Acute Kidney Injury ; diagnostic imaging ; etiology ; Aged ; Humans ; Male ; Necrosis ; diagnostic imaging ; etiology ; Paraganglioma ; complications ; Postoperative Complications ; Retroperitoneal Neoplasms ; complications ; Skin ; diagnostic imaging ; pathology ; Tomography, X-Ray Computed

PURPOSE: We aimed to investigate the effectiveness of ferritin as a contrast agent and a potential reporter gene for tracking tumor cells or macrophages in mouse cancer models. MATERIALS AND METHODS: Adenoviral human ferritin heavy chain (Ad-hFTH) was administrated to orthotopic glioma models and subcutaneous colon cancer mouse models using U87MG and HCT116 cells, respectively. Brain MR images were acquired before and daily for up to 6 days after the intracranial injection of Ad-hFTH. In the HCT116 tumor model, MR examinations were performed before and at 6, 24, and 48 h after intratumoral injection of Ad-hFTH, as well as before and every two days after intravenous injection of ferritin-labeled macrophages. The contrast effect of ferritin in vitro was measured by MR imaging of cell pellets. MRI examinations using a 7T MR scanner comprised a T1-weighted (T1w) spin-echo sequence, T2-weighted (T2w) relaxation enhancement sequence, and T2*-weighted (T2*w) fast low angle shot sequence. RESULTS: Cell pellet imaging of Ad-hFTH in vitro showed a strong negatively enhanced contrast in T2w and T2*w images, presenting with darker signal intensity in high concentrations of Fe. T2w images of glioma and subcutaneous HCT116 tumor models showed a dark signal intensity around or within the Ad-hFTH tumor, which was distinct with time and apparent in T2*w images. After injection of ferritin-labeled macrophages, negative contrast enhancement was identified within the tumor. CONCLUSION: Ferritin could be a good candidate as an endogenous MR contrast agent and a potential reporter gene that is capable of maintaining cell labeling stability and cellular safety.
Animals ; Brain Neoplasms/*diagnostic imaging/pathology ; Cell Line, Tumor ; Cell Tracking/*methods ; Colonic Neoplasms/*diagnostic imaging/pathology ; *Contrast Media/administration & dosage ; Disease Models, Animal ; Female ; *Ferritins/administration & dosage ; Genes, Reporter ; Glioma/*diagnostic imaging/pathology ; Humans ; Injections, Intravenous ; Macrophages ; Magnetic Resonance Imaging/*methods ; Male ; Mice ; Neoplasm Transplantation ; Skin Neoplasms/*diagnostic imaging/pathology ; Time Factors

Technetium-99m methoxyisobutylisonitrile (99mTc-MIBI) uptake is known to be increased in breast cancer because of increased blood flow from angiogenesis and heightened metabolism. We performed a 99mTc-MIBI scan in a patient with mammary Paget's disease. The patient had underlying invasive cancer in the same side of the breast. 99mTc-MIBI scan exhibited a scintigraphic image of the uptake from the invasive cancer lesion located deeply in the breast toward the epidermis. 99mTc-MIBI showed an uptake in the deeply located invasive cancer lesion as well as nipple lesion. Especially, the delayed phase of Tc-MIBI scan demonstrated the tumor site more accurately. In conclusion, 99mTc-MIBI scan could be a useful adjunct to clinical decision making in the management of Paget's disease of the breast.
Breast Neoplasms/radionuclide imaging* ; Breast Neoplasms/pathology ; Case Report ; Female ; Human ; Middle Age ; Nipples/pathology ; Paget's Disease, Mammary/radionuclide imaging* ; Paget's Disease, Mammary/pathology ; Skin/pathology ; Technetium Tc 99m Sestamibi/diagnostic use*

