Pancreatic ductal adenocarcinoma is the most common malignant tumor of the pancreas. The remaining pancreatic tumors are a diverse group of pancreatic neoplasms that comprises cystic pancreatic neoplasms, endocrine tumors and other uncommon pancreatic tumors. Due to the excellent soft tissue contrast resolution, magnetic resonance imaging (MRI) is frequently able to readily separate cystic from noncystic tumors. Cystic tumors are often easy to diagnose with MRI; however, noncystic non-adenocarcinoma tumors may show a wide spectrum of imaging features, which can potentially mimic ductal adenocarcinoma. MRI is a reliable technique for the characterization of pancreatic lesions. The implementation of novel motion-resistant pulse sequences and respiratory gating techniques, as well as the recognized benefits of MR cholangiopancreatography, make MRI a very accurate examination for the evaluation of pancreatic masses. MRI has the distinctive ability of non-invasive assessment of the pancreatic ducts, pancreatic parenchyma, neighbouring soft tissues, and vascular network in one examination. MRI can identify different characteristics of various solid pancreatic lesions, potentially allowing the differentiation of adenocarcinoma from other benign and malignant entities. In this review we describe the MRI protocols and MRI characteristics of various solid pancreatic lesions. Recognition of these characteristics may establish the right diagnosis or at least narrow the differential diagnosis, thus avoiding unnecessary tests or procedures and permitting better management.
Neuroendocrine (NE) cells represent the third epithelial cell type on normal prostatic tissue (in addition to basal and secretory cells). They are localized in all regions of the human prostate at birth but rapidly decrease in the peripheral prostate after birth, and then reappear at puberty. After puberty, their number seems to increase until an apparently optimum level is reached, which persists between the age of 25 and 54. NE cells were defined by Pearse as APUD to refer to chemical characteristics of amine precursor uptake and decarboxylation, common to the cells of this system. The most predominant product of prostatic NE cells is Chromogranin A, but they also produce serotonin, CgB, secretogranin or CgC, thyroid-stimulating hormone-like peptide, calcitonin, katacalcin, PTHrP and a-human chorionic gonadotropin-like peptide. NE cells in normal and neoplastic prostates are devoid of androgen receptors, but they express epidermal growth factor (EGF) receptor and c-erbB-2. For these reason NE cells are androgen-insensitive. The NE component of prostate adenocarcinoma is resistant to hormone therapy; some studies showed that the number of NE tumor cells and CgA serum levels increase with the recovery of human prostate tumor from hormonal therapy. Currently there are no clinical data available to support an active role of radiotherapy in NE differentiation.
Bilateral adrenal hemorrhage is a rare potentially life-threatening event that occurs either in traumatic or nontraumatic conditions. The diagnosis is often complicated by its nonspecific presentation and its tendency to intervene in stressful critical illnesses. Due to many disorders in platelet function, hemorrhage is a major cause of morbidity and mortality in patients affected by myeloproliferative diseases. We report here the computed tomography and magnetic resonance imaging findings of a rare case of bilateral adrenal hemorrhage in a patient with myelodysplastic syndrome, emphasizing the importance of MRI in the differential diagnosis.
• A standardized MRI technique for assessing pelvic floor disorders is not yet established. • This study compares two MRI techniques based on different rectal filling: air-balloon versus gel. • Both MRI techniques proved to be valuable in assessing PFD, with good agreement. • Air-balloon technique is more hygienic and better tolerated than the gel-filling technique. • Gel was superior for rectal invagination, air-balloon for rectocele and uro-genital prolapses.
We report a case of primary colonic lymphoma incidentally diagnosed in a patient presenting a gallbladder attack making particular attention on the diagnostic findings at ultrasound (US) and total body computed tomography (CT) exams that allowed us to make the correct final diagnosis. A 85-year-old Caucasian male patient was referred to our department due to acute pain at the upper right quadrant, spreaded to the right shoulder blade. Patient had nausea and mild fever and Murphy's maneuver was positive. At physical examination a large bulky mass was found in the right flank. Patient underwent to US exam that detected a big stone in the lumen of the gallbladder and in correspondence of the palpable mass, an extended concentric thickening of the colic wall. CT scan was performed and confirmed a widespread and concentric thickening of the wall of the ascending colon and cecum. In addition, revealed signs of microperforation of the colic wall. Numerous large lymphadenopathies were found in the abdominal, pelvic and thoracic cavity and there was a condition of splenomegaly, with some ischemic outcomes in the context of the spleen. No metastasis in the parenchimatous organs were found. These imaging findings suggest us the diagnosis of lymphoma. Patient underwent to surgery, and right hemicolectomy and cholecystectomy was performed. Histological examination confirmed our diagnosis, revealing a diffuse large B-cell lymphoma. The patient underwent to Cyclophosphamide, Hydroxydaunorubicin, Oncovin, Prednisone chemotherapy showing only a partial regression of the lymphadenopathies, being in advanced stage at the time of diagnosis.
The given names and family names of all authors were transposed in the original publication. The correct names are as shown above.The online version of the original article can be found at http://dx.doi.
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.