[Rare tumors of the exocrine pancreas].
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Biomedical subjects
Publications and source records attributed to M C Anglade.
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Duplication of the stomach is a rare congenital malformation. Most reported cases involve infants or young children. On the basis of 3 cases identified at a later age, we describe the CT appearance of this malformation. Those 3 cases were demonstrated by the histological study of the surgical specimen.
Unlike other major abdominal organs, infarctions affecting the liver is extremely rare. In humans, the rarity of hepatic infarction is explained commonly on the basis of the double blood supply via the hepatic artery and portal vein. The imaging studies and clinical records of seven patients with hepatic infarcts were reviewed. These infarctions were essentially observed during post-operative periods: after aortoceliac graft and after accidental ligation of the hepatic artery (4 cases). The other etiologies included: acute hypovolemic shock in patients with atherosclerosis (2 cases) and finally one case of acute thrombocytosis. Dynamic CT was performed initially in all the cases and during the evolution, demonstrating peripheral low attenuation areas without enhancement. Associated splenic infarcts were present in 4 patients and renal infarcts in two. While the clinical and laboratory findings in hepatic infarction can be completely mimicked by hepatic abscess, CT-guided aspirations were performed in 6 patients demonstrating in only one case the presence of infection.
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Sonographic and computed tomographic (CT) examinations have modified the investigation of hepatic, splenic and pancreatic tumors. Because of advances in non-invasive diagnostic procedures, these different benign or malignant tumors are now more frequently detected and surgically treated. However, for these different lesions sonography is the gold standard imaging technique. The different indications for CT and magnetic resonance imaging are discussed for each tumor. For the diagnostic imaging of an acutely injured patient, sonography remains the useful examination in emergencies. The indications for CT scans are limited to the difficulties of sonographic diagnosis in stable trauma patients.
The association between hepatic hemangioma and focal nodular hyperplasia has been occasionally reported. To evaluate the reality of this association, the prevalence of hemangioma was studied in 26 patients with focal nodular hyperplasia by comparison with 27 patients with hepatocellular adenoma. All of these patients underwent surgery, which provided the histologic confirmation of the type of tumor. The presence of hemangioma was assessed by preoperative ultrasonography, dynamic computed tomography, and pathological examination of resected liver specimens. No hemangioma was found in patients with hepatocellular adenoma, but 6 of the 26 patients with focal nodular hyperplasia (23%) had one or two associated hemangiomas that varied in size from 1.5 to 4 cm. All 6 patients having focal nodular hyperplasia and hemangioma were women who had previously used oral contraceptives. None of the patients who had not used oral contraceptives had this association. Moreover, oral contraceptives were taken for a significantly longer period by the women with focal nodular hyperplasia and hemangioma than by those without this association. It is concluded that (a) the association of hemangioma with focal nodular hyperplasia is frequent (23%) and not fortuitous, and (b) prolonged administration of oral contraceptives may facilitate the recognition of this association, possibly by affecting the growth of these tumors.
The authors report a case of leiomyosarcoma of the inferior vena cava, responsible for an acute Budd-Chiari syndrome. The diagnosis, suggested by lower limb edema, ascites, and renal failure, was confirmed by sonography, CT scan, and pathological examination. A mesoatrial shunt and right atrial thrombectomy were performed under extracorporeal circulation. The inferior vena cava was ligated because the tumor was considered to be unresectable.
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BACKGROUND: To determine the incidence of hyperintensity on T1-weighted spin echo (SE) images in benign liver lesions, value of fat-suppressed magnetic resonance (MR) imaging for the detection of fat within these lesions, and the causes of hyperintensity by correlation to pathologic examinations. METHODS: Five hundred forty-nine patients with 805 benign liver lesions including 585 hemangiomas, 188 focal nodular hyperplasias (FNHs), 14 hepatic adenomas (HAs), 14 focal fatty infiltrations (FFIs), two biliary cystadenomas, and two hemorrhagic cysts were examined by T2-weighted and T1-weighted SE MR imaging. For hyperintense lesions on T1-weighted SE images, fat-suppressed images were obtained by selective presaturation of fat. RESULTS: Thirty-two lesions (four FNHs, 10 HAs, 14 FFIs, two biliary cystadenomas, and two hemorrhagic cysts) appeared hyperintense on T1-weighted SE images; 21 of these became hypointense on the fat-suppressed T1 weighted SE images (one FNH, six HAs, and 14 FFIs) and contained fat at pathological examination. The other 11 lesions remained hyperintense on fat-suppressed T1-weighted SE images and had no fat deposition. Causes of hyperintensity in these cases were sinusoidal dilatation, copper deposition, hemorrhage, and high protein content. CONCLUSION: Among benign liver lesions, hyperintensity on T1-weighted SE images is rare (3.9%). Causes of this hyperintensity are fat deposition, copper accumulation, sinusoidal dilatation, bemorrhage, and high protein content. Fat-suppressed imaging can distinguish fat deposition from other causes of hyperintensity.
We report the CT and MR features of two localized abdominal forms of Castleman disease mimicking hypervascular liver tumors due to their unusual location in the porta hepatis and the portacaval space. The MR appearance of Castleman lymph nodes is emphasized, including their characteristics on dynamic turbo-fast low angle shot (FLASH) sequences after Gd-DOTA bolus injection. Our report suggests that the CT and MR features of Castleman lymph nodes in these locations cannot enable their differentiation from other hypervascular masses such as benign liver tumors.
The pathologic changes resulting from liver irradiation include congestion, fibrosis, and veno-occlusive disease. We report an unusual complication of radiation induced injury: acute thrombosis of a main hepatic vein within the radiation port. CT and MR features are described and the etiology of this unusual complication is discussed.
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