Isolated scrotal skin relapse in a child with burkitt lymphoma

En hızlı büyüyen insan tümörü olan Burkitt lenfoma (BL), agresif bir B hücre neoplazisidir. Genellikle ekstranodal bir hastalık şeklinde ortaya çıkar. Ekstranodal alanlara metastazı da sıktır ancak cilt tutulumu nadirdir. On bir yaşında erkek hasta, karın ağrısı ve yutma güçlüğü şikayeti ile başvurdu. Batın sol alt kadranda tespit edilen kitleye uygulanan trucut biyopsi ile BL tanısı konuldu ve BFM-95 B hücreli Non-Hodgkin lenfomu (NHL) tedavi protokolü uygulandı. Hasta tedavi bitiminden 1,5 ay sonra sağ skrotal şişlik şikayeti ile tekrar başvurdu. Fizik muayenesinde, sağ skrotal ödem ve kızarıklık vardı. Skrotum cildinden yapılan biyopsi ile hastaya relaps BL tanısı konuldu ve LMB-Grup C tedavi protokolü uygulandı. Tedavi bitiminden 20 ay sonra hasta batında şişlik ve ağrı şikâyeti ile tekrar geldi. Muayenesinde; batında sol üst-orta kadranda bir kitle saptandı. Yapılan biyopsinin sonucu yine BL olarak rapor edildi ve hastaya COPM (vinkristin, prednizolon, siklofosfamid, metotreksat) tedavi protokolü ile birlikte rituksimab başlandı. Ancak santral sinir sistemi relapsı gelişti ve hasta kaybedildi. Bu olgu daha önce literatürde izole skrotal cilt relapsı bildirilmediği için sunulmuştur.Burkitt lymphoma (BL) that is the most rapidly growing human tumor is an aggressive B-cell neoplasia. It generally occurs as an extranodal disease. Its metastasis into extranodal areas is also frequent, however, its cutaneous involvement is rare. An 11-year-old male presented with the complaints of abdominal pain and difficulty in swallowing. The patient was diagnosed with BL by trucut biopsy that was performed for a mass identified in the left upper abdominal quadrant and B-cell Non-Hodgkin’s lymphoma (NHL) BFM 95 treatment protocol was applied. The patient applied again for the complaint of right scrotal swelling 1.5 months after the completion of therapy. On physical examination, right scrotal edema and redness were identified. The patient was diagnosed with relapsed BL by biopsy taken from scrotal skin and LMB-Group C treatment protocol was applied. The patient came again with the complaints of abdominal swelling and pain 20 months after the completion of therapy. On physical examination, a mass was detected in the left mid-upper quadrant of the abdomen. The result of biopsy was reported as BL again and COPM (cyclophosphamide, vincristine, prednisolone, and methotrexate) treatment protocol and rituximab were started. However, central nervous system (CNS) relapse developed and the patient was lost. This case was presented because isolated scrotal skin relapse has not been reported in the literature

Mikrokalsifikasyonların Tanısında Vakum Destekli Stereotaktik Meme Biyopsisi:Üç Yıllık Deneyimlerimiz

