RESUMO
Patients with penetrating wounds with suspected foreign bodies retained in the wound are often seen in emergency departments. Imaging studies are necessary to rule out the presence of retained foreign bodies. Plain-film X-rays, however, are only useful when the foreign bodies contain radiopaque material (metal, glass, stone, and some plastics). In cases with strong diagnostic suspicion and negative plain films, other imaging tests are necessary. Ultrasonography has proven useful in the identification and location of both radiopaque and radiotransparent foreign bodies. Ultrasonography enables excellent assessment of adjacent anatomical structures (muscles, tendons, ligaments, and neurovascular structures) and of associated lesions. The different materials found in foreign bodies have characteristic ultrasonographic patterns that are useful for diagnosis. Finally, it is important to be familiar with the diagnostic pitfalls to avoid false positives.
Assuntos
Corpos Estranhos/diagnóstico por imagem , Tela Subcutânea/diagnóstico por imagem , Ultrassonografia , Ferimentos Penetrantes/complicações , Calcinose/diagnóstico por imagem , Cicatriz/diagnóstico por imagem , Erros de Diagnóstico , Corpos Estranhos/complicações , Vidro , Hematoma/diagnóstico por imagem , Humanos , Metais , Plantas , Ossos Sesamoides/diagnóstico por imagem , Tomografia Computadorizada por Raios XRESUMO
OBJECTIVE: To describe a rare case of vascular hyaline variant of Castleman's disease presenting as a solitary mass, with special reference to the radiological findings and differential diagnosis. The literature is briefly reviewed. METHODS/RESULTS: A 48-year-old male presented with nonspecific pain in the left flank. Routine analyses were unremarkable. Sonographic and CT studies showed a well-defined, highly vascularized, 3.3 x 3.6 x 4 cm retroperitoneal mass. The risk of hemorrhage made a preoperative biopsy impracticable and the mass was removed surgically. The pathological analysis of the surgical specimen showed a localized retroperitoneal angiofollicular lymphoid hyperplasia (vascular hyaline variant). CONCLUSIONS: Castleman's disease can rarely present as a solitary retroperitoneal mass, which must be distinguished from primary retroperitoneal masses that are usually malignant. Imaging techniques are not conclusive. Definitive diagnosis is based on the postoperative pathological findings.