts and antral lesions has been increased. 3. The sex distribution was relatively equal for the entire series, with male predominence in cysts, malignant tumors, developmental disturbanes and salivary gland lesions and with female predominence in TMJ lesions. 4. Children with malignant tumors and osteomyelitis were somewhat younger and those with TMJ lesions were somewhat older. 5. Heading the list of each group except osteomyelitis was dentigerous cyst, odontoma, malignant lymphoma, fibrous dysplasia, cleft alveolus and palate, inflammatory change, degenerative change of condylar process, sialolithiasis and simple bone cyst respectively.

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Diagnostic Performance of Core Needle Biopsy for Characterizing Thyroidectomy Bed Lesions

  • So Yeong Jeong;Jung Hwan Baek;Sae Rom Chung;Young Jun Choi;Dong Eun Song;Ki-Wook Chung;Won Woong Kim;Jeong Hyun Lee
    • Korean Journal of Radiology
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    • v.23 no.10
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    • pp.1019-1027
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    • 2022
  • Objective: Thyroidectomy bed lesions frequently show suspicious ultrasound (US) features after thyroid surgery. Fine-needle aspiration (FNA) may not provide definitive pathological information about the lesions. Although core-needle biopsy (CNB) has excellent diagnostic performance in characterizing suspicious thyroid nodules, no published studies have evaluated the performance of CNB specifically for thyroidectomy bed lesions. Therefore, we aimed to evaluate the diagnostic performance and safety of CNB for characterizing thyroidectomy bed lesions. Materials and Methods: A total of 124 thyroidectomy bed lesions in 113 patients (79 female and 34 male; age, 23-85 years) who underwent US-guided CNB between December 2008 and December 2020 were included. We reviewed the US imaging features of the target lesions and the histories of previous biopsies. The pathologic results, diagnostic performance for malignancy, and complications of CNB were analyzed. Results: All samples (100%) obtained by CNB were adequate for pathological analysis. Pathological analysis revealed inconclusive results in two lesions (1.6%). According to the reference standard, 50 lesions were ultimately malignant (40.3%), and 72 were benign (58.1%), excluding the two inconclusive lesions. The performance of CNB for diagnosing malignant thyroidectomy bed lesions in the 122 lesions had a sensitivity of 98.0% (49/50), a specificity of 100% (72/72), positive predictive value of 100% (49/49), and negative predictive value of 98.6% (72/73). Eleven lesions were referred for CNB after prior inconclusive FNA results in thyroidectomy bed lesions, for all of which CNB yielded correct conclusive pathologic diagnoses. According to the pathological analysis of CNB, there were various benign lesions (58.9%, 73/124) besides recurrence, including benign postoperative lesions other than suture granuloma (32.3%, 40/124), suture granuloma (15.3%, 19/124), remnant thyroid tissue (5.6%, 7/124), parathyroid lesions (4%, 5/124), and abscesses (1.6%, 2/124). No major or minor complications were associated with the CNB procedure. Conclusion: US-guided CNB is accurate and safe for characterizing thyroidectomy bed lesions.

EXPERIMENTAL STUDY OF ARTIFICIALLY PRODUCED BONE LESIONS IN HUMAN MANDIBLE - Radiologic and Densitometric Evaluation - (하악골 실험병소에 관한 방사선학적 연구)

  • Lee Young-Ho;Ahn Hyung-Kyu
    • Journal of Korean Academy of Oral and Maxillofacial Radiology
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    • v.17 no.1
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    • pp.107-120
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    • 1987
  • The purpose of this study was three-fold: to reexamine whether periapical and central lesions can be detected on the radiograph when they are in the cancellous bone, to investigate regianal differences in radiograph visualization of the lesion, and to. compare the interpretation of radiagraphs by densitometric analysis with the visual interpretation af the same radiographs. Forty-nine apical lesions and eighty-two central lesions were made in 8 mandibles and radiographed serially while being enlarged and deepened. All radiagraphs were evaluated by three dental radiologists. Each lesion was scored of 3 to 0, based on the radiographic appearances. Special radiographs of 15 apical and central lesions were analysed by densitometer and the results were compared with the scores which were previously assigned by three examiners. From this study the following conclusians could be drawn; 1. Experimental lesions confined to cancellous bone were detected an the radiagraphs in 41.3% of the cases. 2. Visualization of periapical lesions in cancellous bone was more apparent than that of central lesions in cancellous bone. 3. Visualization of the periapical lesions confined to. cancellous bane was highest in molar teeth, and detection of the central lesions in alveolar portion was easier than those in lower portion of mandibular body area. 4. It was possible to detect the experimental lesions without cortical plate involvement in 78.6% of the all lesions. 5. Densitometric analysis of radiographs could reproducibly distinguish bone changes, especially of central lesions in cancellous bone.

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Ganglion-like Lesions of the Foot on the Ultrasonography (초음파에서 족부 결절종으로 오인한 유사 병변)

