• Journal of the Korean Society of Radiology
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• v.81 no.6
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• pp.1497-1503
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• 2020

Inflammatory myofibroblastic tumors (IMTs) are rare. They are characterized by myofibroblastic spindle cell proliferation with a varying degree of inflammatory cell infiltration. IMT can occur in any anatomic location but has been reported in the lung, mesentery, and omentum, mainly in children or young adults. It rarely occurs in the pancreas and is often difficult to distinguish from other tumors, including some malignant ones. Therefore, it can be challenging to make a radiological diagnosis of IMT. Here, we present a case of IMT that occurred in the pancreas head of a middle-aged female. The patient's ultrasonography, computed tomography, and magnetic resonance imaging findings are presented along with a review of the literature.

• Korean Journal of Radiology
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• v.23 no.2
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• pp.280-288
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• 2022

Objective: To compare core needle biopsy (CNB) and repeat fine-needle aspiration (rFNA) to reduce the rate of diagnostic surgery and prevent unnecessary surgery in nodules initially diagnosed as atypia/follicular lesions of undetermined significance (AUS/FLUS). Materials and Methods: This study included 231 consecutive patients (150 female and 81 male; mean age ± standard deviation, 51.9 ± 11.7 years) with 235 thyroid nodules (≥ 1 cm) initially diagnosed as AUS/FLUS, who later underwent both rFNA and CNB. The nodules that required diagnostic surgery after the biopsy were defined using three different scenarios according to the rFNA and CNB results: criterion 1, surgery for low-risk indeterminate (categories I and III); criterion 2, surgery for high-risk indeterminate (categories IV and V); and criterion 3, surgery for all indeterminate nodules (categories I, III, IV, and V). We compared the expected rates of diagnostic surgery between CNB and rFNA in all 235 nodules using the three surgical criteria. In addition, the expected rates of unnecessary surgery (i.e., surgery for benign pathology) were compared in a subgroup of 182 nodules with available final diagnoses. Results: CNB showed significantly lower rates of nondiagnostic, AUS/FLUS, and suspicious for malignancy diagnoses (p ≤ 0.016) and higher rates of follicular neoplasm or suspicious for a follicular neoplasm (p < 0.001) and malignant diagnoses (p = 0.031). CNB showed a significantly lower expected rate of diagnostic surgery than rFNA for criterion 1 (29.8% vs. 48.1%, p < 0.001) and criterion 3 (46.4% vs. 55.3%, p = 0.029), and a significantly higher rate for criterion 2 (16.6% vs. 7.2%, p = 0.001). CNB showed a significantly lower expected rate of unnecessary surgery than rFNA for criterion 1 (18.7% vs. 29.7%, p = 0.024). Conclusion: CNB was superior to rFNA in reducing the rates of potential diagnostic surgery and unnecessary surgery for nodules initially diagnosed as AUS/FLUS in a scenario where nodules with low-risk indeterminate results (categories I and III) would undergo surgery.

• Journal of the Korean Society of Radiology
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• v.81 no.5
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• pp.1210-1215
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• 2020

Sparganosis is an uncommon human parasitic infection caused by plerocercoid cysts of the genus Spirometra. Sparganosis of the neck is a rare condition, thus making it difficult to diagnose. It is often initially misdiagnosed as a lymphadenopathy or a soft tissue tumor. Herein, we describe a rare case of apparent sparganosis presenting as a palpable mass in the left neck of a 53-year-old female patient. Imaging studies played a key role in the diagnosis. In this case report, we emphasize that sparganosis should be considered in the differential diagnosis of a palpable superficial mass. We also stress the importance of meticulous radiological review in the context of appropriate clinical suspicion.

• Journal of the Korean Society of Radiology
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• v.84 no.1
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• pp.263-269
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• 2023

Ciliated foregut cyst is a relatively rare disease; thus, most reports are in the form of case studies. This benign cyst is usually found in the mediastinum and account for approximately 20% of all mediastinal masses. However, it is rarely found in the hepatobiliary and peripancreatic regions. Approximately 20 cases of ciliated foregut cysts involving the pancreas have been reported in the Enlgish literature. Here, we present a case of ciliated foregut cyst that occurred in the tail of the pancreas in a 29-year-old female. The patient's ultrasonography, CT, and MRI findings are presented, along with a review of the literature.

