DOCSLIB.ORG

TABLE of CONTENTSINDICE Table of Contents

Total Page：16

File Type：pdf, Size：1020Kb

Download full-text PDF Read full-text
TABLE of CONTENTSINDICE Table of Contents TABLE OF CONTENTSINDICE Table of contents Authors Pulse sequences Collaborators Preface Introduction Acronyms Spin-echo sequences Inversion recovery sequences GENERAL SECTION Gradient-echo sequences Stefano Colagrande, Pasquale Paolantonio Turbo spin-echo sequences Various types of gradient echo Symbols, acronyms, and glossary Echo planar sequences Hybrid sequences Genesis and intrinsic parameters of signal GRE 3D sequences Appendix - A more detailed discussion Introduction about sequences Insertion of the nuclei in the B0: orientation and precession Saturation techniques Transmission of the RF pulse: excitation and phase synchronization Chemical shift Termination of the RF pulse: Types of saturation techniques relaxation and signal formation Selective fat/water saturation Intrinsic parameters with non-Dixon techniques Spin and lattice Selective saturation with Dixon technique T1 or spin-lattice relaxation time Selective saturation of organic tissues T2 or spin-spin relaxation time Selective free-bound water saturation Extrinsic parameters K-space sampling strategies Introduction Introduction Pulse repetition time Sampling K-space typologies Echo time Linear non-echo planar sampling Repetition time and echo time Echo planar sampling Flip angle Radial sampling Matrix Parallel imaging Field of view Appendix - A more detailed discussion Number of averages or number of excitations about sequences and two FAQs Signal-encoding and basic K-space concepts Diffusion imaging Introduction Introduction Encoding gradients Acquisition and quantifi cation K-space Quality and reproducibility Gradients and conventional Intravoxel incoherent motion and Kurtosis bi- and three-dimensional acquisition DWI in everyday practice Multislice technique Type of equipment and indication of parameters Gradients and new acquisition techniques Acquisition and breathing mode K-space and temporal savings methods Extent and number of b-values Rectangular fi eld of view Relationships in administrating contrast medium Scan percentage and age Half scan Clinical utility of DWI acquisitions TABLE OF CONTENTS MR quantifi cation Independent of any encoding Magnetic susceptibility Introduction Magnetic fi eld inhomogeneities Relaxometry MR angiography artifacts T1 mapping Maki effect T2 and T2 mapping* Blurring Fat fraction Dielectric effect Perfusion Post-processing MR safety Semiquantitative non-parametric methods (model-free) Introduction Quantitative parametric methods Static magnetic fi eld Spectroscopy Gradient magnetic fi elds Magnetic fi elds linked to RF General and fl ow semeiotics MRI compatibility with medical devices and implants Introduction Malfunction of active devices or implants Paramagnetic agent semeiotics Pregnancy Flow signal semeiotics Contrast media and pregnancy TOF phenomena Contrast media and safety Phase-shift effects phenomena Essential references of the general section Acquisition: angiography sequences Non-contrast MR angiography SPECIAL SECTION TOF technique PC technique Other non-contrast-enhanced-MR angiography Contrast media techniques Giovanni Morana, Andrea Mazzaro, Contrast-enhanced-MR angiography Alex Faccinetto, Luigi Grazioli Contrast-enhanced-MR angiography sequences Contrast agent administration Introduction Black-blood sequences Mechanism of action Bright-blood sequences Classifi cation Extracellular contrast agents (vascular-interstitial) Equipment CA with intravascular distribution CA with organ-specifi c distribution Introduction CA with gastrointestinal distribution Magnet Radiofrequency coils SAFETY OF MRI CONTRAST AGENTS Gradient system Alfonso Ragozzino, Marta Puglia, Anna Giacoma Tucci Introduction Artifacts Acute adverse reactions Late and very late adverse reactions Introduction Renal adverse reactions (post-contrast acute Phase renal injury) Aliasing Recommendations for clinical practice Radiofrequencies Pregnancy and breastfeeding Movement Gadolinium retention in the body Frequency The choice of gadolinium-based contrast agent Chemical shift High risk Phase and frequency Intermediate risk Gibbs truncation artifact Low risk Slice Multislice cross-talk References TABLE OF CONTENTSINDICE Liver MR IN PEDIATRICS - Liver tumors Luigi Grazioli, Martina Bertuletti, Maria Pia Bondioni, Luigi Grazioli, Barbara Frittoli, Giovanni Morana Francesco Acquafredda, Marcello