Neoplastic pericardial disease: Old and current strategies for diagnosis and management

The prevalence of neoplastic pericardial diseases has changed over time and varies according to diagnostic methods. The diagnostic factor is usually the detection of neoplastic cells within the pericardial fluid or in specimens of pericardium, but the diagnosis may be difficult. Accurate sampling and cytopreparatory techniques, together with ancillary studies, including immunohistochemical tests and neoplastic marker dosage, are essential to obtain a reliable diagnosis. The goals of treatment may be simply to relieve symptoms (cardiac tamponade or dyspnea), to prevent recurrent effusion for a long-term symptomatic benefit, or to treat the local neoplastic disease with the aim of prolonging survival. Immediate relief of symptoms may be obtained with percutaneous drainage or with a surgical approach. For long term prevention of recurrences, various approaches have been proposed: extended drainage, pericardial window (surgical or percutaneous balloon pericardiostomy), sclerosing local therapy, local and/or systemic chemotherapy or radiation therapy (RT) (external or with intrapericardial radionuclides). The outcomes of various therapeutic approaches vary for different tumor types. Lymphoma and leukemias can be successfully treated with systemic chemotherapy; for solid tumors, percutaneous drainage and the use of systemic and/or localsclerosing and antineoplastic therapy seems to offer the best chance of success. The use of "pure" sclerosing agents has been replaced by agents with both sclerosing and antineoplastic activity (bleomycin or thiotepa), which seems to be quite effective in breast cancer, at least when associated with systemic chemotherapy. Local chemotherapy with platinum, mitoxantrone and other agents may lead to good local control of the disease, but the addition of systemic chemotherapy is probably relevant in order to prolong survival. The surgical approach (creation of a pericardial window, even with the mini-invasive method of balloon pericardiostomy) and RT may be useful in recurring effusions or in cases that are refractory to other therapeutic approaches.

Comparative study of mutations in SNP loci of K-RAS, hMLH1 and h MSH2 genes in neoplastic intestinal polyps and colorectal cancer

AIM:To clarify the molecular mechanism involved in pathogenesis of colorectal cancer as well as clinical significance of genetic analysis of histological samples.METHODS:A total of 480 blood and tissue specimens were collected in our hospital from January 2011 to October 2012.In the observation group,there were120 blood specimens and 120 intestinal tract tissue specimens collected from patients with neoplastic intestinal polyps.In the control groupⅠthere were80 blood specimens and 80 intestinal tract tissue specimens collected from patients with colorectal cancer.In the control groupⅡthere were 40 blood specimens and 40 intestinal tract tissue specimens collected from healthy individuals.The gene segments were amplified using PCR and DNA gel electrophoresis along with DNA sequence analysis were employed for the detection of the following single nucleotide polymorphisms(SNPs):K-RAS codons 12 and 13;h MLH1(human mut S homolog 1)gene missense mutation at Va1384Asp;h MSH2(human mut S homolog2)gene missense mutation at 2783C/A.RESULTS:The mutation rate of the SNP at Va1384Asp locus of the h MLH1 gene from blood and tissue specimens in the observation group showed no statistical difference from those in the control groupⅠ.The mutation rates of SNPs in codons 12 and 13 of K-RAS and at 2783C/A locus of the h MSH2 gene were significantly lower in the observation group than in the control groupⅠ(χ2=15.476,29.670,10.811,16.618,33.538,7.898,P<0.05).The mutation rate of SNP at Va1384Asp locus of the h MLH1 gene was significantly higher in the observation group when compared to the control groupⅡ(χ2=10.486,4.876,P<0.05).The mutation rates of SNPs in codons 12 and 13 of K-RAS and at 2783C/A locus of the h MSH2 gene did not show any statistical difference from those in the control groupⅡ.CONCLUSION:There may be important clinical significance and relevance between neoplastic intestinal polyps and colorectal cancer in terms of the mechanisms involved in the

NEOPLASTIC TRANSFORMATION OF HUMAN EMBRYONIC NASOPHARYNGEAL EPITHELIAL CELLS INDUCED BY N,N'-DINITROSOPIPERAZINE (DNP) IN VITRO

This experiment is the first report on N, N'-dini-trosopiperazine (DNF)-induced neoplastic transformation of human embryonic nasopharyngeal (HENPE) cells. The transformed cells showed a prolonged life span, anchorage independent growth, chromosome aberration, tumorigenicity and an altered cell morphological appearance. The results demonstrated that DNP was able to induce not only nasopharyngeal carcinoma (NPC) of rats in vivo, but also neoplastic transformation of HENPE cells in vitro.

