A Case of Advanced Unicentric Retroperitoneal Castleman's Disease, Associated With Psoriasis.

We present here a 32-year-old male with advanced lately diagnosed, right sided retroperitoneal mass, which had been already treated due to progressive muco-cutaneous lesions clinically consistent with psoriasis, during recent four years. The advanced retroperitoneal mass resected surgically and reported as hyaline-vascular castleman disease with a dense focus of coarse calcification, on histopathology. Association of psoriasis and castlman disease is discussed in this case report.

Validation of Contrast Enhanced Ultrasound Technique to Wire Localization of Sentinel Lymph Node in Patients with Early Breast Cancer.

Axillary staging is one of the primary steps in management of Breast cancer patients. Current standard methods including blue dye and radicolloid have limitations and disadvantages. In this study, the feasibility of visualization of lymph node pathways and localization of SLN with the help of CEUS was assessed. 50 patients with early breast cancer diagnosis underwent CEUS and wire localization, methylenblue dye, and isotope scan methods for SLN detection. The pathology findings of the wired SLN were compared with those obtained from, methylenblue dye, and isotope scan methods. Lymph node wiring was successfully performed in 48 patients.Radio-isotope technique detected SLN in all 50 patients while blue-dye succeeded in 48. Sensitivity of CEUS to detect SLN compared with radio-isotope and blue dye methods was 96 % and 100 %, respectively. Considering costs and facilities required to perform radio-isotope technique and complications of blue dye we may accept CEUS with the help of micro-bubble contrasts as a viable alternative. However, more studies with larger sample volumes, using various drugs, and including non-selective population are warranted to better clarify feasibility and accuracy of this technique in comparison with current methods.

The accuracy of limited B-mode compression technique in diagnosing deep venous thrombosis in lower extremities.

BACKGROUND: Deep vein thrombosis (DVT) is prevalent in the emergency departments. Nearly 60% of them may lead to pulmonary embolism. A complete color-flow duplex ultrasound (CFDU), performed by the radiologists, is the most common diagnostic method used to detect DVT. A limited B-mode compression technique (BMCT) can also be useful for the emergency specialists visiting suspicious cases. OBJECTIVES: The purpose of this study was to compare the sensitivity, specificity, and accuracy of a BMCT done by emergency medicine residents with that of a CFDU in diagnosing the proximal DVT of lower extremities. METHODS: This prospective study was conducted on 74 patients (41 men and 33 women) presenting with painful and swollen lower limbs in the emergency department of Imam Khomeini Hospital. First, the affected lower extremity was examined by a BMCT carried out by one of the 2 emergency medicine residents. Then, the CFDU was performed by a radiologist blinded to the results of the BMCT. The sensitivity, specificity, and accuracy of the BMCT were compared with that of the CFDU as a gold standard. RESULTS: The mean age of the patients was 55.16 ± 17.4 years. Positive results were reported in 35 patients (47.3%) using the 2 tests. Compared with CFDU, BMCT had a sensitivity, specificity, accuracy, positive predictive values, and negative predictive values of 100%. CONCLUSION: These findings suggest that BMCT performed by the emergency medicine specialists to diagnose proximal DVT of lower extremities is not only an acceptable method but also less time-consuming when compared with CFDU.