The diagnosis of cystic liver disease has made great progress with the advent of enhanced imaging techniques. At the same time, its management has gradually improved over the past few decades, providing the basis for the development of appropriate diagnostic and treatment guidelines. To this end, the European Association for the Study of the Liver has developed clinical guidelines for the diagnosis and treatment of non-infectious cystic liver disease. This guideline put forward recommendations based on an in-depth review of the relevant literature for addressing clinical issues, including the diagnosis and treament of hepatic cysts, hepatic mucocystic tumors, biliary hamartomas, polycystic liver disease, Caroli disease or Caroli syndrome, biliary hamartomas, and peribiliary cyst.
Humans ; Liver Diseases/pathology* ; Cysts/pathology* ; Caroli Disease/diagnosis* ; Liver Neoplasms/therapy* ; Hamartoma

PURPOSE: The prevalence of supernumerary teeth has been reported to be between 0.1% and 3.8%. The aim of this study was to determine the prevalence, clinical significance, and associated pathologies of fourth molars based on a retrospective study and a literature review. MATERIALS AND METHODS: A 5-year retrospective prevalence study was conducted at the Department of Oral Diagnosis and Dentomaxillofacial Radiology of Okayama University Hospital, Okayama, Japan. The study involved extracting data from the digital records of patients from January 1, 2013 through December 31, 2017. The sampling frame included all patients who had panoramic radiographs, cone-beam computed tomography (CT), and multislice CT images during the period under review. RESULTS: A total of 26,721 cases were reviewed and 87 fourth molars were identified. The prevalence of fourth molars in the 5-year study at Okayama was calculated as 0.32%. The mean age of patients with a fourth molar was 30.43 years, and the male-to-female ratio was 1:0.98. The vast majority of cases were in the maxilla (92%) and had normal shapes (89.7%); furthermore, 82.8% of cases were unerupted. CONCLUSION: The prevalence of fourth molars in the study population was found to be 0.32%, and fourth molars occurred with approximately equal frequency in males and females. Fourth molars were more common in the maxilla and were predominantly unerupted and small.
Cone-Beam Computed Tomography ; Cross-Sectional Studies ; Diagnosis, Oral ; Female ; Humans ; Japan ; Male ; Maxilla ; Odontogenic Cysts ; Odontoma ; Pathology ; Prevalence ; Retrospective Studies ; Tooth, Supernumerary

In this study, we describe our diagnosis and treatment of two patients who presented with femoral vessel compression caused by a cystic lesion in the groin. One case was diagnosed as adventitial cystic disease (ACD) of the common femoral artery resulting in leg claudication and the other was diagnosed as a ganglion cyst (GC) causing femoral vein compression and unilateral leg swelling. The operative findings differed between these two cases with respect to the dissection of the cyst and femoral vessel, but the postoperative histological examination results were similar. The pathogenesis of ACD and GC is not fully understood, and further investigation is needed to delineate the exact pathology of these uncommon conditions.
Adventitia ; Diagnosis ; Femoral Artery ; Femoral Vein ; Ganglion Cysts ; Groin* ; Hip ; Humans ; Leg ; Pathology

Congenital cysts of the gallbladder are extremely rare, hence only a few ciliated foregut cysts of gallbladder have been reported. We report a case of a 20-year-old woman presenting with mild right upper quadrant abdominal discomfort, with normal levels of serum bilirubin and liver function tests. Abdominal ultrasonography revealed a well-defined cystic mass measured about 2 cm attached to the neck of gallbladder, with internal echogenic debris suggesting a complicated cyst, such as a hemorrhagic cyst. Abdominal computed tomography and magnetic resonance cholangiopancreatography revealed similar findings. Laparoscopic cholecystectomy showed a slightly distended gallbladder. The size of cyst on the neck was 1.6x1.2 cm, and it contained mucosa lined by ciliated pseudostratified columnar epithelium and underlying smooth muscle layers. Histopathology identified a ciliated foregut cyst of gallbladder.
Abdomen/diagnostic imaging ; Cholangiopancreatography, Magnetic Resonance ; Cholecystectomy, Laparoscopic ; Cysts/diagnostic imaging/pathology/surgery ; Female ; Gallbladder/pathology/surgery ; Gallbladder Diseases/*diagnosis ; Humans ; Tomography, X-Ray Computed ; Ultrasonography ; Young Adult

