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Multiple sporadic schwannomas in a previously radiated field 曾接受过放射治疗的区域出现多个散发性裂隙瘤
Q4 Medicine Pub Date : 2024-09-20 DOI: 10.1016/j.radcr.2024.09.051

Peripheral nerve sheath tumors are a heterogenous group of predominantly benign tumors of neurogenic origin that arise outside of the central nervous system and include schwannomas and neurofibromas. These tumors often occur sporadically, however multiple lesions are generally associated with genetic syndromes such as neurofibromatosis (type 1 and 2) and schwannomatosis, and occasionally these tumors and their malignant variations are associated with a history of radiation treatment. Multiple benign schwannomas in an irradiated field have seldom been reported in the literature. We describe a case of a 49-year-old male with a history of right sided irradiated testicular cancer who presented with 2 histologically confirmed benign schwannomas in the right pelvic wall and right psoas muscle.

周围神经鞘瘤是一组异源性的神经源性良性肿瘤,主要发生在中枢神经系统之外,包括裂神经瘤和神经纤维瘤。这些肿瘤常为散发性,但多发性病变通常与遗传综合征有关,如神经纤维瘤病(1 型和 2 型)和分裂瘤病,偶尔这些肿瘤及其恶性变异也与放射治疗史有关。文献中很少有关于在一个照射野中出现多个良性分裂瘤的报道。我们描述了一例 49 岁的男性病例,他曾有右侧睾丸癌照射史,经组织学证实,他的右侧盆壁和右侧腰肌出现了 2 个良性分裂瘤。
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引用次数: 0
Autoimmune pulmonary alveolar proteinosis presenting as localized multifocal GGOs: A case report 表现为局部多灶性 GGOs 的自身免疫性肺泡蛋白沉着症:病例报告
Q4 Medicine Pub Date : 2024-09-20 DOI: 10.1016/j.radcr.2024.08.097

Pulmonary alveolar proteinosis (PAP) is a rare disease, which is characterized by the alveolar accumulation of surfactant. A crazy-paving appearance on chest thin-section computed tomography (TSCT) is a characteristic feature of this disease. We report an unusual case of PAP, which presented as multiple localized ground glass opacites (GGOs) on TSCT in an 80-year-old female. As one of these lesions at the apex of the right lung increased in size, it was suspected to be a pulmonary adenocarcinoma. However, the others became smaller during the follow-up period. Right upper lobectomy was performed, and PAP was histologically diagnosed. In cases exhibiting multiple localized GGOs, PAP should be considered, even if GGOs with a crazy-paving-like appearance are distributed in a lobular rather than diffuse manner.

肺泡蛋白沉积症(PAP)是一种罕见疾病,其特点是肺泡内表面活性物质堆积。胸部薄层计算机断层扫描(TSCT)上的疯狂铺路外观是这种疾病的特征。我们报告了一例不寻常的 PAP 病例,患者是一名 80 岁的女性,在 TSCT 上表现为多个局部磨玻璃不透明斑(GGOs)。由于其中一个位于右肺顶端的病灶增大,因此被怀疑是肺腺癌。然而,在随访期间,其他病灶都变小了。患者接受了右肺上叶切除术,经组织学检查确诊为肺腺癌。在出现多个局部 GGOs 的病例中,即使具有疯狂铺路样外观的 GGOs 是以小叶而非弥漫的方式分布,也应考虑为 PAP。
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引用次数: 0
Silicone granuloma with intact breast implants: A case report 硅胶肉芽肿伴有完整的乳房假体:病例报告
Q4 Medicine Pub Date : 2024-09-20 DOI: 10.1016/j.radcr.2024.08.092

Silicone granuloma formation is a potential complication of silicone implant rupture. Breast magnetic resonance imaging (MRI) is a useful diagnostic tool to assess implant integrity and complications; however, there can be overlap in the enhancement pattern of silicone granuloma and malignancy. We present the case of an 85 year old with suspicious axillary masses on clinical exam for which MRI was recommended. MRI demonstrated enhancing masses in the right axilla that were suspicious for malignancy and biopsy was ultimately performed. This case discusses the use of inversion recovery sequences on MRI, as well as ultrasound, to differentiate malignancy from silicone granuloma formation to prevent unnecessary biopsies.