THE ROLE OF PSYCHOSOCIAL STRESSORS,PERSONALITY AND COPING IN THE MULTIFACTORIAL ORIGIN,INITIATION AND CLINICAL COURSE OF NEOPLASTIC DISEASE AND IN HOST-DEFENSE

Summary: Retrospective and prospective bio-behavioral cancer studies have revealed that psycho social stressors may play a pivotal role in the initiation and progression of malignant neoplasia. In recent research, a pattern has emerged, which in analogy to the coronary prone pattern (type A) has been labelled type C, encompassing suppression of emotional responses, such as anger and hostility, rationality and antiemotionality, as well as high social conformity and a lack of self-assertiveness. There is growing evidence in both infrahuman and human research that specific coping styles (repressive coping) with stress may be associated with specific biologic responses, including neuroendocrine, immunologic and other bodily functions. The application of this model appears to be of importance for further research, as well as for the detection of high risk individuals, but also in regard to therapy, rehabilitation, early detection and possibly also prevention of malignant disease. This concept suggests also new directions and modifications of stress research, as stressors are to be viewed not necessarily as pathological, but in some instances as quite possibly salutary, depending on the nature of the stres-sor, the psychophysiologic state of the individual and his or her ability to cope with adverse life situations. Quite naturally, the development of this concept is still in its initial stages, there remain anumber of open questions, and it needs hardly to be pointed out in this connection that further and painstaking clinical and laboratory work is warranted in order to clarify the role of stressors, life and coping styles and its biological concomitants in neo-plastic disease.

Genomic profile concordance between pancreatic cyst fluid and neoplastic tissue

BACKGROUND DNA mutational analysis of pancreatic cystic fluid (CF) is a useful adjunct to the evaluation of pancreatic cysts. KRAS/GNAS or RAF/PTPRD/CTNNB1/RNF43 mutations are highly specific to precancerous or advanced neoplasia. Several studies recently demonstrated the ability of next-generation sequencing (NGS)analysis to detect DNA mutations in pancreatic CF, but few studies have performed a systematic comparative analysis between pancreatic CF and neoplastic surgical tissue (NT). The value of CF-NGS analysis indicators for determining surgical resection necessitates evaluation. AIM To confirm whether CF genomic profiles are a reliable malignancy predictor by comparing NGS mutational analyses of CF and NT. METHODS Patients requiring surgery for high-risk pancreatic cysts were included in a multicenter prospective pilot study. DNA from CF (collected by endoscopic ultrasound-guided fine needle aspiration (known as EUS-FNA)) and NT (collected by surgery) were analyzed by NGS. The primary objective was to compare the mutation profiles of paired DNA samples. The secondary objective was to correlate the presence of specific mutations (KRAS/GNAS, RAF/ PTPRD/CTNNB1/RNF43/POLD1/TP53) with a final cancer diagnosis. Sensitivity and specificity were also evaluated. RESULTS Between December 2016 and October 2017, 20 patients were included in this pilot study. Surgery was delayed for 3 patients. Concordant CF-NT genotypes were found in 15/17 paired DNA, with a higher proportion of mutated alleles in CF than in NT. NGS was possible for all pancreatic CF collected by EUS-FNA. In 2 cases, the presence of a KRAS/GNAS mutation was discordant between CF and NT. No mutations were found in 3 patients with NT or pancreatic cysts with high-grade dysplasia. The sensitivity and specificity of KRAS/GNAS mutations in CF to predict an appropriate indication for surgical resection were 0.78 and 0.62, respectively. The sensitivity and specificity of RAF/PTPRD/CTNNB1 /RNF43/POLD1/TP53 mutations in CF were 0.55 and 1.0, respectively. CONCLUSION Mutational analyses of CF and NT were highly concordant, confirming the value of NGS analysis of CF in the preoperative malignancy assessment. However, these results need to be confirmed on a larger scale.

