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Das P, Dixit R, Prakash A, Daga MK, Singh R. Diffusion-weighted magnetic resonance imaging of abdominal tuberculosis: a new take on an old disease. Abdom Radiol (NY) 2022; 47:3446-3458. [PMID: 35864265 DOI: 10.1007/s00261-022-03607-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/14/2022] [Revised: 06/24/2022] [Accepted: 06/24/2022] [Indexed: 06/15/2023]
Abstract
Abdominal tuberculosis is a major cause of mortality and morbidity in developing countries also re-emerging in western world due to the AIDS epidemic and population migration. Large proportion of the patients are young and hence radiation exposure is of concern. In addition, in some patients, contrast may be contraindicated or repeat studies may be required, where MR especially DWI may be useful. The aim of the study is to describe MRI features in abdominal tuberculosis including DWI in the involved bowel, lymphadenopathy, omental, and peritoneal thickening. Nodes being especially easy to appreciate on DWI, thus DWI in conjunction with routine noncontrast MR sequence can be useful technique to identify abdominal tubercular lesions in patients with contraindication to contrast.
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Affiliation(s)
- Prince Das
- Department of Radiodiagnosis, Maulana Azad Medical College, New Delhi, India
| | - Rashmi Dixit
- Department of Radiodiagnosis, Maulana Azad Medical College, New Delhi, India.
| | - Anjali Prakash
- Department of Radiodiagnosis, Maulana Azad Medical College, New Delhi, India
| | - M K Daga
- Department of Medicine, Maulana Azad Medical College, New Delhi, India
| | - Rajdeep Singh
- Department of Surgery, Maulana Azad Medical College, New Delhi, India
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Zhang Y, Yu T, Zhang W, Yang G. Contrast-Enhanced Ultrasound Imaging Features of Focal Splenic Tuberculosis. Med Sci Monit 2021; 27:e932654. [PMID: 34526476 PMCID: PMC8454255 DOI: 10.12659/msm.932654] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/16/2022] Open
Abstract
Background The aim of this study was to characterize the contrast-enhanced ultrasound imaging features of focal splenic tuberculosis. Material/Methods We retrospectively analyzed the conventional ultrasound (US) and contrast-enhanced ultrasound (CEUS) imaging features of 22 patients with splenic TB confirmed by surgical histopathology or biopsy. Results Conventional US demonstrated that 15 of the 22 patients had a single lesion, while 7 had multiple lesions. The maximum diameter of the lesions ranged from 1.0 to 3.7 cm. Of the 22, 17 were detected with hypoecho and 5 were detected with complex echo by conventional US. Seven (7/22) were detected with blood flow signals by color Doppler flow image (CDFI). CUES demonstrated that 18 cases (81.8%, 18/22) began to enhance in the arterial phase, mostly followed by slow wash-out in the intermediate or late parenchymal phase, and 4 (18.2%, 4/22) presented with non-enhancement during all phases. The enhancement patterns were categorized into 4 types: Type I, homogeneous enhancement (2/22); Type II, rim-like enhancement (12/22); Type III, septation-like enhancement (4/22); and Type IV, non-enhancement (4/22). Conclusions CEUS showed that splenic TB lesions were enhanced in the arterial phase, followed by slow washed out or persistent enhancement in the intermediate and late parenchymal phases. The rim- or septation-like enhancement may be helpful for diagnosing splenic TB. The splenic lesions presenting round hypoecho by conventional US and complete non-enhancement by CEUS are highly suspicious of splenic TB.
