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Tohru Takeshita

Publications and source records attributed to Tohru Takeshita.

12 recordsLinked to original sources

Brown tumor with fluid-fluid levels in a patient with primary hyperparathyroidism: radiological findings.

We report a case of a brown tumor with fluid-fluid levels in a patient with primary hyperparathyroidism. A 19-year-old woman presented with a 3-month history of pain in the left pubic region. The laboratory data showed elevated serum calcium and intact parathyroid hormone, confirming the diagnosis of primary hyperparathyroidism. Plain radiography and computed tomography (CT) showed an expansile lytic lesion of the superior ramus of the left pubis. The cortex was thinned. On magnetic resonance (MR) images, the lesion was solid and cystic. The solid area of the lesion showed heterogeneous low to intermediate signal intensity on T1-weighted images and heterogeneous low to high signal intensity on T2-weighted images. The cystic area showed several fluid-fluid levels on T2-weighted images. Dynamic contrast-enhanced MR images after administration of Gd-DTPA showed marked, early enhancement of the solid area of the lesion. A delayed image showed prolonged enhancement of the solid area and enhancement of the septa and walls of the cystic area. Histopathology of a biopsy specimen showed fibroblastic proliferation, abundant giant cells, and focal hemosiderin deposition, which supported the diagnosis of a brown tumor. After removing the parathyroid adenoma, the brown tumor regressed and became sclerotic on radiographs.

Adult↗

Radiosensitive functional dye: clinical application for estimation of patient skin dose.

Institutional review board approval and informed patient consent were obtained. The purpose of the study was to prospectively evaluate the use of radiosensitive indicators to estimate patient entrance skin dose (ESD). Forty-six patients wore a jacket with 48 or 52 indicators adhered to the back during percutaneous coronary interventions; they had eight additional indicators on their upper arms. The patients' ESDs were calculated according to the change in color of the indicators. There were good correlations between the ESDs estimated by using color measurements performed with an optical instrument and those estimated at visual observation (P < .001) and between the ESDs estimated by using a thermoluminescent dosimeter and those estimated by using color measurements (P < .001). The radiosensitive indicator method seems to be useful for estimating ESDs and their distribution during percutaneous coronary intervention; however, visual observation is reliable for estimating doses of up to 5 Gy only. (c) RSNA, 2006.

Aged↗

Regional cerebral blood flow in a patient with Nasu-Hakola disease.

We report a functional neuroimaging study of a 43-year-old woman with Nasu-Hakola disease (NHD). Regional cerebral blood flow (rCBF) images were measured with technetium-99m ethyl cysteinate dimer single photon emission computed tomography (SPECT). rCBF was decreased in the bilateral frontal lobes and thalamus. This finding was consistent with the known underlying neuropathology in patients with NHD. Brain SPECT is useful for demonstrating the pathophysiologic brain region in patients with NHD.

Adult↗

Ovarian fibroma (fibrothecoma) with extensive cystic degeneration: unusual MR imaging findings in two cases.

Two cases of ovarian fibroma (fibrothecoma) with extensive cystic degeneration are described. One case revealed a large multiloculated cystic mass with a small solid part. Each locule showed variable signal intensity on both T1- and T2-weighted magnetic resonance (MR) images. The other case revealed a parviloculated cystic mass with a small solid part. In both cases, the solid parts were located at the periphery of the mass and showed distinct low signal intensity on both T1- and T2-weighted MR images and slight enhancement. It should be noted that ovarian fibromas (fibrothecomas) with extensive cystic degeneration are a rare exception to the rule that solid components in a cystic adnexal mass imply malignancy.

Aged↗

Noncardiogenic pulmonary edema as the first manifestation of pheochromocytoma: a case report.

We report here a case of pheochromocytoma presenting with noncardiogenic pulmonary edema, which is an unusual first manifestation of pheochromocytoma. Chest radiograph showed diffuse consolitaion and ground-glass opacity on both lungs. Neither pleural effusion nor cardiomegaly was present. High-resolution computed tomography (HRCT) showed widespread ground-glass opacity with fine intralobular reticular opacity (so-called "crazy-paving" appearance) and consolidation in a strikingly dependent distribution. The areas of ground-glass opacity and consolidation were sharply marginated by interlobular septa, showing a geographic appearance. The pulmonary edema and dyspnea resolved over three days without cardioactive or diuretic treatment. Noncardiogenic pulmonary edema is an unusual first manifestation of pheochromocytoma. It is important to recognize this unusual manifestation in the emergency situation.

Adrenal Gland Neoplasms↗

CT and MR findings of basal cell adenoma of the parotid gland.

We report a case of basal cell adenoma in the left parotid gland. A 34-year-old woman presented with a non-tender mass in the left parotid gland. She had first noted it 7- years previously, and it had been gradually increasing in size. The tumor was well-circumscribed with a smooth contour. On noncontrast-enhanced CT, the tumor showed homogeneous soft tissue attenuation. No cystic portion or calcification was seen. The tumor showed homogeneous moderate enhancement on contrast-enhanced CT. Capsule-like ring enhancement was demonstrated. On T1-weighted MR imaging, the tumor was homogeneously hypointense to the surrounding parotid tissue and isointense to muscle. On T2-weighted imaging the tumor was homogeneously hyperintense to muscle but slightly hypointense to the surrounding parotid tissue. On Gd-enhanced T1-weighted imaging, the tumor demonstrated homogeneous moderate enhancement. Capsule-like ring enhancement was also demonstrated. Salivary (technetium-99m-pertechnetate) scintigraphy did not show any uptake in the tumor.

Adenoma↗

Brown tumor of the sphenoid sinus in a patient with secondary hyperparathyroidism: CT and MR imaging findings.

We present a case of brown tumor of the sphenoid sinus in a patient with secondary hyperparathyroidism. CT showed an expansile soft-tissue attenuation mass centered in the sphenoid sinus. CT at bone window setting demonstrated expansile, lytic change and remodeling of the surrounding bone. On MR imaging, the lesion showed iso-intensity to gray matter on T1-weighted images and heterogeneous hyperintensity on T2-weighted images, and showed intense enhancement. The extent of the lesion and its relationship to the surrounding structures were best evaluated by CT and MR imaging.

Bone Remodeling↗

Benign pleomorphic adenoma with extensive cystic degeneration: unusual MR findings in two cases.

Two cases of benign pleomorphic adenoma (PA) with extensive cystic degeneration are described. In both cases magnetic resonance (MR) imaging revealed entirely cystic tumors with an irregularity at the cyst wall. Some additional findings were observed: one case showed layering within the cyst contents caused by intratumoral hemorrhage, and the other had a small mural nodule at the cyst wall that showed very low intensity on both T1- and T2-weighted images and corresponded pathologically to the hyaline stroma. In both cases, preoperative diagnosis was difficult based on the MR findings alone. Benign PA should be included in the differential diagnosis of an entirely cystic parotid mass.

Adenoma, Pleomorphic↗