1.Role of Contrast-enhanced Ultrasound in Distinguishing between Benign and Malignant Thyroid Nodules with Calcification.
Zhen-Fang WANG ; Jing SHANG ; Yuan ZHU ; Bo LIU
Acta Academiae Medicinae Sinicae 2021;43(6):905-910
Objective To explore the roles of conventional ultrasound and contrast-enhanced ultrasound in distinguishing between benign and malignant thyroid nodules with calcification. Methods A total of 102 solid thyroid nodules with calcification in 76 patients were evaluated by conventional ultrasound alone and conventional ultrasound combined with contrast-enhanced ultrasound.The features obtained through conventional ultrasound alone and that combined with contrast-enhanced ultrasound were scored,and the diagnostic performance of the two methods was analyzed based on the final pathological results. Results The distribution of microcalcification(
Calcinosis/diagnostic imaging*
;
Contrast Media
;
Diagnosis, Differential
;
Humans
;
Sensitivity and Specificity
;
Thyroid Neoplasms
;
Thyroid Nodule/diagnostic imaging*
;
Ultrasonography
2.Spontaneous Resolution of Iatrogenic Calcinosis Cutis after Parenteral Calcium Gluconate Therapy in Neonates
Kwang Soon SONG ; Si Wook LEE ; Du Han KIM ; Kyung Keun MIN ; Chang Jin YON
The Journal of the Korean Orthopaedic Association 2019;54(2):192-196
Iatrogenic calcinosis cutis is due to the intravenous administration of calcium gluconate or calcium chloride to treat hypocalcemia. The arthors report three cases of calcinosis cutis with calcifications involving the upper or lower extremities in neonates following the extravasation of calcium gluconate. Three neonates, a 2-week-old girl, 4-week-old boy, and a 4-week-old girl, were consulted for indurated nodules after the intravenous administration of calcium gluconate at the intensive care unit. Complete remission of palpable nodule and calcification was observed on the radiograph at three weeks, four weeks and six months after the initial presentation in each. All three neonates with iatrogenic calcinosis curtis were resolved spontaneously without functional and cosmetic complications. According to enhancement of the patient's cognition about benign disease, a suitable explanation of the disease and avoiding unnecessary treatment through an early diagnosis of iatrogenic calcinosis cutis will reduce a number of potential medical malpractice disputes.
Administration, Intravenous
;
Calcinosis
;
Calcium Chloride
;
Calcium Gluconate
;
Calcium
;
Cognition
;
Dissent and Disputes
;
Early Diagnosis
;
Female
;
Humans
;
Hypocalcemia
;
Infant, Newborn
;
Intensive Care Units
;
Lower Extremity
;
Male
;
Malpractice
3.Improvement in Multiple Metastatic Calcinosis Cutis Lesions after Hemodialysis in a Patient with Chronic Renal Failure: A Case Report
In Hye CHOI ; Chul Jong PARK ; Kyung Ho LEE
Korean Journal of Dermatology 2019;57(5):270-273
Metastatic calcinosis cutis refers to the deposition of calcium salts in normal tissue secondary to an underlying defect in calcium and/or phosphate metabolism. It commonly affects periarticular areas in patients with chronic renal failure. We report a case of a 51-year-old man with a past medical history of peritoneal dialysis for chronic renal failure, who presented with multiple yellowish nodules on his right thumb. In view of the asymptomatic non-inflamed fluctuating nodules, the differential diagnoses included bacterial, tuberculous, atypical mycobacterial, or fungal infections. Histopathological and radiological examinations revealed calcifications in the right thumb and shoulder with elevated serum phosphorus and parathyroid hormone levels. The lesions improved after the patient was switched from peritoneal dialysis to hemodialysis. We report a case of metastatic calcinosis cutis in a patient with chronic renal failure. We emphasize the importance of imaging for accurate diagnosis and follow-up of calcinosis cutis and that hemodialysis scores over peritoneal dialysis in the treatment of this condition.
