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Quantification of phosphorus metabolites in human calf muscle and soft-tissue tumours from localized MR spectra acquired using surface coils.

Metabolite concentrations determined from MR spectra provide more specific information than peak area ratios. This paper presents a method of quantification that allows metabolite concentrations to be determined from in vivo 31P MR spectra acquired using a surface coil and ISIS localization. Corrections for the effects of B1 field inhomogeneity produced by surface coils are based on a measured and calibrated spatial sensitivity field map for the coil. Account is taken of imperfections in pulse performance, coil loading effects and relaxation effects, the latter making use of published metabolite relaxation times. The technique is demonstrated on model solutions. The concentrations of the main 31P metabolites in normal human calf muscle measured using this method are [PCr] = 26.9 +/- 4.1 mM; [Pi] = 3.6 +/- 1.2 mM; [NTP] = 6.8 +/- 1.8 mM. Quantification of spectra acquired from soft-tissue tumours in patients both pre- and post-treatment showed that changes in metabolite concentrations are more sensitive to metabolic changes than changes in peak area ratios.

Adenosine Triphosphate↗

Multifocal recurrent adult rhabdomyoma.

The clinical and morphologic features of a recurrent, multifocal, adult, extracardiac rhabdomyoma are reported. This benign skeletal muscle neoplasm is composed of large round to polyhedral cells containing cross striations. The ultrastructural features consist of hypertrophic Z bands, intranuclear inclusions, and numerous mitochondria with linear, intracristal inclusions. The low thymidine labeling index and long potential doubling time correspond wi th the length of time for clinical recurrence.

Aged↗

Branched-chain amino acids: a role in skeletal muscle proteolysis in catabolic states?

A 48-h starvation period resulted in a great increase in muscle proteolysis-as measured following the release of tyrosine into the medium-in incubated isolated rat extensor digitorum longus (EDL) muscles. We have quantified the contribution of the different proteolytic systems to the increased protein degradation and observed a considerable activation in the ATP-dependent proteolytic (60%) and in the calcium-dependent (125%) systems, while no increases were observed in lysosomal proteolysis. The addition of 10 mM leucine to the incubation medium did not result in any changes in either total proteolytic rate or the activity rates of any of the different systems studied. In addition, the presence of the amino acid did not influence the levels of mRNA for the different genes studied-ubiquitin, C8 proteasome subunit, E2 conjugating enzyme, m-calpain, and cathepsin B. In a similar way, as observed during starvation, tumor growth resulted in increased protein degradation in incubated isolated EDL muscles from animals bearing the Yoshida AH-130 ascites hepatoma. The increased rate of protein degradation affected all the proteolytic systems studied: ATP- and calcium-dependent and lysosomal. Finally, leucine addition (10 mM), although not able to revert the increased proteolytic rate, resulted in a decrease in the gene expression for ubiquitin, C8 proteasome subunit and cathepsin B.

Adenosine Triphosphate↗

Sepsis increases lung glutamine synthetase expression in the tumor-bearing host.

Acute stresses such as trauma or endotoxemia augment GLN demand and are associated with increased release of this amino acid from skeletal muscle and lung as well as increased expression of glutamine synthetase (GS, the principal enzyme of GLN synthesis) in these tissues. Muscle GLN release is also increased during chronic catabolic states which are associated with depletion of lean body mass, such as starvation or malignancy. We hypothesized that the expression of GS in response to an acute stress would be altered in tumor-bearing rats (TBR) experiencing severe cachexia and therefore a previously heightened GLN demand. Male Fischer 344 rats were implanted with methylcholanthrene-induced fibrosarcoma tumors or underwent sham operations and pair-feeding (sham) with TBR partners. When tumor burden reached approximately 15% of carcass weight, animals received injections of either Escherichia coli lipopolysaccharide (LPS, 1 mg/kg body wt) or saline vehicle. Rats were sacrificed 8 h after injection and lung and muscle tissue were analyzed for GS mRNA and protein via Northern and Western blot techniques, respectively. LPS injection caused an equivalent 4- to 6-fold increase in lung and muscle GS mRNA in both TBR and sham rats (P < 0.01). LPS did not produce a significant increase in GS protein level in muscle tissue of either group or in lung tissue of sham rats. In contrast, endotoxin did lead to a 3.5-fold increase in GS protein levels in lung tissue of TBRs (P < 0.05). This increase in lung GS protein may signify the importance of the lung in maintaining GLN homeostasis during chronic catabolic states where muscle mass is diminished.