Amaç: Vakum destekli stereotaktik meme biyopsisi VDSB , günümüzde giderek artan sıklıkla kullanılan, gereksiz eksizyonel biyopsileri önleyebilecek, basit, güvenli, minimal invaziv bir perkütan biyopsi yöntemidir. Bu geriye dönük çalışmanın amacı, mikrokalsifikasyonların tanısında kullandığımız VDSB ile ilgili deneyimlerimizi sunmaktır. Gereç ve Yöntem: Selçuk Üniversitesi Tıp Fakültesi Hastanesi’nde, 2010-2013 yılları arasında mamografisinde mikrokalsifikasyon saptanmış ve VDSB uygulanmış 46 olgunun dosya bilgileri geriye dönük olarak incelenmiştir. Mikrokalsifikasyonların özellikleri, VDSB uygulamaları sırasında ve sonrasında karşılaşılan erken ve geç dönem komplikasyonlar, histopatolojik sonuçlar, takip sonuçları değerlendirilmiş ve sonuçlar hasta sayısı, yüzde ve ortalama ± standart sapma olarak sunulmuştur. Bulgular: VDSB yapılan 46 olguya ait mamogramlarda en çok küme oluşturan pleomorfik %32,6 mikrokalsifikasyonlar görülmüştür.VDSB’ye bağlı erken dönem komplikasyonlar %15,2 olguda ağrı, %2,2 olguda hematom, % 2,2 olguda ise ekimozdur. Olguların hiç birisinde geç dönemde komplikasyon ile karşılaşılmamıştır. 29 olguda % 63 histopatoloji benign, 17 olguda %37.0 ise malign olarak sonuçlanmıştır. 11 %23,9 olguda saptanan duktal karsinoma insitu, bir olguda %2,2 saptanan lobüler karsinoma insitu, dört %8,7 olguda saptanan atipik duktal hiperplazi göz önüne alındığında, toplam 16 olguda %34,7 tümör henüz prekürsor iken veya hücre içi aşamada yakalanmıştır. Sonuç: VDSB, özellikle mamografik mikrokalsifikasyonların tanısında cerrahi biyopsilere göre öncelikle tercih edilebilecek minimal invaziv bir yöntemdir. Benign olgularda hasta için anksiyete ve morbidite kaynağı olabilecek gereksiz cerrahi girişimleri önlemekte malign olgularda ise klinisyene tedavi planında yol gösterici olmaktadı

Comparison of apparent diffusion coefficient values among different MRI platforms: a multicenter phantom study

PURPOSE:We aimed to compare apparent diffusion coefficient (ADC) values among magnetic resonance imaging (MRI) scanners from different vendors.MATERIALS AND METHODS:We used a custom-made phantom solution consisting of distilled water, 0.9% NaCl, 25% NaCl, and shampoo for diffusion-weighted MRI (DW-MRI) examinations. DW-MRI was performed with similar sequence parameters using six different 1.5 Tesla MR scanners (scanners A–F). ADC maps were automatically constructed for all DW-MR images (b factors of 0 and 1000 s/mm2). ADC measurements were performed using regions of interest and seven different software programs, including four different postprocessing workstations, two different picture archiving and communication systems, and operator console software for each MR scanner.RESULTS:The ADC values generated by scanners A and F were higher and those of scanner B were lower than those generated by the other scanners (P = 0.002). The intravendor difference in the ADC values averaged from scanners D, E, and F was statistically significant (P < 0.001). The difference between the ADC values obtained by scanners C and E was not statistically different (P = 0.15).CONCLUSION:ADC values may differ among different MRI systems used for DW-MRI. Thus, the MRI vendor should be considered when using DW-MRI in a clinical setting

Computed tomography-based morphometric measurements of the atlas (C1) posterior arc

Study design: Single-center retrospective study Objectives: This study is performed to determine the anatomic feasibility of the C1 posterior arc screw and help select an optimal screw trajectory in treating patients with craniovertebral junction pathologies. Material and Methods: We reported a single-centre retrospective study. Forty patients (20 male and 20 female) who underwent cervical computed tomography (CT) were chosen from the hospital records. Based on CT images, we measured left laminar length (LLL), right laminar length (RLL), left laminar angle (LLA), right laminar angle (RLA), left laminar axial thickness (LLAT), right laminar axial thickness (RLAT), left laminar coronal thickness (LLCT), right laminar coronal thickness (RLCT), and craniocaudal angle (CCA) of the C1 posterior arc. Results: The mean values and standard deviations (SD) for nine parameters at the C1 posterior arc were determined. LLL, RLL, LLCT, and RLCT were statistically longer in men than women. RLAT was bigger in men but there was no statistical difference. RLA was statistically wider in women than men. LLA and CCA were wider in women but there was no statistical difference, LLAT was bigger in women but there was no statistical difference. There was no statistical difference in measurements by age. Conclusion: &nbsp;The results of this study are important to avoid neurovascular injury and pedicle breakage because of choosing large screw while performing C1 laminar screw fixation

Comparison of CT virtual cystoscopy and conventional cystoscopy for bladder tumors