Napolitano Introduction Introduction MR technique Benign lesions MR anatomy and anatomic variants of the liver Hepatic hemangioma Mesenchymal hamartoma HEPATOPATHY AND CIRRHOSIS Focal nodular hyperplasia Introduction Hepatic adenoma Diffuse liver diseases Nodular regenerative hyperplasia Acute hepatitis Malignant lesions Chronic hepatitis Hepatoblastoma Hepatocellular carcinoma Steatosis-steatohepatitis Fibrolamellar hepatocellular carcinoma Cirrhosis Cholangiocarcinoma Cirrhosis in hemochromatosis Undifferentiated embryonal sarcoma Hepatocellular carcinoma Biliary rabdomyosarcoma NON-CIRRHOTIC AND ONCOLOGICAL LIVER Angiosarcoma Introduction References Benign lesions Cysts Portal system Hamartoma Alfonso Ragozzino, Onorina Bruno, Hemangioma Giuseppe Di Costanzo, Anna Giacoma Tucci Hepatocellular adenoma Focal nodular hyperplasia Introduction Perivascular epithelioid cell tumors MR technique Abscesses Clinical features Infl ammatory pseudotumor Anatomical variants of the portal vein Malignant lesions Portal hypertension Cholangiocarcinoma (intrahepatic) Portal vein obstruction Hepatic lymphoma Portal vein thrombosis Rare primitive lesions Portal vein thrombosis and cirrhosis Metastases Neoplastic obstruction of the portal vein Liver in oncological patients: clinical problems Portosinusoidal vascular disease Identifi cation Isolated thrombosis of the splenic vein Characterization Liver transplant Suprahepatic veins LIVER IMAGING REPORTING Budd-Chiari syndrome AND DATA SYSTEM (LI-RADS) DIAGNOSTIC CRITERIA References Federica Vernuccio, Roberto Cannella, Giuseppe Brancatelli Liver transplantation: Introduction pre- and post-operative evaluations MR LI-RADS: contexts and target population Rita Golfi eri, Alfonso Ragozzino, MR features for categorization of observations Irene Pettinari, Matteo Renzulli Major features Ancillary features favoring malignancy, Pre-operative imaging not HCC in particular Pre-operative evaluation Ancillary features favoring HCC in particular of liver transplantation candidates Ancillary features favoring benignity Pre-operative evaluation of a living donor Diagnostic categories and management Post-operative imaging Steps for assigning LR-1 Post-transplant normal fi ndings to LR-5 diagnostic category Post-transplant complications LI-RADS treatment algorithm References TABLE OF CONTENTS Gallbladder and biliary system Neoplastic pancreatic cystic lesions Alfonso Ragozzino, Giuseppe Di Costanzo, Acinar cell cystic neoplasm Marta Puglia, Anna Giacoma Tucci References Introduction Spleen MR technique Alessandro Stecco, Alessio Paschè Normal MR anatomy Anatomical variants Introduction Non-neoplastic lesions MR technique Congenital anomalies Normal MR anatomy Lithiasis Benign lesions Phlogistic pathology Cysts Malignant lesions Hamartoma Cholangiocarcinoma Hemangioma Periampullary carcinomas Lymphangioma Gallbladder carcinoma Malignant lesions Polyps Hemangiosarcoma Metastasis Lymphoma Post-surgical evaluation Metastasis Post-operative complications Vascular alterations Traumatic injuries Splenic infarction Gallbladder trauma Splenic artery aneurysms Biliary system trauma Infectious pathology Abscesses MR IN PEDIATRICS - Choledochal cysts Tuberculosis and malformations Infl ammatory pathology Maria Pia Bondioni, Alfonso Ragozzino, Sarcoidosis Francesco Laffranchi, Marcello Napolitano Trauma Splenomegaly Choledochal cysts References Spontaneous biliary perforation Biliary atresia Gastrointestinal system Alagille syndrome Inspissated bile plug syndrome ESOPHAGUS Gallbladder and biliary lithiasis Domenico De Santis, Andrea Laghi Gallbladder agenesis Introduction MR technique References Organic pathology Motility pathology Pancreas Giovanni Morana, Alex Faccinetto, STOMACH Silvia Venturini, Riccardo Manfredi Elena Lucertini, Andrea Laghi Introduction Introduction MR technique MR technique Sequences Benign lesions Gastrointestinal stromal tumor Non-tumoral lesions Lipomas Acute pancreatitis Malignant lesions Recurrent acute pancreatitis Adenocarcinoma Chronic pancreatitis Lymphoma Paraduodenal pancreatitis Autoimmune pancreatitis SMALL BOWEL Non-neoplastic pancreatic cystic lesions Domenico De Santis, Andrea Laghi Malignant lesions Pancreatic carcinoma Introduction Neuroendocrine tumors MR technique TABLE OF CONTENTSINDICE MR enteroclysis and MR enterography MR IN PEDIATRICS - Kidney tumors Benign lesions Angelo Lazzara, Marcello Napolitano, Crohn disease Alessandro Campari, Maria Pia Bondioni Celiac disease Adenoma