Animals↗

Leiomyoma of the bladder.

A case of leiomyoma of the bladder in a 37-year-old man is described. Clinical features and findings on excretory urography resembled a malignant tumor of the small pelvis. Ultrasound, computed tomography, and angiography nevertheless made the correct preoperative diagnosis. Special emphasis is given to the differentiation between benign and malignant smooth muscle neoplasms.

Adult↗

[Solitary plasmacytoma of the shoulder. Diagnosis and therapeutic methods].

5% of all multiple myelomas manifest as solitary plasmocytomas. The multiple myeloma is the most frequent malignant transformation of the haematopoetic system, with an incidence of 2:100,000 per year. 1% of all solitary plasmocytomas are found in the extremities, accounting for less than one case per year in Germany. In this article we present the case of a fifty year old patient with a solitary plasmocytoma of the shoulder region and discuss the diagnostic and therapeutic procedures involved.

Diagnosis, Differential↗

Intracranial leiomyosarcoma in a patient with AIDS.

We report an intracranial leiomyosarcoma in the pontine cistern of a 34-year-old woman infected with the human immunodeficiency virus (HIV). The clinical, radiological and pathological data are reviewed. The tumor was Epstein-Barr virus (EBV) positive by in situ hybridization. This case emphasizes that smooth muscle neoplasms arising in the setting of immunocompromise can occur intracranially, and corroborates a hypothesis that EBV coinfection may have a role in development of these tumors.

Acquired Immunodeficiency Syndrome↗

Leiomyomas of the gallbladder and splenic calcifications in an HIV-infected child.

Smooth muscle neoplasms seem to be particularly frequent in children with AIDS, and several cases of such lesions, both benign and malignant (leiomyomas and leiomyosarcomas), have recently been reported in the literature. We describe here the imaging findings in a boy with AIDS who developed two leiomyomas of the gallbladder wall as well as calcification of the intraparenchymal splenic arteries.

Acquired Immunodeficiency Syndrome↗

Low-grade liposarcoma with osteosarcomatous dedifferentiation: radiological and histological features.

We describe the radiological and pathological findings of a rare case of a low-grade liposarcoma associated with a high-grade osteosarcomatous component in a 78-year-old woman. Pre-operative imaging demonstrated a well-encapsulated homogeneous fatty tumour in the right buttock deep to the gluteal musculature. Centrally within the fatty tumour a region of increased soft tissue attenuation on CT and heterogeneous high signal on fat-saturated T2-weighted MRI was seen with amorphous calcification/ossification. Histological assessment revealed a low-grade liposarcoma containing an area of dedifferentiation that resembled an osteosarcoma. We describe the radiological-pathological findings in this rarely reported clinical entity and discuss the differential diagnosis of calcification within lipomatous tumours.

Aged↗

Skeletal muscle lymphoma: observations at MR imaging.

We present the MR appearances of three patients with biopsy-proven primary lymphoma of skeletal muscle. In each case lymphoma resulted in bulky expansion of the involved muscle, homogeneously isointense to skeletal muscle on T1-weighted images, homogeneously hyperintense to skeletal muscle on T2-weighted images and diffusely enhancing following intravenous administration of gadopentate dimeglumine.

Adult↗

Non-Hodgkin lymphoma in skeletal muscle manifesting as homogeneous masses with CT attenuation similar to muscle.

Two cases are presented of masses in muscle due to non-Hodgkin lymphoma (NHL) that were homogeneous and isoattenuating to normal muscle on CT. In each case, the mass was clinically suspected of representing soft tissue sarcoma. However, the masses were relatively inapparent on CT, being visible predominantly as mass effect--an appearance unlike that of soft tissue sarcomas. It is important to be aware that NHL in muscle can be difficult to detect at CT, even with intravenous contrast enhancement; therefore, a clinically apparent mass should not be dismissed on the basis of an apparently unremarkable CT scan of the region. Such findings should suggest the diagnosis of NHL rather than sarcoma.

Aged↗

Intramuscular spindle cell hemangioendothelioma.

Spindle cell hemangioendothelioma occurring in skeletal muscle is extremely rare. No reported studies have performed an imaging evaluation of intramuscular spindle cell hemangioendothelioma. We report on such a tumor arising in an unusual site, the right extensor digiti minimi, in a 46-year-old woman. An en bloc resection was performed and the patient has been disease free for 8 years. Radiologic imaging in the present case showed similar findings to those described in intramuscular hemangioma.

Female↗