We report a case of hepatocellular carcinoma with hypercalcemia. There was no evidence of bone metastasis or increase in parathyroid hormone-related protein. The serum level of intact parathyroid hormone (intact PTH) was very high, and the results of the hepatic venous sampling suggested that the tumor produced intact PTH. Transcatheter arterial chemoembolization effectively controlled the humoral hypercalcemia.

Aged↗

PubMedDate not supplied

Dysplasia epiphysealis hemimelica of the proximal tibia showing epiphyseal osteochondroma in an adult.

A 33-year-old woman was referred to our hospital complaining of pain and a tumorous lesion in her left knee joint in the absence of any history of trauma. Radiological examinations demonstrated an osseous mass originating from the epiphysis of the proximal tibia, with a continuous osteoblastic lesion involving the lateral half of the epiphysis. The pathological diagnosis of these lesions was compatible with that of osteochondroma. The clinical and pathological features of this case were considered to be identical with those of dysplasia epiphysealis hemimelica, although this patient was older than patients described in previous reports, and demonstrated no other symptoms such as valgus or varus deformity or limb-length discrepancy.

Adult↗

PubMedDate not supplied

Chondrosarcoma of the sternum: CT features.

Eleven sternal chondrosarcomas were reviewed with radiologic emphasis on the CT findings. Typical clinical presentation was a large painless anterior chest wall mass in an elderly individual. In six cases the chest radiograph strongly suggested an underlying cartilaginous neoplasm owing to the appearance of typical mineralized cartilage matrix, i.e., a pattern of stippled, flocculent, or curvilinear ("rings and arcs") calcifications. Calcifications were detected on CT in all 11 patients. Excepting the three smallest lesions, averaging 4 cm in diameter, on CT the tumors exhibited a scalloped or lobulated contour, also typical for cartilaginous neoplasms. Six tumors were centered in the sternal body, four in the xyphoid process, and one in the manubrium. In addition, CT was especially important in localizing the lesion when the tumor was either small in size or centered in the xyphoid process (where all four chondrosarcomas grew in an inferior direction). Because of its ability to detect subtle matrix mineralization and delineate the extent and probable origin of the tumor, CT strongly favored the preoperative diagnosis of sternal chondrosarcoma and was also helpful in surgical management.

Adult↗

PubMedDate not supplied

MR of enchondroma and chondrosarcoma: rings and arcs of Gd-DTPA enhancement.

MR studies of five chondrosarcomas and three enchondromas were performed with intravenous Gd-DTPA administration. All tumors showed enhancement of scalloped margins and curvilinear septa (ring-and-arc pattern) on T1-weighted SE sequences with Gd-DTPA. On radiologic-pathologic correlation, the enhanced areas corresponded to fibrovascular bundles surrounding hyaline cartilage lobules. The rings and arcs of enhancement with Gd-DTPA on MR is a reflection of the lobulated growth pattern of cartilaginous tumors and therefore helpful in differential diagnosis of bone tumors.

Adolescent↗

PubMedDate not supplied

Giant cell tumors of bone containing large amounts of hemosiderin: MR-pathologic correlation.

We present three giant cell tumors of bone that contained large amounts of hemosiderin and compare their MR appearance with intraoperative findings and histological characterization. Histologically, hemosiderin was found in multinucleated giant cells, mononuclear stromal cells, and xanthoma cells. All cases showed markedly decreased signal areas on both T1- and T2-weighted MR imaging due to hemosiderin deposition; this made evaluation of the integrity of the adjacent cortices difficult. In one case, extraosseous tumor extension appeared as a signal void area on MR imaging. Findings on immunohistochemical studies suggested the giant cells may have a histiocytic nature. Because the tumor cells themselves have a phagocytic nature, the decreased signal areas in and around giant cell tumors should be regarded as active tumor tissues in delineating the tumor on MR imaging.

Adult↗

PubMedDate not supplied

MR appearance of periosteal chondrosarcoma of the foot.

OBJECTIVE: To assess the role of MRI in evaluating periosteal chondrosarcoma in the foot, an anatomically complicated location. MATERIALS AND METHODS: Three cases of surgically and histologically confirmed periosteal chondrosarcomas occurring in the foot (58-year-old woman, 57-year-old woman, and 63-year-old man) were retrospectively reviewed with an emphasis on MR findings. RESULTS: Magnetic resonance successfully delineated the hypovascular nature and lobulating pattern of the lesion suggesting the cartilaginous component, the periosteal location with sparing bone marrow, and the extent of involvement of adjacent structures. These findings were either not seen or less clearly seen on CT in the former two cases. CONCLUSION: In cases of periosteal chondrosarcomas in the foot MRI can play a significant role both in the characterization of the lesion and in planning surgical therapy.

