Drug-induced mucosal alterations observed during esophagogastroduodenoscopy.

Several features of drug-induced mucosal alterations have been observed in the upper gastrointestinal tract, i.e., the esophagus, stomach, and duodenum. These include pill-induced esophagitis, desquamative esophagitis, worsening of gastroesophageal reflux, chemotherapy-induced esophagitis, proton pump inhibitor-induced gastric mucosal changes, medication-induced gastric erosions and ulcers, pseudomelanosis of the stomach, olmesartan-related gastric mucosal inflammation, lanthanum deposition in the stomach, zinc acetate hydrate tablet-induced gastric ulcer, immune-related adverse event gastritis, olmesartan-asso-ciated sprue-like enteropathy, pseudomelanosis of the duodenum, and lanthanum deposition in the duodenum. For endoscopists, acquiring accurate knowledge regarding these diverse drug-induced mucosal alterations is crucial not only for the correct diagnosis of these lesions but also for differential diag-nosis of other conditions. This minireview aims to provide essential information on drug-induced mucosal alterations observed on esophagogastroduodenoscopy, along with representative endoscopic images.

A Case Study on Pyogenic Granuloma With Review of the Literature: An Unexpected Sequela or a Complication of Dental Extraction?

Pyogenic granuloma is a common reactive oral lesion primarily found in the gingiva and rarely in extraction sockets. While it can develop at any age, it is more prevalent in the third and fourth decades of life with a higher occurrence in females. Various factors contribute to its development and surgical removal is the gold standard treatment; however, there are various other methods available. This case report documents a rare event in which a female patient in her early 40s presented with an exophytic lesion affecting the extraction socket of her maxillary right lateral incisor. The lesion was effectively removed through surgical excision. Additionally, it explores the clinical features and pathogenesis of this lesion. The purpose of this case report is to shed light on the uncommon incidence of pyogenic granuloma following tooth extraction. This non-neoplastic vascular growth often presents as an erythematous, ulcerated lesion with a tendency to bleed, with either a sessile or pedunculated base. Our case is one of only five instances documented in the literature, underscoring the importance of knowledge and timely response in such unusual circumstances. We emphasize the significance of early detection and management for improved patient outcomes and a better understanding of this rare condition.

Review of oral and pharyngolaryngeal benign lesions detected during esophagogastroduodenoscopy.

Recent advancements in endoscopy equipment have facilitated endoscopists' detection of neoplasms in the oral cavity and pharyngolaryngeal regions. In particular, image-enhanced endoscopy using narrow band imaging or blue laser imaging play an integral role in the endoscopic diagnosis of oral and pharyngolaryngeal cancers. Despite these advancements, limited studies have focused on benign lesions that can be observed during esophagogastroduodenoscopy in the oral and pharyngolaryngeal regions. Therefore, this mini-review aimed to provide essential information on such benign lesions, along with representative endoscopic images of dental caries, cleft palate, palatal torus, bifid uvula, compression by cervical osteophytes, tonsil hyperplasia, black hairy tongue, oral candidiasis, oral and pharyngolaryngeal ulcers, pharyngeal melanosis, oral tattoos associated with dental alloys, retention cysts, papilloma, radiation-induced changes, skin flaps, vocal cord paresis, and vocal fold leukoplakia. Whilst it is imperative to seek consultation from otolaryngologists or dentists in instances where the diagnosis cannot be definitively ascertained by endoscopists, the merits of attaining foundational expertise pertaining to oral and pharyngolaryngeal lesions are unequivocal. This article will be a valuable resource for endoscopists seeking to enhance their understanding of oral and pharyngolaryngeal lesions.

Diagnostic Accuracy of Fine Needle Aspiration Cytology (FNAC) in Salivary Gland Lesions with Histopathological Examination (HPE) Correlation in a Tertiary Care Centre in Southern India.

