Dynamic enhanced computed tomography imaging findings of an inflammatory fibroid polyp with massive fibrosis in the stomach

Inflammatory fibroid polyp(IFP) is a rare benign lesion of the gastrointestinal tract. We report a case of computed tomography(CT) imaging finding of a gastric IFP with massive fibrosis. CT scans showed thickening of submucosal layer with overlying mucosal hyperenhancement in the gastric antrum. The submucosal layer showed increased enhancement on delayed phase imaging. An antrectomy with gastroduodenostomy was performed because gastric cancer was suspected, particularly signet ring cell carcinoma. The histopathological diagnosis was an IFP with massive fibrosis. The authors suggest that when the submucosal layer of the gastric wall is markedly thickened with delayed enhancement and preservation of the mucosal layer, an IFP with massive fibrosis should be considered in the differential diagnosis.

Imaging findings of primary pulmonary synovial sarcoma with secondary distant metastases:A case report

BACKGROUND Synovial sarcoma(SS)accounting for 6%-10%of primary soft tissue malignancies mainly occurs in deep soft tissue adjacent to joints of the limbs.Primary pulmonary SS(PPSS)is rare and has a poor prognosis.Cases of secondary distant metastases of PPSS occur rarely and there is a lack of corresponding imaging reports.We summarized the imaging findings of PPSS with multiple metastases confirmed by surgery and pathology,and shared valuable information on PPSS.CASE SUMMARY A 43-year-old female patient had a solid space occupying lesion in the right upper lobe of the lung.The results of a hemogram,erythrocyte sedimentation rate(ESR)and tumor markers were all within the normal range,tuberculin skin test(5 TU PPD)was negative(-).Chest computed tomography examination showed similar round soft tissue density in the posterior segment of the right upper lobe.Thoracoscopic-assisted wedge resection of the right upper lobe of the lung,right upper lobe resection and lymph node dissection were performed.Nine months after surgery,ultrasound examination showed multiple metastases on the chest wall and kidney.CONCLUSION PPSS is a rare malignant lung tumor with strong invasiveness,early distant metastasis and poor prognosis.There are very few imaging reports.PPSS is often manifested as irregular tumor and calcification,and the metastases have extremely low echo on ultrasonography.Contrast-enhanced ultrasound indicates that the arterial phase of tumor metastases shows rapid centripetal high enhancement,manifested as“fast forward and fast regression”.

Characteristic MR imaging findings and surgical treatment of cavernous hemangiomas in cavernous sinus

Objective To analyze the imaging character and surgical therapy of cavernous hemangiomas in cavernous sinus(CSHs).Methods From 2001 to 2008,13 patients with CSHs were surgically treated in our department. The diameters of CSHs varied from 3. 5 cm to 6. 0 cm. Results All the patients were operated on with no mortality.

Autoimmune pancreatitis with different clinical manifestations and imaging findings:a series of three cases

Autoimmune pancreatitis(AIP)is a rare and emerging immune-mediated pancreatitis.The involvement of the pancreas with lymph-oplasmacytic infiltration and fibrosis on histology is the most common features and has been well studied in the literature.It is characterized by a nonspecific presentation that mimics a malignant process.The purpose of this report is to explore the different clinical and paraclinical aspects of this disease,as well as the challenges posed by its management.The series are made up of three different cases of patients with elevated serum IgG4 levels and pancreatic changes.The first case initially revealed cholestatic jaundice with extrahepatic and intrahepatic cholangitis,and ultrasound reflected multiple occupying changes in the pancreas.The elevated serum IgG4 level was brilliant.Patient improved under the influence of corticosteroids.The second case was clinically asymptomatic,just found weight loss.Magnetic resonance revealed a round mass in the head of the pancreas and was considered as a neuroendocrine tumor.The patient showed slightly elevated serum IgG4 level,but was sensitive to hormone therapy.The third case concerned epigastric pain and enlarged lymph nodes.It was initially diagnosed as pancreatic cancer with distant metastasis,but also finally resolved by corticosteroid treatment.The clinical presentation of AIP is heterogeneous,as evidenced by our three clinical cases.Further observational and interventional studies are needed to better identify and manage this disease.