Introduction Malignant lesions Wilms tumor Gastrointestinal stromal tumors Adenocarcinoma Neuroendocrine tumors URINARY TRACT Lymphoma Maria Assunta Cova, Ilaria Fiorese, Maria Chiara Ricciardi, Irene Campo COLON MR technique Marta Zerunian, Andrea Laghi Benign lesions MR technique Fibroepithelial polyp Colorectal polyps and cancer Pyonephrosis Malignant lesions RECTUM (RECTAL CANCER) Transitional cell carcinoma Andrea Delli Pizzi, Regina G. H. Beets-Tan Introduction MR IN PEDIATRICS - Urinary tract malformations Rectal cancer management - general concepts Angelo Lazzara, Marcello Napolitano, MR technique Alessandro Campari, Maria Pia Bondioni Primary staging T-staging Embriology N-staging Diagnosis Restaging after chemoradiotherapy Classifi cations
Load more

Recommended publications
  • Abdominal and Pelvic Imaging Findings Associated with Sex Hormone Abnormalities
    UCSF UC San Francisco Previously Published Works Title Abdominal and pelvic imaging findings associated with sex hormone abnormalities. Permalink https://escholarship.org/uc/item/7cq623wg Journal Abdominal radiology (New York), 44(3) ISSN 2366-004X Authors Kurzbard-Roach, Nicole Jha, Priyanka Poder, Liina et al. Publication Date 2019-03-01 DOI 10.1007/s00261-018-1844-1 Peer reviewed eScholarship.org Powered by the California Digital Library University of California Abdominal Radiology https://doi.org/10.1007/s00261-018-1844-1 (0123456789().,-volV)(0123456789().,-volV) REVIEW Abdominal and pelvic imaging findings associated with sex hormone abnormalities 1 1 1 2 Nicole Kurzbard-Roach • Priyanka Jha • Liina Poder • Christine Menias Ó Springer Science+Business Media, LLC, part of Springer Nature 2018 Abstract Hormones are substances that serve as chemical communication between cells. They are unique biological molecules that affect multiple organ systems and play a key role in maintaining homoeostasis. In this role, they are usually produced from a single organ and have defined target organs. However, hormones can affect non-target organs as well. As such, biochemical and hormonal abnormalities can be associated with anatomic changes in multiple target as well as non-target organs. Hormone-related changes may take the form of an organ parenchymal abnormality, benign neoplasm, or even malignancy. Given the multifocal action of hormones, the observed imaging findings may be remote from the site of production, and may actually be multi-organ in nature. Anatomic findings related to hormone level abnormalities and/or laboratory biomarker changes may be identified with imaging. The purpose of this image-rich review is to sensitize radiologists to imaging findings in the abdomen and pelvis that may occur in the context of hormone abnormalities, focusing primarily on sex hormones and their influence on these organs.
    [Show full text]
  • Liver & Pancreas
    276A ANNUAL MEETING ABSTRACTS 1263 Renal Pathology in Hematopoeitic Cell Transplantation Design: We studied 58 consecutive liver allografts from 53 pediatric patients (<18 Recipients yrs) who underwent OLT from 1995-2006. All allograft biopsies were scored for the ML Troxell, M Pilapil, D Miklos, JP Higgins, N Kambham. OHSU, Portland, OR; following features: 1) CLH (mild, moderate, severe), 2) portal AR (mild, moderate, Stanford Univ, Stanford, CA. severe), 3) zone 3 fibrosis (mild=perivenular or severe=bridging), and 4) ductopenia. Background: Hematopoietic cell transplantation (HCT) associated acute and chronic Five explanted livers that were removed during the course of retransplantation for graft renal toxicity can be due to cytotoxic conditioning agents, radiation, infection, failure in this group were also reviewed. immunosuppressive agents, ischemia, and graft versus host disease (GVHD). We have Results: Mean age at OLT was 7 yrs (range 7 wks-18 yrs) with 29 boys and 24 girls. reviewed consecutive renal biopsy specimens in HCT patients from a single center. We reviewed a total of 417 allograft biopsies (mean 7.2 per allograft) obtained 2 days Design: The files of Stanford University Medical Center Department of Pathology were - 11 yrs post-OLT; 200 (48%) of these were protocol biopsies. Forty-six allografts (79%) searched for renal biopsy specimens in patients who received HCT (1995-2005); 11 had >1 yr of histologic follow-up, 29 (50%) had >3 yrs, and 21 (36%) >5 yrs. Overall, cases were identified (post BMT time 0.7 to 14.5 years). The biopsies were processed CLH was observed on at least one occasion in 38 (66%) allografts.
