An incidental large adrenal schwannoma: A case report.

Adrenal schwannoma is a rare tumor of Schwann cell origin that represents less than 0.2% of all adrenal tumors. These typically benign tumors are most often found in the head, neck, and limbs. However, schwannomas can also rarely occur rarely in the adrenal gland within the retroperitoneal cavity. In the adrenal gland, these tumors arise from the medulla and are difficult to diagnose, often misdiagnosed as other benign or malignant entities. In this article, we report the case of a 43-year-old female with a large left adrenal mass revealed by biopsy to be a schwannoma. We focus on the use of radiological imaging modalities and immunohistochemical analysis to optimize diagnosis and treatment intervention of this rare tumor.

The future of radiology and radiologists: AI is pivotal but not the only change afoot.

Uncertainty regarding the future of radiologists is largely driven by the emergence of artificial intelligence (AI). If AI succeeds, will radiologists continue to monopolize imaging services? As AI accuracy progresses with alacrity, radiology reads will be excellent. Some articles show that AI can make non-radiologists experts. However, eminent figures within AI development have expressed concerns over its possible adverse uses. Bad actors, not bad AI, may account for a future in which AI is not as successful as we might hope and, as some fear, even pernicious. More relevant to current predictions over the course of AI in medicine, and radiology in particular, is how the evolution of AI is often seen in a vacuum. We cannot predict the future with certainty. But as we contemplate the potential impact of AI in radiology, we should remember that radiology does not exist in a vacuum; while AI is changing, so is everything else. The medical system, not to mention the world's population, has been severely impacted by the global COVID-19 pandemic and numerous experts expect future worldwide pandemics. We cannot predict the condition of the healthcare system in two decades but may assume that radiology will likely remain critical in any future medical practice. For now, we should responsibly use all tools at our disposal (including AI) to make ourselves as indispensable as possible. Our best chances of remaining relevant and instrumental to patient care will likely hinge on our ability to lead the changes rather than be passively impacted by them.

Solitary plasmacytoma of the pancreas: A rare case report.

A plasmacytoma is a cancerous growth of abnormal plasma cells that arise within osseous or soft tissue structures. In soft tissue structures, plasmacytomas can present as solitary or multiple masses in the absence of systemic involvement. Solitary plasmacytomas can be subcategorized as extramedullary plasmacytoma (derived from plasma cells located in soft tissues) or osseous plasmacytoma (derived from plasma cells located in the bone marrow). Infrequently, these tumors can arise as extramedullary lesions from the pancreas and present similarly to other tumors, such as pancreatic neuroendocrine tumors (PNETs). In this article, we report the case of a 62-year-old male with a diagnosis of solitary plasmacytoma of the pancreas. We focus on optimizing diagnosis and management through the application of radiological imaging modalities, specifically computed tomography (CT) scans and positron emission tomography-computed tomography (PET-CT) scans.

Metastatic sclerosing epithelioid fibrosarcoma.

Sclerosing epithelioid fibrosarcoma is a rare fibrosarcoma variant in which more than half of patients experience local recurrence or metastatic spread. In the current literature, there is limited and nonspecific imaging data, contributing to frequent misdiagnosis and delays in treatment intervention. Given the poor prognosis associated with this malignancy and the high probability of metastases, accurate and prompt diagnoses are critical. In this article, we report the case of a 27-year-old female diagnosed with metastatic sclerosing epithelioid fibrosarcoma following the discovery of a growing palpable mass on her right gluteus maximus muscle. We focus on the use of radiological imaging modalities in optimizing diagnosis and correlate our imaging and pathological findings.

Primary renal liposarcoma simulating angiomyolipoma.

Liposarcomas are infrequent malignant tumors of mesenchymal origin most commonly seen in the extremities. Although infrequent, these can develop as primary lesions in the soft tissue of the kidney, making them difficult to diagnose through imaging modalities alone. Primary renal liposarcomas are associated with poor prognoses, increasing the importance of timely and accurate diagnosis. In extremely rare instances, the tumor can arise directly from the fat in the epicenter of the kidney, disguised as an angiomyolipoma. In this article, we report the case of a 54-year-old female who was diagnosed with a well-differentiated liposarcoma of the kidney and underwent radical nephrectomy. Our objective is to evaluate unique radiological imaging findings and correlate with histopathological analysis to optimize diagnosis.

Primary diffuse large B-cell lymphoma of the cecum.

