Pedunculated hepatocellular carcinoma was first described by Roux in 1987, and Goldberg and Wallerstein presented a case with pathological description in 1934. Since then 37 cases have been reported in the world literature. A pedunculated hepatocellular carcinoma, occurred in a 69-year-old woman, was encountered. It was attached to the Glission's capsule of the right lobe of liver inferiorly, and was connected to the porta hepatis bt a mesenteric pedicle containing arteries, veins, bile ducts and nerve bundles. The tumor mass was completely encapsulated, and measured 8.5x8x6 cm and 255 gm. It was composed of hepatocellular carcinoma of a well-differentiated, acinar type. Tumor cells were positive for HBsAg, but negative for alpha-fetoprotein on peroxidase-antiperoxidase staining. The liver exhibited macronodular cirrhosis on gross examination. This tumor is thought to have on in the supernumerary lobe of liver.
Female ; Humans ; Carcinoma, Hepatocellular

The primary malignant melanoma arising in the leptomeninges of the central nervous system is extremely rare. We report a case of malignant melanoma, apparently thought to be originated from leptomeninges, with diffuse neoplastic process widely spreaded over the leptomeninges of 42 years old man, who had suffered severe headache, nausea and left hemiparesis. This patient is free of the symptoms for six months after operation. The literature on this subject is briefly reviewed.
Adult ; Central Nervous System ; Headache ; Humans ; Melanoma* ; Nausea ; Paresis

Authors compared early phase scan of the IV bolus CT (two phase incremental bolus dynamic CT) with late enhanecd scan similar to the conventional contrast enhanced CT for evaluation of the advantages of the IV bolus CT with two viewpoints of the pancreatic or peripancreatic mass and peripancreatic lymphadenopathy in 68 patients-28 cases of the pancreatic cancer, 6 cases of the pancreatitis and 34 cases of the pancreatic or peripancreatic metastasis. On the diagnosis of the pancreatic or peripancreatic mass, IV bolus CT could show the lesion(s) more easily in 41% (Grade II; 13/31) and much more easily in 34% (Grade III; 10/31) when compared with conventional contrast CT scan. The diagnosis of the peripancreatic lymph node involvement was also easy in 51%(Grade II; 20/39) and much easier in 37% (Grade III; 14/39). We thought that these differences were originated from the increase of the contrast between the lesion and normal portion because the early enhanced scans reflected the active blood flow change more exactly. Therefore IV bolus CT had advantages in comparison with the conventional drip infusion contrast CT in the diagnosis of the presence and pathologic extension of the pancreatic and peripancreatic lesion.
Diagnosis ; Infusions, Intravenous ; Lymph Nodes ; Lymphatic Diseases ; Neoplasm Metastasis ; Pancreatic Neoplasms ; Pancreatitis ; Tomography, X-Ray Computed

Authors compared early phase scan of the IV bolus CT (two phase incremental bolus dynamic CT) with late enhanecd scan similar to the conventional contrast enhanced CT for evaluation of the advantages of the IV bolus CT with two viewpoints of the pancreatic or peripancreatic mass and peripancreatic lymphadenopathy in 68 patients-28 cases of the pancreatic cancer, 6 cases of the pancreatitis and 34 cases of the pancreatic or peripancreatic metastasis. On the diagnosis of the pancreatic or peripancreatic mass, IV bolus CT could show the lesion(s) more easily in 41% (Grade II; 13/31) and much more easily in 34% (Grade III; 10/31) when compared with conventional contrast CT scan. The diagnosis of the peripancreatic lymph node involvement was also easy in 51%(Grade II; 20/39) and much easier in 37% (Grade III; 14/39). We thought that these differences were originated from the increase of the contrast between the lesion and normal portion because the early enhanced scans reflected the active blood flow change more exactly. Therefore IV bolus CT had advantages in comparison with the conventional drip infusion contrast CT in the diagnosis of the presence and pathologic extension of the pancreatic and peripancreatic lesion.
Diagnosis ; Infusions, Intravenous ; Lymph Nodes ; Lymphatic Diseases ; Neoplasm Metastasis ; Pancreatic Neoplasms ; Pancreatitis ; Tomography, X-Ray Computed

We performed IV bolus CT scan in 40 patients with final diagnosis of various hepatic masses in order to evaluate hemodynamic changes and differentiating characters of the lesions. Preenhanced, early and late phase post enhanced, and delayed CT scans were obtained with rapid IV bolus injection of contrast materials and table sliding method for pertinent scans. In hepatomas, early enhanced CT scan directly showed hypervascular change and active viable portion of the mass and late phase CT scan showed capsular enhancement. In addition, extracapsular invasion and post-embolization recurrence were more easily visualized. In hemangiomas, early and late enhancing types could be categorized according to the time of maximal enhancement. In metastatic liver malignancies and cholangiocarcinomas, specific findings were seen in early phase and delayed CT scans and not in conventional CT scan. In conclusion, IV bolus CT scan is a very useful CT method in demonstrating the characteristic hemodynamic patterns and in differential diagnosis of the hepatic masses.
Carcinoma, Hepatocellular ; Cholangiocarcinoma ; Contrast Media ; Diagnosis ; Diagnosis, Differential ; Hemangioma ; Hemodynamics ; Humans ; Liver ; Methods ; Recurrence ; Tomography, X-Ray Computed*