Calcinosis
;
Calcium
;
Diagnosis
;
Diagnosis, Differential
;
Follow-Up Studies
;
Humans
;
Kidney Failure, Chronic
;
Metabolism
;
Middle Aged
;
Parathyroid Hormone
;
Peritoneal Dialysis
;
Phosphorus
;
Renal Dialysis
;
Salts
;
Shoulder
;
Thumb
4.Diffusion-weighted imaging texture features in differentiation of malignant from benign nonpalpable breast lesions for patients with microcalcifications-only in mammography.
Shujun CHEN ; Guoliang SHAO ; Feng SHAO ; Minming ZHANG
Journal of Zhejiang University. Medical sciences 2018;47(4):400-404
OBJECTIVE:
To evaluate the application of MR diffusion-weighted imaging(DWI) texture features in differentiation of malignant from benign nonpalpable breast lesion for patients with microcalcifications-only in mammography.
METHODS:
The clinical and MR-DWI data of 61 patients with microcalcifications, who underwent three-dimensional positioning of breast X-ray wire from October 2012 to December 2015 in Zhejiang Cancer Hospital, were retrospectively analyzed, including 38 patients with malignant lesions and 23 patients with benign lesions. Two radiologists independently drew the regions of interest (ROI) on DWI for image segmentation, and 6 histogram features and 16 grayscale symbiosis matrix (GLCM) texture features were extracted on each ROI. The random forest algorithm was applied to select the features and built the classification model. The leave-one-out cross-validation (LOOCV) was used to validate the classifier, and the performance of the classifier was evaluated by ROC curve.
RESULTS:
Six features were selected, including histogram features of mean, variance, skewness, entropy, as well as contrast (0°) and correlation (45°) in GLCM. The histogram features of mean, variance, skewness and entropy were significantly different between the benign and malignant breast lesions (all <0.05). The AUC of the model was 0.76, and the diagnostic accuracy, sensitivity and specificity were 77.05%, 84.21% and 65.21%, respectively.
CONCLUSIONS
The texture feature analysis of DWI can improve the diagnostic accuracy of differentiating benign and malignant breast nonpalpable lesions with microcalcifications-only in mammography. Histogram features of mean, variance, skewness, entropy of DWI may be used as important imaging markers.
Breast
;
diagnostic imaging
;
Breast Neoplasms
;
diagnostic imaging
;
Calcinosis
;
diagnostic imaging
;
Diagnosis, Differential
;
Diffusion Magnetic Resonance Imaging
;
Female
;
Humans
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Mammography
;
Retrospective Studies
;
Sensitivity and Specificity
5.A rare development of tumoral calcinosis of the ear auricle.
Sam Yong LEE ; Han Gyeol LEE ; Kwang Seog KIM ; Jae Ha HWANG
Archives of Craniofacial Surgery 2018;19(4):287-290
Tumoral calcinosis is a condition characterized by deposition of calcium salts in the skin and sub- cutaneous tissue, commonly found around the joints. However, tumoral calcinosis of the auricle is extremely rare. We present the case of a 13-year-old boy with tumoral calcinosis of the helix of the ear auricle. A 13-year-old boy presented with a 10-year history of an enlarging mass on the left auricle. The mass was hard, non-tender, and non-compressible. The patient had no history of trauma. Complete surgical excision and pathological examination of the specimen was performed. The final diagnosis of the excised mass was tumoral calcinosis. After 9 months of follow-up, there were no signs of recurrence of the tumor and the patient was satisfied with the surgical results. Tumoral calcinosis of the auricle is extremely rare and may be misdiagnosed as other tumors. Pathological examination is essential for definitive diagnosis and complete surgical excision should be considered as the treatment of choice.
Adolescent
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Calcinosis*
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Calcium
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Diagnosis
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Ear Auricle*
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Ear Neoplasms
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Ear*
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Follow-Up Studies
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Humans
;
Joints
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Male
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Recurrence
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Salts
;
Skin
6.Rare finding of Eustachian tube calcifications with cone-beam computed tomography.