This study aimed to determine the diagnostic yield of fine-needle aspiration cytology (FNAC) in salivary gland lesions compared to histopathological diagnosis. The present study was done on patients above 18 years of age, with a palpable swelling, who are clinically diagnosed as salivary gland lesions were evaluated. A total of 31 patients were evaluated in this study. The mean age of the patients was 41 years ± 16.08. The male to female ratio of patients evaluated in our study was 1: 1.066, with a marginal preponderance in the female population. There was a higher incidence of carcinoma in females than males. Parotid gland lesions comprised 83.9% of all the salivary gland lesions analyzed, while submandibular gland lesions comprised 16.1%. In our study, the distribution between non-neoplastic, neoplastic benign, and neoplastic malignant lesions was 9.6%, 83.8%, and 6.4%. The overall diagnostic accuracy for non-neoplastic and neoplastic lesions is 90.3%, with a sensitivity of 89% and a specificity of 100%. The segregation of the results into the positive and negative class of diagnostic outcomes shows 80.6% for true positive, 9.7% for true negative, 0% for false-positive, and 9.7% for false-negative reports. Diagnostic accuracy in differentiating non-neoplastic and neoplastic lesions is 90.3%, with a sensitivity and specificity of 89.0% and 100%, respectively. The diagnostic accuracy of FNAC in differentiating benign from malignant lesions in our study is 93.5% (29 out of 31), the sensitivity of FNAC in our study for diagnosing malignancy is poor, and the specificity is 100%. It can be concluded that FNAC is more accurate in diagnosing benign lesions and more specific than sensitive in diagnosing malignant lesions.

Cardiac Masses and Pseudomasses: An Overview about Diagnostic Imaging and Clinical Background.

A cardiac lesion detected at ultrasonography might turn out to be a normal structure, a benign tumor or rarely a malignancy, and lesion characterization is very important to appropriately manage the lesion itself. The exact relationship of the mass with coronary arteries and the knowledge of possible concomitant coronary artery disease are necessary preoperative information. Moreover, the increasingly performed coronary CT angiography to evaluate non-invasively coronary artery disease leads to a rising number of incidental findings. Therefore, CT and MRI are frequently performed imaging modalities when echocardiography is deemed insufficient to evaluate a lesion. A brief comprehensive overview about diagnostic radiological imaging and the clinical background of cardiac masses and pseudomasses is reported.

Accuracy of Proton Magnetic Resonance Spectroscopy in Distinguishing Neoplastic From Non-neoplastic Brain Lesions.

OBJECTIVE: To evaluate the advantage of a combination of magnetic resonance spectroscopy (MRS) and magnetic resonance imaging (MRI) over MRI in the diagnosis of intracranial mass lesions to differentiate between neoplastic and non-neoplastic lesions and compare them with histopathology and clinical data as gold standard. METHODOLOGY: This was a descriptive cross-sectional study conducted at the Department of Radiology, Apollo Hospital located in Jubilee Hills, Hyderabad. In the present study, a total of 60 patients of all ages with brain masses found through MRI with positive clinical symptoms, regardless of gender, were included. We also involved patients with non-brain cancers suspected of spreading to the brain. RESULT: MRI identified 63% of lesions as neoplastic and 37% as non-neoplastic. Combining MRI and MRS increased accuracy, with 65% of the lesions diagnosed as neoplastic and 35% as non-neoplastic, demonstrating that MRS significantly enhances diagnostic precision compared to MRI alone. CONCLUSION:  This study aimed to see how combining MRI and MRS helps diagnose brain masses, comparing with histopathology as the gold standard. MRI alone identified 63% as neoplastic, but MRI with MRS improved accuracy (65%). MRI sensitivity was 87.80%, but combined with MRS, it increased to 92.68%. Thus, the study concluded that the combination of MRI and MRS is more accurate than MRI alone.

The value of contrast-enhanced ultrasonography in the diagnosis of primary testicular non-neoplastic and neoplastic lesions in adults.