Amputation, Surgical↗

PubMedDate not supplied

T2 relaxation time of bone marrow water and lipid: correlation with serum ferritin in normal individuals.

PURPOSE: This study investigated the correlation between the iron content of bone marrow and the transverse relaxation times (T2 values) of bone marrow water and lipid on MRI. METHOD: The T2 of the water and lipid fractions of bone marrow was selectively measured in the L1-3 vertebral bodies using the chemical shift misregistration effect on MRI. Results were compared to the serum ferritin levels in 27 healthy subjects. RESULTS: The 1/T2 of the water fraction ws strongly correlated with the serum ferritin, but there was no correlation between the 1/T2 of the lipid fraction and serum ferritin. CONCLUSION: Selective T2 measurement of the water fraction in bone marrow allows precise estimation of the marrow iron content.

Adult↗

PubMedDate not supplied

FDG-PET in differential diagnosis and grading of chondrosarcomas.

PURPOSE: The purpose of this work was to investigate the usefulness of PET with [18F]2-deoxy-2-fluoro-D-glucose (FDG) in the differential diagnosis and grading of chondrosarcomas. METHOD: Four enchondromas, one osteochondroma, and six chondrosarcomas were prospectively studied by FDG-PET. The significance of the standardized uptake value (SUV) was evaluated in comparison with clinical, radiological, and histopathological findings of the tumors. RESULTS: The SUV ranged from 0.7 to 1.3 (mean 0.96+/-0.22) in benign cartilage tumors and from 1.3 to 3.3 (2.23+/-0.80) in chondrosarcomas. This SUV difference between benign and malignant tumors was statistically significant (p = 0.011) in contrast to considerable overlap of clinical and radiological findings. Among chondrosarcomas, the SUV of one Grade I tumor was 1.3; those of four Grade II tumors were 1.3, 1.9, 2.5, and 3.1; and that of one Grade III tumor was 3.3. CONCLUSION: Our preliminary study showed that FDG-PET could be an objective and quantitative adjunct in the differential diagnosis and grading of chondrosarcomas.

Adult↗

PubMedDate not supplied

Gd-DTPA: a possible alternative contrast agent for use in CT during intraarterial administration.

Explore the source record for details and available documents.

Angiography, Digital Subtraction↗

PubMedDate not supplied

Preliminary study of proton magnetic resonance spectroscopy in bone and soft tissue tumors: an unassigned signal at 2.0-2.1 ppm may be a possible indicator of malignant neuroectodermal tumor.

PURPOSE: To evaluate the utility of proton magnetic resonance spectroscopy in bone and soft tissue tumors, especially whether or not the N-acetyl aspartate signal (NAA) could be recognized in neurogenic tumors. MATERIALS AND METHODS: Forty-nine proton magnetic resonance spectroscopy studies were performed in 60 bone and soft tissue tumors. The patients were 28 males and 30 females. Eleven studies were incomplete, and were excluded from analysis. A point-resolved spectroscopy sequence (TR=1500 or 2000 ms, and TE=30, 60, 136, or 272 ms) was used on a 1.5-Tesla clinical MR scanner. RESULTS: An unassigned signal at about 2.0-2.1 ppm was recognized in six of 47 lesions: clear cell sarcoma (2/2), Ewing sarcoma (1/1), malignant fibrous histiocytoma (1/3), malignant schwannoma (1/1), and mucoepidermoid carcinoma (1/1). Neuroblastoma (1/1), primitive neuroectodermal tumor (1/1), and malignant melanoma (1/1) after chemotherapy or radiotherapy did not show this signal. This signal was not detected in neurofibroma (9/9), schwannoma (6/6), pheochromocytoma (2/2), or other mesenchymal tumors of non-neuroectodermal origin. CONCLUSIONS: The assigned signal at about 2.0-2.1 ppm was detected in a small percentage of bone and soft tissue tumors and could be suggestive of an untreated malignant tumor of neuroectodermal origin.

Adolescent↗

PubMedDate not supplied

Dynamic contrast-enhanced MR imaging of the water fraction of normal bone marrow and diffuse bone marrow disease.