Ali Z SYED ; Anna HAWKINS ; Leela Subashini ALLURI ; Buthainah JADALLAH ; Kiran SHAHID ; Michael LANDERS ; Hussein M ASSAF
Imaging Science in Dentistry 2017;47(4):275-279
Soft tissue calcification is a pathological condition in which calcium and phosphate salts are deposited in the soft tissue organic matrix. This study presents an unusual calcification noted in the cartilaginous portion of the Eustachian tube. A 67-year-old woman presented for dental treatment, specifically for implant placement, and cone-beam computed tomography (CBCT) was performed. The CBCT scan was reviewed by a board-certified oral and maxillofacial radiologist and revealed incidental findings of 2 distinct calcifications in the cartilaginous portion of the Eustachian tube. To the authors' knowledge, no previous study has reported the diagnosis of Eustachian tube calcification using CBCT. This report describes an uncommon variant of Eustachian tube calcification, which has a significant didactic value because such cases are seldom illustrated either in textbooks or in the literature. This case once again underscores the importance of having CBCT scans evaluated by a board-certified oral and maxillofacial radiologist.
Aged
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Calcinosis
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Calcium
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Cone-Beam Computed Tomography*
;
Diagnosis
;
Eustachian Tube*
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Female
;
Humans
;
Incidental Findings
;
Radiography
;
Salts
7.Liposclerosing myxofibrous tumor of bone: a clinicopathologic analysis.
Juan ZHOU ; Dingjun HU ; Zhiming JIANG ; Huizhen ZHANG
Chinese Journal of Pathology 2016;45(1):21-24
OBJECTIVETo explore the clinicopathologic features and imaging diagnosis of 17 cases of liposclerosing myxofibrous tumor (LSMFT) and to discuss the mechanism of the disease.
METHODSCases of LSMFT diagnosed in 2014 were included in this retrospective study. The clinicopathologic features and imaging findings were evaluated.
RESULTSThere were 17 cases of LSMFT, occurring in 11 men and 6 women with a mean age of 46 years (range, 26-67 years). Patients were asymptomatic or presented with pain localized over the lesions. Most (13/17) lesions were located in the intertrochanteric region. Radiographs showed well-defined and often extensively sclerotic margin. MRI showed the lesions to be relatively heterogeneous on T1W, and heterogeneous with high signal intensity on T2W with fat suppression. Microscopically, LSMFT was characterized by a complex mixture of histologic elements, including myxofibrous and collagen tissues, lipomatous areas, xanthoma cells, calcification, irregular ossification and pseudo-Paget's bone.
CONCLUSIONSLSMFT is a benign fibro-ossesous lesion with unique imaging characteristics and histologic features, occurring preferentially in some locations. It might represent end-stage degenerative changes in other benign bone lesions such as fibrous dysplasia, simple bone cyst and intraosseous lipoma secondary to trauma from forces and ischemic bone injury exerted on the intertrochanteric region of the femur.
Adult ; Aged ; Bone Neoplasms ; diagnosis ; pathology ; Calcinosis ; Female ; Femur ; pathology ; Fibroma ; diagnosis ; pathology ; Hip Joint ; pathology ; Humans ; Magnetic Resonance Imaging ; Male ; Middle Aged ; Retrospective Studies
8.Gastrointestinal Stromal Tumor of the Stomach Presenting as Multilobular with Diffuse Calcifications.
Sae Hee KIM ; Moon Soo LEE ; Byung Sun CHO ; Joo Seung PARK ; Hyun Young HAN ; Dong Wook KANG
Journal of Gastric Cancer 2016;16(1):58-62
Gastrointestinal stromal tumors (GISTs) are the most common primary mesenchymal neoplasms of the gastrointestinal tract and usually appear as a well-circumscribed mass. However, it may be difficult to confirm the extent of the disease for some GISTs. A 70-year-old asymptomatic female presented for a regular physical exam. An esophagogastroduodenoscopy showed a 2.0 cm protruding mass on the gastric fundus. Endoscopic ultrasound revealed an ill-defined heterogenous hypoechoic lesion (3.0×1.5 cm). A computed tomography (CT) scan demonstrated a 4.5 cm multifocal calcified mass at the gastric body as well as at the gastric fundus. Laparoscopic gastric wedge resection was performed according to the extent of multifocal calcifications that are shown on the CT. Intraoperative specimen mammography and intraoperative biopsy might be helpful to obtain a tumor-free margin. Final pathologic diagnosis was an intermediate risk GIST in multilobular form. In patients with diffuse multifocal calcifications in the stomach, the possibility of GIST should be considered.
