Two cases of pancreatic lymphoepithelial cyst are presented. Abdominal ultrasonography and endoscopic ultrasonography demonstrated cysts containing keratinized material, indicative of this diagnosis.

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PubMedDate not supplied

Hepatocellular carcinoma with sarcomatous change: characteristic findings of two-phased incremental CT.

BACKGROUND: Because of its poor prognosis, the diagnosis of hepatocellular carcinoma with sarcomatous change (HCCSC) is clinically important. The purpose of this study is to elucidate the characteristic CT findings of HCCSC. METHODS: Two-phased dynamic incremental CT images of six histologically proven HCCSC were retrospectively reviewed. RESULTS: All tumors (100%) exhibited peripheral enhancement on delayed CT images. Lymphadenopathy was observed in 100% (six of six patients); intrahepatic metastases, in 83% (five of six). Both metastatic lesions showed findings similar to those of the primary hepatic tumors, such as peripheral enhancement. Histopathological delayed and/or prolonged peripherally enhanced areas consisted of viable cancer cells with sarcomatous changes. CONCLUSIONS: The appearance of HCCSC on CT is that of an irregularly demarcated intrahepatic mass with delayed or prolonged peripheral enhancement, frequently with intrahepatic metastases and lymphadenopathy.

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PubMedDate not supplied

Radiologically identifiable intratumoral portal vein in intrahepatic cholangiomas: a diagnostic pitfall.

BACKGROUND: Although intratumoral patent portal vein (ITPV) is one of the characteristic features of benign hepatic lesions, ITPVs can be demonstrated in malignant tumors. We present the spectrum of MR and CT findings of ITPV identified in intrahepatic cholangiomas with pathological correlations. METHODS: The ultrasound, CT and/or MRI findings of pathologically-confirmed intrahepatic cholangiomas were reviewed and correlated with surgical specimen or autopsy findings. RESULTS: Intratumoral patent vessels were radiographically-demonstrated in 5 patients with intrahepatic cholangiomas. All intratumoral vessels were secondary or tertiary order portal vein branches. Some wall thickening was identified on pathological examinations. CONCLUSION: The radiological demonstration of intratumoral portal vein is not a specific sign of benignity. In the case of a hepatic tumor with a patent portal tract, cholangioma should be considered, as well as benign tumors or lymphoma.

Adenoma, Bile Duct↗

PubMedDate not supplied

Helical CT evaluation of arterial invasion in pancreatic tumors: comparison with angiography.

BACKGROUND: Although helical computed tomography (HCT) has been widely employed for the evaluation of pancreatic tumors, its capability in the diagnosis of peripancreatic arterial invasion has not been established. METHODS: HCT with a sequential cine-display was carried out in 34 patients with solid pancreatic tumors and 28 control subjects without angiographic abnormality. The HCT scans were compared with angiograms. RESULTS: All major arteries (celiac, superior mesenteric, splenic, gastroduodenal) and superoanterior pancreaticoduodenal arteries were well demonstrated by HCT in control subjects. However, posterior pancreaticoduodenal arcades and other smaller arteries were poorly identified. Although 19 major arterial invasions were equally diagnosed by HCT and angiography in patients with pancreatic tumors, only 4 of 11 minor arterial invasions were correctly diagnosed by HCT. CONCLUSIONS: Although HCT has some limitations in the evaluation of minor peripancreatic arteries, it can provide enough information for making a decision about conducting pancreatic surgery.

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PubMedDate not supplied

Hepatocellular carcinoma with pyrexia: report of a case.

Reported here is a case of an unusual type of hepatocellular carcinoma (HCC). Since this patient with liver mass exhibited continuous pyrexia, an inflammatory pseudotumor or abscess was strongly suspected. Two-phased incremental CT, MR with and without Gd-DTPA administration, and angiography demonstrated peripheral enhancement of the hepatic mass. Histologically, the tumor proved to be HCC with sarcomatoid degeneration. When one encounters a patient with a mass clinically and radiologically mimicking an inflammatory pseudotumor or an abscess, poorly differentiated HCC with sarcomatoid degeneration should be suspected.

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