Mesane tümörlerinde sanal BT sistoskopi ve konvansiyonel sistoskopi bulgularının karşılaştırılması AMAÇ: Bu çalışmanın amacı, mesane tümörlerinin tespitinde kontrast madde doldurularak yapılan sanal sistoskopinin etkinliğini araştırmaktır. GEREÇ VE YÖNTEM: Ağrısız hematüri şikayeti bulunan ve mesane kanseri düşünülen ardışık 36 olgu (28 erkek ve 8 kadın; yaş aralığı, 51-82; ortalama ± SD, 65 ± 7) sanal sistoskopi ile değerlendirildi. İntravenöz yoldan verilen kontrast madde ile dolan mesane, tek kesitli spiral bilgisayarlı tomografi (BT) ile 2 mm kesit kalınlığında incelendi. BT tarama bilgileri, gölgeli yüzey gösterimi metodu kullanılarak yapılacak olan interaktif navigasyon işlemi için iş istasyonuna aktarıldı. Tüm olgular konvansiyonel sistoskopi ile incelendi. Sanal sistoskopi sonuçları konvansiyonel sistoskopi sonuçlan ile karşılaştırıldı. BULGULAR: Yirmi sekiz olguda konvansiyonel sistoskopide görülen 78 mesane tümörünün 71'i sanal görüntülerde de izlendi. Olguların 5'i hem konvansiyonel hem de sanal sistoskopide normal görünmekteydi. Sanal sistoskopide, 5 mm ve daha küçük çaptaki 12 lezyonun 7'si tanımlanabildi. Çalışmamızda sanal sistoskopide mesane lezyonlanmn tanımlanmasında aşağıdaki istatistiksel değerleri bulduk: Sensitivite %94, spesifisite %90, pozitif prediktif değer %87, negatif prediktif değer %93 ve doğruluk %93. SONUÇ: BT sanal sistoskopi, 5 mm ve daha büyük mesane tümörlerinin görüntülenmesinde başarı ile kullanılabilen noninvaziv bir yöntemdir. Anahtar kelimeler: Mesane tümörü, Bilgisayarlı tomografi (BT), sanal sistoskopiComparison of CT virtual cystoscopy and conventional cystoscopy for bladder tumors PURPOSE: The purpose of this study was to investigate the value of contrast material- filled virtual cystoscopy in the detection of bladder tumors. MATERIALS AND METHODS: Thirty-six consecutive patients (28 male and 8 female; range age, 51-82 years; mean age ± SD, 65 ± 7 years) who had painless hematuria and suspected to have bladder neoplasm prospectively evaluated with virtual cystoscopy. After the intravenous injection of contrast medium, the contrast material-filled bladder was examined with single detector helical computed tomography (CT) scan with 2-mm slice thichness. Sourch CT data were transferred to a workstation for interactive navigation using surface rendering. All patients also underwent conventional cystoscopy. The results of virtual cystoscopy were compared with the findings of conventional cystoscopy. RESULTS: Seventy-one of 78 bladder tumors detected with conventional cystoscopy in 28 patients were also shown on virtual images. Five patients had a normal appearance on both conventional cystoscopy and virtual cystoscopy. On virtual cystoscopy, seven of the 12 lesions 5 mm or smaller in diameter could be identified. We found the following statistical values for the idendification of bladder lesions on virtual cystoscopy: sensitivity, 94%; spesificity, 90%; positive predictive value, 87%; negative predictive value, 93%; and accuracy 93%. CONCLUSION: CT virtual cystoscopy is a noninvasive technique which is used succesfully for detection of bladder tumors larger than 5 mm. Keywords: Bladder tumor, Computed tomography (CT), Virtual cystoscop

Van Der Knaap Hastalığı: Manyetik Rezonans Görüntüleme Bulguları

Van der Knaap hastalığı, megalensefalik lökoensefalopati ve subkortikal kistlerle karakterize nadir bir antitedir. Bu yazıda Van der Knaap hastalığı’nın radyolojik ve klinik tanı kriterlerine sahip üç pediatrik olgunun beyin manyetik rezonans görüntüleme MRG ve manyetik rezonans spektroskopi MRS bulguları sunulmuştu

