OBJECTIVE: To evaluate the value of enhancement features and quantitative parameters of contrast-enhanced ultrasonography (CEUS) in differentiating solid hypoechoic renal angiomyolipomas (AMLs) from clear cell renal cell carcinomas (ccRCCs). MATERIALS AND METHODS: We analyzed the enhancement features and quantitative parameters of CEUS in 174 hypoechoic renal masses (32 AMLs and 142 ccRCCs) included in the study. RESULTS: Centripetal enhancement pattern was more common in AMLs than in ccRCCs on CEUS (71.9% vs. 23.2%, p < 0.001). At peak enhancement, all AMLs showed homogeneous enhancement (100% in AML, 27.5% in ccRCCs; p < 0.001). Quantitative analysis showed no significant difference between rise time and time to peak. Tumor-to-cortex (TOC) enhancement ratio in AMLs was significantly lower than that in ccRCCs (p < 0.001). The criteria of centripetal enhancement and homogeneous peak enhancement together with TOC ratio < 91.0% used to differentiate hypoechoic AMLs from ccRCCs resulted in a sensitivity and specificity of 68.9% and 95.8%, respectively. CONCLUSION: Both qualitative and quantitative analysis with CEUS are valuable in the differential diagnosis of hypoechoic renal AMLs from ccRCCs.
Adult ; Aged ; Angiomyolipoma/*diagnosis/pathology/*ultrasonography ; Carcinoma, Renal Cell/*diagnosis/pathology/*ultrasonography ; Contrast Media ; Diagnosis, Differential ; Female ; Humans ; Kidney Neoplasms/diagnosis/pathology/*ultrasonography ; Language ; Lipoma/ultrasonography ; Male ; Middle Aged ; Sensitivity and Specificity

We report a case of prenatally diagnosed congenital perineal mass which was combined with anorectal malformation. The mass was successfully treated with posterior sagittal anorectoplasty postnatally. On ultrasound examination at a gestational age of 23 weeks the fetal perineal mass were found on the right side. Any other defects were not visible on ultrasonography during whole gestation. Amniocentesis was performed to evaluate the fetal karyotyping and acetylcholinesterase which were also normal. As the fetus grew up, the mass size was slowly increased more and more. At birth, a female neonate had a perineal mass on the right side as expected. During operation, the anal sphincteric displacement was found near the mass and reconstructed through posterior sagittal incision. This is the first reported case of prenatally diagnosed congenital perineal mass, after birth which was diagnosed as lipoblastoma and even combined with anorectal malformation. This case shows that it can be of clinical importance to be aware of this rare fetal perineal mass in prenatal diagnosis and counseling.
Adult ; Amniocentesis ; *Anal Canal/abnormalities/pathology/ultrasonography ; *Digestive System Abnormalities/diagnosis/pathology/ultrasonography ; Female ; Gestational Age ; Humans ; Infant, Newborn ; *Lipoma/diagnosis/pathology/ultrasonography ; Male ; *Perineum/pathology/ultrasonography ; Pregnancy ; Prenatal Diagnosis ; *Rectal Neoplasms/diagnosis/pathology/ultrasonography ; *Rectum/abnormalities/pathology/ultrasonography ; Ultrasonography, Prenatal/*methods

Endometriosis is a condition where uterine mucosal tissue is located outside of the uterus, which may be pelvic or extrapelvic. The term endometrioma is used when extrapelvic endometriosis appears as a discrete mass. A 34-year-old female, with an abdominal mass along the scar site of a cesarean section, was transferred from her local hospital following the diagnosis of a foreign body granuloma or infected lipoma. The patient had history of two cesarean sections, 5 and 7.5 years previously. The abdominal mass was associated with abdominal pain, which increased in severity during her menstrual cycle. The ultrasonography showed a solid irregular, ill defined mass, with heterogeneous echogenicity. The cytological findings showed epithelial and stromal cells. A mass excision was performed under local anesthesia. The final pathology results confirmed an endometrioma in the abdominal wall, and the microscopic findings indicated benign endometrial glands, with surrounding spindled endometrial cells in the soft tissue of the abdominal wall. The treatment of choice is wide local excision of endometrial tissue, with a clear margin. An endometrioma in the abdominal scar, following a cesarean section, is a rare event, but may be more frequent than estimated from the literature. This case was reported with a brief review of the literature.
Abdominal Pain ; Abdominal Wall ; Adult ; Anesthesia, Local ; Cesarean Section ; Cicatrix* ; Diagnosis ; Endometriosis* ; Female ; Granuloma, Foreign-Body ; Humans ; Lipoma ; Menstrual Cycle ; Mucous Membrane ; Pathology ; Pregnancy ; Stromal Cells ; Ultrasonography ; Uterus

A 58-year-old Chinese woman presented with deranged liver function tests, which was discovered incidentally during surveillance for statins therapy. Ultrasonography and computed tomography revealed a large lipoma originating from the greater omentum, which was treated with surgical resection. This case is reported due to the rare occurrence of omental lipomas.
Abdomen ; diagnostic imaging ; pathology ; Female ; Humans ; Lipoma ; diagnosis ; surgery ; Liver ; physiopathology ; Liver Function Tests ; Middle Aged ; Omentum ; pathology ; surgery ; Peritoneal Neoplasms ; diagnosis ; surgery ; Radiography, Abdominal ; methods ; Treatment Outcome ; Ultrasonography