Pseudoneoplastic lesions of the testis and paratesticular structures

Pseudotumors or tumor-like proliferations (non-neoplastic masses) and benign mimickers (non-neoplastic cellular proliferations) are rare in the testis and paratesticular structures. Clinically, these lesions (cysts, ectopic tissues, and vascular, inflammatory, or hyperplastic lesions) are of great interest for the reason that, because of the topography, they may be relevant as differential diagnoses. The purpose of this paper is to present an overview of the pseudoneoplasic entities arising in the testis and paratesticular structures; emphasis is placed on how the practicing pathologist may distinguish benign mimickers and pseudotumors from true neoplasia. These lesions can be classified as macroscopic or microscopic mimickers of neoplasia

JOURNAL OF ULTRASOUND IN MEDICINE

Objective. To reveal the arterial Doppler sonographic findings in cases of posttraumatic reflex sympathetic dystrophy. Methods. Eleven patients had hand reflex sympathetic dystrophy, and 9 had foot reflex sympathetic dystrophy. The duration of symptoms ranged from 1 to 28 weeks, and the history of fracture ranged from 6 to 48 weeks. Bilateral brachial or popliteal arteries proximal to injuries were evaluated by Doppler sonography with a 7.5-MHz linear transducer All patients also had triphasic bone scintigraphy and extremity thermography. Results. Two patients had monophasic waveforms and 4 had low-pulsatility triphasic waveforms on the affected limbs when compared with the asymptomatic limbs. All opposite asymptomatic limbs had normal triphasic waveforms in these 6 cases. Spectral analysis revealed a loss or decrease of a normal reversed flow component with a reduced pulsatility index on the affected limb. Fourteen other patients had symmetric triphasic waveforms. We observed that the patients who had stage 1 reflex sympathetic dystrophy and warm limbs with durations of symptoms of more than 2 weeks had positive Doppler sonographic findings, whereas all patients with stage 2 reflex sympathetic dystrophy and all with normal skin temperature, regardless of stage, had normal waveforms. Conclusions. Doppler sonography revealed loss of normal triphasic arterial waveforms in some of the cases of stage 1 disease, whereas many cases of stage 1 disease and all cases of stage 2 disease had normal findings. Therefore, we think that Doppler sonography cannot be used for the diagnosis of reflex sympathetic dystrophy but may help in assessing hemodynamic stages of the disease

NUCLEAR MEDICINE COMMUNICATIONS

It has been suggested that low back pain (LBP) may arise from lumbosacral transitional vertebral articulation (LSTVA) itself. It is known that bone scintigraphy is a valuable tool for the recognition of pain arising from bone and articular diseases. Therefore we aimed to show planar and SPELT bone scintigraphic findings of LSTVA and compare them with the LBP and X-ray findings. Twenty-eight patients (aged 20-63 years) in whom LSTVA had been identified radiographically were evaluated with planar bone scintigraphy, utilizing Tc-99m methylene diphosphonate; and single photon emission computed tomography (SPELT) bone scintigraphy. Eighteen patients had LBP whereas 10 had not. There were 25 type IIA, one type IIB and two type IIIA LSTV articulation. On planar images, normal or non-focal minimally increased uptake superimposed on the upper sacroiliac joint was seen in patients without degenerative changes regardless of LBP whereas SPELT showed non-focal mild increased uptake on the area medial to the upper sacroiliac joint. Planar scans showed normal to non-focal mild, and mild-to-moderately increased uptake whereas SPELT demonstrated focal mild-to-moderately and markedly increased uptake in patients with degenerative changes without LBP and with LBP, respectively. The X-ray results showed an association of LBP degenerative changes, and the SPELT results showed a focal, markedly increased, uptake. We conclude that this focal, markedly increased, uptake may show the metabolically active degenerative changes of LSTV articulation and may help to reveal the pain arising from LSTVA. Therefore we propose that bone scintigraphy may be considered for the evaluation of patients with LBP thought to arise from LSTV articulation. ((C) 2004 Lippincott Williams Wilkins)

JOURNAL OF CLINICAL AND ANALYTICAL MEDICINE

Metastases to female genital organs from extragenital cancers are uncommon. Uterine cervix is one of the less uncommon site of the genital tract for extragenital organ tumors. We present a case of operated breast cancer who had silent metastases to the ovaries and uterine cervix. Metastatic involvement of the gynecologic organs should be considered in women with a history of breast cancer who present with vaginal bleeding or suspicious changes on transvaginal ultrasound. Uterine cervix should always kept in mind as a part of metastasis

GYNECOLOGIC ONCOLOGY

Background. Although many histopathological, clinical, and imaging findings of ESS have been described, intense calcifications have not been reported previously. Case. A 54-year-old female was admitted with vaginal bleeding and abdominal pain. Gynecologic examination revealed a huge, firm pelvic mass extending up to the epigastrium. Transabdominal ultrasonography and computed tomography demonstrated a well-demarcated uterine mass containing heterogeneous solid and cystic areas and a centric curvilinear calcification. Histopathological diagnosis was established as undifferentiated high-grade endometrial stromal sarcoma. Conclusion. Endometrial stromal sarcomas should be considered in the differential diagnosis of uterine masses containing curvilinear calcifications. (c) 2005 Elsevier Inc. All rights reserved