Sarcoidosis-like reactions in metastatic renal cell carcinoma patients treated with immune-based combinations.

Aim: The incidence of drug-induced sarcoidosis-like reactions (DISR) in patients treated with immune checkpoint inhibitors (ICIs) is rising. We determine the incidence and characteristics of DISR in a metastatic renal cell carcinoma (mRCC) population. Methods: We retrospectively reviewed clinico-radiological data of 83 mRCC patients treated at a single institution with immune-based combinations. Results: 15 patients received immune-doublet (ipilimumab-nivolumab), while 68 patients received other immune-based combinations. Two cases of DISR (2.4%) were evidenced, with enlargement of mediastinal lymph nodes that mimicked disease progression, thus requiring a biopsy which showed histological features of DISR. Conclusion: In our series of the incidence of DISR, radiological and clinical features, are in line with literature. DISR diagnosis is often only radiological, and its occurrence is possibly associated with a better outcome.

The development of sarcoidosis-like lesions (DISR) is a rare event observed in cancer patients receiving immunotherapy. DISR occurrence represents a huge diagnostic issue, because its clinical and radiological features simulate disease progression. We present a series of 83 patients with kidney cancer receiving immunotherapy. During the therapy, two of these patients showed enlargement of chest lymph nodes that could be interpreted as disease progression. However, the microscopic analysis of these lymph nodes showed evidence of DISR. In conclusion, DISR should be adequately recognized to correctly manage patients who receive immunotherapy.

Correlation between imaging and histology in benign solitary retroperitoneal nerve sheath tumors: a pictorial review.

BACKGROUND: Benign nerve sheath tumors presenting as solitary retroperitoneal masses (RBNSTs) pose a complex diagnostic challenge for multidisciplinary teams regarding differential diagnosis, staging, and treatment planning. This article reviews the role played by different imaging techniques in assessing RBNSTs and elucidates their typical pathological features with a particular emphasis on the correlation between imaging and histological findings. Furthermore, some examples of retroperitoneal tumors that merit consideration in the process of differential diagnosis based on cross-sectional investigations (CSIs) are reported. The correlation between tissue architecture and appearance on imaging can help increase the accuracy of differential diagnosis with other retroperitoneal neoplasms at CSIs. CRITICAL RELEVANCE STATEMENT: This educational review critically examines the correlation between imaging and histological features in solitary retroperitoneal benign nerve sheath tumors, offering valuable insights for improving the accuracy of differential diagnosis in clinical radiology. KEY POINTS: RBNSTs are challenging to diagnose because they lack specific radiological features. Differential diagnosis of RBNSTs from other retroperitoneal neoplasms on imaging is complex. Surgical removal of RBNSTs is recommended for an accurate diagnosis.

Interrupted aortic arch: A case report.

Interrupted aortic arch diagnosed in adult age is a rare entity, with only a few cases published in the literature. Most of them are classified as type A interrupted aortic arch and differential diagnosis is associated with severe chronic coarctation. We present a case of a 52-year-old woman accessed to the emergency department for chest and right upper limb pain that increased in the last days. She underwent a computed tomography angiogram showing interruption of the aortic arch, distal to left subclavian artery origin, large bilateral collateral vessels connecting subclavian arteries to descending aorta with multiple voluminous aneurysms, a bicuspid aortic valve, dilatated tubular segment of ascending thoracic aorta, and a suspected atrial septal defect. A nonsystematic literature review regarding these conditions has been performed.

Ultrasound findings in the omental bursa: a short pictorial essay.

The omental bursa is a complex and important anatomical region. It serves as a barrier to block pathological processes, but it is also a channel for disease spread in the abdominal cavity. It is a large recess of the peritoneal cavity formed by a double-layered fold of serous peritoneum situated inferiorly to the liver, posteriorly to the lesser omentum and the stomach and anteriorly to the pancreas. Ultrasound (US) has an important role in the study of the omental bursa, as it is generally the first examination to be performed in the presence of abdominal pain. US is inexpensive, widely available and able to identify many of the alterations that may occur in the abdomen. However, US findings are often varied and unspecific, ranging from fluid collections to diffuse infiltration. Familiarity with the various diseases that may affect the omental bursa is essential in order to be able to identify them during US examination of the abdomen. US imaging is useful in the follow-up after treatment and to guide drainage of fluid collections.

An antecubital fossa "cyst" caused by postoperative kinking of the brachial artery.

A 77-year-old woman was referred to our staff for evaluation of a "cystic" mass in the antecubital fossa. The recent medical history included surgical excision of a median-nerve schwannoma. The postoperative course had been uneventful. The sonographic examination revealed kinking of the brachial artery; color Doppler imaging showed aliasing at the level of the kink. The case illustrates the value of ultrasound in the diagnosis of fluid-filled lesions of the elbow, including those that are rare and unexpected.

[Ultrasound and color Doppler in nephrology. Technology and applications]. / L'ecografia e il color Doppler in nefrologia. Tecnologie e applicazioni ecografiche.

Advances in digital technology in the last decades have led to a fast development of ultrasound technology. Ultrasound information originating from stationary structures or red blood cells moving into the vessels can be visualized with different imaging modalities. Conventional B-mode sonography provides anatomical details based on acoustic impedance differences. Gray-scale sonography represents the structural echoes as brightness points. Based on the Doppler effect, vascular scattering can be represented as spectral wave velocity depending on time (velocity/time curve), or as dual-scale color mapping depending on the changes in average blood velocity. The flow-in is depicted in red and the flow-out in blue. The analysis of the vascular scattering enhanced by infusion of contrast agents is the basis of contrast-enhanced harmonic imaging. The perfusional pattern of tissues allows the differential diagnosis of expansive lesions. Tissue strain analysis provides a new dimension of diagnostic information. It is used in elastographic imaging to describe relative physical tissue stiffness properties. Tissue stiffness information is complementary to and independent of the acoustic impedance information provided by B-mode imaging as well as the vascular flow information provided by Doppler imaging. Adjacent tissue elements may appear identical using conventional B-mode or Doppler imaging. When stress (axial force) is applied to tissues, they show different degrees of deformation. Comparing the baseline and stress image information, each tissue element may be labeled by its relative stiffness. A lighter shade indicates relatively soft tissue (elastic), while a darker shade indicates relatively stiff tissue (non-elastic).