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Affiliation(s)
- Ying Zhang
- Department of Ultrasonography, Affiliated Hangzhou Chest Hospital, Zhejiang University School of Medicine (Integrated Chinese and Western Hospital of Zhejiang Province, Hangzhou Red Cross Hospital), Hangzhou, Zhejiang, China (mainland)
| | - Tianzhuo Yu
- Department of Ultrasonography, Affiliated Hangzhou Chest Hospital, Zhejiang University School of Medicine (Integrated Chinese and Western Hospital of Zhejiang Province, Hangzhou Red Cross Hospital), Hangzhou, Zhejiang, China (mainland)
| | - Wenzhi Zhang
- Department of Ultrasonography, Affiliated Hangzhou Chest Hospital, Zhejiang University School of Medicine (Integrated Chinese and Western Hospital of Zhejiang Province, Hangzhou Red Cross Hospital), Hangzhou, Zhejiang, China (mainland)
| | - Gaoyi Yang
- Department of Ultrasonography, Affiliated Hangzhou Chest Hospital, Zhejiang University School of Medicine (Integrated Chinese and Western Hospital of Zhejiang Province, Hangzhou Red Cross Hospital), Hangzhou, Zhejiang, China (mainland)
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Splenic Involvement in Disseminated Mycobacterium avium-intracellulare Infection: Magnetic Resonance Imaging Findings. J Comput Assist Tomogr 2018; 42:151-154. [PMID: 28708727 DOI: 10.1097/rct.0000000000000639] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
We report the imaging findings of a patient with disseminated Mycobacterium avium-intracellulare complex presenting with multiple splenic lesions incompletely characterized on computed tomography in whom magnetic resonance imaging helped narrow the differential diagnosis. We discuss the magnetic resonance imaging findings suggesting the diagnosis, including the presence of focal susceptibility artifact within the lesions (ie, signal drop on T1 in-phase imaging), marked hypointensity on diffusion-weighted imaging, and faint progressive peripheral enhancement after contrast administration. We provide pathologic correlation to explain these imaging characteristics and a review of the literature of imaging characteristics in splenic involvement of M. avium-intracellulare complex infection.
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Ayyala RS, Anupindi SA, Taylor GA, Gee MS, Bellah RD, Chauvin NA. Imaging of Splenic Infections (and Their Mimickers) in Children. CURRENT RADIOLOGY REPORTS 2016. [DOI: 10.1007/s40134-015-0129-5] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
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Lee NK, Kim S, Kim DU, Seo HI, Kim HS, Jo HJ, Kim TU. Diffusion-weighted magnetic resonance imaging for non-neoplastic conditions in the hepatobiliary and pancreatic regions: pearls and potential pitfalls in imaging interpretation. ACTA ACUST UNITED AC 2015; 40:643-62. [PMID: 25216848 DOI: 10.1007/s00261-014-0235-5] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
Potentially, diffusion-weighted magnetic resonance imaging (DWI) can assess the functional information on concerning the status of tissue cellularity, because increased cellularity is associated with impeded diffusion. DWI in the hepatobiliary and pancreatic regions has demonstrated the usefulness to detect malignant lesions and differentiate them from benign lesions. However, it has been shown more recently that there is some overlap in ADC values for benign and malignant neoplasms. Moreover, some non-neoplastic lesions in the hepatobiliary and pancreatic regions exhibit restricted diffusion on DWI, because of pus, inflammation, or high cellularity. Focal eosinophilic liver disease, hepatic inflammatory myofibroblastic tumor, granulomatous liver disease, acute cholecystitis, xanthogranulomatous cholecystitis, focal pancreatitis, or autoimmune pancreatitis frequently exhibit restricted diffusion on DWI, which may be confused with malignancy in the hepatobiliary and pancreatic regions. Thus, DWI should not be interpreted in isolation, but in conjunction with other conventional images, to avoid the diagnostic pitfalls of DWI. Nevertheless, the presence of diffusion restriction in the non-neoplastic lesions sometimes provides additional information regarding the diagnosis, in problematic patients where conventional images have yielded equivocal findings. DWI may help differentiate hepatic abscess from malignant necrotic tumors, gallbladder empyema from dense bile or sludge in the gallbladder, and pylephlebitis from bland thrombosis in the portal vein. Therefore, knowledge of DWI findings to conventional imaging findings of diffusion-restricted non-neoplastic conditions in the hepatobiliary and pancreatic regions helps establishing a correct diagnosis.