    [Show full text]
  • "Gastrointestinal Tract Pathology"
    IIC,J CALIFORNIA TUMOR TISSUE REGISTRY "GASTROINTESTINAL TRACT PATHOLOGY" Study Cases, Subscription A March 2000 California Tumor Tissue Registry c/o: De1mrtment of Pathology and Human Anatomy Loma Linda Univcr.;ily School ofMcd.icine 11021 Campus Avenue, AH 335 Lomn Linda, California 92350 (909) 558-4788 FAX: (909) 558·0188 E-mail: [email protected] Case oftbe Month: www.llu.edu/Uu/cttr/cotm Target audience: Practicing pathologists and pathology residents. Goal: To acquairu the participam with the hiswlogic featu res of a variety of benign and malignant neoplasms and tumor-l ike conditions. Objectives: n1e participant will be able to recognize morphologic features ofa variety of benign and malignam neoplasms and tWllOr-like conditions and relate those processes to pertinent references in d1e medical literature. Educational methods and media: Review of representative glass slides v.ith associated histories. Feedback on consensus diagnoses lt·om participating pathologists. Listing of selected references from the medical literature. Principal faculty: Weldon K. Bullock, Ml) Donald R. Chase, MD CME Credit: Lorna Li.nda University School of Medicine designates this continuing medical education·activity for up to 2 hours of Category I of the Physician's Recogn ition Award oft he· American Medical Association. CME credit is offered for d1e subscription year only. Accreditation: Loma Linda University School of Medicine is accredited by the Accreditation Council for Continuing Medical Education (ACCME) to sponsor continuing medical education for physicians. Contributor: James A. Henry, M.D. Case No. 1 - March 2000 Woodbridge, VA Tissue from: Terminal ileum Accession #28502 Clinical Abstract: This 37-year-old black female presented with several weeks' history of right lower quadrant abdominal pain radiating to the right side of the back and right inguinal area.
    [Show full text]
  • Conversion of Morphology of ICD-O-2 to ICD-O-3
    NATIONAL INSTITUTES OF HEALTH National Cancer Institute to Neoplasms CONVERSION of NEOPLASMS BY TOPOGRAPHY AND MORPHOLOGY from the INTERNATIONAL CLASSIFICATION OF DISEASES FOR ONCOLOGY, SECOND EDITION to INTERNATIONAL CLASSIFICATION OF DISEASES FOR ONCOLOGY, THIRD EDITION Edited by: Constance Percy, April Fritz and Lynn Ries Cancer Statistics Branch, Division of Cancer Control and Population Sciences Surveillance, Epidemiology and End Results Program National Cancer Institute Effective for cases diagnosed on or after January 1, 2001 TABLE OF CONTENTS Introduction .......................................... 1 Morphology Table ..................................... 7 INTRODUCTION The International Classification of Diseases for Oncology, Third Edition1 (ICD-O-3) was published by the World Health Organization (WHO) in 2000 and is to be used for coding neoplasms diagnosed on or after January 1, 2001 in the United States. This is a complete revision of the Second Edition of the International Classification of Diseases for Oncology2 (ICD-O-2), which was used between 1992 and 2000. The topography section is based on the Neoplasm chapter of the current revision of the International Classification of Diseases (ICD), Tenth Revision, just as the ICD-O-2 topography was. There is no change in this Topography section. The morphology section of ICD-O-3 has been updated to include contemporary terminology. For example, the non-Hodgkin lymphoma section is now based on the World Health Organization Classification of Hematopoietic Neoplasms3. In the process of revising the morphology section, a Field Trial version was published and tested in both the United States and Europe. Epidemiologists, statisticians, and oncologists, as well as cancer registrars, are interested in studying trends in both incidence and mortality.