Fruquintinib beneficial in elderly patient with neoplastic pericardial effusion from rectal cancer:A case report

BACKGROUND Neoplastic pericardial effusion(NPE)is a rare consequence of rectal cancer and carries a poor prognosis.Optimal management has yet to be determined.Fruquintinib is an oral anti-vascular endothelial growth factor receptor tyrosine kinase inhibitor approved by the China Food and Drug Administration in September 2018 as third-line treatment of metastatic colorectal cancer.CASE SUMMARY Herein,we report an elderly patient with NPE from rectal cancer who responded to the use of fruquintinib.In March 2015,a 65-year-old Chinese woman diagnosed with KRAS-mutated adenocarcinoma of the rectum was subjected to proctectomy,adjuvant concurrent chemoradiotherapy,and adjuvant chemotherapy.By October 2018,a mediastinal mass was detected via computed tomography.The growth had invaded parietal pericardium and left hilum,displaying features of rectal adenocarcinoma in a bronchial biopsy.FOLFIRI and FOLFOX chemotherapeutic regimens were administered as first-and second-line treatments.After two cycles of second-line agents,a sizeable pericardial effusion resulting in tamponade was drained by pericardial puncture.Fluid cytology showed cells consistent with rectal adenocarcinoma.Single-agent fruquintinib was initiated on January 3,2019,as a third-line therapeutic.Ten cycles were delivered before the NPE recurred and other lesions progressed.The recurrence-free interval for NPE was 9.2 mo,attesting to the efficacy of fruquintinib.Ultimately,the patient entered a palliative care unit for best supportive care.CONCLUSION Fruquintinib may confer good survival benefit in elderly patients with NPEs due to rectal cancer.

Study on medication regularity of traditional Chinese medicine cases in treatment of neoplastic fever based on data mining

Objective:To analyze the medication regularity of traditional Chinese medicine cases in treatment of neoplastic fever in order to guide clinical medication.Methods:The database of China National Knowledge Infrastructure,Vip database and WanFang medical network were searched.The cases involving traditional Chinese medicine prescription in the treatment of neoplastic fever were screened.After extracting the prescriptions and Chinese medicines,make statistics according to frequency analysis,cluster analysis and association analysis.Results:79 literatures were included which involving 123 decoctions.221 traditionalChinese medicines were included in the statistics,the most frequently used traditional Chinese medicines were Gancao,Chaihu,Huangqi and Shengdihuang.The proportion of heat-clearing drugs in Chinese medicines was the largest(23.98%).The most common property of the Chinese medicines is cold property,accounting for 51.13%.The higher frequencies of flavors of the Chinese medicines are bitter,sweet and acrid,the sum of which is 84.66%.The most common meridian of Chinese medicines is liver meridian,accounting for 19.82%.The cluster analysis and association analysis of high frequency Chinese medicines showed that high frequency Chinese medicines could form three clustering formulas,and could get 18 pairs of high frequency drug combinations.Conclusion:Traditional Chinese medicines for heat-clearing,deficiencytonifying,phlegm-resolving,blood stasis-dispeling are mostly used to the treatment of neoplastic fever.The results of cluster analysis and association analysis of high frequency traditional Chinese medicines can provide certain reference and guidance for clinical medication.

Effects of a long-term administration of aqueous extract of Prunella vulgaris L.on survival,spontaneous thyroid carcinoma and neoplastic C-cell hyperplasia in rats

Objective To investigate the effects of an aqueous extract of Prunella vulgaris L.(PV)on survival,spontaneous thyroid carcinoma and its preneoplastic lesion in rats.Methods A total of 552 Wistar rats were randomly assigned into 4 groups(n=138)and given one of the following diets for 24 months:chow diet(control),2.5(low),8.25(middle)and 25(high)g/kg body weight PV diets.After the intervention,serum metabolic parameters including indicators of liver and renal function,glucose and lipid profiles were measured.

Clinical Observation on the Treatment of Male Neoplastic Anemia with Yixuesheng Capsule(益血生胶囊) Combined with Recombination Human Erythropoietin

Objective:To explore the efficacy and mechanism of Yixuesheng capsule(益血生胶囊,YXS) combined with recombination human erythropoietin(RHE) in treating male neoplastic anemia(NA).Methods: Sixty-five patients were randomized into two groups,the 33 patients in the treated group treated with a combined therapy of YXS and RHE,and the 32 in the control group treated with RHE alone,all for 12 weeks.Related clinical indexes,including hemoglobin(Hgb),red blood cell(RBC),hematocrit(HMC),testosterone(T),estradiol (E_2) an...