PURPOSE: To clarify the contrast-enhancement pattern of the normal hematopoietic element by isolating the signal of the water fraction in vertebral bone marrow and to investigate whether this approach can be used to characterize bone marrow pathology in several diffuse bone marrow diseases. METHODS: Two groups were examined: 30 normal healthy volunteers and 19 patients with primary diffuse bone marrow disease (aplastic anemia [n=8], myelodysplastic syndrome (MDS) [n=5], chronic myelogenic leukemia (CML) [n=4], polycythemia vera [n=2]). Isolation of the signal of hematopoietic tissue was done by the chemical-shift misregistration effect. Twenty consecutive T1-weighted midsagittal lumbar vertebral images were obtained immediately after the intravenous administration of Gd-DTPA of 0.1 mmol/kg body weight, and the pattern of the time-intensity curve, the peak contrast-enhancement (CE) ratio, and the washout rate (%/min) of bone marrow in normal volunteers were compared with those in patients suffering from primary diffuse bone marrow disease. RESULTS: The pattern of the time-intensity curve of patients with aplastic anemia showed a low peak value followed by a slow washout. However, the pattern of time-intensity curves in patients with MDS, CML, and polycythemia vera was similar to that of normal volunteers. The peak CE ratio of the water fraction in normal marrow ranged from 0.45 to 1.26 (mean +/- S.D.: 0.87 +/- 0.18). Patients with aplastic anemia showed an abnormally lower peak CE ratio of the water fraction (mean +/- S.D.: 0.34 +/- 0.19, p<0.0001). On the other hand, the peak CE ratio of the water fraction in patients with MDS was significantly higher than that of normal volunteers (mean +/- S.D. 1.35 +/- 0.39, p<0.05). In contrast, the peak CE ratio of patients with CML or polycythemia vera did not differ significantly from that of normal volunteers. The mean washout rate of patients with aplastic anemia was significantly lower than that of normal volunteers (mean +/- S.D.: 3.50 +/- 2.51%/min vs. 7.13 +/- 1.74%/min, p<0.01). However, there was no significant difference in the washout rate among patients with MDS, CML, polycythemia vera, and normal volunteers. CONCLUSION: Dynamic contrast-enhanced MR imaging of the water fraction provides additional valuable qualitative information about structural changes of the hematopoietic element.

Adolescent↗

PubMedDate not supplied

Intraosseous cholesterol granuloma of radius showing a lamellar structure on MR images: a case report.

We report a case of an intraosseous cholesterol granuloma in the radius showing a lamellar structure on MRI. T1-weighted imaging revealed a central area of mildly increased signal intensity with a surrounding low-intensity layer. On T2-weighted images, the central lesion demonstrated low-intensity signals, and the surrounding area exhibited a lamellar structure with three layers of high, low, and high intensity from the inside. On histological examination, the central area was found to consist of cholesterine crystals embedded in erythrocytes, and in the surrounding lamellar structure collagenous tissue may have provided the low signals, with vessel- and giant cell-enriched structures present at both the inner and outer margins, presumably evoking the high-intensity signals. The present lesion may have been formed by chronic hemorrhage into a preexisting simple bone cyst.

Adult↗

PubMedDate not supplied

MR evaluation of laryngohypopharyngeal cancer: value of gadopentetate dimeglumine enhancement.

PURPOSE: To investigate the value of gadopentetate dimeglumine-enhanced MR imaging in determining the extent of laryngohypopharyngeal cancer. METHODS: Unenhanced and contrast-enhanced T1-weighted, proton-density-weighted, and T2-weighted images from 24 patients with laryngohypopharyngeal cancer were reviewed and compared with the pathologic findings of resected specimens. In 18 patients, ex vivo MR images of the resected specimens were also compared with pathologic findings. RESULTS: Laryngohypopharyngeal cancer showed intermediate intensity on T1-weighted and proton-density-weighted images, high intensity on T2-weighted images, and moderate enhancement on T1-weighted enhanced images. Cartilage-invaded tumor enhanced moderately, whereas unossified cartilage in contact with tumors but without tumor invasion showed no enhancement. Laryngohypopharyngeal mucosa enhanced intensely; endolaryngeal muscles enhanced less. CONCLUSIONS: Enhanced MR images were more useful in assessing the extent of tumors and the presence of laryngeal cartilage invasion than were proton-density-weighted and T2-weighted images.

Aged↗