Hepatic lipoma: a case report

Karaciğerde lipom nadir görülen benign tümörlerdir. Bu lezyonlar genellikle boyutlarına bağlı olmaksızın bulgu vermezler ve rastlantısal olarak saptanırlar. Histolojik olarak bu lezyonlar matür adipoz dokudan oluşur ve malign dejenerasyon riski yoktur. Lipomlar karakteristik görüntüleme bulgularına sahiptir. Kırkiki yaşında kadın hasta dispeptik yakınmalar ile hastanemize başvurdu. Hastaya abdominal ultrasonografi (US) yapıldı ve karaciğerde sağ lobda iyi sınırlı, solid, homojen, hiperekoik kitle lezyonu saptandı. Magnetik rezonans (MR) görüntülemede aynı lezyon T1 ve T2 ağırlıklı görüntülerde hiperintens kitle olarak izlendi. Kitle lezyonu postkontrastlı yağ baskılı T1 ağırlıklı görüntülerde homojen hipointens olup kontrast tutulumu göstermedi. US ve MR görüntüleme bulguları değerlendirildiğinde son radyolojik tanı karaciğerde lipom olarak kondu.Hepatic lipomas are rare benign tumours. They are usually asymptomatic regardless of size and are discovered incidentally. Histologically these lesions consist of mature adipose tissue and have no risk of malignant degeneration. The imaging appearance of lipomas is characteristic. A 42-year-old woman was admitted to the hospital because of dyspeptic symptoms. Abdominal ultrasound (US) examination was performed and solid, homogenous, hyperechoic, well delineated tumor mass in right liver lobe was revealed. Magnetic resonance (MR) imaging demonstrated the same lesion on T1 and T2 weighted images as hyperintense mass. The lesion was homogeneously hypointense and did not show enhancement on postcontrast fat-suppressed T1-weighted images. The final radiological diagnosis was hepatic lipoma according to US and MR image findings

Nonpalpable BI-RADS 4 breast lesions: sonographic findings and pathology correlation

PURPOSEWe aimed to evaluate ultrasonography (US) findings for Breast Imaging Reporting and Data System (BI-RADS) category 4 lesions using BI-RADS US lexicon and determine the positive and negative predictive values (PPV and NPV) of US with respect to biopsy results.METHODSSonograms of 186 BI-RADS 4 nonpalpable breast lesions with a known diagnosis were reviewed retrospectively. The morphologic features of all lesions were described using BI-RADS lexicon and the lesions were subcategorized into 4A, 4B, and 4C on the basis of the physician’s level of suspicion. Lesion descriptors and biopsy results were correlated. Pathologic results were compared with US features. PPVs of BI-RADS subcategories 4A, 4B, and 4C were calculated.RESULTSOf 186 lesions, 38.7% were malignant and 61.2% were benign. PPVs according to subcategories 4A, 4B, and 4C were 19.5%, 41.5%, and 74.3%, respectively. Microlobulated, indistinct, and angular margins, posterior acoustic features, and echo pattern were nonspecific signs for nonpalpable BI-RADS 4 lesions. Typical signs of malignancy were irregular shape (PPV, 66%), spiculated margin (PPV, 80%) and nonparallel orientation (PPV, 58.9%). Typical signs of benign lesions were oval shape (NPV, 77.1%), circumscribed margin (NPV, 67.5%), parallel orientation (NPV, 70%), and abrupt interface (NPV, 67.6%).CONCLUSIONBI-RADS criteria are not sufficient for discriminating between malignant and benign lesions, and biopsy is required. Subcategories 4A, 4B, and 4C are useful in predicting the likelihood of malignancy. However, objective and clear subclassification rules are needed

Conventional and Diffusion-Weighted MR Imaging Findings of Parotid Gland Tumors

Objective: To investigate diffusion-weighted magnetic resonance imaging (MRI) findings of parotid gland lesions in addition to conventional MRI findings and demographic data.Methods: A retrospective evaluation was made of the demographic data, histopathologic data, preoperative conventional and diffusion-weighted MRI of 74 patients who underwent parotidectomy. The patients were categorized according to the histopathology (pleomorphic adenoma [PA], Warthin’s Tumor [WT] and malignant Tumor [MT]).Results: Histologically, 30 patients had PA, 27 patients had WT, and the remaining 17 patients had MT. The mean age of the PA, WT and MT groups were 44±21 (20-72), 55±10 (41-71) and 62±20 (21-76) years, respectively. The WT (81%) and MT (70%) groups were male dominant, while the PA group showed female dominance (55%). The PA group showed statistically significant difference in terms of age (p<0.05) and gender (p=0.009) compared to the other two groups. The median apparent diffusion coefficient (ADC) values for the PA, WT and MT groups were 1.99±0.94 (1.10-2.41) x 10-3 mm2/s, 0.92±0.35 (0.21-1.79) x 10-3 mm2/s and 1.20±0.34 (0.78-1.47) x 10-3 mm2/s, respectively. PA was differentiated from the other two groups (p=0.001). The sensitivity and specificity for distinguishing PAs from WT was 97% and 85%, respectively, when the ADC cutoff value was 1.25; and for distinguishing PAs from MT was 77% and 83%, respectively, when the ADC cutoff value was 1.35.Conclusion: ADC measurements are useful for the differentiation of PA from both WT and MT; and can be used as a complementary tool to predict the histopathology in the preoperative planning of parotid tumors