Reevaluation of mandibular morphometry according to age, gender, and side

WOS: 000434304300093PubMed: 29461369Aim: This study aims to reevaluation the linear and angular measurements of mandibles with multidetector computed tomography (MDCT) that is a new method and used frequently in recent years. Materials and Methods: The archived MDCT images of 100 adult patients (age range, 15-74 years) without mandibular operation and trauma history were evaluated retrospectively. Mandibular ramus heights, maximal mandibular length, mandibular symphysis height, mandibular angles, and mandibular foramen distance measurements were performed on MDCT images. All measurement parameters were analyzed by gender, age groups, and sides. Results: Mandibular linear length measurements were higher in males than in females (P<0.05). Only mandibular symphysis height was statistically significantly different in age groups (P<0.05). The Angle 1 (gonial angle) was found to be significantly higher in females (P<0.05). The Angle 3 (right condyle-gnathion-left condyle angle) was observed to be significantly higher in the 60+ age group (P<0.05). The 3 of the mandibular foramen measurements (distance from the front edge, distance to gonion, and height of lingula) were found to be higher in males than in females (P<0.05). There were no significant differences according to age groups in these measurements. The lengths of the mandibular canals were higher in males (44.72mm) than in females (41.68mm). There was no statistically significant difference was found between gender, age groups, and sides of mandibular canal length. Conclusion: The MDCT was found to be a reliable method for the detection of mandibular morphometry when compared with the results of other radiographic images studies

Mental foramen and lingual vascular canals of mandible on MDCT images: anatomical study and review of the literature

WOS: 000424279500011PubMed: 28409316The mental foramen and lingual vascular canals are related to vessels and nerves in the mandibular body. The aim of the present study was to determine the number and location of these structures and to make measurements of them. The archived Multidetector Computed Tomography images of 100 adult (15- to 70-year-old) patients were evaluated retrospectively. The diameters of the mental foramens and their distances from the front, back, upper and lower reference points were measured. The distribution of mental foramens with respect to the teeth was also researched. The presence of lingual vascular canals, and the number of median and lateral canals was determined, and the length of the median lingual vascular canals measured. All measurement parameters were analyzed by gender, side and age group. Eleven patients demonstrated a total of 15 accessory mental foramen. Median lingual vascular canals were observed in 100% of cases, with lateral lingual vascular canals determined in 32%. Significant differences were observed in the results of different gender groups (P < 0.05); in contrast, no significant difference was observed related with age or side. Accessory mental foramen was determined mostly in males, and unilaterally on the right side; also, the distances of mental foramen, except the distance from the back border of the mandible (P < 0.05), were found to be higher, bilaterally, in males. Variation of mental foramen, as well as the presence, position and size of lingual vascular canals can be clearly investigated by multidetector computed tomography. A preoperative knowledge of the positions of neurovascular and bone structures is very important for preventing complications that may occur during or after operations

Pulmonary Mr Angiography In Swyer-James Syndrome

Aim : The aim of this study was to investigate the pulmonary magnetic resonance angiography (MRA) imaging findings in Swyer - James syndrome (SJS) as a alternative imaging modalities. Methods : Thirteen patients had posteroanterior inspiratory/expira-tory chest X-ray films and pulmonary MRA with SJS (6 males, 7 females) were retrospectively studied . Gradient-echo pulmonary MRA was performed in all patients with a 1. 5 T MR unit. MRA imaging was performed in a single breath-hold during the injection of contrast media. Image analysis of the patients was performed. The results of pulmonary artery diameters and pulmonary periph-eral vasculature were compared between normal sides versus the affected sides. Statistical analysis was performed with the Student t test. Results : The smaller pulmonary artery on the affected side with poor peripheral vasculature was observed with gadolinium-en-hanced gradient-echo MRA in all patients . There was a significant difference between the diameters of the pulmonary arteries of the normal versus the disease sides (p< 0.0005). Conclusion: MRA successfully depicted the small pulmonary artery with diminished peripheral vasculature in patients with SJS. This study showed the pulmonary MRA imaging could be used as a al-ternative imaging modalities in the evaluation of patient with SJS