Image Findings and Common Musculoskeletal Disorders for Pediatrics in the Saudi Arabian Society

Aim: To detect the most common musculoskeletal disorders and to explore the common injury and indication of different musculoskeletal systems, and then to obtain the causes of disorders by observing clinical indications via images. Methodology: The subjects in this project consisted of both genders—males and females and were investigated randomly by collecting data from the PACS unit that exists in the radiology department at KAUH. The participants had a mean age of 7.4 ± 0.3 years, a mean height of 118.2 ± 2.5 cm, a mean mass of 27.8 ± 1.5 kg, and a mean BMI of 19.6 ± 0.8 kg/m2. The author settled the study plan by building a special, appropriate questionnaire to be handed out to the patients and covered mainly the prospective studies of randomly selected patients who came to the emergency unit and the outpatient units from other departments at KAUH in Jeddah. Results: The ratio of injuries in male children (77%) against females (23%) is 3:1, and this ratio is considered significant between age groups for males when compared with females. The injuries existed most in the age groups of 4 to 6 years old and 8 to 10 years old with approximately the same percentage of the total subjects as about 21% for each age group. Trauma injury was significant (81%) compared to other types of causes in all age groups. There was a significant relationship between the causes of injuries and the age groups in pediatrics (p 0.05) between the site of injuries and age groups. The significant site that resulted from trauma was the knee (100%), out of the total traumas’ subject. There was a highly significant relationship between the site of injuries and its causes (p = 0.006, i.e. p < 0.05) that were expected. Conclusion: More awareness and understanding in the society are needed and we should concentrate on increasing the knowledge of such by providing them with more learning courses.

Factors associated with gastrointestinal stromal tumor rupture and pathological risk:A single-center retrospective study

BACKGROUND Gastrointestinal stromal tumor(GIST)is a rare gastrointestinal mesenchymal tumor with potential malignancy.Once the tumor ruptures,regardless of tumor size and mitotic number,it can be identified into a high-risk group.It is of great significance for the diagnosis,treatment,and prognosis of GIST if non-invasive examination can be performed before surgery to accurately assess the risk of tumor.AIM To identify the factors associated with GIST rupture and pathological risk.METHODS A cohort of 50 patients with GISTs,as confirmed by postoperative pathology,was selected from our hospital.Clinicopathological and computed tomography data of the patients were collected.Logistic regression analysis was used to evaluate factors associated with GIST rupture and pathological risk grade.RESULTS Pathological risk grade,tumor diameter,tumor morphology,internal necrosis,gas-liquid interface,and Ki-67 index exhibited significant associations with GIST rupture(P<0.05).Gender,tumor diameter,tumor rupture,and Ki-67 index were found to be correlated with pathological risk grade of GIST(P<0.05).Multifactorial logistic regression analysis revealed that male gender and tumor diameter≥10 cm were independent predictors of a high pathological risk grade of GIST[odds ratio(OR)=11.12,95%confidence interval(95%CI):1.81-68.52,P=0.01;OR=22.96,95%CI:2.19-240.93,P=0.01].Tumor diameter≥10 cm,irregular shape,internal necrosis,gas-liquid interface,and Ki-67 index≥10 were identified as independent predictors of a high risk of GIST rupture(OR=9.67,95%CI:2.15-43.56,P=0.01;OR=35.44,95%CI:4.01-313.38,P<0.01;OR=18.75,95%CI:3.40-103.34,P<0.01;OR=27.00,95%CI:3.10-235.02,P<0.01;OR=4.43,95%CI:1.10-17.92,P=0.04).CONCLUSION Tumor diameter,tumor morphology,internal necrosis,gas-liquid,and Ki-67 index are associated with GIST rupture,while gender and tumor diameter are linked to the pathological risk of GIST.These findings contribute to our understanding of GIST and may inform non-invasive examination strategies and risk assessment for this condition.