Contrast-enhanced ultrasound in the diagnosis of a solitary neck mass: a case report of metastatic seminoma.

Seminoma accounting for approximately 98% of malignant testicular tumours and it typically presents as a painless, palpable solid mass in the testis. Seminomas presenting only as a solitary neck mass are very rare. This case report describes a previously healthy 35-year-old male that presented with a 3-month history of the incidental discovery of a mass in his right neck. He had no testicular symptoms. He underwent neck ultrasound, contrast-enhanced ultrasound, computed tomography and positron emission tomography. Serum human chorionic gonadotropin (3.90 mIU/ml) was raised and alpha-fetoprotein (3.79 ng/ml) was within normal limits. Clinical examination and imaging examinations did not find any suspicious signs of testicular cancer. Biopsy from the neck mass confirmed the diagnosis of metastatic seminoma. The case report presents the ultrasound and contrast-enhanced ultrasound characteristics of seminoma and provides an update of the literature regarding this very rare metastatic site for seminomas.

CEUS helps to rerate small breast tumors of BI-RADS category 3 and category 4.

PURPOSE: The primary aim of this study was to explore if classification, whether using the BI-RADS categories based on CEUS or conventional ultrasound, was conducive to the identification of benign and malignant category 3 or 4 small breast lesions. MATERIAL AND METHODS: We evaluated 30 malignant and 77 benign small breast lesions using CEUS. The range of enhancement, type of enhancement strength, intensity of enhancement, and enhancement patterns were independent factors included to assess the BI-RADS categories. RESULTS: Of the nonenhanced breast lesions, 97.8% (44/45) were malignant, while, of the hyperplasic nodules, 96.8% (30/31) showed no enhancement in our study. Category changes of the lesions were made according to the features determined using CEUS. The results showed that these features could improve diagnostic sensitivity (from 70.0 to 80.0, 80.0, 90.0, and 90.0%), reduce the negative likelihood ratio (from 0.33 to 0.22, 0.25, 0.11, and 0.12), and improve the NPV (from 88.8 to 92.2, 91.2, 96.2, and 95.5%). However, this was not conducive to improve diagnostic specificity or the PPV. CONCLUSION: The vast majority of nonenhanced small breast lesions were malignant and most of the hyperplasic nodules showed no contrast enhancement. As a reference, CEUS was helpful in identifying BI-RADS category 3 or 4 small breast lesions.

[Value of contrast-enhanced sonography in early diagnosis of breast cancer].

OBJECTIVE: To assess the clinical value of contrast-enhanced ultrasonography (CEUS) in early diagnosis of breast cancer. METHODS: CEUS was performed in 107 cases of ultrasound BI-RADS(®) category 3 or category 4 small breast tumors (diameter no greater than 10 mm) before surgery. The range, type and patter of enhancement of the tumor and the surrounding tissues were observed, and the time-intensity curve (TIC) was analyzed for TIC curve type, basic and peak intensity, enhancement intensity, rising slope, and enhancement intensity. The results were analyzed comparatively between benign and malignant tumors. RESULTS: The peak intensity, enhancement intensity index and peak time in CEUS were statistically significant between benign and malignant breast tumor (t=-2.310, -2.592, -2.127, P=0.021, 0.010, 0.033), and the intensity difference and rising slope also differed significantly (t=-3.422, -3.388, P=0.001, 0.001). TIC curve type, enhancement pattern, enhancement types and enhancement range were statistically significantly between benign and malignant breast tumor (P<0.001). CONCLUSION: Benign and malignant BI-RADS(®) category 3 or 4 small breast tumors differ in the peak intensity, enhancement intensity index and peak time in CEUS. More nodular hyperplasia showed no enhancement in CEUS, and 97.8% of the lesions without enhancement are benign. In enhanced breast nodules, malignant breast lesions show more quick wash-in and wash-out type and quick wash-in and slow wash-out type, and the latter is more common; benign lesions often show a slow wash-in and slow wash-out type. In CEUS, the range of enhancement in malignant nodules is wider than that in two-dimensional ultrasound.

[Effect of X-ray exposure on soluble tumor necrosis factor receptor-p75 release in hepatocellular carcinoma HepG2 cells in vitro].

OBJECTIVE: To investigate the effects of X-ray exposure on the release of soluble tumor necrosis factor receptor-p75 (sTNFR-p75) in hepatocellular carcinoma HepG2 cells in vitro. METHODS: Enzyme-linked immunosorbent assay (ELISA) was used to examine the levels of sTNFR-p75 in the supernatants of HepG2 cells before and after X-ray exposure. The cell apoptosis was analyzed by flow cytometry and transmission electron microscope(TEM), and the morphological changes of the cells were examined under optical microscope and transmission electron microscope(TEM). RESULTS: X-ray exposure of the cells resulted in a strong increase of cell apoptosis (P<0.05) and sTNFR-p75 production in the cells as compared with the those before the exposure (P<0.01). Optical microscopy revealed apoptotic changes of HepG2 cell after the exposure, shown as cell shrinkage, spherical cell morphology, cytoplasmic and nuclear condensation. Apoptotic bodies were detected by TEM. CONCLUSION: X-ray exposure induces HepG2 cells apoptosis by inhibiting the release of sTNFR-p75 into the supernatant.

[Expressions of tumor necrosis factor receptor I and II in human gastric carcinoma].

OBJECTIVE: To study the clinical significance of expressions of tumor necrosis factor receptor I and II(TNFR I and II) and their relationship with clinical pathology in human gastric carcinoma. METHODS: SABC immunohistochemical method was used to examine the expressions of TNFR I and II in 51 cases of gastric carcinoma, 41 adjacent mucosal and 15 normal gastric mucosa tissues. RESULTS: The positivity rates of TNFR I and II expressions in human gastric carcinoma were significantly higher than those in the adjacent mucosal and normal mucosal tissues, and their expressions were significantly higher in the surrounding mucosa than in the normal tissues. In gastric carcinoma tissues, no correlations of TNFR I and II expressions with serous membrane invasion or lymph node metastasis were found, but the differentiation grade was positively correlated with TNFR expressions (r=-0.3111, P=0.035; r=-0.5952, P=0.000, respectively). CONCLUSION: TNFR I and II expressions are valuable indicators for determining the malignancy and predicting the differentiation grade of gastric carcinoma.