A Nomogram-based Model to Predict Neoplastic Risk for Patients with Gallbladder Polyps

Background and Aims:Gallbladder polyp(GBP)assessment aims to identify the early stages of gallbladder carcinoma.Many studies have analyzed the risk factors for malignant GBPs.In this retrospective study,we aimed to establish a more accurate predictive model for potential neoplastic polyps in patients with GBPs.Methods:We devel-oped a nomogram-based model in a training cohort of 233 GBP patients.Clinical information,ultrasonographic find-ings,and blood test findings were analyzed.Mann-Whitney U test and multivariate logistic regression analyses were used to identify independent predictors and establish the nomogram model.An internal validation was conducted in 225 consecutive patients.Performance and clinical bene-fit of the model were evaluated using receiver operating characteristic curves and decision curve analysis(DCA),re-spectively.Results:Age,cholelithiasis,carcinoembryonic antigen,polyp size,and sessile shape were confirmed as independent predictors of GBP neoplastic potential in the training group.Compared with five other proposed predic-tion methods,the established nomogram model presented better discrimination of neoplastic GBPs in the training co-hort(area under the curve[AUC]:0.846)and the validation cohort(AUC:0.835).DCA demonstrated that the greatest clinical benefit was provided by the nomogram compared with the other five methods.Conclusions:Our developed preoperative nomogram model can successfully be used to evaluate the neoplastic potential of GBPs based on simple clinical variables that maybe useful for clinical decision-making.

Early and long-term results of combined cardiac surgery and neoplastic resection in patients with concomitant severe heart disease and neoplasms

Background It is a surgical dilemma when patients present with both severe heart disease and neoplasms. The best surgical treatment remains controversial. This study aimed to analyze the early and long-term results of simultaneous surgical treatment of severe heart disease and neoplasms. Methods We reviewed the clinical records of 15 patients who underwent simultaneous neoplastic resection and cardiac surgery between September 2006 and January 2011. There were 5 male and 10 female patients. The mean age was （59.2±12.5） years and the mean left ventricular ejection fraction was （57.4±11.0）%. All patients were followed up completely for a period of 12 to 51 months （mean, （33.1±11.2） months）. Results Fifteen patients underwent simultaneous cardiac surgery and neoplastic resection. Cardiac procedures consisted of off pump coronary artery bypass grafting （n=7）, aortic valve replacement （n=3）, mitral valve replacement （n=3）, mitral valve replacement with coronary artery bypass grafting （n=1） and left atrial myxoma resection （n=1）. Neoplastic resection consisted of lung cancer resection （n=5）, colonic cancer resection （n=3）, gallbladder resection （n=1）, colonic cancer resection with gallbladder resection （n=1）, hysterectomy （n=2）, hysterectomy with bilateral salpingo-oophorectomy （n=2） and left ovariectomy （n=1）. Pathological examination confirmed malignant disease in 10 patients and benign disease in 5 patients. There were no perioperative myocardial infarctions, stroke, pericardial tamponade, renal failure or hospital deaths. The most frequent complications were atrial fibrillation （33.3%）, pneumonia （26.7%）, low cardiac output syndrome （6.7%） and delayed healing of surgical wounds （6.7%）. There was 1 late death 42 months after surgery for recurrent malignant disease. At 1 and 3 years, survival rates were 100% （Kaplan-Meier method）. Conclusions Simultaneous cardiac surgery and neoplastic resection was not associated with increased early or late morbidity or mortality. Cardiopulmonary bypass does not appear to adversely affect survival in patients with malignant disease. The long-term survival was determined by tumor stage.