硅胶肉芽肿的形成是硅胶假体破裂的一种潜在并发症。乳房磁共振成像(MRI)是评估植入物完整性和并发症的有效诊断工具;然而,硅胶肉芽肿和恶性肿瘤的增强模式可能存在重叠。我们介绍了一例 85 岁患者的病例,该患者在临床检查中发现可疑的腋窝肿块,建议其进行核磁共振成像检查。核磁共振成像显示右侧腋窝有增强肿块,怀疑为恶性肿瘤,最终进行了活检。本病例讨论了如何利用核磁共振成像的反转恢复序列和超声波来区分恶性肿瘤和硅胶肉芽肿的形成,以避免不必要的活检。
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引用次数: 0
Spinal schwannoma: Limitations of CT imaging 脊神经分裂瘤:CT 成像的局限性
Q4 Medicine Pub Date : 2024-09-20 DOI: 10.1016/j.radcr.2024.08.122

Spinal schwannomas are benign lesions that most commonly appear in the lumbar and thoracic regions of the spine. Although computed tomography (CT) scans are often used to assess spinal conditions, they are ineffective at detecting soft tissue abnormalities. This case is for a 49-year-old female who experienced a gradual loss of sensation and strength in her lower extremities, along with increased urinary urgency, over six weeks. In addition, mid-back pain has been present for one year. Initially, a CT scan was done and did not show any significant findings, which suggested the absence of a spinal abnormality. However, magnetic resonance imaging (MRI) revealed an intradural extramedullary lesion causing spinal cord compression. The patient successfully underwent surgery to remove the tumor, and histological analysis confirmed it as spinal schwannoma. This case underlines the diagnostic limitations of CT imaging for spinal lesions and illustrates the superior accuracy of MRI. Thus, a negative CT should not halt further diagnostic evaluation when symptoms persist.

脊柱裂孔瘤是一种良性病变,最常见于腰椎和胸椎部位。虽然计算机断层扫描(CT)常用于评估脊柱状况,但在检测软组织异常方面效果不佳。本病例是一名 49 岁女性的病例,六周以来,她的下肢逐渐失去知觉和力量,并伴有尿急症状。此外,中背部疼痛已持续一年。起初,她接受了 CT 扫描,但未发现任何明显异常,这表明她的脊柱没有异常。然而,磁共振成像(MRI)显示硬膜外病变导致脊髓受压。患者成功接受了肿瘤切除手术,组织学分析证实为脊神经分裂瘤。本病例强调了 CT 成像对脊柱病变的诊断局限性,并说明了磁共振成像的高准确性。因此,当症状持续存在时,CT 阴性不应阻止进一步的诊断评估。
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引用次数: 0
Cystic lymphangioma of the omental bursa in adult: A rare case report 成人网囊囊性淋巴管瘤:罕见病例报告
Q4 Medicine Pub Date : 2024-09-19 DOI: 10.1016/j.radcr.2024.08.149

Cystic lymphangioma is a benign lymphatic malformation that primarily affects children, with rare occurrences in adults. These malformations are most commonly found in the head and neck region, though their presence in the abdominal cavity is infrequent. In this report, we present the case of 71-year-old women with a cystic lymphangioma located in the omental bursa. The rarity of this condition in adults, combined with its unusual abdominal location, highlights the unique aspects of this case. This report explores the clinical presentation, diagnostic challenges, and management strategies for these uncommon lymphatic malformations.