BACKGROUND: Different pathological types of testicular tumors are treated differently. Malignant germ cell tumors require radical orchiectomy, while benign tumors may only need mass enucleation. Contrast-enhanced ultrasonography (CEUS) is more sensitive than conventional ultrasonography in displaying tumor microvessels, which helps distinguish between benign and malignant tumors. METHODS: This was a retrospective analysis of 35 patients with pathological-confirmed primary testicular non-neoplastic and neoplastic lesions in our hospital from February 2017 to February 2022. Conventional ultrasonography and CEUS imaging findings of included lesions were retrospectively analyzed and their diagnostic values were compared with the pathological results. RESULTS: There were 13 cases of benign testicular lesions (including 1 case of spontaneous hematoma, 2 cases of segmental infarctions, 5 cases of epidermoid cysts, 2 cases of Sertoli cell tumors, and 3 cases of Leydig cell tumors) and 23 cases of malignant testicular lesions (including 10 cases of seminomas, 1 case of embryonal carcinoma, 2 cases of mixed germ cell tumors, 2 cases of spermatocytic tumors, and 8 cases of lymphomas). The sensitivity, specificity, positive predictive value, negative predictive value and accuracy rates of conventional ultrasound in diagnosing benign testicular tumors by "onion skin-like" echo (epidermoid cysts) and peripheral annular blood flow were 30.8%, 100.0%, 100.0%, 71.9% and 75.0%, respectively. All testicular non-neoplastic lesions and epidermoid cysts showed no enhancement by CEUS. All Sertoli-Leydig cell tumors (SLCTs)' CEUS imaging showed uniform high enhancement (no necrosis area), fast forward, and slow backward. 80.0% (12/15) malignant germ cell tumors showed heterogeneous enhancement and fast forward and fast backward in CEUS. All lymphomas showed fast forward and fast backward, and 87.5% (7/8) of them showed uniform high levels of enhancement in CEUS. According to CEUS without enhancement (non-neoplastic lesions and epidermoid cysts) and uniform high enhancement with fast forward and slow backward (SLCT), the sensitivity, specificity, positive predictive value, negative predictive value and accuracy rates for diagnosing benign testicular tumors were all 100.0%. Compared with conventional ultrasound, the difference was statistically significant (p = 0.004). CONCLUSIONS: CEUS could accurately distinguish between benign and malignant testicular tumors, as well as differentiate specific pathological types (testicular focal infarction, epidermoid cysts, spermatocytic tumors, SLTC and lymphoma). Accurate preoperative diagnosis is critical for guiding the selection of appropriate treatment plans for different pathological types of testicular tumors.

Valor actual de los hallazgos histológicos de biopsias de próstata negativas en la predicción del riesgo futuro de cáncer de próstata clínicamente significativo / The current value of histological findings in negative prostate biopsies to predict the future risk of clinically significant prostate cancer

Introducción: Se recomienda realizar una biopsia prostática (PBx) de repetición ante una sospecha persistente de cáncer de próstata (PCa) o cuando se identifica proliferación acinar atípica (ASAP), neoplasia intraepitelial de alto grado (HGPIN) extensa (≥3 zonas de biopsia) o HGPIN con células atípicas sospechosas de adenocarcinoma (PIN-ATYP). Actualmente se recomienda realizar una resonancia magnética multiparamétrica (mpMRI) y PBx guiada por mpMRI (MRI-TBx) en una PBx de repetición. Nuestro objetivo fue analizar el valor actual para predecir el riesgo de PCa clínicamente significativo (csPCa) del hallazgo de ASAP, mHGPIN, PIN-ATYP y otros hallazgos histológicos.MétodosSe realizó un análisis retrospectivo de 377 PBx de repetición. Se realizó MRI-TBx cuando la puntuación PI-RADS fue≥3 y PBX sistemáticas de 12 cilindros guiadas por ecografía transrectal (TRUS) cuando fue≤2. ASAP, HGPIN, HGPIN multifocal (mHGPIN), PIN-ATYP y otros 8 hallazgos histológicos fueron reportados prospectivamente en las PBx negativas. El csPCa fue definido como grado ISUP≥2.ResultadosLa incidencia de ASAP, mHGPIN y PIN-ATYP fue 4,2%, 39,7% y 3,7% respectivamente, y la tasa de csPCa fue estadísticamente similar en los pacientes con estos hallazgos histológicos. Sin embargo, las tasas de csPCa con atrofia proliferativa inflamatoria (PIA) presente y ausente fueron 22,2% y 36,1%, respectivamente. La PIA fue el único hallazgo histológico que predijo un menor riesgo de csPCa, con OR de 0,54 (IC 95%: 0,308-0,945, p=0,031). La PIA fue, también, un factor predictor independiente en un modelo combinando variables clínicas y mpMRI, que obtuvo un área bajo la curva de 0,86 (95% IC: 0,83-0,90).ConclusionesLa PIA resultó ser el único hallazgo histológico predictor del riesgo de csPCa, y puede contribuir en un modelo predictivo; mHGPIN no fue predictor de riesgo de csPCa. La baja incidencia de ASAP (4,2%) y PIN-ATYP (3,7%) impidió que pudiéramos obtener conclusiones sobre estas lesiones. (AU)

