RESUMO
Syphilitic proctitis is a rare presentation of sexually transmitted infection that poses a diagnostic challenge as it mimics rectal cancer clinically, radiologically and endoscopically. We report a case of a 66-year-old male patient with a background of HIV infection presenting with obstructive bowel symptoms and initial diagnosis of rectal cancer on CT. Sigmoidoscopy and histopathology were non-diagnostic. A diagnosis of secondary syphilis was suspected after obtaining sexual history and diagnostic serology, avoiding planned surgical intervention.
Assuntos
Infecções por HIV , Obstrução Intestinal , Penicilinas/administração & dosagem , Proctite/diagnóstico , Neoplasias Retais/diagnóstico , Reto , Treponema pallidum , Idoso , Antibacterianos/administração & dosagem , Diagnóstico Diferencial , Infecções por HIV/complicações , Infecções por HIV/terapia , Humanos , Obstrução Intestinal/diagnóstico , Obstrução Intestinal/etiologia , Masculino , Proctite/etiologia , Proctite/fisiopatologia , Proctite/terapia , Reto/diagnóstico por imagem , Reto/microbiologia , Reto/patologia , Infecções Sexualmente Transmissíveis/diagnóstico , Infecções Sexualmente Transmissíveis/terapia , Sigmoidoscopia/métodos , Sífilis/complicações , Sífilis/diagnóstico , Sífilis/terapia , Tomografia Computadorizada por Raios X/métodos , Treponema pallidum/imunologia , Treponema pallidum/isolamento & purificaçãoRESUMO
Advances in the early detection and treatment of esophageal cancer have meant improved survival rates for patients with esophageal cancer. Accurate pretreatment and post-neoadjuvant treatment staging of esophageal cancer is essential for assessing operability and determining the optimum treatment plan. This article reviews the multimodality imaging approach in the diagnosis, staging, and assessment of treatment response in esophageal cancer.
Assuntos
Diagnóstico por Imagem , Neoplasias Esofágicas/diagnóstico por imagem , Neoplasias Esofágicas/terapia , Neoplasias Esofágicas/patologia , Humanos , Terapia Neoadjuvante , Estadiamento de NeoplasiasRESUMO
The prognosis and preferred management of breast implant-associated anaplastic large cell lymphoma is dependent on whether lymphoproliferative cells are confined to within the fibrous capsule, in an effusion or lining the fibrous capsule, or if there is spread beyond the capsule in the form of a mass lesion. We describe a case where 18F-fludeoxyglucose positron emission tomography-CT was used to confirm localized disease and guide management decisions.
RESUMO
We report a case of a patient who was found to have a uterine lipoleiomyoma on ultrasound and MRI, which was later confirmed with histological evidence. Uterine lipoleiomyomas are rare benign tumours that are often misdiagnosed on imaging, leading to unnecessary invasive procedures. Increased awareness of the tumour and its characteristics on imaging can aid future preoperative diagnosis.
Assuntos
Diagnóstico por Imagem/métodos , Leiomioma/diagnóstico , Lipoma/diagnóstico , Neoplasias Uterinas/diagnóstico , Biópsia por Agulha , Endossonografia/métodos , Feminino , Seguimentos , Humanos , Histeroscopia/métodos , Imuno-Histoquímica , Leiomioma/patologia , Leiomioma/cirurgia , Lipoma/patologia , Lipoma/cirurgia , Imageamento por Ressonância Magnética/métodos , Pessoa de Meia-Idade , Resultado do Tratamento , Neoplasias Uterinas/patologia , Neoplasias Uterinas/cirurgiaRESUMO
Menstrual complaints are common and include pain, abnormal bleeding, and menstrual irregularity. The etiology is wide-ranging and includes endometriosis, fibroids, adenomyosis, pelvic congestion syndrome, pelvic inflammatory disease, endometrial hyperplasia, and polyps. Polycystic ovarian syndrome and some congenital uterine anomalies may present with menstrual disturbance and have been included in this review. Transvaginal ultrasound is widely used as first-line investigation. Magnetic resonance imaging is used increasingly with high diagnostic accuracy and confidence. Its multiplanar capacity and superior tissue contrast resolution enable accurate presurgical mapping of fibroids, deep pelvic endometriosis, and adenomyosis. Similarly, accurate differentiation of congenital uterine anomalies depends on multiplanar imaging with either 3-dimensional ultrasound or magnetic resonance imaging. Recent advances in imaging and radiological intervention, combined with an understanding of the underlying causes of menstrual dysfunction, therefore aid in accurate diagnosis and optimal treatment planning.
Assuntos
Doenças dos Genitais Femininos/diagnóstico , Imageamento por Ressonância Magnética/métodos , Distúrbios Menstruais/diagnóstico , Ultrassonografia de Intervenção/métodos , Doenças Uterinas/diagnóstico , Diagnóstico Diferencial , Dismenorreia/complicações , Dismenorreia/diagnóstico , Hiperplasia Endometrial/complicações , Hiperplasia Endometrial/diagnóstico , Endometriose/complicações , Endometriose/diagnóstico , Feminino , Doenças dos Genitais Femininos/complicações , Genitália Feminina/diagnóstico por imagem , Genitália Feminina/patologia , Humanos , Imageamento Tridimensional/métodos , Leiomioma/complicações , Leiomioma/diagnóstico , Distúrbios Menstruais/complicações , Doença Inflamatória Pélvica/complicações , Doença Inflamatória Pélvica/diagnóstico , Pelve/irrigação sanguínea , Síndrome do Ovário Policístico/complicações , Síndrome do Ovário Policístico/diagnóstico , Pólipos/complicações , Pólipos/diagnóstico , Sensibilidade e Especificidade , Doenças Uterinas/complicações , Doenças Uterinas/congênito , Hemorragia Uterina/complicações , Hemorragia Uterina/diagnóstico , Malformações Vasculares/complicações , Malformações Vasculares/diagnósticoRESUMO
The purpose of this retrospective medical audit was to evaluate the effect of discontinuing routine administration of oral contrast material to oncology patients undergoing follow-up multidetector computed tomography (CT) on reader evaluation of study adequacy. Analysis of 100 patients' experience of CT shows that positive oral contrast material was their least pleasant experience (P < .0001). Abandoning the routine use of positive oral contrast material for follow-up scans in general oncology patients undergoing multidetector CT, with section reconstruction thickness of 2.5 mm, was audited for 447 patents and included 5-13-month follow-up. The patient satisfaction study and clinical audit were performed according to local institutional audit guidelines. Since this was a clinical audit project, ethical approval was not required under UK National Health Service research governance arrangements. No patient needed to be recalled, no related diagnostic error has been reported, and follow-up CT, available in 285 of 447 cases (64%), revealed no error on the audited scan. We conclude that the routine use of positive oral contrast material is unnecessary for follow-up multidetector CT for general oncology indications.