囊性淋巴管瘤是一种良性淋巴畸形,主要发生在儿童身上,成人也极少发生。这种畸形最常见于头颈部,但在腹腔内也不常见。在本报告中,我们介绍了一例 71 岁女性网囊淋巴管瘤病例。这种疾病在成人中非常罕见,加上其不寻常的腹腔位置,凸显了本病例的独特之处。本报告探讨了这种不常见淋巴管畸形的临床表现、诊断难题和治疗策略。
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引用次数: 0
Antenatally diagnosed myelomeningocele with associated chiari ii malformation in the third trimester. A case report 产前诊断为脊髓脊膜膨出症并伴有第三孕期脊髓脊膜畸形。病例报告
Q4 Medicine Pub Date : 2024-09-19 DOI: 10.1016/j.radcr.2024.09.045

Myelomeningocele, a severe form of open neural tube defect which is mostly associated with Chiari II malformation remains a cause of adverse neonatal outcomes. Myelomeningocele is mostly detected in the second trimester and subsequently followed up in the third trimester. We present a case of myelomeningocele with associated Chiari II malformation that was diagnosed for the first time in the third trimester in a 32-year-old pregnant woman. Previously performed ultrasound at 12 weeks gestation was unremarkable. Considering the prognosis of the detected anomalies, the patient opted for medical termination of the pregnancy after receiving thorough counselling.

Third trimester anomaly screening should be encouraged as part of routine third trimester scans; particularly in women who report late for antenatal care and those who lack periconceptional folate supplementation.

脊髓膜膨出症是一种严重的开放性神经管缺陷,主要与奇异畸形(Chiari II)有关,是导致新生儿不良预后的原因之一。脊髓膜膨出多在妊娠后三个月发现,随后在妊娠后三个月进行随访。我们报告了一例脊髓膜膨出并伴有奇拉氏II畸形的病例,该病例是一名32岁的孕妇在怀孕三个月时首次确诊的。之前在妊娠 12 周时进行的超声检查并无异常。考虑到所发现异常的预后,患者在接受了全面的咨询后选择了药物终止妊娠。应鼓励将第三孕期异常筛查作为第三孕期常规扫描的一部分,尤其是对那些迟报产前检查和缺乏围孕期叶酸补充的妇女。
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引用次数: 0
Dural arteriovenous fistula mimicking a stroke: A misdiagnosis of two months 模仿中风的硬膜动静脉瘘:两个月的误诊
Q4 Medicine Pub Date : 2024-09-19 DOI: 10.1016/j.radcr.2024.09.043

We present a case of a 70-year-old male who presented with left-sided weakness and dysarthria. Cranial imaging was suggestive of a cerebellar infarct and the patient was treated with aspirin and clopidogrel. Two months later a fall prompted further cranial imaging, which was concerning for an intracranial mass with vasogenic edema. Computed tomography angiogram (CTA) was negative for vascular lesion. Ultimately, a DSA revealed a Borden III dAVF between the right occipital artery and the posterior cerebellar vein that was treated with endovascular embolization.

我们报告了一例 70 岁男性患者的病例,他出现左侧肢体无力和构音障碍。头颅影像学检查提示小脑梗塞,患者接受了阿司匹林和氯吡格雷治疗。两个月后,患者因摔倒而进一步接受头颅造影检查,结果显示颅内肿块伴血管源性水肿。计算机断层扫描血管造影(CTA)显示血管病变为阴性。最后,DSA检查发现右枕动脉和小脑后静脉之间有一个博登III型dAVF,并进行了血管内栓塞治疗。
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引用次数: 0
Spontaneous coronary artery dissection and valvular disease revealing an antiphospholipid syndrome in a young woman: Case report 一名年轻女性自发性冠状动脉夹层和瓣膜病揭示了抗磷脂综合征:病例报告
Q4 Medicine Pub Date : 2024-09-19 DOI: 10.1016/j.radcr.2024.08.080

Antiphospholipid syndrome (APS) is characterized by hypercoagulability, manifesting as venous or arterial thrombosis, and pregnancy-related complications, such as fetal loss, pre-eclampsia, and eclampsia. These conditions occur in the presence of antiphospholipid antibodies (aPL), including anticardiolipin antibodies (aCL) and/or a positive lupus anticoagulant (LA) test.