Angiosarcoma is an uncommon malignancy, which spread out from the endothelial cells of vessels. Scalp angiosarcoma with cervical lymph node metastasis is particularly rare. This article describes a rare case of angiosarcoma of the scalp, presenting as neck inflammation. Imaging procedures such as computed tomography (CT), magnetic resonance image (MRI) and ultrasonography (US) were not sufficient to diagnose this case. A needle biopsy provided an effective and accurate diagnosis of cervical lymph node metastasis. Additional observation and physical examination was required to diagnose the origin of the primary cancerous lesion. Once the angiosarcoma diagnosis was confirmed histologically, sequential weekly and monthly docetaxel (DTX) treatment was effective in preventing reoccurrence. Nonetheless, the optimization of angiosarcoma treatment remains a future goal. Although patients generally describe pain and swelling at the primary lesion site, this patient complained only of painful neck inflammation, without any indication of pain or swelling of the scalp. A revised diagnostic protocol should note that cervical lymph node metastasis of unknown primary origin may result from angiosarcoma of the scalp.
Aged ; Antineoplastic Agents ; therapeutic use ; Cranial Irradiation ; Head and Neck Neoplasms ; diagnostic imaging ; pathology ; therapy ; Hemangiosarcoma ; diagnostic imaging ; pathology ; therapy ; Humans ; Lymphatic Metastasis ; Male ; Neck ; pathology ; Positron-Emission Tomography ; Radiography ; Scalp ; pathology ; Skin Neoplasms ; diagnostic imaging ; pathology ; therapy ; Taxoids ; therapeutic use ; Ultrasonography

BACKGROUNDTuberous sclerosis (TS) is an autosomal dominant disorder with a significant range of clinical expressions. The involvement of vital organs, such as the brain, kidney, heart and lung is the main cause of death in patients with TS. The aim of this study is to summarize the characteristic cutaneous features and common extracutaneous involvement of TS, which are helpful to the early detection of visceral involvement.

METHODSThe analyzed clinical data from 78 patients with TS included those from detailed history, physical and dermatological examination, cranial computed tomography (CT) and magnetic resonance imaging (MRI), abdominal ultrasonography, chest roentgenography, hand and foot X-ray and ophthalmologic examination.

RESULTSThe skin, brain and kidney were involved frequently in TS patients. Hypomelanotic macules were the most common and earliest cutaneous lesions. Their number was more than 3 in 81.5% of the patients. They were followed by facial angiofibromas and Shangreen's patch in a decreasing frequency. Forehead plaque, facial angiofibromas and Shagreen's patch appeared in patients at mean age of 2.6, 6.0 and 8.1 years respectively. Cranial CT showed a high positive rate in TS patients.

CONCLUSIONSCutaneous features of TS are helpful in the early diagnosis of the disease. Hypomelanotic macules are especially important for patients with epilepsy or babies whose number of hypomelanotic macules is more than 3. Cranial CT is of great value in the diagnosis of TS. The involvement of visceral organs such as the brain and kidney should be examined in TS patients.

Adolescent ; Adult ; Angiomyolipoma ; etiology ; Child ; Child, Preschool ; Female ; Humans ; Infant ; Kidney Neoplasms ; etiology ; Male ; Radiography ; Skin ; pathology ; Tuberous Sclerosis ; complications ; diagnostic imaging ; pathology

OBJECTIVETo study the clinicopathologic features and differential diagnosis of myxoid dermafibrosarcoma protuberans (DFSP).

METHODSThe clinical and pathologic features of 16 cases of myxoid DFSP were reviewed.

