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[Primary neurogenous sarcoma of the lung; report of a case].

We report a case of a 27-year-old woman with primary neurogenous sarcoma of the lung. She had no symptoms but an abnormal shadow of the right lower lung field on the chest X-ray. Chest computed tomography (CT) revealed a well defined round mass, 20 mm in maximum diameter, at the right S9. Pathological study of the specimen obtained by CT-guided percutaneous needle biopsy showed undefferentiated carcinoma. Positron emission tomography (PET) disclosed intensely increased uptake of fluoro-2-deoxy-D-glucose (FDG) at the lung lesion without other abnormal uptakes. The patient underwent right lower lobectomy of the lung and mediastinal lymph nodes dissection. Results from immunohistological study yielded a definitive diagnosis of neurogenous sarcoma. Postoperative course was uneventful, and there has been no evidence of recurrence and metastasis for more than a year after the surgery. Reported cases of primary neurogenous sarcoma of the lung are reviewed.

Adult↗

Malignant change in cutaneous neurofibromas--case reports.

Neurofibromatosis is the most common single gene disorder to affect the nervous system, with an estimated incidence of 1 in 3000 live births. Neurofibromatosis (NF) may be classified into von Recklinghausen NF (NFI) and bilateral acoustic NF (NFII) based on the distribution of lesions. The most common lesion associated with the von Recklinghausen type is the neurofibroma. Various complications are associated with neurofibromatosis, the most feared of which is malignant change in the neurofibroma. This article describes the study of 7 cases of proven malignant change in neurofibromas with regards to presentation, clinical progress and treatment followed by a review of the present literature.

Adult↗

Congenital plexiform neurofibroma with a sarcomatous nodule in a three month old child.

Congenital plexiform neurofibroma is regarded as pathognomonic of neurofibromatosis (NF) especially when it is large and involves a major nerve trunk with changes of elephantiasis neuromatosa. Only very rarely malignant changes have been reported in cases who have NF for less than 5 years. 'Borderline' lesions are seen especially in patients with NF. In such cases criteria of mitotic activity should be utilized in establishing the diagnosis of malignancy. A case of 3 month child with congenital plexiform neurofibroma involving neck with elephantiasis neuromatosa with sarcomatous nodule has been described in the present article. The criteria for malignancy in nerve sheath tumors have also been discussed.

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A 30-year-old man with a mass in the distal left thigh and radiating leg pain.

The following case describes the imaging and clinical findings of a condition of interest to the orthopaedic surgeon. Initial history, physical findings, and imaging examinations are presented here for your consideration. The final clinical diagnosis and relevant discussion can be found on the following pages.

Adult↗

[Magnetic resonance in thoracic pathology: characterization by intensity values].

The authors examined prospectively 100 patients with lung diseases--50 of them benign and 50 malignant. The mean value of all lesions was measured with a constant region of interest (ROI); the muscle was considered as the reference tissue. Histopathology was the gold standard for the patients who underwent CT-guided needle biopsy and/or surgery; clinical-radiologic follow-up (average time: 2 years) was the gold standard for nonsurgical patients. A superconductive 1.5-T magnet with circular polarization body coil was used; T1- and T2-weighted spin echo images were acquired on the coronal and axial planes, respectively. The mean values with the constant ROI were measured both on the lesions and on the reference tissue to calculate and compare the T1-lesion/T1-muscle and T2-lesion/T2-muscle ratios in benign and malignant conditions. The t-test, the linear regression and correlation test and the analysis of variance were used to analyze the data. T1 benign lung disease/T1 muscle ratio was 1.21, while T1 malignant lung disease/T1 muscle ratio was 1.27, with no statistically significant difference. T2 benign lung disease/T2 muscle ratio was 2.63, while T2 malignant lung disease/T2 muscle ratio was 4.80: the difference was statistically significant (p < 0.001). To conclude, in chest diseases, the measurement of mean values in T2 allowed malignancy-indicative values (> 4 ratio) and positively benign values (< 2.5 ratio) to be identified.

Adenocarcinoma↗