Small intestinal lipomas: diagnostic value of multi-slice CT enterography.

AIM: To analyze the clinical and imaging features of the small intestinal lipomas and to evaluate the diagnostic value of multi-slice computed tomography (CT) enterography. METHODS: Fourteen cases (one had two intestinal lesions) of surgically confirmed lipomas of the small intestine were retrospectively analyzed. The location, size, clinical and radiological aspects were discussed. RESULTS: Twelve patients presented with abdominal pain, of whom three complained of paroxysmal colic. Melena or bloody stools was mentioned in five cases. One lesion was detected incidentally during routine physical examination. One lesion was found unexpectedly during the preoperational evaluation for cholecystitis. Examination of the abdomen revealed palpable masses in four cases. Precontrast CT scan showed round or oval well-defined hypo-intense intraluminal masses with the attenuation ranging from -130 HU to -60 HU. On contrast enhancement CT scan, no striking enhancement was seen. CONCLUSION: The small intestinal lipomas are rare and difficult to diagnose merely based on clinical manifestations, while the characteristic features at small intestinal CT enterography can help establish reliable prospective diagnoses.

Solid-pseudopapillary tumor of the pancreas: CT and MRI features of 3 cases.

BACKGROUND: Solid-pseudopapillary tumor of the pancreas is a rather rare but low-grade malignant tumor with good prognosis after surgical excision. METHODS: In 3 patients with solid-pseudopapillary tumor of the pancreas which were proved pathologically, the imaging features (CT in all and MRI in one patient) of the tumor were analyzed. RESULTS: In the 3 female patients under 35-year-old who presented no jaundice, CT revealed that huge solid-cystic masses of the pancreatic head with calcification in one and slight dilation of the pancreatic duct in another, but without dilation of the bile duct system in all. MRI demonstrated mixed signal intensity on T1WI and T2WI of the mass in one patient. CT and MRI revealed obvious enhancement of the cystic wall and solid part of the masses. CONCLUSIONS: CT and MRI findings of solid-pseudopapillary tumor of the pancreas are characteristic, and the diagnosis can be made preoperatively with the combination of clinical features.

[Angiographic diagnosis of gastrointestinal stromal tumors].

OBJECTIVE: To investigate the angiographic feature and its diagnostic value in gastrointestinal stromal tumor (GIST). METHODS: Twelve patients with pathologically proved GIST underwent angiography using PUCK and DSA one week before operation. The origin, size, morphology and angiographic appearance of the lesion were retrospectively analyzed. RESULTS: It was found that two tumors originated from stomach, eight from jejunum, and two from ileum. Seven cases were benign but five malignant. Obviously thickened and enlarged feeding artery was detected in eight tumors, and early-developed vein was found in three. Two types of angiographic changes of GIST were observed: 1) twisted irregular neoplastic vessels with partially coarse and indistinct margin were found in four cases, which were all malignant; 2) ball-like neoplastic vessels with homogeneous stain in tumor were found in eight cases, seven of them were benign but one was malignant. CONCLUSION: Angiography may be helpful in localization and diagnosis as well as defining the size of GIST, and especially in patients with melena of unknown origin.

Imaging features of ciliated hepatic foregut cyst.

Ciliated hepatic foregut cyst (CHFC) is a very rare cystic lesion of the liver that is histologically similar to bronchogenic cyst. We report one case of CHFC that was hard to distinguish from solid-cystic neoplasm in imaging features. Magnetic resonance imaging was helpful in differentiating these cysts from other lesions.

Angiographic findings of gastrointestinal stromal tumor.

AIM: To discuss the angiographic features of gastrointestinal stromal tumor (GIST) and to evaluate their diagnostic role. METHODS: Twelve patients with pathologically proved GIST underwent angiography (DSA)1 wk before operation, using Puck and digital subtraction DSA. The origin, size, morphology and angiographic appearance of the lesions were reviewed. RESULTS: Two tumors arose from stomach, 8 from jejunum, and 2 from ileum. Seven cases were benign and 5 were malignant. Obviously thickened supplying arteries were detected in 8 tumors, and early-developed veins were found in 3. Two types of angiographic changes of GIST were observed. Four cases had twisted irregular neoplastic vessels with partially coarse and indistinct margins, which were all malignant. Eight cases had ball-like neoplastic vessels with uniform tumor staining, of which 7 were benign and 1 was malignant. CONCLUSION: Angiography facilitates localization and diagnosis of GIST, helps define their size, range and location, and is especially valuable to patients suffering from melena with unknown reasons.

[Radiological features of primary pulmonary non-Hodgkin lymphoma: report of three cases].

OBJECTIVE: To describe the radiographic and CT findings of primary pulmonary non-Hodgkin lymphoma (PPL),and to evaluate percutanous transthoracic needle biopsy (PTNB) in the diagnosis of PPL. METHODS: Chest radiographs and CT scans of three patients with histologically proven PPL were reviewed. The diagnosis of PPL was confirmed histologically with specimens obtained by means of PTNB. RESULTS: Consolidation with air bronchograms on the chest X-ray films and CT scans was found in all cases. Multiple ill-defined nodules of various size in both lungs and a mass with air bronchogram in the right lower lobe on the CT scan were present in one case. Ground-glass opacity or reticular lesions were present in both lung fields. Hilar/mediastinal adenopathy and pericardial/pleural effusion were not features of these cases. PTNB was diagnostic in all three cases. No complications occurred during these procedures. CONCLUSIONS: PPL has some specific imaging features. Radiographic and CT findings are helpful in the diagnosis of primary pulmonary malignant lymphoma. A specific diagnosis can be obtained by means of PTNB.