Clinical features of neoplastic pathological fracture in long bones

Background Pathological fractures signify a potentially more aggressive subset of the original disease with higher misdiagnosis rates and inferior oncologic results. The purpose of the present study was to explore the clinical features of neoplastic pathological fracture in extremities. Methods From August 2002 to December 2010, a consecutive series of 139 patients suffering neoplastic pathological fracture were recruited, including 79 males and 60 females with a mean age of 31.3 years. Fractures were classified into five groups： tumor-like lesions （55）, benign bone tumors （13）, giant cell tumors （7）, primary malignant bone tumors （28）, and metastatic bone tumors （36）. Based on their inducing forces, pathologic fractures were classified into four grades： spontaneous fracture, functional fracture, minor injury, and traumatic injury. Patients＇ age, fracture site, histological diagnoses, fracture forces, prodromes, and misdiagnosis were well reviewed. Kruskal-Wallis and X2 tests were used to compare forces and prodromes within different types of bone tumors. Results The highest pathologic fracture morbidity was 32.3% （45/139）, which lay in the 11-20 year group, and 86.1% of metastatic tumors occurred in the 50-80 year group. The common sites of fractures were femur, humerus, and tibia. The fracture forces in benign bone tumors and tumor-like lesions are the strongest, followed by metastatic tumors and primary malignant bone tumors （Hc=80.980, P=0.000）. Sixty-seven patients （48.2%） had local prodromes before pathologic fracture. The incidence rates of prodromes between primary malignant tumors and metastatic bone tumors had no significant difference （P=0.146）, but they were all obviously higher than that of benign bone tumors and tumor-like lesions. Twenty patients experienced misdiagnosis. Conclusion Minor injury forces and local prodromes are clinical features of neoplastic pathologic fractures and they are also the critical factor avoiding misdiagnoses.

STUDY OF NEOPLASTIC TRANSFORMATION OF HUMAN FETAL LUNG CELLS INDUCED BY A NEW NITROSAMINE COMPOUND (MAMBNA) in vitro

The model system of neoplastic transformation of human cells in vitro, as a desirable way for screening potential carcinogens and studying the mechanisms of carcinogenesis, has aroused great interest in a lot of laboratories. But till now,

STUDY OF NEOPLASTIC TRANSFORMATION OF HUMAN FETAL KIDNEY EPITHELIAL CELLS INDUCED BY DIETHYL-NITROSAMINE in vitro

About 90 percent of human malignant tumors result from the neoplastic transformation of epithelial cells. As the conclusions obtained from animal cells cannot be extrapolated to humans directly, and the humans are not allowed to be used for carcinogen-esis experiments, establishment of a transformation system of human epithelial

Paraneoplastic cerebellar degeneration:initial presentation of mucosa-associated lymphoid tissue lymphoma in a patient with primary Sjogren’s syndrome

A 29-year-old Chinese woman complained of recurring dizziness for 5 months and gait disturbance for 2 months.On admission(April 2016),she was found to have a widebased gait,horizontal nystagmus and positive heel-kneeshin test.Initial hematological,biochemical,microbiological,hormonal investigations and tumor serum markers were unremarkable.Oligoclonal bands were observed in cerebrospinal fluid(CSF)without other pathological changes,while magnetic resonance imaging(MRI)of cervical spine and brain were normal.An anterior mediastinal mass was noted by computed tomography(CT)[Figure 1A].Despite a lack of paraneoplastic antibodies in CSF or serum,such as anti-neuronal nuclear autoantibody type 1(ANNA-1,also known as"anti-Hu"),ANNA-2(also known as"anti-Ri"),Purkinje cell antibody type 1(PCA-1,also known as"anti-Yo"),anti-CV2(also known as"collapsin response mediator protein 5[CRMP5]"),anti-Ma,anti-Amphiphysin,anti-Tr(also known as"delta/notch-like epidermal growth factorrelated receptor[DNER]")and anti-glutamic acid decarboxylase(GAD),her neurological manifestation still pointed toward one of the paraneoplastic neurological syndromes(PNSs).

Higher risk of neoplastic progression of Barrett’s esophagus in patients with systemic sclerosis

Systemic sclerosis(SSc)is a multisystem connective-tissue disorder of unknown etiology affecting various internal organs and skin.Esophageal involvement is present in≤70%–90%of the patients and is manifested by severe gastroesophageal-reflux disease and dysmotility.Although Barrett’s esophagus(BE)has been reported in patients with SSc[1,2],the risk of neoplastic progression has not been reported before in the USA.Therefore,we aimed to study the prevalence of BE in SSc and incidence of neoplastic progression.