Isolated heaptic tuberculous granuloma with no coexistent tuberculosis elsewhere in the body is extremely rare. We report a case of pathologically proven tuberculous granuloma in the liver followed with both IV bolus and portal CT scans. The lesion on preenhanced CT scan showed undefinable isodensity. After IV bolus injection, it showed poor enhancement with central low-density and surrounding hyperdenity due to compensatory hypervascularity of the left lobe of liver in early phase. It showed peripheral rim enhancement in late phase and in delayed phase showed relatively homogeneous but slightly decreased contract enhancement. On portal CT scan, it showed a hypodense portal defect similar to other hepatic mass lesions. During follow-up studies, it was a slowly growing mass which was more easily detectable by prtal CT scans than bolus CT scans.
Follow-Up Studies ; Granuloma* ; Liver ; Tomography, X-Ray Computed ; Tuberculosis

A case of fibroepithelial polyp with stromal atypia in a 25-year-old female is described. The tumor arose from the vaginal wall and measured 3.5 cm in maximal diameter. It was composed of hypercellular connective tissue stroma and focal myxoid area containing numerous atypical mono- and multinucleated stromal cells. These cells may mislead to make a diagnosis of sarcoma, particulary of botryoid rhabdomyosarcoma.
Adult ; Connective Tissue ; Diagnosis ; Female ; Humans ; Polyps* ; Rhabdomyosarcoma ; Sarcoma ; Stromal Cells* ; Vagina*

Congenital agenesis of the right lobe of liver is a rare anomaly and only 33 cases have been reported. CT showed absence of the right lobe of liver and compensatory hypertrophy of the other lobe. We report the CT findings of a new case of this anomaly with a review of the literatures.
Hypertrophy ; Liver*

BACKGROUND: In patients with endometrial carcinoma, preoperative evaluation of exact staging has important prognostic and therapeutic implications. The incidence of pelvic and aortic lymph node involvement in endometrial carcinoma depends on grade of tumor differentiation and depth of myometrial invasion. MATERIAL AND METHOD: To evaluate whether MRI provides a preoperative assessment for staging of endometrial carcinoma, MRI was undertaken in 28 patients, a few weeks before operation. Myometrial invasion was devided in three categories, and involvement of cervix, adnexa, and pelvic cavity were classified. RESULTS: The results of MR imaging were compared with these of pathology. The preoperative MRI staging of endometrial carcinoma was correct in 22 out of 28 patients. In the evaluation of myometrial invasion, the MR imaging underestimated in 4 cases and overestimated in 1 case. CONCLUSION: In patients with endometrial carcinoma, MR imaging is very useful in the assessment of the depth of myometrial invasion, stromal invasion of cevix, lymphatic & pelvic metastases and extent of the lesion.
Cervix Uteri ; Endometrial Neoplasms* ; Female ; Humans ; Incidence ; Lymph Nodes ; Magnetic Resonance Imaging* ; Neoplasm Metastasis ; Pathology

STUDY DESIGN: Thirteen patients with cervical interlocked facets dislocation in whom closed reduction by skull traction was failed were evaluated about the patterns of ruptured disc fragment. Objects : To evaluate the causes of failure at closed reduction, and the relation between ruptured discs and interlocked facets, and the treatment results through an anterior approach. SUMMARY OF LITERATURE REVIEW: In traumatic dislocation of the cervical facet joints, spinal cord or nerve roots injury associated with the ruptured disc fragment has been reported. However, there is few report evaluating the patterns of ruptured disc fragment as a cause of reduction failure. MATERIALS AND METHODS: Between 1988 and 1997, thirteen patients were treated by anterior fusion with plate after complete removal of the intervertebral disc through anterior approach and reduction of interlocked facets by O1iveira method. They have been followed for an average of 36 months(range : 12-96 months). The interlocking was bilateral in seven cases and unilateral in six cases. We assessed the types of ruptured disc fragment by preoperative MRI and CT and the clinical and radiological results. RESULTS: Ruptured disc fragment was found in all thirteen patients with interlocked facets dislocation. The patterns of ruptured discs were within the uncovertebral joints in 5 cases, posterioly under the posterior longitudinal ligament in 3 cases, anteriorly under intact anterior longitudinal ligament in 3 cases and combined under the anterior and posterior longitudinal ligament in 2 cases. The displacement of ruptured disc fragment were seemed to be the cause of failure in closed reduction. CONCLUSIONS: Intervertebral disc injury should be evaluated carefully with MRI and CT in the lower cervical interlocked facet dislocations before trial of reduction or decision makings of treatment.
Dislocations* ; Humans ; Intervertebral Disc ; Joints ; Longitudinal Ligaments ; Magnetic Resonance Imaging ; Skull ; Spinal Cord ; Spine* ; Traction ; Zygapophyseal Joint