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Affiliation(s)
- Nam Kyung Lee
- Department of Radiology, Biomedical Research Institute, Pusan National University Hospital, Pusan National University School of Medicine, Pusan National University, #179, Gudeok-Ro, Seo-Gu, Busan, 602-739, Republic of Korea
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Bielewicz-Zielińska A, Brzezicki J, Rymko M, Jeka S. Unusual location of tuberculosis in the course of tumor necrosis factor α inhibitor therapy. Reumatologia 2015; 53:161-4. [PMID: 27407244 PMCID: PMC4847295 DOI: 10.5114/reum.2015.53139] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/02/2015] [Accepted: 06/26/2015] [Indexed: 11/17/2022] Open
Abstract
Tuberculosis is an infectious disease caused by Mycobacterium tuberculosis complex mycobacteria. Extrapulmonary tuberculosis usually develops more than two years after infection or many years later. Factors favoring onset of the disease are malnutrition, older age, renal failure, diabetes, cancer, immunosuppression and biological treatment, e.g. tumor necrosis factor α (TNF-α) inhibitors. The paper presents a case of a 56-year-old patient with ankylosing spondylitis treated with infliximab, diagnosed with tuberculosis of the spleen. The unusual location and uncharacteristic symptoms created a lot of diagnostic difficulties, particularly as during qualification for biological treatment tests are performed to exclude infection with Mycobacterium tuberculosis. Pharmacological treatment of tuberculosis is typical, but in the case of tuberculosis of the spleen, splenectomy also is a method of treatment. The decision was made to implement pharmacological treatment, which proved to be effective, so the patient avoided surgery.
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Affiliation(s)
| | - Jan Brzezicki
- Department of Rheumatology, Voivodeship Hospital, Elbląg, Poland
| | - Marcin Rymko
- NZOZ Nasz Lekarz, Clinical Trials Office, Toruń, Poland
| | - Sławomir Jeka
- Clinic of Rheumatology and Connective Tissue Diseases, University Hospital No. 2 Dr. Jan Biziel, Collegium Medicum in Bydgoszcz, Nicolaus Copernicus University in Toruń, Poland
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Nononcologic applications of diffusion-weighted imaging in the gastrointestinal system. AJR Am J Roentgenol 2015; 204:758-67. [PMID: 25794064 DOI: 10.2214/ajr.14.12729] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/18/2022]
Abstract
OBJECTIVE The purpose of this article is to review infectious, inflammatory, and auto-immune-mediated processes in the gastrointestinal system where diffusion-weighted imaging can be helpful as well as pitfalls associated with its use. CONCLUSION Diffusion-weighted imaging has become an important and widely used tool in abdominal and pelvic MRI, but it has been used primarily for oncologic applications. As more body MRI protocols are routinely including diffusion-weighted imaging, this sequence can be useful in evaluating an increasing number of nononcologic processes.
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Li G, Xu P, Pan X, Qin H, Chen Y. The effect of age on apparent diffusion coefficient values in normal spleen: A preliminary study. Clin Radiol 2014; 69:e165-7. [DOI: 10.1016/j.crad.2013.11.017] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/20/2013] [Revised: 11/21/2013] [Accepted: 11/26/2013] [Indexed: 01/19/2023]
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Prapruttam D, Hedgire SS, Mani SE, Chandramohan A, Shyamkumar NK, Harisinghani M. Tuberculosis--the great mimicker. Semin Ultrasound CT MR 2014; 35:195-214. [PMID: 24929261 DOI: 10.1053/j.sult.2014.02.002] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
Tuberculosis is an immense health problem in the developing world, and it remains a health care challenge in the developed world. It can affect virtually any organ system in the body. Diagnosis of tuberculosis is often difficult. Many patients with tuberculosis present with nonspecific symptoms, negative purified protein derivative skin test result, and negative findings on culture specimens. Cross-sectional imaging with ultrasound, multidetector computed tomography, and magnetic resonance imaging plays an important role in the diagnosis of tuberculosis. Tuberculosis demonstrates a variety of radiologic features depending on the organ involved and can mimic a number of other disease entities. Cross-sectional imaging alone is insufficient in reaching a conclusive diagnosis. Tuberculosis is a great mimicker as its radiologic manifestations can simulate numerous other diseases across the body systems. However, recognition and understanding of the common and uncommon radiologic manifestations of tuberculosis should alert considering tuberculosis in the high-risk population and correct clinical setting to enable appropriate treatment.