Neoplastic macrovascular invasion represents an independent risk factor for dismal survival in sorafenib treatment for hepatocellular carcinoma

Aim: Sorafenib efficacy and safety in advanced hepatocellular carcinoma (HCC) have been demonstrated in two randomized international clinical trials and in clinical practice studies. Because of poor survival advantage, to identify clinical and biological parameters remains an unmet clinical need. Methods: Eighty-four patients treated with sorafenib were evaluated for response to therapy and prognostic factors possibly associated with survival. Results: Median overall survival was 8.5 months. Median duration of therapy was 2.5 months with a median daily dose of 800 mg (IQR 600-800). Dose was adjusted in 52% of patients. Radiological response to therapy showed a significant impact on survival. Child-Pugh score and neoplastic invasion of the portal system were negatively associated with survival. Continuation of sorafenib even at lower dose was positively correlated with survival. The multivariate analysis identified vascular invasion as the only independent variable: median survival of 5.5 months for neoplastic portal vein thrombosis compared to 12 months in the remaining subjects. Conclusion: A lower sorafenib daily dose is advantageous, even though the reason of this association cannot be explained at present. Neoplastic portal vein thrombosis is strongly associated with dismal survival. Alternative or complementary treatment approaches should be studied in order to improve outcome in this subgroup of patients.

Intrathecal dexamethasone and methotrexate treatment of neoplastic meningitis from solid tumors

Aim:Neoplastic meningitis(NM)from solid tumors is an advanced malignancy with poor prognosis.Intrathecal chemotherapy is a reliable treatment,and we have obtained some experiences in the treatment of NM with intrathecal dexamethasone and methotrexate(IT DXM and MTX).Methods:Retrospective study of 23 patients with NM from lung cancer(n=11),breast cancer(n=3),gastric cancer(n=1),malignant melanoma(n=1),unknown cancer(n=7)was conducted.Among these patients,eight received IT DXM and MTX treatment,and 15 patients were placed into a palliative care group.Overall survival(OS)was compared,and the patients’characteristics,symptoms,and some laboratory examinations were analyzed to find the risk factors affecting OS.Results:OS of IT DXM and MTX group was significantly longer than that of the palliative care group(P=0.01).The median survival(MS)of palliative care group was 7.53 weeks(5.50-9.57;n=15),and of the IT DXM and MTX group,28.63 weeks(12.50-44.75;n=8);IT DXM and MTX prolonged the OS of NM patients(regression coefficient=−2.923),with odds ratio(OR)being 0.054(0.09-0.323).Spinal nerves damage decreased the OS(regression coefficient=1.595),with OR being 4.928(1.382-17.579).Conclusion:IT DXM and MTX have prolonged the patients’MS,which could be used as a fundamental treatment of NM.Time of induction treatment should be flexible and individualized,and induction treatment could restart when central nervous system relapse.Patients with spinal nerves damage are apt to live shorter.

Value of magnifying endoscopy with narrow-band imaging in diagnosis of 124 early gastric neoplastic lesions

Objective To investigate the value of intervening part(IP)ratio under magnifying endoscopy with narrowband imaging(ME-NBI)in the diagnosis of early gastric neoplastic lesions.Methods From September 2012 to May 2015,a total of 124 patients with suspected superficial gastric neoplastic lesions under white light endoscope(WLI)were enrolled,87 male with mean age of(63.

Contrast-enhanced ultrasonography in peripheral lung consolidations: What's its actual role?

AIM:To evaluate the diagnostic accuracy of contrastenhanced ultrasonography(CEUS)in the differential diagnosis between neoplastic and non-neoplastic peripheral pleuro-pulmonary lesions.METHODS:One hundred patients with pleural or peripheral pulmonary lesions underwent thoracic CEUS.An 8 microliters/mL solution of sulfur hexafluoride microbubbles stabilized by a phospholipid shell(SonoVue)was used as US contrast agent.The clips were stored and independently reviewed by two readers,who recorded the following parameters:presence/absence of arterial enhancement,time to enhancement(TE),extent of enhancement(EE),pattern of enhancement(PE),presence/absence of wash-out,time to wash-out,and extent of wash-out.After the final diagnosis(based on histopathologic findings or follow-up of at least 15 mo)was reached,sensitivity,specificity,positive predictive value(PPV),negative predictive value(NPV),positive likelihood ratio(PLR),negative likelihood ratio(NLR)of each CEUS parameter in the differential diagnosis between neoplastic and nonneoplastic lesions were calculated.Furthermore,an arbitrary score based on the ratio between the PPVs of each CEUS parameter was calculated,to evaluate if some relationship could exist between overall CEUS behaviour and neoplastic or non-neoplastic nature of the lesions.