No abstract

Objectives: To review the disease pattern of synovial sarcoma in a tertiary sarcoma centre in Hong Kong. Methods: Patients with a histological diagnosis of synovial sarcoma from June 2000 to June 2014 were recruited. Patient data were collected using the electronic Patient Record System and available images were reviewed using the Picture Archiving and Communication System. Kaplan-Meier analysis was performed for overall survival. Multivariate Cox regression was performed to evaluate potential prognostic factors. Results: A total of 45 consecutive patients with a mean age of 39 years and male-to-female ratio of 1:1.05 were recruited. Tumours were evident in the lower extremities in 28 (62%) cases, in the upper extremities in four (9%), and elsewhere in 13 (29%). The mean duration of symptoms to diagnosis was 1.5 years. The mean tumour size was 7.0 cm. Metastatic disease was present in 11 (24%) patients at initial diagnosis. The most common site of metastasis was the lung. Nineteen patients died of synovial sarcoma during follow-up. The median survival time was 7.5 years. Tumour size of >5 cm (hazard ratio [HR] = 10.06; 95% confidence interval [CI], 1.30-78.15; p = 0.027) and presence of metastasis at diagnosis (HR = 5.56; 95% CI, 1.20-25.77; p = 0.028) were significant adverse prognostic factors after adjustment for age, gender, tumour location, histological subtypes, and adjuvant therapy. Conclusion: Tumour size of >5 cm and presence of metastasis at diagnosis were identified as adverse prognostic factors.

Primary pericardial osteosarcoma is exceedingly rare, with only a few reported cases in the literature. We describe the clinical, radiological, and pathological features of a left primary pericardial osteosarcoma in a 72-year-old man.

1 Effects of oral administration of equipotent antihypertensive doses of propranolol and nadolol on renal function were examined in 20 hypertensive patients with moderately impaired renal function. 2 Creatinine clearance increased, and serum 32-microglobulin concentrations decreased, when patients were switched from propranolol to nadolol therapy (creatinine clearance = 46.7 + 4.9 ml mint-on propranolol and 52.7 + 5.9 on nadolol; P2-microglobulin = 6.14 ± 0.66 mg 1-1 on propranolol and 5.62 + 0.62 on nadolol). When patients were put back on propranolol, their creatinine clearances (45.9 + 5.0 ml min7l) and serum 132-microglobulin concentrations (6.51 + 0.67 mg 1-1) returned to values comparable to those obtained before the change to nadolol was made. 3 Serum 132-microglobulin concentrations correlated significantly with creatinine clearance (r = -0.819, P < 0.001).

No abstract

No abstract

Objectives: To assess the diagnostic performance and clinical efficacy of metal artefact reduction using monoenergetic imaging with dual-energy computed tomography (DECT). Materials: A total of 30 patients with 32 metal device regions were examined using the DECT protocol with 100 kVp and 140 kVp spectra. Specific post-processing software was used to generate optimised monoenergetic images and standard combined images by filtered back projection. Two independent observers subjectively graded the degree of artefact and diagnostic quality of the two sets of images on a five-point rating scale. The beamhardening artefact (mean density of the most pronounced streak 1 cm from the device) was compared between both groups. Qualitative assessment by type of device (internal or external device) was performed. Results: A total of 32 examinations with 19 internal, 10 external, and 3 internal + external implanted metal devices were performed. Monoenergetic imaging was rated superior for artefact reduction in 75% cases and for diagnostic quality in 78% cases, compared with standard combined imaging by filtered back projection (p < 0.001). The mean density of beam hardening artefacts improved from-725.22 HU in standard combined imaging to-519.02 HU using monoenergetic imaging (p = 0.025). The presence of an external metal device adversely affected the artefact reduction performance of monoenergetic imaging (p = 0.045), without significantly affecting diagnostic quality. Conclusion: Monoenergetic extrapolation using DECT can significantly reduce metal artefact and improve diagnostic quality compared with filtered back projection. Its performance was adversely affected by the presence of an external device.

Primary pericardial lymphoma is rare in immunocompetent patients. Its symptoms are non-specific and may lead to a delayed diagnosis. Early detection and characterisation by computed tomography and positronemission tomography-computed tomography, and prompt intervention can result in a favourable prognosis. We report a case of primary pericardial lymphoma in an immunocompetent man who underwent chemotherapy and achieved complete resolution. Clinical, radiological, and pathological manifestations, and differential diagnoses are described.