Aged
;
Biopsy
;
Calcinosis
;
Diagnosis
;
Endoscopy, Digestive System
;
Female
;
Gastric Fundus
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Gastrointestinal Stromal Tumors*
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Gastrointestinal Tract
;
Humans
;
Mammography
;
Stomach*
;
Ultrasonography
9.Widespread intracranial calcifications in a patient with hypoparathyroidism.
Jeong Young SEO ; Ju Hyun SEO ; Younghee CHOE ; Hannah SEOK ; Tae Seo SOHN
The Korean Journal of Internal Medicine 2016;31(2):409-410
No abstract available.
Basal Ganglia Diseases/diagnostic imaging/drug therapy/*etiology
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Calcinosis/diagnostic imaging/drug therapy/*etiology
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Calcium/therapeutic use
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Dietary Supplements
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Female
;
Humans
;
Hypoparathyroidism/*complications/diagnosis/drug therapy
;
Middle Aged
;
Tomography, X-Ray Computed
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Treatment Outcome
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Vitamin D/therapeutic use
10.Role of multiphasic multidetector CT imaging in differential diagnosis of small renal cell carcinoma.
Yanan ZHANG ; Wei GAO ; Bo ZHAO ; Xuening ZHANG ; Email: LUCKYXN@126.COM.
Chinese Journal of Oncology 2015;37(11):850-854
OBJECTIVETo explore the possibility of predicting the histopathological types of small renal cell carcinoma (RCC) by analyzing the different ways of enhancement with multiphasic multidetector computed tomography (MDCT) of small renal cell carcinomas (diameter≤4 cm).
METHODSCT images of 93 cases, diagnosed as RCC by pathology, were analyzed retrospectively, including 70 clear cell renal cell carcinoma (CCRCC), 13 papillary renal cell carcinoma (PRCC) and 10 chromophobe renal cell carcinoma (CRCC). All of the cases were examined by multiphasic multidetector CT scanning.
RESULTSIn plain scans, 46 CCRCCs were homogeneous, 21 CCRCCs were heterogeneous with low-density area and 3 of them had calcification. CCRCCs were enhanced in contrast scan with a presence of "wash in and wash out" enhancement in general. 11 PRCCs were homogeneous and 2 PRCCs had calcification. Slight-homogeneous enhancement and "delayed enhancement" were present in the PRCCs. Six CRCCs were homogeneous and 2 were calcified, 2 CRCCs were heterogeneous with low-density area. The CRCCs presented as slight or moderate enhancement and 5 CRCCs as homogeneous enhancement, while one CRCC was "spoke-wheel-like enhancement", with a trend of "delayed enhancement". Statistically significant differences were revealed among the actual enhanced CT values, the ratio of enhanced CT value to aorta CT value in the corticomedullary phase, nephrographic phase and excretory phase between the CCRCCs and non-CCRCCs (P<0.001). The analysis of receiver operating characteristic curves (ROC) revealed that when the actual enhanced CT value of tumors in CMP larger than 84.2 HU, the ratio of actual enhanced CT value to aorta CT value at the same phase in CMP larger than 0.315 were used as criteria to diagnose CCRCCs and excluded non-CCRCCs, the diagnostic value was best.
CONCLUSIONSMDCT is of an important significance in the diagnosis and differential diagnosis of small CCRCCs and non-CCRCCs.
Calcinosis ; diagnostic imaging ; Carcinoma, Papillary ; diagnostic imaging ; Carcinoma, Renal Cell ; diagnostic imaging ; Carcinoma, Small Cell ; diagnostic imaging ; Contrast Media ; Diagnosis, Differential ; Humans ; Kidney Neoplasms ; diagnostic imaging ; Multidetector Computed Tomography ; ROC Curve ; Retrospective Studies

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