When found in the cecum or rectosigmoid junction, primary colorectal B-cell lymphoma is a rare malignant non-Hodgkin's lymphoma often associated with an unfavorable prognosis. Due to the nonspecific clinical symptoms, these uncommon tumors are often left undefined or misdiagnosed, resulting in delays in treatment and adverse patient outcomes. Contrast-enhanced computed tomography is the most commonly used medical imaging process for primary colorectal lymphoma, but due to the rarity of this disorder, accurate imaging diagnosis remains a clinical challenge. In this article, we report the case of a 70-year-old male who was diagnosed with primary B-cell lymphoma of the cecum. We focus on improving diagnosis through the utilization of radiological imaging modalities, particularly computed tomography (CT) and fluorine-18-fluorodeoxyglucose positron emission tomography/computed tomography (18-F-FDG PET/CT). While imaging modalities are important in recognizing colonic lymphomas, there are no pathognomonic imaging features for lymphoma; therefore, biopsy remains necessary for diagnostic confirmation.

Gastrointestinal basidiobolomycosis masquerading as cancer.

Gastrointestinal basidiobolomycosis is an unusual fungal infection caused by Basidiobolus ranarum, a saprophytic fungus primarily found in soil and decaying vegetables. Basidiobolomycosis typically presents as a chronic subcutaneous swelling and rarely infects the gastrointestinal tract. Thus, the infrequency of gastrointestinal infections, along with nonspecific clinical symptoms, often results in misdiagnosed cases and delays in treatment. In this article, we report the case of a 68-year-old male with gastrointestinal basidiobolomycosis masquerading as metastatic cancer. We focus on the use of radiological imaging modalities and histopathological analysis to optimize the diagnosis and treatment of this rare gastrointestinal infection.

Radiologists' Expectations of Artificial Intelligence in Pancreatic Cancer Imaging: How Good Is Good Enough?

BACKGROUND: Existing (artificial intelligence [AI]) tools in radiology are modeled without necessarily considering the expectations and experience of the end user-the radiologist. The literature is scarce on the tangible parameters that AI capabilities need to meet for radiologists to consider them useful tools. OBJECTIVE: The purpose of this study is to explore radiologists' attitudes toward AI tools in pancreatic cancer imaging and to quantitatively assess their expectations of these tools. METHODS: A link to the survey was posted on the www.ctisus.com website, advertised in the www.ctisus.com email newsletter, and publicized on LinkedIn, Facebook, and Twitter accounts. This survey asked participants about their demographics, practice, and current attitudes toward AI. They were also asked about their expectations of what constitutes a clinically useful AI tool. The survey consisted of 17 questions, which included 9 multiple choice questions, 2 Likert scale questions, 4 binary (yes/no) questions, 1 rank order question, and 1 free text question. RESULTS: A total of 161 respondents completed the survey, yielding a response rate of 46.3% of the total 348 clicks on the survey link. The minimum acceptable sensitivity of an AI program for the detection of pancreatic cancer chosen by most respondents was either 90% or 95% at a specificity of 95%. The minimum size of pancreatic cancer that most respondents would find an AI useful at detecting was 5 mm. Respondents preferred AI tools that demonstrated greater sensitivity over those with greater specificity. Over half of respondents anticipated incorporating AI tools into their clinical practice within the next 5 years. CONCLUSION: Radiologists are open to the idea of integrating AI-based tools and have high expectations regarding the performance of these tools. Consideration of radiologists' input is important to contextualize expectations and optimize clinical adoption of existing and future AI tools.

Radiation-induced osteosarcoma of the chest wall after treatment for unresectable thymoma.

Secondary osteosarcoma is a rare complication of radiation therapy for a primary tumor. Here we report a unique presentation of radiation-induced osteosarcoma of the chest wall after radiation treatment for thymoma. This patient underwent multiple imaging studies, including magnetic resonance imaging and computed tomography with cinematic rendering. Diagnosis of osteosarcoma was confirmed through imaging features and histology. Several surgical procedures were performed to evaluate and attempt resection of the tumor, but ultimately the tumor location and involvement prevented adequate resection and chemotherapy was initiated. This case highlights the importance of identifying clear cumulative dose thresholds for radiation therapy and rare complications of radiotherapy.

A Primer on the Role of iPhone Apps in Medical and Radiology Education and How to Develop Them.

Among the numerous innovations implemented in medical education since the beginning of the 21st century, small-group learning experiences have worked well for modern students and the application of computer technology provided access to thousands of lectures, images, and slides via the internet. This has helped to build an electronic foundation on which further educational adaptations have arisen in the current era, coupled with the altered communications landscape represented by Apple's introduction of the iPhone and Google's subsequent entrance onto the playing field. With the advent of smartphone applications (apps), education has taken on an even more personalized approach. Data show that the use of educational apps has been embraced by today's nursing and medical students, notably including radiology students. We survey recent research on the use and desirability of medical apps and offer practical tips for those ready to embark on developing medical, particularly radiology, educational apps including how to assess and hone them for optimal use.

From medical school through residency applications: Puerto Ricans may face ignorance and prejudice.