RESULTSThere were altogether 15 males and 1 female. The age of the patients ranged from 11 to 73 years (mean = 47 years and median = 48 years). The commonest site of involvement was trunk (number = 11), followed by shoulder (number = 2), head and neck (number = 2), and extremity (number = 1). Similar to conventional DFSP, most patients presented with a slowly enlarging subcutaneous nodule which showed a rapid recent growth in some cases. Amongst the 16 cases studied, 12 occurred de novo and 4 represented local recurrence. The tumors ranged from 2 to 10 cm in greatest dimension (mean = 5 cm and median = 4 cm). Histologically, they were poorly circumscribed and located in the dermis, with focal infiltration into the underlying subcutaneous tissue. Seven cases were purely myxoid and composed of spindly and stellate cells with delicate arborizing vascular meshwork. The remaining 9 cases were predominantly myxoid (> 50%), with 5 cases containing cellular areas resembling conventional DFSP and 4 cases showing fibrosarcomatous transformation. In addition, foci of giant cell fibroblastoma-like areas were noted in 1 case. Immunohistochemical study showed that the tumors cells were positive for CD34. The staining was weak in the myxoid areas, as compared with conventional DFSP. Of the 4 recurrent cases, one patient developed lung metastases.

CONCLUSIONSMyxoid DFSP represents a rare variant of DFSP and may pose important diagnostic pitfalls. It is especially so if the tumor purely consists of myxoid element. Familiarity with the histologic features helps to avoid misdiagnosis.

Abdominal Wall ; Adolescent ; Adult ; Aged ; Antigens, CD34 ; metabolism ; Child ; Dermatofibrosarcoma ; diagnostic imaging ; immunology ; pathology ; surgery ; Diagnosis, Differential ; Female ; Head and Neck Neoplasms ; diagnostic imaging ; immunology ; pathology ; surgery ; Humans ; Lung Neoplasms ; secondary ; Male ; Middle Aged ; Neoplasm Recurrence, Local ; Radiography ; Shoulder ; Skin Neoplasms ; diagnostic imaging ; immunology ; pathology ; surgery ; Young Adult

OBJECTIVETo study the clinicopathologic characteristics, immunophenotype and differential diagnosis of superficial acral fibromyxoma (SAF).

METHODSThe clinical, pathologic and immunohistochemical features of a case of SAF occurring in left middle finger was studied, with review of literature.

RESULTSThe patient was a 62-year-old male who presented with a solitary painful nodule located in the distal aspect of his left middle finger. The nodule lied close to the nail bed and deep to the underlying periosteum. Grossly, the tumor was poorly circumscribed, measured 2 cm in greatest dimension and had a greyish-white cut surface and rubbery consistency. On low-power examination, the tumor was centred in the dermis and displayed a vague lobular pattern. The tumor cells were spindled to stellate in shape and associated with myxoid matrix. Focal fascicular or loose storiform patterns were also noted. A delicate vascular network was identified in the myxoid stroma. Mast cells were readily observed. On high-power examination, the tumor cells were relatively bland-looking and showed at most a mild degree of nuclear atypia. Mitotic figures were rare and coagulative tumor necrosis was absent. Immunohistochemical study showed that the tumor cells were positive for vimentin, CD34 and CD99. Focal staining for CD10 was also demonstrated. Other immunomarkers including actins, desmin and epithelial membrane antigen were negative.

CONCLUSIONSSAF is a distinctive soft tissue tumor occurring mainly in the digits of adults. Awareness of this entity is helpful in distinguishing SAF from other myxoid soft tissue tumors occurring there. Complete excision with clear resection margins is the mainstay of treatment.

12E7 Antigen ; Antigens, CD ; metabolism ; Antigens, CD34 ; metabolism ; Cell Adhesion Molecules ; metabolism ; Dermatofibrosarcoma ; metabolism ; pathology ; Diagnosis, Differential ; Fibroma ; diagnostic imaging ; metabolism ; pathology ; surgery ; Fingers ; pathology ; Follow-Up Studies ; Ganglion Cysts ; metabolism ; pathology ; Humans ; Male ; Middle Aged ; Nerve Sheath Neoplasms ; metabolism ; pathology ; Radiography ; Skin Neoplasms ; metabolism ; pathology ; Soft Tissue Neoplasms ; diagnostic imaging ; metabolism ; pathology ; surgery ; Vimentin ; metabolism