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Affiliation(s)
- Duangkamon Prapruttam
- Division of Abdominal Imaging and Intervention, Massachusetts General Hospital-Harvard Medical School, Boston, MA
| | - Sandeep S Hedgire
- Division of Abdominal Imaging and Intervention, Massachusetts General Hospital-Harvard Medical School, Boston, MA.
| | - Sunithi Elizabeth Mani
- Department of Radiology, Christian Medical College, Thottapalayam, Vellore, Tamil Nadu, India
| | - Anuradha Chandramohan
- Department of Radiology, Christian Medical College, Thottapalayam, Vellore, Tamil Nadu, India
| | - N K Shyamkumar
- Department of Radiology, Christian Medical College, Thottapalayam, Vellore, Tamil Nadu, India
| | - Mukesh Harisinghani
- Division of Abdominal Imaging and Intervention, Massachusetts General Hospital-Harvard Medical School, Boston, MA
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Fasih N, Gulati A, Ryan J, Ramanathan S, Prasad Shanbhogue AK, McInnes M, Macdonald DB, Fraser-Hill MA, Walsh C, Kielar AZ, Bhagat K. The Mysterious Organ. Spectrum of Focal Lesions within the Splenic Parenchyma: Cross-Sectional Imaging with Emphasis on Magnetic Resonance Imaging. Can Assoc Radiol J 2014; 65:19-28. [DOI: 10.1016/j.carj.2012.03.004] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/17/2010] [Revised: 02/12/2012] [Accepted: 03/07/2012] [Indexed: 12/19/2022] Open
Abstract
Incidental splenic lesions are frequently encountered at imaging performed for unrelated causes. Splenic cysts, hemangiomas, and lymphomatous involvement are the most frequently encountered entities. Computed tomography and sonography are commonly used for initial evaluation with magnetic resonance imaging reserved as a useful problem-solving tool for characterizing atypical and uncommon lesions. The value of magnetic resonance imaging lies in classifying these lesions as either benign or malignant by virtue of their signal-intensity characteristics on T1- and T2-weighted imaging and optimal depiction of internal hemorrhage. Dynamic contrast-enhanced sequences may improve the evaluation of focal splenic lesions and allow characterization of cysts, smaller hemangiomas, and hamartomas. Any atypical or unexplained imaging feature related to an incidental splenic lesion requires additional evaluation and/or follow-up. Occasionally, biopsy or splenectomy may be required for definitive assessment given that some of tumours may demonstrate uncertain biologic behavior.
