Hepatic angiomyolipoma (HAML) is a rare benign mesenchymal tumor of the liver, which has highly variable imaging appearances, often leads to missed diagnosis and misdiagnosis. The images of 2 patients with HAML confirmed by pathology were presented in this study, and the typical imaging features of the HAML, the underlying pathophysiological mechanism, and the differential diagnosis were briefly summarized so as to deepen the understanding of HAML and to improve the diagnosis and differential diagnosis abilities of HAML, then reduce the rates of missed diagnosis and misdiagnosis of the HAML.
ObjectiveTo investigate the clinicopathological features, diagnosis and differential diagnosis of villoglandular carcinoma of the uterine cervix. MethodsThe clinical data of a 34-year-old patient diagnosed with villoglandular carcinoma of cervix on April 6, 2010 was retrospectively analyzed. Surgical excision samples were analyzed by means of hematoxylin-eosin and immunohistochemical staining. ResultsThe gross appearance of the tumor mass showed cauliflower-like pattern of growth. Histologically, it was similar to colorectal villoglandular adenoma, and was composed of branching papillae shaped like villous glandular tube structure, and the surface was coated with pseudostratified or stratified columnar cells which showed mild atypia and uncommon mitotic figures. Immunohistochemically, tumor cells were positive for carcinoma embryonic antigen, CK7 and CA125, and negative for estrogen receptor, progesterone receptor, P16, p53 and vimentin. This patient was subjected to a follow-up of 48 months, and was alive without recurrence or metastasis. ConclusionsVilloglandular carcinoma of the uterine cervix is rare and has a favorable prognosis. The diagnosis of villoglandular carcinoma depends on pathological morphology, and meanwhile, it is necessary to distinguish villoglandular carcinoma from other benign and malignant tumors which exhibited papillary growth pattern.
Objective To summarize the updates of diagnosis and differential diagnosis for hepatocellular carcinoma (HCC) with portal vein tumor thrombus (PVTT) for providing evidences for early diagnosis and treatment of PVTT patients. Methods The related literatures on diagnosis and differential diagnosis for HCC with PVTT in recent years were collected and reviewed. Results The serious complications and tumor metastasis are attributed to the PVTT, then it is necessary to make diagnosis accurately according to clinical symptoms, hematological and imaging examinations. The differential diagnosis of PVTT and portal vein thrombosis, portal sponge degeneration and hepatic arteriovenous shunt diseases should be carried out. Conclusions The diagnosis and differential diagnosis of PVTT cannot rely on a single method, and it requires a comprehensive judgment of various diagnostic methods. More accurate and specific diagnostic methods are needed.
ObjectiveTo assess the values of MRI, ultrasound (US), and X-ray in the differential diagnosis of benign and malignant breast lesions. MethodsThe image data of 50 breast lesions confirmed with histopathology were analyzed retrospectively and the values of MRI, US and X-ray mammography in the differential diagnosis of benign and malignant breast lesions based on the breast imaging reporting and data system (BI-RADS) were assessed. The diagnostic efficiency of MRI, US, and X-ray in 50 benign and malignant breast lesions were compared using receiver operating characteristics (ROC) curves. The areas of ROC curves of MRI, US, and X-ray were calculated with Z test using SPSS 16.0. ResultsThere were 44 patients with 50 breast lesions, 26 malignant lesions, 24 benign lesions. Based on the BI-RADS, according to X-ray imaging features, 26 malignant breast lesions were classified as 5 lesions of category 5, 7 lesions of category 4, 6 lesions of category 3, 3 lesions of category 2, 1 lesion of category 1, 4 lesions of category zero. Twenty-four benign breast lesions were classified as 1 lesion of category 4, 3 lesions of category 3, 4 lesions of category 2, 13 lesions of category 1, 3 lesions of category zero. According to the characteristics of US findings, 26 malignant breast lesions were classified as 17 lesions of category 5, 4 lesions of category 4, 1 lesion of category 3, 1 lesion of category 2, 3 lesions of category 1. Twenty-four benign breast lesions were classified as 1 lesion of category 5, 2 lesions of category 4, 4 lesions of category 3, 14 lesions of category 2, 2 lesions of category 1, 1 lesion of category 0. According to MRI imaging findings, 26 malignant breast lesions were classified as 6 lesions of category 5, 18 lesions of category 4, 1 lesion of category 3, 1 lesion of category 1. Twenty-four benign breast lesions were classified as 20 lesions of category 1, 3 lesions of category 2, 1 lesion of category 3. The area under the ROC curve of the MRI, US, and X-ray was 0.977, 0.835, and 0.764, respectively. The differences of MRI with US (Z=2.05, P < 0.05) and MRI with X-ray mammography (Z=2.81, P < 0.05) were statistically significant. While the difference of US with X-ray mammography (Z=0.73, P > 0.05) was't statistically significant. ConclusionsDynamic contrast-enhanced MRI is an accurate examination in the differential diagnosis of benign and malignant breast lesions. The differential diagnostic efficiency of MRI is significantly better than those with US and X-ray.