Introduction: Repeat prostate biopsy (PBx) is recommended under persistent suspicion of prostate cancer (PCa) or in the face of the following findings: atypical small acinar proliferation (ASAP), extense (≥3 biopsy sites) high-grade prostatic intraepithelial neoplasia (HGPIN), or HGPIN with atypical glands, suspicious for adenocarcinoma (PIN-ATYP). Nowadays, multiparametric magnetic resonance imaging (mpMRI) and mpMRI targeted PBx (MRI-TBx) are recommended in repeat PBx. Our objective was to analyze the current value of ASAP, mHGPIN, PIN-ATYP and other histological findings to predict clinically significant PCa (csPCa) risk.MethodsRetrospective analysis of 377 repeat PBxs. MRI-TBx was performed when Prostate Imaging-Reporting and Data System (PI-RADS) score>3 and 12-core transrectal ultrasound (TRUS) systematic PBx when≤2. ASAP, HGPIN, mHGPIN, PIN-ATYP, and 8 other histological findings were prospectively reported in negative PBx. CsPCa was defined as ISUP group grade>2.ResultsIncidence of ASAP, multifocal HGPIN (mHGPIN) and PINATYP was 4.2%, 39.7% and 3.7% respectively, and csPCa rate was statistically similar among men with these histological findings. However, the rate of csPCa was 22.2% when proliferative inflammatory atrophy (PIA) was present, and 36.1% when it was not. PIA was the only histological finding which predicted lower risk of csPCa, with an OR of .54 (95% CI: .308-.945, P=.031). In addition, PIA was an independent predictor of a model combining clinical variables and mpMRI which reached area under de ROC curve of .86 (95% CI: .83-.90).ConclusionsPIA emerged as the only predictive histological finding of csPCa risk and can contribute to a predictive model. mHGPIN failed to predict csPCa risk. The low incidence of ASAP (4.2%) and PIN-ATYP (3.7%) prevented us from drawing conclusions. (AU)

The current value of histological findings in negative prostate biopsies to predict the future risk of clinically significant prostate cancer.

BACKGROUND: Repeat prostate biopsy (PBx) is recommended under persistent suspicion of prostate cancer (PCa) or in the face of the following findings: atypical small acinar proliferation (ASAP); extense (≥3 biopsy sites) high-grade prostatic intraepithelial neoplasia (HGPIN); or HGPIN with atypical glands; suspicious for adenocarcinoma (PIN-ATYP). Nowadays; multiparametric magnetic resonance imaging (mpMRI) and mpMRI targeted PBx (MRI-TBx) are recommended in repeat PBx. Our objective was to analyze the current value of ASAP; mHGPIN; PIN-ATYP and other histological findings to predict clinically significant PCa (csPCa) risk. METHODS: Retrospective analysis of 377 repeat PBxs. MRI-TBx was performed when Prostate Imaging-Reporting and Data System (PI-RADS) score >3 and 12-core transrectal ultrasound (TRUS) systematic PBx when ≤2. ASAP; HGPIN; mHGPIN; PIN-ATYP; and 8 other histological findings were prospectively reported in negative PBx. CsPCa was defined as ISUP group grade >2. RESULTS: Incidence of ASAP; multifocal HGPIN (mHGPIN) and PINATYP was 4.2%; 39.7% and 3.7% respectively; and csPCa rate was statistically similar among men with these histological findings. However; the rate of csPCa was 22.2% when proliferative inflammatory atrophy (PIA) was present; and 36.1% when it was not. PIA was the only histological finding which predicted lower risk of csPCa; with an OR of 0.54 (95%CI: 0.308-0.945; P = .031). In addition; PIA was an independent predictor of a model combining clinical variables and mpMRI which reached area under de ROC curve of 0.86 (95%CI: 0.83-0.90). CONCLUSION: PIA emerged as the only predictive histological finding of csPCa risk and can contribute to a predictive model. mHGPIN failed to predict csPCa risk. The low incidence of ASAP (4.2%) and PIN-ATYP (3.7%) prevented us from drawing conclusions.

Benign peripheral nerve tumors.