  • Chun, Kyung-Ah;Shin, Dong-Hwan;Seo, Dong-Hyun;Singh, Kanwarjot;Suh, Jin-Soo
    • Journal of Korean Foot and Ankle Society
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    • v.14 no.2
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    • pp.169-172
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    • 2010
  • Purpose: The authors have experienced various lesions that simulate ganglion of the foot on the ultrasonography. The purpose of this study is to evaluate ultrasonographic findings of soft tissue lesions, which were interpreted as ganglion but confirmed as different lesions in the foot. Materials and Methods: We reviewed a database of patients with ganglion on the ultrasonography from two different institutions. There were 109 patients who underwent both ultrasonography and surgical confirmation. Twenty one lesions were identified, of which initial interpretation on the ultrasonography included ganglion which pathology revealed to be different lesions. All images were evaluated by one musculoskeletal radiologist, regarding size, margins, internal echogenicity of lesions, and presence of posterior enhancement. Results: Of 21 lesions, there were 6 fibrous tumors including fibroma, giant cell tumor of tendon sheath, and fibromatosis, 3 hemangiomas, 2 epidermal inclusion cysts, 2 chondromas, 2 angioleiomyomas, 1 trichilemal cyst, 1 neurofibroma, 1 granular cell tumor, 1 neurilemmoma, 1 neuromyxoma, and 1 nodular hidradenoma. Mean size of the lesion was 1.1 cm. Margins were smooth in 10, mild lobulation in 8 and marked lobulation in 3 lesions. Lesions were hypoechoic in 16, anechoic in 4 and isoechoic in 1 case. Posterior acoustic enhancement was definitely present in 5 lesions. Conclusion: On the ultrasonography, various soft tissue lesions of the foot may be confused with ganglion. During surgical resection care should be given even to a simple ganglion as it might turn up to be a solid lesions such as fibrous tumors.

IMMUNOHISTOCHEMICAL STUDY ON LYMPHOCYTE DISTRIBUTION IN ENDODONTICALLY TREATED AND UNTREATED PERIAPICAL LESIONS (근관치료전과 후의 치근단 병소에서 임파구의 분포에 관한 면역조직화학적 연구)

  • Oh, Tae-Seok;Lim, Sung-Sam
    • Restorative Dentistry and Endodontics
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    • v.11 no.1
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    • pp.63-75
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    • 1985
  • This study was designed to identify lymphocytes and to compare the lymphocyte distribution in endoodontically treated periapical lesions with that in endodontically untreated periapical lesions by way of immunohistochemical staining. Twenty-one human dental periapical lesions were obtained, frozened, serially sectioned to $4-5{\mu}$, and stained using the three-stage indirect immunoperoxidase technique and monoclonal antibodies for detecting the presence of B,T lymphocyte and T suppressor cell. Following results were obtained; 1. All of the examined periapical lesions had positive staining for B,T lymphocyte and T suppressor cell. 2. The concentration of T lymphocytes in 18 lesions diagnosed as periapical cyst and granuloma in both groups was greater than that of B lymphocytes and 2 periapical lesions identified as abscess in treated lesions had more positive B lymphocytes than positive T lymphocytes. 3. The average numbers of T,B lymphocytes and T suppressor cells in Endodontically treated lesions were lower than those of untreated lesions, but no statistically significant difference was noted. 4. When the distribution ratios of T lymphocytes to B lymphocytes and T suppressor cells to T lymphocytes were compared in Endodontically treated lesions by the histological aspects of the lesions and at the intervals of the duration after Endodontic treatment, a statistically significant change was not found. 5. The mean values of T lymphocytes, B lymphocytes and T suppressor cells in Endodontically treated lesions were markedly decreased in the specimens obtained at 3 month after Endodontic treatment, but no statistically significant difference was found.

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Perirectal Cystic Lesions - Comprehensive CT and MRI Findings

  • Kim, Ji Hoon;Lee, Jong Seok;Kim, Ah Young;Park, Seong Ho;Kim, Hyun Jin;Jang, Jong Keon
    • Investigative Magnetic Resonance Imaging
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    • v.23 no.4
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    • pp.283-295
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    • 2019
  • Perirectal cystic lesions are rare entities, for which only a relatively few research publications are available. These lesions are heterogeneous in nature and can range from benign lesions to malignant lesions; thus, they are sometimes difficult to differentiate. Some studies have reported on retrorectal or presacral cystic lesions, but to our knowledge, there have been only a few reports on perirectal cystic lesions. Cystic lesions arise from the retrorectal space as well as the rectal lumen or adjacent organ, and they should be differentiated based on their characteristics and anatomic location. Thus, we comprehensively studied diseases with a cystic component around the rectum, which are perirectal cystic lesions. A clinical challenge with perirectal cystic lesions is that it is sometimes difficult to distinguish malignant lesions from benign lesions and is thus difficult to determine the extent for surgical excision. We thus attempted to identify benign and malignant imaging features of perirectal cystic lesions.

The Usefulness of FNAB for the Diagnosis of Thoracic Surgical Disease (흉부외과 질환의 진단시 FNAB 의 유용성과 객담세포검사 및 기관지 내시경 검사와의 비교 고찰)

  • 유정훈
    • Journal of Chest Surgery
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    • v.23 no.6
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    • pp.1225-1232
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    • 1990
  • From March 1986 to June 1990, the percutaneous Fine Needle Aspiration Biopsy[FNAB] of 102 thoracic lesions were performed with Westcott needle [slotted 20G or 22G thin needle], for the purpose of identifying and diagnosing thoracic lesions. There were 94 lung lesions [67 malignant tumors, 27 benign lesions] and 8 mediastinal and chest wall lesions. The results of FNAB were compared with sputum cytology and bronchoscopic examinations. The sputum cytologic examinations were performed in 54 cases of malignant lung tumor and the malignant cell was found at the 18 cases [33%]. We bronchoscopic examinations were performed in 24 cases and the malignant cell was found at the 12 cases [55%]. The positive diagnostic rate of malignancy was 100% by FNAB. Among them, 55 cases [82%] were diagnosed by cytologic examinations and 43 cases[64%] by both. The specific diagnoses for benign lung lesions in 15 cases[55%] and for mediastinal and chest well lesions in 5 cases[62%]. The 7 patients[6.9%] developed the pneumothorax and 5 of them required the treatment. Therefore, the FNAB of thoracic lesions may be a preferred diagnostic method because of its safety, simplicity and accuracy.

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