Appendicitis and diverticulitis of the colon: Misleading forms

AbstractAppendicitis and diverticulitis of the colon are the two main causes of febrile acute abdomen in adults. Diagnosis from imaging (ultrasound and CT) is usually easy. However, an imaging procedure which is not suitable for the clinical situation and an examination performed with the wrong protocol are sources of error and must be avoided. Anatomical variants, inflammatory cancers, complicated forms (perforation, secondary occlusion of the small intestine, peripheral abscesses, fistulae, pylephlebitis, liver abscesses) and associated signs related to a peritoneal inflammatory reaction (reflex ileus, reactive ileitis or salpingitis) can also lead to a wrong diagnosis

Malignant rhabdoid tumors of the liver: an exceptional tumor in adults - a case report and literature review

Malignant rhabdoid tumor (MRT) is a very rare liver tumor, with only a few cases reported in the literature. MRT generally occurs in pediatric patients and prognosis is usually very poor. Here we report a very rare case of MRT occurring in a young adult who is still alive with no sign of recurrence at 41 months of follow-up. MRI and computed tomography scans revealed a voluminous heterogeneous mass in the left liver with no specific pattern. The mass included necrotic and fibrous components. Histology showed fusiform, loosely cohesive cells with abundant eosinophilic cytoplasm resulting in eccentric nuclei, thus creating the characteristic rhabdoid appearance. Immunohistochemical studies revealed a lack of nuclear INI1 protein expression. The patient\u27s treatment included a major left liver resection associated with chemotherapy. A thorough search of the literature revealed one case of MRT in a young adult who died at 48 months of follow-up. A less malignant nature of the tumor in young adults may be suspected, but a longer disease-free survival may also be the fruit of aggressive surgical and oncological treatment

Applications of phase-contrast velocimetry sequences in cardiovascular imaging.

AIMS: To describe and illustrate the main applications of phase-contrast flow quantification in cardiovascular imaging. CONCLUSION: Phase-contrast velocimetry sequences provide an accurate, reliable, reproducible and non-invasive study of blood flow, information which is sometimes not available from other investigation methods. The haemodynamic information obtained from these complement MRI angiography images. They appear to have a range of clinical applications, firstly improving pathophysiological understanding but also contributing to the treatment and follow-up strategy after surgical or endovascular treatment

Accuracy of water-enema multidetector computed tomography (WE-MDCT) in colon cancer staging: a prospective study

Purpose To assess the accuracy of water-enema multidetector computed tomography (WE-MDCT) in extra-rectal colon cancer staging. Materials and methods Fifty-three patients (mean age 70 years) with extra-rectal colon cancer proven by colonoscopy and biopsy were prospectively evaluated by preoperative WE-MDCT. CT scans were both intraluminal (water enema or WE) and intravenous (iodinated) contrast enhanced (CE). All patients underwent surgery. Tumors were classified with the TNM staging system. Noted CT features were: tumor size and location; tumor form and edges; spread to the pericolic fat or neighboring organs; thickening of retroperitoneal fascia; number, size, and enhancement of the peritumoral lymph nodes. Tumors were classified on CT into 3 T-stage groups: T1/T2, T3, and T4. Lymph nodes were classified by their density after injection [positive over 100 Hounsfield units (HU)]. Results Tumor localization to the specific colon segment was correct in all the cases. The agreement between WE-MDCT staging and histopathology staging was good (k = 0.64). An irregular and bowl-shaped aspect of the external edges of tumor provided excellent sensitivity for T3/T4 inclusion (Se 97.7%, NPV 85.7%). Thickening of a fascia or the abdominal wall provided good specificity for T4 stage (Sp 88.1%, NPV 94.9%). Enhancement over 100 HU of at least one peritumoral lymph node was the best criterion of N+ staging (Sp 67.7%, NPV 87.5%). Conclusion WE-MDCT permits good staging of colon cancer based on objective features