Idiopathic intracranial hypertension (IIH) is a neurological disorder characterized by an unexplained increase in intracranial pressure that primarily affects obese women of childbearing age, but individuals of any age, gender, or weight may also be affected. Its signature symptoms include disc edema, headache, visual disturbance, and throbbing tinnitus. Due to potentially serious complications, such as vision loss, accurate diagnosis and appropriate treatment management are critical to improving patients' quality of life. Ophthalmologists play a key role in the treatment process, as about half of patients first visit the eye department. Diagnosis of IIH depends not only on clinical presentation, but also on the exclusion of other diseases that may cause similar symptoms, and imaging and other tests to ensure an accurate diagnosis. In order to improve diagnostic accuracy and treatment efficiency, multidisciplinary collaborative diagnosis and treatment mode is advocated, especially in the face of patients with complex trauma or systemic diseases, which can effectively shorten the treatment time and ensure patient safety. Future research directions include establishing China's IIH epidemiological database, exploring clinical diagnosis and treatment methods and basic scientific research, aiming at forming diagnosis and treatment standards suitable for China's national conditions, improving medical level and improving patient prognosis. At the same time, a deeper understanding of the different forms of IIH will better serve the affected populations.
ObjectiveTo evaluate the diagnostic value of ultrasound for gallbladder carcinoma (GA), in order to improve the ability of early ultrasonic and clinical diagnosis of GA. MethodsWe analyzed and compared the clinical data and ultrasonic results of 42 GA cases confirmed by surgery and pathology between January 2008 and December 2013, and summarized the classification, ultrasonographic features, and diagnosis of GA. ResultsAmong the 42 cases, 25 were correctly diagnosed by ultrasound (59.5%), among which 9 were thick-wall type, 11 were protrusion type and 5 were solid type. Seventeen cases were misdiagnosed (40.5%). Pathological results showed 14 cases of highly-differentiated adenocarcinoma, 16 of moderately differentiaed adenocarcinoma, 9 of poorly-differentiated adenocarcinoma, 2 of squamous adenocarcinoma and 1 of neuroendocrine carcinoma. ConclusionUltrasound is the preferred method for the diagnosis of GA because of its convenience, although the diagnostic accuracy is still not good and more efforts should be done.
ObjectiveTo investigate misdiagnosis of primary squamous cell carcinoma of liver (PSCCL) as cholangiocarcinoma before operation and its clinical manifestations, imaging manifestations, etiology, histological origin, pathological characteristics, diagnosis and differential diagnosis, selection of treatment methods, and prognosis, so as to improve understanding and reasonable diagnosis and treatment of disease.MethodThe clinicopathologic data of a case of PSCCL misdiagnosed as cholangiocarcinoma in the West China Hospital of Sichuan University were analyzed retrospectively.ResultsThe patient was admitted to the West China Hospital of Sichuan University with the right hepatic space occupying. The preoperative imaging examination showed that the patient had the imaging characteristics of hepatic cholangiocarcinoma, then the right hemihepatectomy was performed. The postoperative pathological diagnosis was the PSCCL.ConclusionsPreoperative diagnosis of PSCCL is extremely difficult and it is difficult to differentiate it from primary liver cancer, and it is easy to overlook liver metastasis’s occurrence in other parts of the squamous cell carcinoma, which leads to liver metastasis. It is usually diagnosed by pathological diagnosis after operation, and then original lesions in other parts are excluded by various examinations. PSCCL is treated in a variety of ways, but it’s prognosis is not good. At present, there is no unified treatment principle, most of which are surgery, followed by postoperative radiotherapy and chemotherapy. In most cases, because PSCCL’s etiology is unknown and mechanism is not clear, clinicians can only implement individualized treatment according to patient’s condition.