Benign peripheral nerve tumors encompass a wide range of neoplasms and non-neoplastic tumor like lesions. Some of these lesions if not encountered in the setting of genetic syndromes, are occurring sporadically. The principles of oncology should be respectfully followed in every step of diagnostic approach and surgical management. Albeit, classified as benign, some of them do have different level of malignant potential, thus the treating physicians should be aware of that to avoid possible pitfalls with devastating outcomes. This article reviews the most common benign peripheral nerve tumors discussing the clinicopathological findings, imaging appearance and the current trend in their approach.

[Benign and inflammatory lesions of the skull base]. / Benigne und entzündliche Veränderungen der Schädelbasis.

A variety of tumors, tumor-like non-neoplastic and inflammatory lesions occur in the skull base. A wide variety of diseases and lesions complicate the process of radiological diagnosis. The main task of imaging consists of the recognition and characterization of skull base lesions with detailed description of the extent of infiltration of adjacent structures, which is important for preoperative planning. Computed tomography (CT) and magnetic resonance imaging (MRI) are the preferred modalities for evaluating cranial base lesions. Above all, they depict more accurately the involvement of bones, vascular and nerve structures. MRI, especially T1-weighted sequences, provide superior contrast to CT soft tissue, which is useful for detecting lesions surrounded by high-fat bone marrow. T2-weighted MRI imaging is useful for characterizing watery tumor tissue/edema or cystic portions of the lesions. CT outperforms MRI in assessing the presence of calcification and osseous destruction. Knowledge of the clinical symptoms, as well as the overview of possible variants of the skull base lesions, aid in the diagnosis. The aim of this review is to present the most important benign and inflammatory lesions of the skull base as well as to investigate typical imaging phenomena of the most common lesions, and to provide insights into the most important anatomical landmarks of the skull base.

Pattern of oesophageal diseases in Madinah region, Saudi Arabia: An 11 years experience.

The oesophagus can be a site for a variety of lesions including inflammatory disorders, infections, mechanical conditions, toxic and physical injuries, vascular disorders and neoplastic conditions. hence the oesophageal diseases have a wide spectrum of pathological features. An understanding of histopathological details of oesophageal diseases is essential for their accurate diagnosis and management. The main objective of our study was to provide a comprehensive audit of oesophageal diseases in the province of Madinah in Saudi Arabia. From January 2006 to December 2017, were viewed the histopathological patterns of oesophageal lesions in patients at a tertiary care referral hospital who were diagnosed with oesophageal disease after upper gastroendoscopy. Of the 201 patients, 144 (71.6%) cases were found to be non-neoplastic and 57 (28.4%) cases were neoplastic. Our findings were comparable with earlier studies that helped establish a baseline of an oesophageal disease pattern, on the basis of histopathological examinations.

Putting All the Pieces Together: Clinical, Macroscopic and Microscopic Characteristics of Subacute Thyroiditis.

Subacute thyroiditis (SAT) is a self-limiting inflammatory condition of the thyroid gland in which multinucleated giant cells constitute a key histological finding. SAT is generally a clinical diagnosis and consequently its histological features are rarely encountered by pathologist. Herein, we present a case that exemplifies the characteristic clinical and pathological features of this entity. In addition, we compare SAT to other thyroid disorders characterized by the presence of multinucleated giant cells.

CLINICO-PATHOLOGIC REVIEW OF BIOPSIED TONGUE LESIONS IN A NIGERIAN TERTIARY HOSPITAL.

BACKGROUND: Varying pathologic conditions can affect the tongue for which the pattern of occurrence may differ. The aim of this study was to review the clinico-pathologic features of histologically diagnosed cases of tongue lesions that presented in our hospital over a 21 years period. MATERIALS AND METHODS: Data on habits, class of lesion, histological diagnosis, age, gender, and site distributions were analyzed using descriptive frequencies, ranges and means ± SD. Variables were compared using Chi square and ANOVA tests as appropriate. Sites of lesions were coded using the WHO ICD-O code on topography. RESULTS: Tongue lesions were seen in 43 males and 31 females. There was a bimodal peak age of occurrence at 40-49 and 60-69 years of age. Smoking and alcohol intake habits were recorded in 8 cases only. Neoplastic lesions constituted 78.4% of the cases. Using the WHO ICD-O code for topography of lesions, the tongue dorsum (ICD-O-2.0) was the most commonly affected site. Malignant lesions constituted 47.3% of the cases seen. Also, 8.6% of the malignant lesions were seen in younger patients (< 40 years). CONCLUSION: Tongue lesions showed a bimodal age of occurrence with neoplastic lesions as the most histologically diagnosed lesions in our study.