OBJECTIVE: The purpose of this study was to evaluate the accuracy of a preoperative MRI with microscopy coils in determining the primary tumor thickness of malignant melanoma with histopathologic correlation. MATERIALS AND METHODS: Eleven patients with histopathologically confirmed malignant melanoma were included in this study. MR images of the tumors were obtained with a 47-mm microscopy coil on 1.5T MR scanners and were evaluated by two radiologists, who assessed the thickness of the primary tumor on T2-weighted images (T2WI) and gadolinium-enhanced T1-weighted images with fat suppression (Gd-T1WI) and compared the results with the histopathologic findings as the reference standard. Correlations between tumor thickness on MRI and histopathologic examination were assessed using concordance correlation coefficients (CCCs). Inter- and intraobserver variabilities of tumor measurements were also assessed by intraclass correlation coefficient (ICC). RESULTS: Among the 11 cases included in the study, 10 cases from the same number of patients were managed with surgical excision and one case was confirmed with punch biopsy. The primary tumor thickness measured on T2WI showed better correlation with histopathologic results, as compared with measurements taken on Gd-T1WI: the CCC of measurements on T2WI ranged from 0.64 to 0.78, indicating a substantial agreement, whereas the CCC of measurements on Gd-T1WI ranged from 0.50 to 0.61, indicating a moderate to substantial agreement. Inter- and intraobserver agreements of readers 1 and 2 were excellent for both T2WI and Gd-T1WI, with ICC ranging from 0.86 to 0.99. CONCLUSION: MR imaging with microscopy coils may be an accurate technique in the preoperative assessment of tumor thickness in malignant melanoma, especially on T2-weighted images.
Aged ; Aged, 80 and over ; Biopsy ; Contrast Media/diagnostic use ; Female ; Gadolinium DTPA/diagnostic use ; Humans ; Magnetic Resonance Imaging/*instrumentation ; Male ; Melanoma/*pathology ; Middle Aged ; Reproducibility of Results ; Retrospective Studies ; Skin Neoplasms/*pathology

Eccrine spiradenomas are rare, benign, cutaneous tumors that originate in the sweat glands. Eccrine spiradenomas in the breast are very rare and only a few cases have been reported. We report here on the case of a 47-year-old woman with superficial masses in the breast and these masses had gradually increased in size during follow-up. They were confirmed to be an eccrine spiradenoma on pathologic examination. There have been a few reports about the radiologic findings of eccrine spiradenomas of the breast. This is the first case of an eccrine spiradenoma in the breast that was characterized by multiple imaging modalities, including mammography, ultrasonography and MRI. The lesion in our patient was first diagnosed as an epidermal inclusion cyst based on the imaging findings and the mass's superficial location. Although the mammographic and ultrasonographic imaging findings of eccrine spiradenomas and epidermal inclusion cysts are similar, the MRI findings are different between epidermal inclusion cysts and eccrine spiradenomas. Eccrine spiradenomas should be considered in the differential diagnosis of cutaneous and subcutaneous lesions of the breast.
Adenoma, Sweat Gland/*diagnosis/pathology ; Biopsy, Needle ; Diagnosis, Differential ; Diagnostic Errors ; Epidermal Cyst/diagnosis ; Female ; Humans ; Magnetic Resonance Imaging ; Mammography ; Middle Aged ; Skin Neoplasms/*diagnosis/pathology ; Sweat Gland Neoplasms/*diagnosis/pathology ; Ultrasonography, Mammary

Abdominal Neoplasms ; diagnosis ; diagnostic imaging ; Adolescent ; Autoantibodies ; blood ; Diagnosis, Differential ; Female ; Humans ; Mouth Mucosa ; pathology ; Paraneoplastic Syndromes ; diagnosis ; immunology ; pathology ; Pemphigus ; diagnosis ; immunology ; pathology ; Skin ; pathology ; Tomography, X-Ray Computed