    [Show full text]
  • Neoplasms of the Liver
    Modern Pathology (2007) 20, S49–S60 & 2007 USCAP, Inc All rights reserved 0893-3952/07 $30.00 www.modernpathology.org Neoplasms of the liver Zachary D Goodman Department of Hepatic and Gastrointestinal Pathology, Armed Forces Institute of Pathology, Washington, DC, USA Primary neoplasms of the liver are composed of cells that resemble the normal constituent cells of the liver. Hepatocellular carcinoma, in which the tumor cells resemble hepatocytes, is the most frequent primary liver tumor, and is highly associated with chronic viral hepatitis and cirrhosis of any cause. Benign tumors, such as hepatocellular adenoma in a noncirrhotic liver or a large, dysplastic nodule in a cirrhotic liver, must be distinguished from well-differentiated hepatocellular carcinoma. Cholangiocarcinoma, a primary adenocarci- noma that arises from a bile duct, is second in frequency. It is associated with inflammatory disorders and malformations of the ducts, but most cases are of unknown etiology. Cholangiocarcinoma resembles adenocarcinomas arising in other tissues, so a definitive diagnosis relies on the exclusion of an extrahepatic primary and distinction from benign biliary lesions. Modern Pathology (2007) 20, S49–S60. doi:10.1038/modpathol.3800682 Keywords: hepatocellular carcinoma; hepatocellular adenoma; dysplastic nodule; cholangiocarcinoma A basic principle of pathology is that a neoplasm more than 3 to 1 (Figure 1). Among primary liver usually differentiates in the manner of cells that are tumors that come to clinical attention, over three- normally present in the tissue in which the fourths are hepatocellular carcinoma (HCC), while neoplasm arises. Thus, primary neoplasms and the second most common primary malignancy, tumor-like lesions that occur in the liver usually cholangiocarcinoma (CC) accounts for 8% (Figure resemble the major constituent cells of the liver, 2).
    [Show full text]
  • ASC Webinar: Practical Approach to Liver Cytology Indication
    ASC Webinar: Practical Approach to Liver Cytology Barbara A. Centeno, M.D. Director of AP Quality Assurance Director of Cytopathology and Senior member/Moffitt Cancer Center Professor/Departments of Oncologic Sciences Morsani College of Medicine University of South Florida 1 LIVER OUTLINE • Background • Cytology of benign liver and liver nodules • Cytology of Primary Liver Cancers – Hepatocellular carcinoma – Cholangiocarcinoma • Ancillary studies for key differential diagnoses • Metastases 2 Indication: Evaluation of a Mass • Nonneoplastic lesions – hemangioma • Benign liver nodule –FNH – Adenoma • Primary epithelial cancers – HCC –ICC • Less common nonepithelial neoplasms and malignancies • Metastases 3 KEY DIAGNOSTIC ISSUES • Distinction of benign or reactive hepatocytes in nonneoplastic or benign liver nodules from well- differentiated hepatocellular carcinoma • Distinction of poorly differentiated hepatocellular carcinoma from cholangiocarcinoma or metastases • Determination of primary site of origin of metastases • Determination of histogenesis of poorly differentiated malignancie 4 APPROACH TO THE DIAGNOSIS OF LIVER LESIONS • Clinical history – Age and gender • Hepatoblastoma in infants • Adenoma in females – Underlying liver disease • HCV and Cirrhosis as a predisposing risk factor for HCC – Previous history of carcinoma • Radiological imaging – Borders, possible vascular lesion • Cytological findings • Ancillary studies • Correlate all findings 5 Hepatocytes • Monolayered sheets,thin trabeculae, single cells or small, loose groups
    [Show full text]
  • Biopsy Interpretation of Liver Tumors
    Biopsy interpretation of liver tumors Rish K. Pai MD, PhD Professor of Laboratory Medicine & Pathology Mayo Clinic Arizona Florida Society of Pathology Summer 2019 [email protected] ©2017 MFMER | slide-1 Liver mass biopsies: Diagnostic issues • Cirrhotics versus non-cirrhotics • Malignant tumor in the liver • How to approach these biopsies and confirm or exclude HCC • Subtypes of HCC and mixed tumors • Well-differentiated HCC • Recognize and correctly classify benign lesions • Recognize lesional tissue • Hepatocellular adenoma • Focal nodular hyperplasia ©2017 MFMER | slide-2 Liver mass biopsies: Upfront work • Have standard protocols for a biopsy of a liver mass • If multiple cores are taken, separate into different blocks • If a big core, divide and separate