Imaging features and differential diagnosis of obstructive jaundice caused from non-neoplastic diseases / 中华消化外科杂志

Objective To investigate the imaging features and differential diagnosis of obstructive jaundice caused from non-neoplastic diseases.Methods The retrospective descriptive study was conducted.The clinical data of 62 patients with obstructive jaundice caused from non-neoplastic diseases who were admitted to the Peking University People's Hospital between August 2014 and August 2016 were collected,including 13 with immunoglobulin G4 associated cholangitis (IAC),2 with primary sclerosing cholangitis (PSC),21 with recurrent purulent cholangitis (RPC),2 with Mirizzi syndrome,4 with groove pancreatitis (GP) and 20 with Lemmel syndrome.All the patients underwent plain and enhanced scans of computed tomnography (CT) and magnetic resonance imaging (MRI) and magnetic resonanced cholangio-pancreatography (MRCP).Film reading were respectively done by 2 imaging doctors,and then was analyzed again by senior doctors when there is disagreement.Observation indicators:(1) situations of imaging exanination and imaging features;(2) treatment and follow-up.Patients received laboratory and related examinations and then underwent corresponding treatment after diagnosis.Follow-up using outpatient examination and telephone interview was performed once every 6 months to detect patients' prognosis up to November 2016.Results (1) Situations of imaging examination and imaging features:of 62 patients,21 underwent plain and enhanced CT scans,7 underwent plain and enhanced MRI scans,4 underwent MRCP,15 underwent plain and enhanced CT scans and MRCP,1 underwent plain and enhanced CT scans and plain and enhanced MRI scans,3 underwent plain and enhanced MRI scans and MRCP and 11 underwent plain and enhanced CT scans,plain and enhanced MRI scans and MRCP.Imaging features of 13 patients with IAC:MRI scans showed that diffuse and symmetrical bile duct walls were thickened,with delayed enhancement.The narrowed lumen of bile duct was mainly occurred in common bile duct,without occlusion.Of 13 patients with IAC,9 were combined with IgG4 associated pancreatitis and 7 with bilateral nephropathy.Imaging features of 2 patients with PSC:MRI scans showed that bile duct wall was multiple localized thickening and persistent enhancement,that was imaging feature of liver cirrhosis.MRCP examination showed that intra-and extra-hepatic bile ducts had multifocality stricture and beading-like and/or dry twig-like dilatation,and branches of intrahepatic peripheral bile duct were reduced.Imaging features of 21 patients with RPC:MRI and CT scans and MRCP examination showed that there was thickening bile duct wall and delayed enhancement.The first and second level of intrahepatic bile duct were segmental dilatation,distal bile duct dramatically narrowed and branches of intrahepatic bile duct were reduced.Most of extrahepatic bile duct was dilatation and a few were narrow-like changes.There were stones of intrahepatic bile duct and pneumobilia.Liver parenchymal atrophy with cholangiectasis occurred most frequently in left lobe or right posterior lobe of liver.There were secondary liver abscess and cholangiocarcinoma.Imaging features of 2 patients with Mirizzi syndrome:MRI scans showed that there was common hepatic duct stricture caused by stones in the junction between neck of gallbladder and common hepatic duct,and intra-and extra-hepatic bile ducts dilatation in proximal end of stones and normal bile duct in distal end of stones.There were gallbladder and biliary fistulas,irregular gallbladder wall thickening and inflammation around the gallbladder.Imaging features of 4 patients with GP:MRI scans showed that no clear mass was detected in duodenal loop and head of pancreas,with heterogeneous and slightly irregular enhancement.Cyst formation occurred in intramural wall of duodenum and head of pancreas.Enhanced MRI scans showed that common bile duct wall was thickened and slightly irregular stricture,pancreatic duct was normal or mild expansion,and thickened duodenal wall had varying degrees of stenosis of lumen.Imaging features of 20 patients with Lemmel syndrome:MRI scans showed that pouch-like structure was detected inside of the descending duodenum,with thin cyst wall and liquid in cyst wall.MRCP examination showed dilatations of common bile duct and intra-and extra-hepatic bile ducts.(2) Treatment and follow-up:of all the 62 patients,30 underwent corresponding surgeries,including 2 with IAC,1 with PSC,7 with RPC,2 with Mirizzi syndrome,3 with GP and 15 with Lemmel syndrome,and the other 32 without surgery received corresponding medical treatment.Sixty of 62 patients were followed up for 3-17 months.During follow-up,28 patients undergoing surgery received definitive diagnosis and good recovery,2 were lost after definitive diagnosis and 32 undergoing medical treatment were in stable condition.Conclusion Non-neoplastic diseases can cause obstructive jaundice,with a higher misdiagnosis rate,imaging findings of which can be conducive to diagnose diseases and provide clinical treatment.

