Langerhans cell histiocytosis with involvement of the pons: case report

Central nervous system involvement is uncommon in Langerhans cell histiocytosis. The suprasellar region is more frequently affected. There have been few reports of involvement of the brain parenchyma shown on CT or MRI, We present a case of involvement of the pens, showing marked contrast enhancement on MRI

Bone lesions with soft-tissue mass: Magnetic resonance imaging diagnosis of lymphomatous involvement of the bone marrow versus multiple myeloma and bone metastases

Bone metastases from solid primary tumors, as well as multiple myeloma and secondary lymphoma may all present with bone lesions and associated soft-tissue masses on magnetic resonance images of the spine. Tn bone metastases and myeloma, the cortex of the affected bone is usually destroyed and a bulging contour is observed at the site of extraosseous spread. In cases of lymphomatous involvement of the bone marrow, however, we have observed that spread to the extraosseous soft-tissues occurs without alteration of the shape or contour of the affected bone. In order to assess whether this pattern of spread is indeed suggestive or even diagnostic of lymphoma of the bone marrow, we reviewed spinal bone marrow MR images of 66 patients, with bone metastases from solid primary tumors (33 patients), multiple myeloma (20 patients) and stage TV lymphoma with bone marrow involvement (13 patients), who had bone lesions and contiguous soft-tissue masses. If tumor was present on either side of the bony cortex but the contour of the affected bone was preserved, a “wrap-around” sign was diagnosed. A “wrap-around” sign was found in 12 of the 13 patients with lymphoma but in none of the patients with metastases or myeloma. On MR images of the bone marrow, the demonstration of tumor spread beyond the bony cortex without disruption of the outline of the diseased bone may favor the diagnosis of lymphoma more than that of metastases or multiple myeloma

CT appearance of solitary and multiple cystic and cavitary lung lesions

Cystic and cavitary lung lesions constitute a spectrum of pulmonary diseases diagnosed in both children and adults. We reviewed the CT findings of the most common cystic and cavitary lung lesions and we defined useful morphological criteria that will help radiologists to distinguish benign from malignant cavitary lesions. However, in many cases the considerable overlap in morphological features of benign and malignant cavities renders transthoracic needle biopsy necessary to establish the correct diagnosis

Male breast myofibroblastoma and MR findings

Myofibroblastoma of the breast is a rare benign tumor seen predominantly in men in the sixth to seventh decades of life. We present a case of breast myofibroblastoma in a man and describe the mammographic, sonographic, and MR findings

Progestin may modify the effect of low-dose hormone therapy on mammographic breast density

Objectives To evaluate the effect on breast density of two low-dose hormone therapy regimens identical in their estrogen component but different in the progestin. Methods A total of 81 non-hysterectomized postmenopausal women were allocated either to 17β-estradiol 1 mg and norethisterone acetate 0.5 mg E2NETA, n 43 or to 17β-estradiol 1 mg and drospirenone 2 mg E2DRSP, n 38. Treatment was continuous and lasted 12 months. The main outcomes were the changes in breast density according to the Wolfe classification between baseline and 12-month mammograms. Results Involution of the fibroglandular tissue was not seen in either of the treatment groups. Under E2NETA, breast density increased in seven women 16.3. In contrast, only three women 7.9 exhibited a density increase under E2DRSP. Conclusions Although hormone therapy appears to suspend breast involution, it does not increase breast density in the majority of treated women. Progestins differing in pharmacological properties may have a variable impact on breast density. © 2009 International Menopause Society