Intracranial lesions may show contrast enhancement through various mechanisms that are closely associated with the disease process. The preferred magnetic resonance sequence in contrast imaging is T1-weighted imaging (T1WI) at most institutions. However, lesion enhancement is occasionally inconspicuous on T1WI. Although fluid-attenuated inversion recovery (FLAIR) sequences are commonly considered as T2-weighted imaging with dark cerebrospinal fluid, they also show mild T1-weighted contrast, which is responsible for the contrast enhancement. For several years, FLAIR imaging has been successfully incorporated as a routine sequence at our institution for contrast-enhanced (CE) brain imaging in detecting various intracranial diseases. In this pictorial essay, we describe and illustrate the diagnostic importance of CE-FLAIR imaging in various intracranial pathologic conditions.
Arachnoid Cysts/*diagnosis/pathology ; Brain/*pathology ; Brain Neoplasms/*diagnosis/pathology ; Contrast Media ; Humans ; Magnetic Resonance Imaging/*methods

OBJECTIVEThis study described the clinical, surgical, and radiographic findings of simple bone cysts.

METHODSA retrospective study was conducted for patients diagnosed with simple bone cysts in the Department of Oral and Maxillofacial Surgery of the Affiliated Stomatological Hospital of Nanchang University from March 2005 to March 2015. Clinical, radio-graphic, surgical, and follow-up data were gathered. Results were statistically analyzed by central tendency and dispersionusing SPSS 20.0 software.

RESULTSEleven cases of simple bone cysts were collected, including three male and eight female patients. Ten cases (90.9%) were asymptomatic and one case developed symptoms of swelling. All of the cases had no history of trauma in the affected area, and all were solitary; ten cases (90.9%) were unilocular, and one (9.1%) was multilocular.The shape of each lesion could be assigned to four categories: cone (3 cases), round (2 cases), oval (4 cases), and irregular (2 cases). The treatment in 10 cases consisted of surgery to explore the cavity and curettage of the bone walls. During surgery,the bone cavity in seven cases (70%) was vacant, whereas serous fluid was found in two cases (20%) and serous-bloody fluid in one case (10%). Of the ten cases, three cases exhibited complete bone healing and seven cases showed new bone formation.

CONCLUSIONSimple bone cysts of the jaws are usually asymptomatic and appear incidentally on routine radiographies. The prevalence is higher in the mandible and young people. The patient usually has no history of trauma, and the bone cavity of lesion is mostly vacant. Curettage of the bone walls of the lesion is suggested for simple bone cysts. Systemic clinical and radiologic follow-up are necessary to ensure successful treatment.

Bone Cysts ; Dental Caries ; Female ; Hospitals ; Humans ; Jaw Cysts ; diagnosis ; pathology ; Male ; Mandible ; Mandibular Diseases ; Radiology ; Retrospective Studies ; Software

Van Wyk-Grumbach syndrome (VWGS) is a rare complication of prolonged untreated juvenile hypothyroidism characterized by precocious puberty and enlarged multicystic ovaries. A 13-year-old girl visited our outpatient clinic due to menstrual irregularities. She had precocious puberty, pituitary hyperplasia and multiple cystic ovaries in addition to clinical signs of severe congenital hypothyroidism. After the initiation of L-thyroxine therapy, the symptoms were alleviated in a short time. This rare syndrome is easy to be misdiagnosed as pituitary and ovarian tumor. High degree of suspicion and timely diagnosis can prevent unnecessary surgical procedures because the symptoms can be reversed with thyroid hormone supplementation.
Adolescent ; Congenital Hypothyroidism ; complications ; diagnosis ; etiology ; Diagnosis, Differential ; Diagnostic Errors ; Female ; Humans ; Hyperpituitarism ; Hyperplasia ; Menstruation Disturbances ; etiology ; Ovarian Cysts ; diagnosis ; etiology ; Ovary ; pathology ; Pituitary Gland ; pathology ; Puberty, Precocious ; diagnosis ; etiology ; Syndrome ; Thyroxine ; therapeutic use

Intra-articular ganglion cysts of the anterior cruciate ligament (ACL) are rare, and bilateral ganglion cysts are even rarer. These cysts may cause intermittent or chronic nonspecific knee discomfort. Although three cases of bilateral ganglion cysts have been reported in the literature, the knees were not simultaneously affected in those cases. Herein, we report the case of a 56-year-old woman who presented with simultaneous bilateral ganglion cysts of the ACL that were symptomatic. She was successfully treated with arthroscopic resection and debridement. We also present a brief review of the literature, highlighting the aetiology, diagnosis and management of ganglion cysts of the ACL. To the best of our knowledge, this is the first report of simultaneous bilateral intra-articular ganglion cysts of the ACL.
Anterior Cruciate Ligament ; pathology ; surgery ; Arthroscopy ; methods ; Debridement ; methods ; Delayed Diagnosis ; Female ; Ganglion Cysts ; diagnosis ; surgery ; Humans ; Magnetic Resonance Imaging ; Middle Aged

OBJECTIVETo investigate the value of magnetic resonance three dimensional sampling perfection with application optimized contrasts using different flip angle evolution (3D-SPACE) sequences in diagnosis and surgical strategy modification for obstructive hydrocephalus.

