Granulomatous inflammation with multinucleated giant cells is observed in various infectious and noninfectious diseases. It has been found in association with malignant tumors and designated sarcoid-like reaction. The distinction between a tumor-related granulomatous reaction and a true sarcoidosis can be a problematic issue. A case of renal cell carcinoma with sarcomatoid features (Fuhrman nuclear grade IV) with an extensive peritumoral sarcoid-like reaction and a critical review of the few cases of this association described in the literature have been reported, and the problematic clinical and pathological assessments of such lesions are discussed.
Background: Gastrointestinal stromal tumors (GISTs) represent the majority of primary nonepithelial neoplasms of the digestive tract, most frequently expressing the KIT protein detected by the immunohistochemical staining for the CD117 antigen. Extra-gastrointestinal stromal tumors (EGISTs) are neoplasms with overlapping immunohistological features, occurring in the abdomen outside the gastrointestinal tract with no connection to the gastric or intestinal wall.
Background: Congenital cystic adenomatoid malformation (CCAM) of the lung is an uncommon fetal development anomaly of the terminal respiratory structures. The large cyst type usually occurs in stillborn infants or newborn infants with respiratory distress. Cases of CCAM have been previously described in adulthood, more often type I with multiloculated cystic lesions.
The outbreak of novel coronavirus disease 2019 in the city of Wuhan, Hubei Province, China, was declared a pandemic by the World Health Organization (WHO) on March 21, 2020. Since then, this outbreak has forced the scientific community to consider two fundamental aspects: severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), the causative agent of COVID-19, does not only cause pneumonia, and the death of many critically ill patients is caused by multiple organ failure (involving the heart, liver, kidneys, blood, and immune system) (Wang et al., 2020). Therefore, attention should be paid to potential multiorgan injury, and its prevention should be part of the treatment of COVID-19, especially in critically ill patients (Wang et al., 2020).Since the first report of COVID-19 pneumonia by Zhu et al. (Zhu et al., 2020), several studies have been published highlighting the role of chest computed tomography (CT) in detecting typical and atypical parenchymal patterns and in assessing the evolution over time of COVID-19 pneumonia (Chung et al., 2020;Pan et al., 2020). Other findings include enlarged subsegmental pulmonary vessels in 59-89% of COVID-19 pneumonia cases (Bai et al., 2020;Caruso et al., 2020), which could be related to pro-inflammatory factors or hyperaemia (Ye et al., 2020;Li et al., 2003). Pulmonary thromboembolism has been reported on CT in patients with COVID-19 pneumonia with high D-dimer levels (Danzi et al., 2020;Xie et al., 2020), and in COVID-19 patients with normal D-dimer levels, without strong predisposing risk factors for venous thromboembolism (VTE) (Chen et al., 2020).At the moment it is unclear whether hospitalized patients with COVID-19 have a greater risk of VTE than other patients who have chest infections and elevated D-dimer values (Darzi et al., 2020 Feb 24). Critically ill patients are likely to be at increased risk of VTE, especially if they become immobilized on critical care. However, the risk of VTE must be assessed in all patients admitted to the hospital, and prevention should be administered to all high-risk patients according to international guidance on thromboprophylaxis (Anderson et al., 2019). Lee et al. (Lee et al., 2020) performed an observational study and suggested that up to 5-10% of patients with COVID-19 who require mechanical ventilation have acute pulmonary embolism and/or deep venous thrombosis.Coronavirus causes direct endothelial cell injury to the microvessels, with subsequent release of damaged endothelial cells into the bloodstream (Zhang et al., 2020 Mar). Patients with severe COVID-19 are often immobile and present with an acute inflammatory state that leads to hypercoagulability. Therefore pulmonary thromboembolism may be considered in
BackgroundThe aim is to assess the time-density curves (TDCs) and correlate the histologic results for small (≤ 2 cm) PDA and surrounding parenchyma at triphasic Multidetector-row CT (MDCT).MethodsTriphasic MDCT scans of 38 consecutive patients who underwent surgery for a small PDA were retrospectively reviewed. The TDCs were analyzed and compared with histologic examination of the PDA and pancreas upstream/downstream in all cases. Three enhancement patterns were identified: 1) enhancement peak during pancreatic parenchymal phase (PPP) followed by a rapid decline on portal venous phase (PVP) and delayed phase (DP) at 5 minutes (type 1 pattern: normal pancreas); 2) maximum enhancement in PVP that gradually decreases in DP (type 2 pattern: mild chronic pancreatitis or PDA with mild fibrous stroma); 3) progressive enhancement with maximum peak in DP (type 3 pattern: severe chronic pancreatitis or PDA with severe fibrous stroma). A p value less than 0.05 was considered statistically significant. Sensitivity was calculated for PDA detection and an attenuation difference with the surrounding tissue of at least 10 HU was considered.ResultsPDA showed type 2 pattern in 5/38 cases (13.2%) and type 3 pattern in 33/38 cases (86,8%). Pancreas upstream to the tumor had type 2 pattern in 20/38 cases (52,6%) and type 3 pattern in 18/38 cases (47,4%). Pancreas downstream to the tumor had type 1 pattern in 19/25 cases (76%) and type 2 pattern in 6/25 cases (24%). Attenuation difference between tumor and parenchyma upstream was higher of 10 UH on PPP in 31/38 patients (sensitivity = 81.6%), on PVP in 29/38 (sensitivity = 76.3%) and on DP in 17/38 (sensitivity = 44.7%). Attenuation difference between tumor and parenchyma downstream was higher of 10 UH on PPP in 25/25 patients (sensitivity = 100%), on PVP in 22/25 (sensitivity = 88%) and on DP in 20/25 (sensitivity = 80%). Small PDAs were isodense to the pancreas upstream to the tumor, and therefore unrecognizable, in 8 cases (8/38; 21%) at qualitative analysis and in 4 cases (4/38; 10,5%) at quantitative analysis.ConclusionsThe quantitative analysis increases the sensitivity for detection of small PDA at triphasic MDCT.
scite is a Brooklyn-based organization that helps researchers better discover and understand research articles through Smart Citations–citations that display the context of the citation and describe whether the article provides supporting or contrasting evidence. scite is used by students and researchers from around the world and is funded in part by the National Science Foundation and the National Institute on Drug Abuse of the National Institutes of Health.
hi@scite.ai
10624 S. Eastern Ave., Ste. A-614
Henderson, NV 89052, USA
Copyright © 2024 scite LLC. All rights reserved.
Made with 💙 for researchers
Part of the Research Solutions Family.