Analysis of non-neoplastic hepatic lesions in SD rats at different age / 中国职业医学

OBJECTIVE: To explore the non-neoplastic hepatic lesions in SD rats at different ages. METHODS: The specificpathogen free SD rats were collected from the blank control groups used in subacute toxicity tests,subchronic toxicity tests and chronic toxicity combined with carcinogenic tests for safety evaluation. At the end of each experiment,i. e. week 10,19,56 and 108(assigned into four groups: 10,19,56 and 108 weeks,each contained 100 rats with each sex),rats were executed. The liver organ coefficient was calculated,the pathological examination was performed,and the non-tumorous lesions in the liver were analyzed. RESULTS: The liver organ coefficients at the age of 19,56,108 weeks were lower than that of 10 weeks(P < 0. 05); those at the age of 56 and 108 weeks were lower than that of 19 weeks(P < 0. 05),and that of 108 weeks was greater than of 56 weeks(P < 0. 05). Among the 10-week-old,19-week-old,56-week-old and 108-week-old groups,the types of non-neoplastic hepatic lesions detected in the female rats were 6,6,13 and 15 respectively,meanwhile those in the male rats were 6,6,13 and 15 respectively. Both male and female rats,the incidences of hepatocyte fatty degeneration,edema and hepatic infiltration of inflammatory cells were significantly increased with the increase of age in each group(P < 0. 05). The incidences of intrahepatic bile duct proliferation and intrahepatic bile duct fibrosis in rats at the age of 56 and 108 weeks were higher than those at the age of 10 and 19 weeks(P < 0. 008).Moreover,the frequency of hepatic sinus expansion lesions in rats at the age of 108 weeks was higher than those of 19 weeks(P < 0. 008). CONCLUSION: Spontaneous non-neoplastic lesions in the liver of SD rats were common,primarily demonstrated as hepatocyte fatty degeneration,edema and infiltration of inflammatory cells. The incidences of lesions increased with the increase of age.

Stress-reactive rats (high-avoidance female rats) have a shorter lifespan than stress-nonreactive rats (low-avoidance female rats).

Although Hatano high-avoidance and low-avoidance rats (HAA and LAA, respectively) have been selectively bred for good versus poor avoidance learning, HAA rats are known to be more reactive to stress than LAA rats. In this study, HAA and LAA female rats were compared during reproductive aging by observing estrous cycles from 8 to 11 months of age. Furthermore, these rats were allowed to live out their natural lifespans, that is, until 24 months of age, in order to compare their survival and to clarify the relationship between reproductive aging and tumor development. At eight months of age, 2 of 35 HAA rats and 20 of 35 LAA rats had abnormal estrous cycles. The median lifespan of the HAA rats (673 days) was shorter than that of the LAA rats (733 days). The incidence of pituitary neoplasia was higher in the HAA rats than in the LAA rats. These results suggest that HAA female rats (i.e., stress-reactive rats) have a shorter lifespan than LAA female rats (i.e., stress-nonreactive rats) and develop pituitary neoplasia, which was one of the causal factors in their accelerated mortality. However, the onset of an age-matched abnormal cycle did not correspond with their lifespan.