• Journal of the Korean Society of Radiology
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• v.84 no.3
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• pp.719-725
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• 2023

Immunoglobulin G4 (IgG4)-related disease is a rare systemic fibroinflammatory condition characterized by organomegaly or tumefactive lesions associated with lymphoplasmacytic infiltration rich in IgG4 plasma cells. We report a case of IgG4-related disease involving the subcutaneous layer of the left upper arm in a 48-year-old female presenting with an unusual soft tissue mass. US and MRI showed an irregular infiltrative soft tissue mass, indicating possible malignancy or inflammation. We discuss the diagnostic criteria, histopathologic features, radiological features, and treatment of IgG4-related disease.

• Clinics in Shoulder and Elbow
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• v.26 no.4
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• pp.406-415
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• 2023

Background: Surgical management of a massive rotator cuff tear (RCT) is always challenging. This study describes the clinical and radiological outcomes of patients who underwent bridging grafts using a plantaris tendon for an irreparable RCT. Methods: Thirteen patients with a massive RCT were treated with arthroscopic interposition of a folded plantaris tendon autograft between June 2017 and January 2020. For clinical evaluation, a visual analog scale (VAS), American Shoulder and Elbow Surgeons (ASES) score, Disabilities of the Arm, Shoulder, and Hand (DASH) score, Constant-Murley score, and range of motion values were collected. For radiographic evaluation, standardized magnetic resonance imaging and ultrasonography were performed to check the integrity of the interposed tendon. Results: A statistically significant improvement at the final follow-up was evident in scores for the VAS (-3.0, P=0.003), ASES (24.9, P=0.002), D ASH (-20.6, P=0.001), and Constant-Murley values (14.2, P=0.010). In addition, significant improvement was shown in postoperative flexion (17.3°, P=0.026) and external rotation (27.7°, P<0.001). In postoperative radiologic evaluations, the interposed tendons were intact at the last examination in 12 of the 13 patients. No complications related to donor sites were reported. Conclusions: An arthroscopic bridging graft for irreparable RCTs using a modified Mason-Allen stitch and a plantaris autograft resulted in improved short-term radiological and clinical outcomes. Graft integrity was maintained for up to 2 years in most patients. Level of evidence: IV.

• Korean Journal of Radiology
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• v.21 no.5
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• pp.550-560
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• 2020

Objective: To evaluate the interobserver agreement, diagnostic value, and associated clinical factors of automated breast ultrasound (ABUS) coronal features in differentiating breast lesions. Materials and Methods: This study enrolled 457 pathologically confirmed lesions in 387 female (age, 46.4 ± 10.3 years), including 377 masses and 80 non-mass lesions (NMLs). The unique coronal features, including retraction phenomenon, hyper- or hypoechoic rim (continuous or discontinuous), skipping sign, and white wall sign, were defined and recorded. The interobserver agreement on image type and coronal features was evaluated. Furthermore, clinical factors, including the lesion size, distance to the nipple or skin, palpability, and the histological grade were analyzed. Results: Among the 457 lesions, 296 were malignant and 161 were benign. The overall interobserver agreement for image type and all coronal features was moderate to good. For masses, the retraction phenomenon was significantly associated with malignancies (p < 0.001) and more frequently presented in small and superficial invasive carcinomas with a low histological grade (p = 0.027, 0.002, and < 0.001, respectively). Furthermore, continuous hyper- or hypoechoic rims were predictive of benign masses (p < 0.001), whereas discontinuous rims were predictive of malignancies (p < 0.001). A hyperechoic rim was more commonly detected in masses more distant from the nipple (p = 0.027), and a hypoechoic rim was more frequently found in large superficial masses (p < 0.001 for both). For NMLs, the skipping sign was a predictor of malignancies (p = 0.040). Conclusion: The coronal plane of ABUS may provide useful diagnostic value for breast lesions.