It is not that unusual to find that Americans are unaware that Puerto Rico is a territory of the United States, and, like them, Puerto Ricans are U.S citizens enjoying the same liberties, freedoms, and rights. It may be less expected to face such incognizance or ignorance within the medical community as careers in medicine offer healthcare professionals the opportunity to serve patients spanning race, ethnicity, gender, sexual orientation, religion, and other demographic differences. Unfortunately, some of the personal experiences of the primary author have prompted us to cull four personal narratives of Puerto Rican individuals (Boricuas), who comprise 20.8% of the Hispanic, Latino, or Spanish Origin applicants to U.S. medical schools, during various early stages of a medical career. Of course, these personal anecdotes, offered in response to just a few general questions about recent experiences of bias in medical applications or in early training, do not indicate pervasive bias. Similarly, these instances may be more common than people in the medical community would prefer to believe. In the brief narratives that follow, Boricuas at different junctures in their medical educations highlight the bias that they have faced and their reactions to it. We present this information with the hope of promoting awareness of potential biases at different stages of medical education.

CT of retroperitoneal solitary fibrous tumor.

Solitary fibrous tumors are rare tumors of pluripotent fibroblastic or myofibroblastic origin that generally arise among older individuals, with a mean age of onset ranging from 55 to 65 years. Though typically associated with pleural involvement, solitary fibrous tumors can emerge in virtually every anatomic location within the body. Although most solitary fibrous tumors are benign, approximately 20% may exhibit malignant features such as local invasion, recurrence, and metastases. In this article, we report the case of a 58-year-old male with a diagnosis of a retroperitoneal solitary fibrous tumor. We analyze computed tomography imaging findings and additionally correlate imaging features with the patient's unique pathological and genotypic findings to optimize diagnosis.

CT of pancreatic schwannoma.

Schwannomas are a type of nerve sheath tumor formed by Schwann cells. They typically occur in the head and neck area, the trunk, and flexor surfaces of the upper and lower extremities. Schwannomas are often benign, and pancreatic schwannomas are extremely uncommon. Given the rarity of these tumors and their clinical similarity to other pancreatic lesions, however, pancreatic schwannomas are challenging to diagnose preoperatively. In this article, we report the case of a 69-year-old female who was diagnosed with a pancreatic schwannoma. We focus on optimizing diagnosis and management through the application of radiological imaging modalities, specifically computed tomography scans with cinematic rendering.

Evaluation and Comparison of Two Media-Rich Radiology Apps Regarding Pathology of the Lumbar Spine: Lessons for Medical Education App Developers and Content Creators.

BACKGROUND: Mobile applications have become an increasingly popular component of medical education over the past 2 decades. Visual layout and aesthetics are important considerations in app design given Generation Z's strong preference for visually appealing digital content. In this study, we evaluate students' perceptions of an educational app related to pathology of the lumbar spine before and after a redesign of its workflow and illustrations. OBJECTIVE, MATERIAL AND METHODS: A professional user experience and interface designer was recruited for the revision of an iOS app focused on anatomy and pathology of the lumbar spine on abdominal computed tomography (CT). Revisions focused on developing the app to make it more visually appealing, increasing ease of use, and fixing bugs. An IRB-approved study was conducted in which participants were asked to interact with the original and revised versions of the app prior to completing a survey regarding their perception of the graphics, animation style, overall app design, and content. RESULTS: Overall impressions of the revised app were more positive than the original app, with 89% of respondents finding the revised app's graphics to be visually appealing compared to 39% regarding the original app. Further, 95% of respondents indicated that the revised app's layout was organized and user-friendly compared to 73% regarding the original. Both apps received similarly positive ratings for participants' understanding of the presented materials. CONCLUSION: User feedback is key when designing mobile health and educational applications. Feedback may be sought via formal usability testing or app-specific surveys. The aesthetics, layout, and ease of use of mobile apps are important considerations and, in the absence of content alteration, may influence user engagement. Knowledge regarding these factors may guide content creators when developing and deploying mobile health applications.

Corrigendum to "Response to letter to the editor Re: Case report CT of rhabdomyolysis as a sequela of drug abuse" [Radiology Case Reports 18 (2023) 729].

[This corrects the article DOI: 10.1016/j.radcr.2022.11.028.].

Life Lessons on the Importance of Love and Friendship.

As noted in the Gallop employee engagement survey, friendships are a vitally important part of work-place productivity, engagement, and satisfaction. The recent "Great Resignation" across many industries, including medicine, has underscored the importance of friendship at work. In this manuscript, we will recount aspects of the life of noted author, Dr. Sanford Greenberg, in which remarkable friends and loved ones gave of themselves to help him overcome significant challenges. Dr. Greenberg, who became blind during college, ultimately persevered to pursue scholarship and philanthropy. The manuscript is written predominantly from his first-person perspective.