METHODSFrom March 2013 to July 2014, there were 152 cases admitted in People's Liberation Army General Hospital suffered from hydrocephalus, including 88 male patients and 64 female patients aging from 8 months to 79 years. All patients were performed magnetic resonance T2WI and 3D-SPACE sequence scanning before operation. Surgical strategy was made after evaluation of 3D-SPACE sequence. Non-communicating hydrocephalus was treated with endoscopic third ventriculostomy (ETV) and communicating hydrocephalus was treated with ventriculo-peritoneal shunt. According to MR images of direct observation to site of obstruction to determine the detection rate. MRI 3D-SPACE and cranial CT examination were performed in regular follow-up studies.

RESULTSThe relevance ratio of 3D-SPACE for the diagnosis of non-communicating hydrocephalus was 98.3% (114/116), while the relevance ratio of conventional T2-weighted MRI was 72.4% (84/116). Among the 152 patients, there were 36 cases with cerebral aqueduct film obstruction, 22 cases with space-occupying lesions in pineal region, posterior part of the third ventricle, or space-occupying lesions in quadrigeminal bodies area, 10 cases with Dandy-Walker symptom, 18 cases with cyst of the anterior pool of the bridge, 16 cases with cysticercosis, 4 cases with cyst of lateral ventricle, 2 cases with cyst of fourth ventricle, 2 cases with space-occupying lesion in foramen ofmonro, 2 cases with foramen ofmonro atresia, 4 cases with craniopharyngioma, 36 cases with communicating hydrocephalus. There were 112 hydrocephalus cases (73.7%) were treated with ETV, without shunt catheter insertion in follow-up study from 1 to 18 months (average (14±9) months).

CONCLUSIONSFor obstructive hydrocephalus, MRI 3D-SPACE sequence image has high diagnostic yield rate for providing more detailed anatomical information than conventional MRI. Hence, the advanced imaging methods are helpful for surgical treatment strategy decision making.

Adolescent ; Adult ; Aged ; Child ; Child, Preschool ; Craniopharyngioma ; pathology ; Cysts ; pathology ; Female ; Follow-Up Studies ; Humans ; Hydrocephalus ; diagnosis ; surgery ; Imaging, Three-Dimensional ; Infant ; Magnetic Resonance Imaging ; Male ; Middle Aged ; Pineal Gland ; pathology ; Third Ventricle ; Ventriculostomy ; Young Adult

OBJECTIVETo study the pathology, imaging and clinical features of a child with trisomy 21 syndrome associated interstitial lung disease.

METHODData of a case with trisomy 21 syndrome associated interstitial lung disease confirmed by lung imaging and pathology were collected, analyzed and the related reports in literature were reviewed.

RESULTThe patient was a one year and 7 months old boy who suffered from severe pneumonia and recurrent infection during his hospital stay. When his disease was stable, he did not have shortness of breath and cyanosis, but a chest computed tomography (CT) showed ground-glass opacity, regional emphysema, band-like change in lung parenchyma, which indicated interstitial lung diseases. Unequal air inflation in bilateral lungs and diffuse over-distension of peripheral air spaces in lung surface were seen through thoracoscope. Pathological examination indicated that alveolar, alveolar ducts and alveolar sac were enlarged, alveolar septa was expanded. There were two reports in lung pathology of trisomy 21 syndrome, alveolar growth abnormalities was seen in 86%-88% cases. The multiple subpleural cysts in chest CT was characteristic. Clinically, trisomy 21 syndrome had high morbidity of respiratory tract infection and progress to respiratory failure frequently. Prolonged postoperative desaturation was constant which required long duration of respiratory support.

CONCLUSIONTrisomy 21 syndrome associated alveolar growth abnormalities were confirmed, which manifest as alveolar simplification in pathology and interstitial lung diseases in imaging. The risk of respiratory failure in these cases caused by infection and surgery should be considered.

Cysts ; pathology ; Down Syndrome ; complications ; Humans ; Infant ; Lung ; pathology ; Lung Diseases, Interstitial ; diagnosis ; etiology ; Male ; Postoperative Period ; Pulmonary Alveoli ; pathology ; Respiratory Insufficiency ; Respiratory Tract Infections ; Tomography, X-Ray Computed