• Korean Journal of Radiology
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• v.21 no.5
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• pp.598-604
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• 2020

Objective: Proper management of lymph nodes (LNs) with ultrasonographic (US) indeterminate features in thyroid cancer patients remains elusive. We aimed to evaluate the malignancy risk and US findings predictive of malignancy for US indeterminate LNs in preoperative thyroid cancer patients through node-by-node correlation. Materials and Methods: A total of 348 LNs in 284 thyroid cancer patients, who underwent fine-needle aspiration or core-needle biopsy between December 2006 and June 2015, were included. We determined the malignancy risks for US probably benign, indeterminate, and suspicious categories. For US indeterminate LNs, which had neither echogenic hilum nor hilar vascularity in the absence of any suspicious finding, US findings were compared between benign and metastatic LNs using Mann-Whitney U test and Fisher's exact test. Results: US imaging diagnoses were probably benign in 20.7% (n = 72) cases, indeterminate in 23.6% (n = 82), and suspicious in 55.7% (n = 194). Malignancy risk of US indeterminate LNs (19.5% [16/82]) differed from those of the US probably benign (2.8% [2/72]) (p = 0.002) and US suspicious LNs (78.4% [152/194]) (p < 0.001). Among US indeterminate LNs, there were no significant differences in short, long, and long-to-short diameter (L/S) ratios between benign and metastatic LNs (3.9 vs. 3.8 mm, p = 0.619; 7.3 vs. 7.3 mm, p = 0.590; 1.9 vs. 1.9, p = 0.652). Conclusion: US indeterminate LNs were frequently encountered during preoperative evaluation and had intermediate malignancy risk. Given the lack of discriminative power of size criteria and L/S ratio, clinical factors such as surgical strategy and node size should be considered for proper triage of US indeterminate LNs in thyroid cancer.

• The Korean Journal of Nuclear Medicine
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• v.22 no.1
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• pp.83-92
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• 1988

The cocktails of two $^{131}I$ labeled Monoclonal antibody (MCAB) (Anti CA 19-9 F$(ab')_2$ + Anti CEA $F(ab')_2$ fragment), which react specially, with human gastrointestinal cancers, were administered to 10 patients with colorectal (7), stomach(2) and pancreas(1) cancer for scintigraphic detection. All patients were known or postoperatively recurrent cases, and serum tumor markers, CA 19-9 and CEA, were measured with immunoradiometric assay, just before immunoscintigraphy (ISG). The tumor marker's level in serum is not correlated with positive tumor uptake in ISG. The sensitivity and specificity of ISG in detection of 21 tumor sites, based on surgery, CT, ultrasonography and pathology, were 90.5% and 100% One case of colon cancer showed gall bladder metastasis, which was neglected on CT study. Tumor/non tumor uptake ratio of radiolabelled antibody were progressively increased from day 3 to day 7 during study. We summerized as follows 1) The use of cocktails of CEA and CA 19-9 MCAB $F(at')_2$ increased sensitivity and specificity in ISG. 2) Delayed imaging (later than 5 days) increases sensitivitv and specificity due to exclusion of nonspecific iodine accumulation in stomach and lung. 3) Second tracer technique is essential for anatomical landmark by use of a double isotope scan, but subtraction technique, a possible source of artifacts, is no longer necessory when delayed imaging is performed. 4) It may be possible to use two MCAB cocktails of CA 19-9 and CEA in Radioimmunodetection of stomach and pancreas cancer. In conclusion, ISG using MCAB cocktails, $F(ab')_2$ fragment of anti CA 19-9 and Anti CEA, provide additional opportunity for tumor localization and detection of colorectal and other G-I cancer, such as stomach and pancreas.

• Journal of Veterinary Clinics
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• v.21 no.1
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• pp.72-75
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• 2004

A ten months old, female Yorkshire terrier weighing 2.88 kg referred to veterinary leaching hospital of college of veterinary medicine, Konkuk University because of syncope, cough and dyspnea. First hematological and serum chemical test revealed thrombocytopenia, mild anemia, and increase of concentration of ALP (195 U/L). On 57 days later, second hematological and serum chemical test revealed polycythemia, increase of concentration of ALP (211 UR.), and Tchol (387 mg/dl). Right atrium enlargement, main pulmonary artery bulge and cardiomegaly (VHS = 11.5) were observed in radiographic findings. Ultrasohographic images showed both right and left ventricular dilation and turbulent flow between the descending aorta and the main pulmonary artery in color Doppler imaging. ECG showed left ventricular enlargement, SA block, and electrical alternant. Thoracotomy was performed through left fourth intercostal incision under isoflurane anesthesia. Patent ductus arteriosus was double ligated with 1-0 silk. Cough and dyspnea disappeared on 5 days after operation. Turbulent flow was not found in color doppler imaging of ultrasonography on 10 days after operation. Ten months later after the operation, syncope could not exist any more.