Gd-EOB-DTPA-enhanced magnetic resonance imaging for bile duct intraductal papillary mucinous neoplasms

AIM: To investigate gadolinium-ethoxybenzyldiethylenetriamine-pentaacetic acid(Gd-EOB-DTPA)-enhanced magnetic resonance imaging(MRI) of intraductal papillary mucinous neoplasms of the bile duct(IPMN-B). METHODS: The imaging findings of five cases of IPMN-B which were pathologically confirmed at our hospital between March 2012 and May 2013 were retrospectively analyzed. Three of these cases were diagnosed by duodenal endoscopy and biopsy pathology, and two cases were diagnosed by surgical pathology. All five patients underwent enhanced and non-enhanced computed tomography(CT), magnetic resonance cholangiopancreatography, and Gd-EOB-DTPA-enhanced MRI; one case underwent both Gd-EOB-DTPA-enhanced MRI and positron emission tomography-CT. The clinical data and imaging results for these cases were compared and are presented.RESULTS: Conventional imaging showed diffusedilatation of bile ducts and multiple intraductal polypoid and papillary neoplasms or serrated changes along the bile ducts. In two cases, Gd-EOB-DTPA-enhanced MRI revealed dilated biliary ducts and intraductal tumors, as well as filling defects caused by mucin in the dilated bile ducts in the hepatobiliary phase. GdEOB-DTPA-enhanced MRI in one case clearly showed a low-signal tumor in the hepatobiliary phase, similar to what was seen by positron emission tomographyCT. In two patients, routine inspection was unable to discern whether the lesions were inflammation or tumors. However, Gd-EOB-DTPA-enhanced MRI revealed a pattern of gradual enhancement during the hepatobiliary phase, and the signal intensity of the lesions was lower than the surrounding liver parenchyma, suggesting tissue inflammation in both cases, which were confirmed by surgical pathology. CONCLUSION: Gd-EOB-DTPA-enhanced MRI reveals the intraductal mucin component of IPMN-B in some cases and the extent of tumor infiltration beyond the bile ducts in invasive cases.

Burkitt-like lymphoma with 11q aberration confirmed by needle biopsy of the liver:A case report

BACKGROUND Burkitt-like lymphoma with 11q aberration(BLL-11q)is a rare provisional lymphoma,and the majority of cases are usually diagnosed by excisional lymph node biopsy.Here we report a case of BLL-11q diagnosed by needle biopsy of the liver in order to improve further understanding of the disease,reduce misdiagnosis,and identify treatment regimens.CASE SUMMARY The patient was a 67-year-old male.He complained of increased frequency of stools for more than one year,periumbilical pain and discomfort exceeding 3 mo.A computed tomography scan suggested an appendiceal malignant tumor with multiple metastases of the peritoneum,omentum,and liver.Needle biopsy of liver nodules showed that the tumor cells were of median size,the shape was consistent,a small number of tumor cells were large,the“starry sky”pattern was evident,and some tissue cells showed multiple apoptotic debris with coarse particles.Immunohistochemistry was positive for CD20,CD10,BCL6,and MYC.The Ki-67 proliferation index was more than 95%.Molecular biological detection indicated a lack of MYC,BCL2 and BCL6 gene rearrangement with 11q aberration.Therefore,the diagnosis was BLL-11q of the liver.After eight courses of chemotherapy,the abdominal and pelvic peritoneal masses and liver nodules had almost disappeared.The patient recovered well after a follow-up period of more than 13 mo.CONCLUSION BLL-11q is rare,but patients treated with standard chemotherapy for Burkitt lymphoma can have a good prognosis.Reducing the dose of chemotherapy or developing specific therapies to prevent overtreatment may be considered,but more case studies are needed.

Fabrication and compressive behavior of open-cell aluminum foams via infiltration casting using spherical CaCl_(2) space-holders

The infiltration casting fabrication process based on spherical CaCl_(2) space-holders and the compressive behavior including the mechanical performance and energy absorption capacity of open-cell aluminum foams were investigated.Open-cell aluminum foams with different porosities in the range of 63.1%to 87.3%can be fabricated by adjusting compression ratios of CaCl_(2) preforms prepared by precision hot-pressing.The compression tests show that a strain-hardening phenomenon always occurs especially for open-cell aluminum foam with low porosity,resulting in the inclining stress-strain curve in the plateau region.The energy absorption capacity of open-cell aluminum foam decreases with increasing porosity when compared at the same strain.However,when compared at a given stress,each foam can absorb the maximal energy among the five foams in a special stress range.Additionally,open-cell aluminum foam possesses the maximum energy absorption efficiency at its optimum operating stress.At this stress condition,the foam can absorb the highest energy compared with other foams at the same stress point.The optimum operating stress and the corresponding maximal energy absorption decrease with increasing the porosity.The optimum operating stress for energy absorption can also be determined similarly when taking into consideration of the lightweight extent of foams.

Re-recognition of BMPR1A-related polyposis:beyond juvenile polyposis and hereditary mixed polyposis syndrome

Background Bone morphogenetic protein receptor type 1A(BMPR1A)is responsible for two individual Mendelian diseases:juvenile polyposis syndrome and hereditary mixed polyposis syndrome 2,which have overlapping phenotypes.This study aimed to elucidate whether these two syndromes are just two subtypes of a single syndrome rather than two isolated syndromes.Methods We sequenced the BMPR1A gene in 186 patients with polyposis and colorectal cancer,and evaluated the clinicopathological features and phenotypes of the probands and their available relatives with BMPR1A mutations.Results BMPR1A germline mutations were found in six probands and their three available relatives.The numbers of frameshift,nonsense,splice-site,andmissensemutations were one,one,two,and two,respectively;two of the sixmutations were novel.Typical juvenile polyps were found in only three patients.Two patients had colorectal cancer rather than any polyps.Conclusions Diseases in BMPR1A germline mutation carriers vary from mixed polyposis to sole colorectal cancer,and typical juvenile polyps do not always occur in these carriers.The variety of phenotypes reflected the features of BMPR1Amutation carriers,which should be recognized as a spectrum of one syndrome.Genetic testing may be a good approach to identifying BMPR1A-related syndromes.