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Affiliation(s)
- Najla Fasih
- Department of Diagnostic Imaging, The Ottawa Hospital, University of Ottawa, Ontario, Canada
| | - Ajay Gulati
- PGIMER (Post Graduate Institute of Medical Education and Research), Chandigarh, India
| | - John Ryan
- Department of Diagnostic Imaging, The Ottawa Hospital, University of Ottawa, Ontario, Canada
| | - S. Ramanathan
- PGIMER (Post Graduate Institute of Medical Education and Research), Chandigarh, India
| | | | - Matthew McInnes
- Department of Diagnostic Imaging, The Ottawa Hospital, University of Ottawa, Ontario, Canada
| | - David B. Macdonald
- Department of Diagnostic Imaging, The Ottawa Hospital, University of Ottawa, Ontario, Canada
| | | | - Cynthia Walsh
- Department of Diagnostic Imaging, The Ottawa Hospital, University of Ottawa, Ontario, Canada
| | - Ania Z. Kielar
- Department of Diagnostic Imaging, The Ottawa Hospital, University of Ottawa, Ontario, Canada
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Tirumani SH, Ojili V, Gunabushanam G, Shanbhogue AKP, Nagar A, Fasih N, Chintapalli KN. Imaging of tuberculosis of the abdominal viscera: beyond the intestines. J Clin Imaging Sci 2013; 3:17. [PMID: 23814689 PMCID: PMC3690674 DOI: 10.4103/2156-7514.111234] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/14/2013] [Accepted: 03/09/2013] [Indexed: 02/06/2023] Open
Abstract
There is an increasing incidence of both intra- and extra-thoracic manifestations of tuberculosis, in part due to the AIDS epidemic. Isolated tubercular involvement of the solid abdominal viscera is relatively unusual. Cross-sectional imaging with ultrasound, multidetector computed tomography (CT), and magnetic resonance imaging (MRI) plays an important role in the diagnosis and post treatment follow-up of tuberculosis. Specific imaging features of tuberculosis are frequently related to caseous necrosis, which is the hallmark of this disease. However, depending on the type of solid organ involvement, tubercular lesions can mimic a variety of neoplastic and nonneoplastic conditions. Often, cross-sectional imaging alone is insufficient in reaching a conclusive diagnosis, and image-guided tissue sampling is needed. In this article, we review the pathology and cross-sectional imaging features of tubercular involvement of solid abdominopelvic organs with a special emphasis on appropriate differential diagnoses.
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Affiliation(s)
- Sree Harsha Tirumani
- Department of Imaging, Dana Farber Cancer Institute, Harvard Medical School, Boston, MA, USA
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Suzuki T, Takeuchi M, Naiki T, Kawai N, Kohri K, Hara M, Shibamoto Y. MRI findings of granulomatous prostatitis developing after intravesical Bacillus Calmette-Guérin therapy. Clin Radiol 2013; 68:595-9. [PMID: 23384503 DOI: 10.1016/j.crad.2012.12.005] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/05/2012] [Revised: 12/17/2012] [Accepted: 12/19/2012] [Indexed: 11/30/2022]
Abstract
AIM To evaluate magnetic resonance imaging (MRI) findings of granulomatous prostatitis (GP) developing after intravesical Bacillus Calmette-Guérin (BCG) therapy. MATERIALS AND METHODS Ten patients with pathologically proven GP underwent prostatic MRI. Lesion shape and signal intensity (SI) were evaluated on T2-weighted (T2WI), T1WI, and diffusion-weighted imaging (DWI). RESULTS Polygonal nodular lesions with notches, diffuse lesions, and cystic lesions with mural nodules were seen in two, six, and one patients, respectively. The remaining patient had a diffuse and cystic lesion. All diffuse lesions showed higher SI than muscle on T1WI and higher SI than the normal peripheral zone (PZ) on DWI. On T2WI, six of seven diffuse lesions showed a slightly lower SI than bone marrow and the remaining one lesion was iso-intense. All nodular lesions showed a low SI similar to muscle on T2WI and were iso-intense to muscle on T1WI. On DWI, two each of the four nodular lesions showed slightly lower SI and slightly higher SI than the normal PZ, respectively. All contents within the cyst and mural nodules showed markedly high and low SI on T2WI, respectively. On DWI, all fluids within cysts showed markedly high SI. One each of the mural nodules showed slightly higher SI and slightly lower SI than the normal PZ on DWI. CONCLUSION Three main MRI patterns of GP were identified: diffuse, nodular, and cystic with mural nodule; among them, the diffuse type was the most common. Cystic lesions with mural nodules could accompany the lesion.