Differential Diagnosis between Neoplastic and Non-Neoplastic Brain Lesions in Radiology / Diagnóstico diferencial entre lesões cerebrais neoplásicas e não neoplásicas em radiologia

Introduction The observation of multiple lesions in a skull computed tomography (CT) scan is always cause for concern because of the frequent possibility of neoplastic etiology, although granulomatous, infectious, vascular, iatrogenic, demielinating, trauma, parasitic diseases, and strokes can produce a similar aspect on radiology. A wide range of non-neoplastic conditions can mimic a brain tumor, both clinically and radiologically, representing a potential pitfall for physicians involved in patient care. The study's goal is to alert specialists to the possibility of other neoplastic and nonneoplastic etiologies in the differential diagnosis of hypodense lesions in non-contrast. Methods We performed a literature review using PubMed, Medline, Science Direct, Embase, Clinical Trials, Ebsco, and Scielo. Articles were selected in the period of 1986 to 2015. Discussion Knowledge of various etiologies when with multiple lesions appear on computed tomography allows specialists to guide the diagnosis to appropriate treatment, avoiding the irradiation of non-neoplastic lesions and unnecessary surgeries. The most common lesions were the neoplasm (74% to 86%), especially gliomas, followed by infections (8% to 15%), and infarcts (0.6% to 6%), which represent nonneoplastic lesions. Conclusion Given the relatively high percentage of wrong neuroradiology diagnoses, most cases may require histological diagnosis, because even magnetic resonance imaging (MRI) renders difculties in distinguishing such lesions.

Introdução Observação de múltiplas lesões na tomograa computadorizada de crânio (TC) é sempre motivo de preocupação por causa da possibilidade frequente de etiologia neoplásica, embora as doenças granulomatosas, infecciosas, vascular, iatrogênica, desmielinizante, trauma, e parasitárias podem produzir aspecto semelhante na radiologia. Uma ampla gama de condições não neoplásicas pode mimetizar um tumor cerebral, tanto clínica, quanto radiologicamente, representando uma armadilha potencial para os médicos envolvidos no cuidado ao paciente. O objetivo do estudo é alertar a possibilidade de outras etiologias neoplásicas e não neoplásicas no diagnóstico diferencial de lesões hipodensas em TC sem contraste. Métodos Revisão da literatura utilizando PubMed, MEDLINE, Google Scholar, Ensaios Clínicos, EBSCO, Scielo, Tópicos em radiologia. Foram selecionados por período 1986- 2015. Discussão O conhecimento de várias etiologias, quando confrontado com múltiplas lesões na tomograa computadorizada permite o direcionamento do diagnóstico para o tratamento adequado, evitando a irradiação de lesões não neoplásicas e cirurgias desnecessárias. As lesões mais frequentes são neoplasias (74% a 86%), especialmente gliomas, seguido de infecções (8% a 15%) e infartos (0,6% a 6%), que representam lesões não neoplásicas. Conclusão Como um possível resultado da percentagem relativamente elevada de diagnósticos errados neurorradiológicos, o diagnóstico histológico faz necessário, porque mesmo Ressonância pode ser difícil na diferenciação de tais lesões.

A Case of Caseous Calcification in the Left Ventricular Outflow Tract with Loss of Consciousness / 日本心臓血管外科学会雑誌

<p>A 61-year-old woman presented with loss of consciousness. Echocardiography revealed a hypoechoic, round mass of 12×13 mm with a smooth border in the left ventricular outflow tract, leading to a diagnosis of loss of consciousness caused by left ventricular outflow tract obstruction, and surgical excision of the mass was performed. The mass, with a smooth, elastic soft surface and filled with yellow, creamy contents, was observed within a range from the subannular region of the left coronary cusp to the anterior mitral leaflet. Pathological examination showed central degeneration and liquefaction, as well as cystic, coarse-granular calcium deposition surrounded by inflammatory cell infiltration and fibroblast proliferation. No tumor cells were seen. Abscess was excluded by preoperative clinical presentations, hematologic data, and culture testing, and thus the mass was considered as caseous calcification of the mitral annulus. Here, we report a case of caseous calcification of the mitral annulus, a rare nonneoplastic lesion thought to be a variant of mitral annular calcification, with literature review.</p>

Urinary filariasis masquerading as the bladder tumor: A case report with cyto-histological correlation.

Filariasis is a prevalent parasitic infection of lymphatic frequently seen in tropical countries. It has been reported in cytological samples from various sites; however, presence of microfilaria in smears from the urine sample is an uncommon finding. We describe an interesting and unusual case of elderly female who presented with achylous hematuria and an exophytic mass lesion in urinary bladder on computed tomography scan suspected of neoplastic mass lesion; however diagnosed as urinary filariasis on urine cytology and bladder biopsy.