Different imaging findings of inflammatory myofibroblastic tumor of the liver

Inflammatory myofibroblastic tumor(IMT) in the liver is an uncommon lesion of uncertain pathogenesis.In most cases,symptomatological imaging and clinical studies suggest malignancy.We report a case of liver IMT with imaging findings from positron emission tomography/computed tomography(PET/CT),contrastenhanced computed tomography(CECT) and contrastenhanced ultrasonography(CEUS).This report was the first to depict a PET/CT scan of a liver IMT that revealed an inhomogeneous,intense(fluorine 18)-fluoro-2-deoxy-D-glucose uptake.The CECT and CEUS images showed a hepatic artery supplying blood to the mass and necrosis.The characteristic histopathological features and the presence of spindle cells expressing smooth muscle actin,collagen fibers and lymphocytes allowed for the diagnosis of liver IMT.Recognizing such findings will help to achieve a correct diagnosis and may prevent inappropriate treatment.

Gastric metastasis from ovarian carcinoma: A case report and literature review

An isolated parenchymal gastric metastasis from ovarian carcinoma without any other sites of recurrence is extremely rare. Only two cases have been reported, both of which were symptomatic. We herein report such a case without any symptoms. A 61-year-old woman presented with a high cancer antigen-125 level without any other clinical manifestation. A subsequent 18 F-fluorodeoxyglucose (18F-FDG) positron emission tomography/computed tomography scan revealed a submucosal mass with hypermetabolism of 18F-FDG (standardized uptake value:5.36) in the gastric antrum. The final pathology after gastric antrectomy showed a metastatic gastric tumor from a primary ovarian carcinoma. We also performed an extensive literature review about gastric metastasis from ovarian carcinoma published until recently, and this is the first case of an isolated parenchymal gastric metastasis from ovarian carcinoma without any symptoms.

Efficacy of DR, CT and MRI in bone tumors

Objective: The aim of the study was to investigate the efficacy of digital radiography(DR), computed tomography(CT) and magnetic resonance imaging(MRI) in bone tumors. Methods: Fifty-five patients with histologically confirmed bone tumors underwent imaging examinations. Fifty-five patients were performed DR, 21 CT and 20 MRI. Results: DR of 51 patients clearly revealed bone changes. DR of 40 patients well showed marginal. Twenty tumors appeared periosteal reaction on DR and 19 calcification on DR. CT scan of 21 patients clearly depicted bone changes, marginal and calcification and CT scan of 8 revealed periosteal reaction. MRI scan of 20 patients all showed marginal and soft-tissue mass and bone marrow edema was prominent in 8 patients. Conclusion: DR is the first imaging approach for born tumors. CT well reveal the extent and minute structure of the bone tumors, the extent, soft-tissue mass and bone marrow edema are more dramatically demonstrated on MRI imaging. DR integrates with CT and MRI, is helpful in diagnosis of bone tumors.

What is a reliable CT scan for diagnosing splenosis under emergency conditions?

Splenosis is a condition in which splenic tissue is present in a non-anatomical position. Implants of splenic tissue can mimic neoplasms and only specific examinations can confirm the correct diagnosis. Here we report a case of a 23-year-old male patient with a history of surgical splenectomy during childhood after trauma. He was admitted to the emergency department with acute bowel obstruction. An abdominalpelvic computed tomography (CT) scan revealed small bowel obstruction and the presence of two rounded, solid masses located in the rectal-vescical pouch. Quantitative analyses of the different density values in the arterial phase and early portal venous phase demonstrated that these lesions were highly vascularised (92 and 97 Hounsfield Units, respectively). The hypothesis of an ectopic splenic mass was made after evaluation of the CT images and clinical history. The acute bowel obstruction caused by adhesive intestinal syndrome was resolved by surgical adhesiolysis. The smallest mass adherent to the rectum was removed. Histopathologic examination confirmed the benign nature of the lesion, which consisted of splenic tissue.

