Adult ; Brain Stem Neoplasms ; complications ; pathology ; surgery ; Female ; Hemangioma, Cavernous ; complications ; pathology ; surgery ; Humans ; Magnetic Resonance Imaging ; Tremor ; etiology

No abstract available
Colonic Neoplasms/complications/*pathology ; Colonic Polyps/complications/*pathology/surgery ; *Colonoscopy ; Gastrointestinal Hemorrhage/*etiology ; Hemangioma, Cavernous/complications/*pathology ; Humans ; Male ; Middle Aged

PURPOSE: We aimed to evaluate the histologic and radiologic findings of vascular lesions after stereotactic radiosurgery (SRS) categorized as radiation-induced cavernous hemangioma (RICH). MATERIALS AND METHODS: Among 89 patients who underwent neurosurgery for cavernous hemangioma, eight RICHs from 7 patients and 10 de novo CHs from 10 patients were selected for histopathological and radiological comparison. RESULTS: Histologically, RICHs showed hematoma-like gross appearance. Microscopically, RICH exhibited a hematoma-like area accompanied by proliferation of thin-walled vasculature with fibrin deposits and infiltrating foamy macrophages. In contrast, CHs demonstrated localized malformed vasculature containing fresh and old clotted blood on gross examination. Typically, CHs consisted of thick, ectatic hyalinized vessels lined by endothelium under a light microscope. Magnetic resonance imaging of RICHs revealed some overlapping but distinct features with CHs, including enhancing cystic and solid components with absence or incomplete popcorn-like appearance and partial hemosiderin rims. CONCLUSION: Together with histologic and radiologic findings, RICH may result from blood-filled space after tissue destruction by SRS, accompanied with radiation-induced reactive changes rather than vascular malformation. Thus, the term "RICH" would be inappropriate, because it is more likely to be an inactive organizing hematoma rather than proliferation of malformed vasculature.
Adult ; Aged ; Brain/*pathology ; Brain Neoplasms/*pathology ; Female ; Hemangioma, Cavernous/complications/*pathology/surgery ; Hematoma/surgery ; Humans ; *Magnetic Resonance Imaging ; Male ; Middle Aged ; Radiosurgery/adverse effects ; Treatment Outcome

OBJECTIVETo study the clinicopathologic features and immunophenotype of splenic littoral cell angioma.

METHODSThe clinical features, radiologic findings and histopathology of 17 cases of splenic littoral cell angioma were retrospectively reviewed. Immunohistochemical study was carried out on paraffin-embedded tissues, using normal spleen, cases of congestive splenomegaly and cavernous hemangioma as controls.

RESULTSAll the 17 cases had similar clinical manifestations and radiologic findings. There was mild to moderate splenomegaly, with solitary or multifocal space-occupying lesions. Hepatic cysts were observed in 5 of the 17 cases. One case was also accompanied by serous cystadenoma of ovary. Gross examination revealed enlarged spleen containing single or multiple tan-colored nodules which ranged from 0.2 cm to 6.0 cm in diameter. Histologically, the lesions consisted of anastomosing vascular channels, sometimes with papillary or cavernous appearance. Two types of component cells were identified. A population of smaller cells lined the vascular channels, while another population of larger cells often floated in the vascular lumen. Both cell populations showed little cytologic atypia. Immunohistochemical study demonstrated that the smaller cells of all cases were positive for CD31 and polyclonal factor VIII-related antigen. They were negative for CD34, histiocytic markers and S-100 protein. CD8 and CD21 were expressed in 1 and 1 of the 17 cases respectively. On the other hand, the larger cells expressed histiocytic markers, including CD68 (KP1 and PG-M1), CD163 and lysozyme. There was also focal positivity for CD31. The staining for CD34, monocolonal factor VIII-related antigen and S-100 protein was negative. The immunophenotype of splenic littoral cell angioma was different from that of the controls.

CONCLUSIONSLittoral cell angioma is a benign condition, likely secondary to hemodynamic disturbance in spleen. The littoral cells become hyperplastic and anastomose, resulting in a hemangioma-like growth associated with histiocytic reaction. Attention to the characteristic histopathologic findings and immunophenotype are crucial for diagnosis.

