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

Outcomes of high-risk breast lesions diagnosed using image-guided core needle biopsy: results from a multicenter retrospective study

PURPOSEThe clinical management of high-risk lesions using image-guided biopsy is challenging. This study aimed to evaluate the rates at which such lesions were upgraded to malignancy and identify possible predictive factors for upgrading high-risk lesions.METHODSThis retrospective multicenter analysis included 1.343 patients diagnosed with high-risk lesions using an image-guided core needle or vacuum-assisted biopsy (VAB). Only patients managed using an excisional biopsy or with at least one year of documented radiological follow-up were included. For each, the Breast Imaging Reporting and Data System (BI-RADS) category, number of samples, needle thickness, and lesion size were correlated with malignancy upgrade rates in different histologic subtypes. Pearson’s chi-squared test, the Fisher–Freeman–Halton test, and Fisher’s exact test were used for the statistical analyses.RESULTSThe overall upgrade rate was 20.6%, with the highest rates in the subtypes of intraductal papilloma (IP) with atypia (44.7%; 55/123), followed by atypical ductal hyperplasia (ADH) (38.4%; 144/375), lobular neoplasia (LN) (12.7%; 7/55), papilloma without atypia (9.4%; 58/611), flat epithelial atypia (FEA) (8.7%; 10/114), and radial scars (RSs) (4.6%; 3/65). There was a significant relationship between the upgrade rate and BI-RADS category, number of samples, and lesion size Lesion size was the most predictive factor for an upgrade in all subtypes.CONCLUSIONADH and atypical IP showed considerable upgrade rates to malignancy, requiring surgical excision. The LN, IP without atypia, pure FEA, and RS subtypes showed lower malignancy rates when the BI-RADS category was lower and in smaller lesions that had been adequately sampled using VAB. After being discussed in a multidisciplinary meeting, these cases could be managed with follow-up instead of excision

Correlation of renal B-mode ultrasonographic findings with diabetic nephropathy stage

Amaç: Çalışmamızda diabetik nefropati’nin farklı evrelerindeki hastalarda, B-mod Ultrasonografi (US) ile tespit edilen renal morfolojik özelliklerin kontrol grubu kullanılarak karşılaştırılması amaçlanmıştır. Yöntem: Kontrol grubu olarak 20 sağlıklı kişi alınmıştır. Çalışma grubu olarak ise tip-2 diabet tanısı olan 69 hasta alınmıştır. Heriki gruptaki hastalar böbreklerin boyutu; parenkim kalınlığı ve parenkim eko şiddeti yönünden B-mod US ile değerlendirilmiştir. Diabetik hastalar, 24 saatlik idrardaki albumin ekskresyon oranlarına (AEO) göre 3 gruba ayrılmıştır (Grup-1: AEO 300 mg/ gün); ve her grup için ortalama renal parenkim kalınlığı ve renal uzunluk hesaplanmıştır. SPSS programı kullanılarak, bu değerler için gruplar arası karşılaştırma yapılmıştır. Bulgular: Böbrek boyutlarına göre, çalışma grubu ile kontrol grubu arasındaki farklılık araştırıldığında, istatistiksel olarak anlamlı farklılık gözlenirken, ortalama parenkim kalınlığının kontrol grubu ile hasta grupları arasında istatistiksel olarak farklı olmadığı görülmüştür. Hasta grupları, kendi içinde kıyaslandığında yine istatistiksel olarak anlamlı farklılık izlenmemiştir. Kortikal hiperekojenite saptanma oranlarının,ortalama serum BUN ve kreatinin klerens değerlerinin ise nefropati evresiyle korelasyonu izlenmiştir. Sonuç: Diabetik hastalarda, ilerleyen nefropati ile birlikte ultrasonografik olarak parenkim kalınlıkları anlamlı olarak değişmezken, eko şiddetinde artma ve sağlıklı bireylere göre böbrek boyutlarında azalma gerçekleşmektedir.Aim: We aimed to investigate the renal morphological features detected by B-mode ultrasonography (US) in various clinical stages of diabetic nephropathy by means of a control group. Methods: As control group, 20 healthy person were selected. As study group, 69 patients with type-2 diabetes were included. All cases in both groups were evaluated with B-mode US in terms of renal length, parenchymal thickness and echogenicity. Diabetic patients were divided into 3 groups according to 24-hour urinary albumin excretion ratios (AER) (Group-1: AER300 mg/ day); and mean renal parenchymal thickness and length were measured. By SPSS programme, mean values were compared between groups. Results: When mean renal length was compared between control and study groups, significant difference was noticed; but when mean renal parenchymal thickness was compared, no significant difference was demonstrated between two groups. When study groups were compared between each other,no statistically significant difference was seen. Cortical hyperechogenicity ratios; mean serum BUN and creatinine clearance rates, were correlated with nephropathy stage. Conclusion: With progression of nephropathy in diabetic patients,renal parenchymal thickness do not significantly differ; but hyperechogenicity and decrease in renal dimensions (control versus study group) occur

Multiple simultaneous venous and arterial thromboses in a patient with factor V Leiden disorder: detection by multislice computed tomography

Durakoglugil, Emre/0000-0001-5268-4262WOS: 000363622000007PubMed: 25838926Arterial thrombosis is extremely rare in patients with factor V Leiden (FVL) mutation. Recent advances in multislice computed tomography (MSCT) technology facilitated diagnosis of thromboembolic events accurately without delay. We report a patient with FVL mutation and acute bilateral lower extremity deep venous thromboses, pulmonary thromboembolism, and acute left anterior descending artery thrombosis, all diagnosed by MSCT. MSCT has been utilized for prompt diagnosis of the concomitant thrombotic pathologies simultaneously