The San Juan Islands Thrust System： New Perspectives from LIDAR and Sonar Imagery

New LIDAR （Light Detection and Ranging） and sonar imagery have revealed remarkable geomorphic details never seen before and not visible by any other means. Numerous faults and other geologic structures are plainly visible on LIDAR and sonar images. Many previously unknown faults criss-cross the islands and large fault scarps are visible on sonar imagery along the margins of the larger islands. Sonar images of sea floor morphology show many submerged faults as long linear scarps with relief up to 300m （1,000 fl）, some of which visibly truncate geologic structures. The San Juan Lopez fault, the largest fault in the islands, extends for at least 65 km （40 mi） from Stuart Island to Rosario strait with a scarp up to 330m （1,000 it） high. Since 1975, the basic structural framework of the San Juan Islands has been considered to consist of five stacked thrust faults, the Rosario, Orcas, Haro, Lopez, and Buck Bay faults, constituting the San Juan Thrust （Nappe） System that has shuffled together far distant terranes. However, the new LIDAR and sonar imagery shows that most of the mapped extent of these postulated faults are actually segments of high angle, dipslip faults and are not thrust faults at all. Thus, the San Juan Thrust （Nappe） System does not exist. The age of these faults is not accurately known and more than one period of high angle faulting may have occurred. Faults shown on L1DAR images of the surface of the islands appear as visible gashes, etched out by erosion of fault zones with few fault scarps. However, the sea floor faults have bold relief and high scarps. A late Pleistocene moraine lies undisturbed across the San Juan Lopez fault.

Progression of hepatic hyperperfusion disorders revealed during follow-up CT scan of digestive system neoplasm

Objective： The aim of this study was to investigate progression of hepatic hyperperfusion disorders revealed during follow-up contrast material-enhanced multi-slice spiral computed tomography （MSCT） scan of digestive system neoplasm. Methods： Three-phase contrast material-enhanced MSCT were performed during the follow-up in patients with digestive system malignant tumor confirmed histologically. The progression of hepatic hyperperfusion disorders revealed on contrast material-enhanced CT image were investigated at the 2 years follow-up with approximately 6 months interval. Results： The hepatic hyperperfusion disorders were showed in 39 patients on follow-up contrast material-enhanced MSCT scans. Among the 39 patients, initial hyperperfusion disorders were revealed in 6 （15.38%）, 26 （66.67%）, and 7 （17.95%） patients in 6, 12, and 18 months during follow-up respectively. The initial hyperperfusion disorders revealed in 12 months were more frequent than those revealed in 6 months （X2 = 14.82, P 〈 0.05） and 18 months （X2 = 15.02, P 〈 0.05）. Among the 39 patients, the hyperperfusion disorders progressed into liver metastasis based on typical CT findings in 37 （94.87%） patients, and were not obvious changes in 2 （5.13%） patients. Among the 37 patients, the hyperperfusion disorders progressed into metastasis in 10 （25.64%） patients in 6 months after the hyperperfusion disorders were revealed, and in 27（69.23%） patients in 12 months. The hyperperfusion disorders developing into metastasis were more in 12 months than those in 6 months （X2= 14.98, P 〈 0.05）. Conclusion： Most hepatic hyperperfusion disorders revealed at the follow-up of digestive system neoplasm may be early manifestations of liver metastasis. The careful follow-up of hepatic hyperperfusion disorders is necessary.

Synchronous primary cancer of the rectum and lung:a case report

Multiple primary cancers refer to the condition where more than two cancers occur independently in an individual. The incidence of lung cancer in cases of colorectal cancer is rare and synchronous rectal cancer and lung cancer is even rare. A 61-year-old man was referred to our hospital with a 2-month history of blood in his stool, tenesmus, and mucous discharge in July 2010. Colonoscopy showed an irregular ulcerated rectal mass and histological examination of biopsy material showed a poorly differentiated adenocarcinoma. Computed tomography （CT） scan of the chest and abdomen showed a mass in the posterior segment of the right upper lobe of the lung and a mass in the right rectal wall of upper rectum. The rectal tumor was diagnosed as primary cancer based on the findings of immunohistochemical stain. An anterior resection （AR） and video assisted thoracoscopic （VAT） wedge resection were performed and histological findings of resected rectal and lung tumor specimen showed synchronous primary rectal cancer and lung cancer. A combination chemotherapy regimen with docetaxel and Iobaplatin was used and the patient was successfully discharged from hospital in August 2010. Although the incidence of synchronous multiple primary cancers is very low, we need to remain suspicious, when faced with two or even multiple organ lesions, and employ the necessary examination methods to confirm the diagnosis. For synchronous multiple primary cancers, if conditions allow, surgical resection for all the cancers can be performed in a single operation.