Giant Hemosiderotic Dermatofibroma: A Case Report and Review of the Literature

Dermatofibroma is a common benign fibrohistiocytic lesion that usually appears as a slow-growing, firm dermal nodule with a predilection for the legs of middle-aged women. They are usually smaller than 2 cm in diameter. Many histological variants have been described. Generally, the clinical and histological diagnosis is straightforward, but differentiating it from other cutaneous tumors can be difficult in atypical cases and rare variants. Giant dermatofibroma is a rare clinical variant of dermatofibroma and less than 25 cases have been reported. It is characterized essentially by its unusually large size, which often mimics malignant tumors clinically. We first present the case of a giant hemosiderotic dermatofibroma in a 54-year-old patient, who presented with a large ulcerated mass of the left foot which was excised, and then review the literature briefly

Primary pulmonary malignant meningioma with lymph node and liver metastasis in a centenary woman, an autopsy case

Primary meningiomas arising outside the central nervous system are very rare. They have been reported in the head and neck region, in the thorax, the retroperitoneum, and the pelvis. Usually, they behave as slow-growing tumors with a good prognosis. Herein, we report an autopsy case of a 108-year-old woman, known for a right-sided slowly growing lung nodule for 39years. Death was attributed to cachexia. At post-mortem, a 15-cm mass was present in the right inferior lobe of the lung, associated with an ipsilateral hilar lymphadenopathy, and another 10-cm mass in the liver. Histology revealed a WHO grade III meningioma. No tumor was observed in the cranial cavity. This case illustrates a rare location of meningioma and highlights its biological behavior, with a very slow progression from a most probably benign tumor to a malignant lesion with metastasis over four decade

Potential of hybrid 18F-fluorocholine PET/MRI for prostate cancer imaging

Purpose: To report the first results of hybrid 18F-fluorocholine PET/MRI imaging for the detection of prostate cancer. Methods: This analysis included 26 consecutive patients scheduled for prostate PET/MRI before radical prostatectomy. The examinations were performed on a hybrid whole-body PET/MRI scanner. The MR acquisitions which included T2-weighted, diffusion-weighted and dynamic contrast-enhanced sequences were followed during the same session by whole-body PET scans. Parametric maps were constructed to measure normalized T2-weighted intensity (nT2), apparent diffusion coefficient (ADC), volume transfer constant (K trans), extravascular extracellular volume fraction (v e) and standardized uptake values (SUV). With pathology as the gold standard, ROC curves were calculated using logistic regression for each parameter and for the best combination with and without PET to obtain a MR model versus a PETMR model. Results: Of the 26 patients initially selected, 3 were excluded due to absence of an endorectal coil (2 patients) or prosthesis artefacts (1 patient). In the whole prostate, the area under the curve (AUC) for SUVmax, ADC, nT2, K trans and v e were 0.762, 0.756, 0.685, 0.611 and 0.529 with a best threshold at 3.044 for SUVmax and 1.075×10−3mm2/s for ADC. The anatomical distinction between the transition zone and the peripheral zone showed the potential of the adjunctive use of PET. In the peripheral zone, the AUC of 0.893 for the PETMR model was significantly greater (p = 0.0402) than the AUC of 0.84 for the MR model only. In the whole prostate, no relevant correlation was observed between ADC and SUVmax. The SUVmax was not affected by the Gleason score. Conclusion: The performance of a hybrid whole-body 18F-fluorocholine PET/MRI scan in the same session combined with a prostatic MR examination did not interfere with the diagnostic accuracy of the MR sequences. The registration of the PET data and the T2 anatomical MR sequence data allowed precise localization of hypermetabolic foci in the prostate. While in the transition zone the adenomatous hyperplasia interfered with cancer detection by PET, the quantitative analysis tool performed well for cancer detection in the peripheral zone

Kayexalate Intake (in Sorbitol) and Jejunal Diverticulitis, a Causative Role or an Innocent Bystander?

Small intestine diverticulosis is a rare entity that is asymptomatic in the majority of cases. However, it may cause serious complications, such as infection, hemorrhage, intestinal obstruction and diverticulitis. Kayexalate (sodium polystyrene sulfonate) in sorbitol has been associated with colonic necrosis and less frequently with upper gastrointestinal injuries in a subset of uremic patients treated for hyperkalemia. We report a case of jejunal diverticulosis with mucosal injury and diverticulitis in a uremic patient treated with Kayexalate and discuss the potential role of Kayexalate in the pathogenesis of diverticulitis