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Affiliation(s)
- T Suzuki
- Department of Radiology, Graduate School of Medical Sciences, Nagoya City University, Nagoya City, Japan.
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Fernández de Orueta L, Rodríguez Álvarez S, Núñez Otero J, Gómez Rubio M, Cacho Calvo J, Esteban Fernández J. [Symptomatic hypercalcemia presenting as a case of isolated splenic tuberculosis]. Med Clin (Barc) 2012; 139:443-5. [PMID: 22809966 DOI: 10.1016/j.medcli.2012.04.029] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/23/2012] [Accepted: 04/26/2012] [Indexed: 11/30/2022]
Abstract
BACKGROUND AND OBJECTIVE To describe an unusual clinical presentation as isolated splenic tuberculosis. PATIENT AND METHODS We report a case of isolated splenic tuberculosis, a rare form of extrapulmonary tuberculosis in an immunocompetent patient, and, as a peculiarity, debuts in the form of symptomatic hypercalcemia. RESULTS We deeply report the clinical case and the procedures performed to exclude other diseases. We emphasize the usefulness of fine needle aspiration of the spleen to obtain microbiological samples, and the use of specific polymerase chain reaction for mycobacterias to establish the definitive diagnosis of this entity. In agreement with other authors, we chose initial medical treatment with antituberculous drugs, reserving surgery for refractory cases or in case of spontaneous splenic rupture. CONCLUSION Hypercalcemia can be a presentation of granulomatous diseases. The isolated involvement of the spleen by mycobacterias is a rare form of extrapulmonary tuberculosis and more so in immunocompetent patients.
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Takeuchi M, Suzuki T, Sasaki S, Ito M, Hamamoto S, Kawai N, Kohri K, Hara M, Shibamoto Y. Clinicopathologic significance of high signal intensity on diffusion-weighted MR imaging in the ureter, urethra, prostate and bone of patients with bladder cancer. Acad Radiol 2012; 19:827-33. [PMID: 22341371 DOI: 10.1016/j.acra.2012.01.013] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/11/2011] [Revised: 01/18/2012] [Accepted: 01/30/2012] [Indexed: 01/05/2023]
Abstract
RATIONALE AND OBJECTIVES The aim of this study was to determine the clinicopathologic significance of high-intensity areas in the ureter, urethra, prostate, and bone incidentally found on diffusion-weighted magnetic resonance imaging (DWI) for the staging of bladder cancer. MATERIALS AND METHODS Axial and sagittal DWI and T2-weighted imaging of the pelvis were evaluated in 157 patients with bladder cancer. Two observers assessed T2-weighted imaging with DWI independently. The observers pointed out 67 areas showing abnormal high signal intensity on DWI in the ureter (n = 17), urethra (n = 8), prostate (n = 20), and bone (n = 22). Of the 67 high-intensity areas, 33 lesions were confirmed histopathologically (ureter, n = 10; urethra, n = 7; prostate, n = 16), and 22 bone lesions were diagnosed using T1-weighted imaging and follow-up computed tomography. Thus, 55 lesions were evaluable for correlation with DWI findings. RESULTS Of the 55 high-intensity areas, 28 (53%) were synchronous or metastatic urothelial cancer or invasion of urothelial cancer. The remaining 27 (47%) were a ureteral clot in one, a ureteral stone granuloma in one, prostatic cancer in six, granulomatous prostatitis in three, and normal red bone marrow in 16. CONCLUSIONS DWI is useful to comprehend the extent of bladder cancer and to detect incidentally coexisting diseases. Other imaging, endoscopic, and clinical findings would be useful to reduce false positivity.
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Affiliation(s)
- Mitsuru Takeuchi
- Department of Radiology, Nagoya City University Graduate School of Medical Sciences, 1 Kawasumi Mizuho-cho, Mizuho-ku, Nagoya Aichi, 467-8601, Japan.
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