Superior mesenteric artery embolism associated with Cisplatin-induced aortic thrombosis.

Cardiovascular complications of cancer therapy are among the most important factors affecting cancer prognosis. Cisplatin-induced aortic thrombosis is rare but can be life-threatening in the event of peripheral embolism. In this report, we describe a case of superior mesenteric artery (SMA) embolism associated with cisplatin-induced aortic thrombosis. A 66-year-old male, diagnosed with esophageal cancer, initiated systemic chemotherapy with a regimen consisting of 5-fluorouracil and cisplatin, combined with radiotherapy. After 7 days of chemoradiotherapy, the patient developed a floating thrombus in the ascending aorta and an SMA embolism; chemoradiotherapy was then discontinued. Laparoscopy revealed an ischemic small intestine that required resection; intravenous unfractionated heparin was initiated 3 days after. Computed tomography showed disappearance of the floating aortic thrombus and reduce SMA thrombus size. Early detection of cisplatin-induced aortic thrombosis may prevent fatal outcomes in symptomatic peripheral embolisms, such as SMA embolism, considering anticoagulation, and discontinuation of cisplatin-based chemotherapy may cause resolution of thrombus events.

Sight-threatening optic neuropathy is associated with paranasal lymphoma.

Malignant lymphoma around the orbit is very rare. We present a rare case of optic neuropathy caused by lymphoma. A 61-year-old Japanese woman was referred to our hospital for evaluation of idiopathic optic neuropathy affecting her right eye. The patient was treated with steroid pulse therapy (methyl-predonisolone 1 g daily for 3 days) with a presumed diagnosis of idiopathic optic neuritis. After she had been switched to oral steroid therapy, endoscopic sinus surgery had been performed, which revealed diffuse large B cell lymphoma of the ethmoidal sinus. Although R-CHOP therapy was immediately started, prolonged optic nerve compression resulted in irreversible blindness. Accordingly, patients with suspected idiopathic optic neuritis should be carefully assessed when they show a poor response, and imaging of the orbits and brain should always be done for initial diagnosis because they may have compression by a tumor.

Focal liver lesions: breathhold gradient- and spin-echo T2-weighted imaging for detection and characterization.

PURPOSE: To evaluate breathhold gradient- and spin-echo (GRASE) T2-weighted imaging for the detection and characterization of focal liver lesions. MATERIALS AND METHODS: Two GRASE sequences with different echo times (75 and 90 msec, GRASE75 and GRASE90) were compared with respiratory-triggered fast spin-echo (SE) and breathhold fast SE in 64 patients with 103 malignant and 51 benign lesions. Compared with respiratory-triggered and breathhold fast SE, GRASE reduced scan time by 77% to 82% and 21% to 27%, respectively. Two independent readers evaluated image quality and reviewed 504 liver segments on a segment-by-segment basis. Observer performance was evaluated with receiver operating characteristic (ROC) curve analysis. The signal-to-noise ratio (SNR) of liver and spleen, and lesion-to-liver contrast-to-noise ratio (CNR) were also measured. RESULTS: The overall quality of the GRASE images was higher than that of the respiratory-triggered and breathhold fast SE images, although signal inhomogeneities were more frequently observed with GRASE. No significant difference in the values of the area under the ROC curve (Az) for malignant lesion detection was found. The mean SNR and CNR were highest for respiratory-triggered fast SE. CONCLUSION: T2-weighted breathhold GRASE has the potential to provide faster liver imaging.

Fat necrosis of breast: a potential pitfall in breast MRI.

Fat necrosis is a benign nonsuppurative inflammatory process of adipose tissue. Occasionally fat necrosis may mimic a breast cancer clinically, mammographically, and sonographically. There have been some previous reports on the MR imaging of the fat necrosis. In some MR findings of fat necrosis, it was difficult to distinguish it from malignant lesions. We report a case of fat necrosis presenting the irregular enhancement with the non-enhancing area of central areas on MRI.

Inflammatory intramammary lymph node mimicking the malignant lesion in dynamic MRI: a case report.

Enlarged intramammary lymph node (LN) may be caused by inflammation [Arch. Surg. 109 (1974) 759.], reaction to dermatitis [Radiology 137 (1980) 15.], tuberculosis [Histopathology 17 (1990) 91.], foreign body such as gold [Hum. Pathol. 19 (1988) 992.], neoplasm including metastasis [Arch. Surg. 109 (1974) 759; AJR, Am J Roentgenol 146 (1986) 133.], and malignant lymphoma [AJR, Am J Roentgenol 161 (1993) 779.]. It is difficult to distinguish benign enlarged LNs from malignant lesion clinically, mammographically, and sonographically. There have been a few reports on the magnetic resonance imaging (MRI) of enlarged intramammary LNs in the English literature. In this article, we present a case in which dynamic MRI indicated inflammatory LNs as highly suspicious of malignancy.

Hepatic involvement of visceral larva migrans due to Toxocara canis: a case report--CT and MR findings.

Imaging findings of hepatic lesions of visceral larva migrans are reported. A 44-year-old man presented with chills, eruptions, marked leukocytosis (31,400/microlitter), and eosinophilia (eosinophil, 72%). Multiple liver nodules were detected as low-density lesions on computed tomography (CT). They were visualized as high signal intensity lesions on T2-weighted, and as low signal intensity lesions on T1-weighted magnetic resonance imaging (MRI). The patient was diagnosed as having visceral larva migrans due to Toxocara canis, by Toxocara immnoserological test. After antihelmintic therapy, multiple liver nodules disappeared on CT. We consider that the differential diagnosis of multiple liver nodules should include visceral larva migrans.