Antiphospholipid syndrome (APS) can manifest as a primary, isolated condition or be associated with connective tissue diseases, such as systemic lupus erythematosus (SLE). The cardiac system is one of the main target organs affected by APS.

This report describes a rare clinical case involving a young woman with a history of recurrent miscarriages, who presented with cardiac complications, including severe mitral regurgitation and Spontaneous coronary artery dissection. Etiological assessment identified antiphospholipid antibody syndrome as the underlying cause.

The multidisciplinary management plan included initiating therapeutic-dose anticoagulation, followed by referring the patient for potential mitral valve replacement surgery.

抗磷脂综合征(APS)的特点是高凝状态,表现为静脉或动脉血栓形成,以及与妊娠有关的并发症,如胎儿死亡、先兆子痫和子痫。抗磷脂综合征(APS)可表现为原发性、孤立的病症,也可与结缔组织疾病(如系统性红斑狼疮)相关。心脏系统是受 APS 影响的主要靶器官之一。本报告描述了一个罕见的临床病例,患者是一名年轻女性,有反复流产史,并出现心脏并发症,包括严重的二尖瓣反流和自发性冠状动脉夹层。多学科管理计划包括开始治疗剂量的抗凝治疗,然后将患者转诊至可能的二尖瓣置换手术。
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引用次数: 0
Axillary skin lesion: A rare presentation of metastatic male breast cancer 腋窝皮肤损伤:转移性男性乳腺癌的罕见表现
Q4 Medicine Pub Date : 2024-09-19 DOI: 10.1016/j.radcr.2024.08.110

Male breast cancer is an uncommon condition, accounting for less than 1% of all breast carcinomas and under 1.5% of all malignant tumors in men. Skin lesions can often be the initial reason for consultation. At this advanced stage, diagnosis is typically delayed, leading to a poor prognosis. Herein, we report the case of a 66-year-old man who presented with a dermo-epidermal axillary mass, indicative of cutaneous metastasis from an invasive ductal carcinoma.

男性乳腺癌并不常见,在所有乳腺癌中占比不到 1%,在男性所有恶性肿瘤中占比不到 1.5%。皮肤病变通常是就诊的最初原因。在这一晚期阶段,诊断通常会被延误,导致预后不良。在此,我们报告了一例 66 岁男性的病例,他出现了皮肤表皮腋窝肿块,显示为浸润性导管癌的皮肤转移。
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引用次数: 0
Ventricular fibrillation arrest in aortic dissection presenting as myocardial injury 主动脉夹层中的心室颤动停止,表现为心肌损伤
Q4 Medicine Pub Date : 2024-09-19 DOI: 10.1016/j.radcr.2024.08.140

An acute aortic dissection can be a tremendously fatal vascular condition if not managed promptly. However, the symptom profile of aortic dissections can be ambiguous to numerous conditions which are more common and greater pursued by clinicians before suspicion of dissection is made. The case presented in this study is of a 61-year-old male who arrives to the emergency department for concern of new-onset chest pain which progresses into ventricular fibrillation arrest prior to diagnosis of aortic dissection. This case report profiles the mimicking possibility of aortic dissection to present as acute myocardial injury, and the utility of models use to differentiate the workup between aortic dissections and acute coronary syndromes.

如果不及时处理,急性主动脉夹层可能是一种致命的血管疾病。然而,主动脉夹层的症状特征可能与许多疾病不一致,而这些疾病更常见,临床医生在怀疑夹层之前会更多地考虑这些疾病。本研究中的病例是一名 61 岁的男性,因担心新发胸痛而到急诊科就诊,在确诊为主动脉夹层之前,胸痛发展为心室颤动停搏。本病例报告介绍了主动脉夹层模仿急性心肌损伤的可能性,以及使用模型区分主动脉夹层和急性冠状动脉综合征的实用性。
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引用次数: 0
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Radiology Case Reports
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