Adult ; Aged ; Antigens, CD ; metabolism ; Antigens, Differentiation, Myelomonocytic ; metabolism ; Diagnosis, Differential ; Female ; Follow-Up Studies ; Hemangioma ; immunology ; pathology ; Hemangioma, Cavernous ; immunology ; pathology ; Humans ; Immunohistochemistry ; Male ; Middle Aged ; Platelet Endothelial Cell Adhesion Molecule-1 ; metabolism ; Receptors, Cell Surface ; metabolism ; Retrospective Studies ; Spleen ; pathology ; Splenic Neoplasms ; complications ; immunology ; pathology ; Splenomegaly ; metabolism ; pathology ; von Willebrand Factor ; metabolism

The primary esophageal lymphoma is extremely rare, and shows various morphologic characteristics. Only a single case of mucosa-associated lymphoid tissue (MALT) type lymphoma confined to the esophagus has been reported in the literature. A 61-yr-old man was referred to our hospital for evaluation of an esophageal submucosal tumor (SMT) that had been detected incidentally by endoscopy. He had a history of pulmonary tuberculosis with long-term anti-tuberculosis medication 15 yr before, and also had a history of syphilis, which had been treated one year before. He had been taking a synthetic thyroid hormones for the past 10 months because of an autoimmune thyroiditis. Endoscopy showed a longitudinal round and tubular shaped smooth elevated lesion, which was covered with intact mucosa and located at the mid to distal esophagus, 31 cm to 39 cm from the incisor teeth. Endoscopic ultrasonography (EUS) showed a huge longitudinal growing intermediate- to hypo-echoic mass located in the submucosal layer with internal small, various sized honeycomb-like anechoic lesions suggesting germinal centers. Subsequently, he underwent a surgery, which confirmed the mass as a primary esophageal low-grade B-cell lymphoma of MALT type.
Alcoholism/complications ; Diagnosis, Differential ; Esophageal Neoplasms/pathology* ; Esophageal Neoplasms/radiography ; Esophageal Neoplasms/ultrasonography ; Esophagoscopy ; Gastritis/complications ; Helicobacter Infections/complications ; Hemangioma, Cavernous/diagnosis ; Human ; Incidental Findings ; Lymphoma, Mucosa-Associated Lymphoid Tissue/pathology* ; Lymphoma, Mucosa-Associated Lymphoid Tissue/radiography ; Lymphoma, Mucosa-Associated Lymphoid Tissue/ultrasonography ; Male ; Middle Aged ; Mucous Membrane/pathology ; Neoplasm Invasiveness ; Smoking ; Thyroiditis, Autoimmune/complications

OBJECTIVETo evaluate three dimensional dynamic contrast-enhanced magnetic resonance angiography (3D-DCE MRA) in diagnosis of cavernous transformation of portal vein (CTPV).

METHODSTwenty-four patients with CTPV underwent 3D-DCE MRA examinations and the reconstructed images were retrospectively analyzed. A series of clinical, laboratory and imaging studies were performed on all these cases. Among all cases 14 underwent operations and 2 with hepatocellular carcinoma complicated portal thrombosis received transhepatic artery chemoembolization.

RESULTThe CTPA was located in the main trunk in 10 cases, in both the main trunk and left/right branches in 8, and in left or right branches of the portal vein in 4. In the remaining 2 cases CTPA was located at the level of superior mesenteric vein. MRA revealed multiple circuitous collateral veins striding over obstruction to extend into the liver in 9 cases,and in 7 it simultaneously showed streaky or dot-like low signal intensities representing thrombi in the extensively dilated network of portal system. MRA did not clearly demonstrate the structure of the portal vein but only showed multiple sinuous network of venous collaterals strangling together in 6 cases. In 15 cases it also showed the route and distribution of multiple hepatofugal venous collaterals.

CONCLUSION3D-DCE MRA can provide adequate information about the site and severity of CTPA.

Adult ; Aged ; Aged, 80 and over ; Contrast Media ; Female ; Hemangioma, Cavernous ; diagnosis ; etiology ; pathology ; Humans ; Image Processing, Computer-Assisted ; Imaging, Three-Dimensional ; Liver Neoplasms ; complications ; Magnetic Resonance Angiography ; methods ; Male ; Middle Aged ; Portal Vein ; pathology ; Retrospective Studies ; Venous Thrombosis ; diagnosis ; etiology ; pathology