into two blocks • Cut unstained slides upfront to avoid wasting tissue • Don’t use up all the tissue: • Reserve tissue for molecular testing ©2017 MFMER | slide-3 Classification of liver tumors: Context! Cirrhotic liver Non-Cirrhotic liver • Hepatocellular carcinoma • < 50 y: • Hepatocellular adenoma • Cholangiocarcinoma • Focal nodular hyperplasia • Mixed • Hepatocellular carcinoma HCC/Cholangiocarcinoma • Other primary tumors • Metastases • Macroregenerative nodule (only on explant) • > 50 y: • Metastases • Dysplastic nodule (only on • Hepatocellular carcinoma explant) • Cholangiocarcinoma • Focal nodular hyperplasia • Other primary tumors ©2017 MFMER | slide-4 A note on Dysplastic nodules • Dysplastic nodule is only diagnosed in the setting of known cirrhosis – very rare to diagnose
    [Show full text]
  • Diagnosis and Management of Focal Liver Lesions
    ACG Clinical Guideline: Diagnosis and Management of Focal Liver Lesions Jorge A. Marrero, MD,1 Joseph Ahn, MD, FACG,2 K. Rajender Reddy, MD, FACG3 1University of Texas at Southwestern, Dallas, Texas, USA; 2Oregon Health and Science University, Portland, Oregon, USA; 3University of Pennsylvania, Philadelphia, Pennsylvania, USA Am J Gastroenterol advance online publication 19 August 2014; doi: 10.1038/ajg.2014.213 Abstract Focal liver lesions (FLL) have been a common reason for consultation faced by gastroenterologists and hepatologists. The increasing and widespread use of imaging studies has led to an increase in detection of incidental FLL. It is important to consider not only malignant liver lesions, but also benign solid and cystic liver lesions such as hemangioma, focal nodular hyperplasia, hepatocellular adenoma, and hepatic cysts, in the differential diagnosis. In this ACG practice guideline, the authors provide an evidence-based approach to the diagnosis and management of FLL. Preamble The writing group was invited by the Practice Parameters Committee and the Board of the Trustees of the American College of Gastroenterology to develop a practice guideline regarding the suggested diagnostic approaches and management of focal liver lesions (FLLs). FLLs are solid or cystic masses or areas of tissue that are identified as an abnormal part of the liver. The term “lesion” rather than “mass” was chosen because “lesion” is a term that has a wider application, including solid and cystic masses. This guideline will be limited to primary liver lesions and the management approach to FLLs rather than focusing on the diagnosis and management of metastatic lesions, hepatocellular carcinoma, or cholangiocarcinoma.
    [Show full text]
  • Fat-Containing Lesions of the Liver : a Pictorial Essay
    Diagnostic and Interventional Imaging (2015) 96, 201—211 ICONOGRAPHIC REVIEW / Gastrointestinal imaging Fat-containing lesions of the liver : A pictorial essay a a a M. Tekath , T. Klotz , P.F. Montoriol , c a a,∗,b J. Joubert-Zakeyh , J.-M. Garcier , D. Da Ines a Department of Radiology and Medical Imaging, Clermont-Ferrand University Hospital, Estaing University Hospital, 1, place Luci-Aubrac, 63003 Clermont-Ferrand cedex 1, France b Clermont University, University of Auvergne, ISIT, CNRS, UMR6284, BP 10448, 63000 Clermont-Ferrand, France c Anatomical and Cytological Pathology, Clermont-Ferrand University Hospital, Estaing University Hospital, Estaing University Hospital, 1, place Lucie-Aubrac, 63003 Clermont-Ferrand cedex 1, France KEYWORDS Abstract The presence of fat within a hepatic lesion is unusual and can help to direct the Liver tumor; radiologist’s diagnosis. The aim of this iconographic review is to specify the various hepatic Hepatic steatosis; lesions that may contain fat and their appearance particularly on MRI. A histological correlation Magnetic resonance is also suggested for the most commonly found tumors. The identification of fat within a hepatic imaging tumor, along with other radiological signs and reflection on the clinical and epidemiological context, can lead to a diagnosis being reached or suggested, with confirmation if necessary, by a pathological examination. © 2013 Éditions franc¸aises de radiologie. Published by Elsevier Masson SAS. All rights reserved. The presence of fat in a liver lesion is not a standard finding and it can help to guide the radiologist towards a diagnosis. Fat may be macroscopic or microscopic. MRI is the modality of choice for detecting a fatty component in a hepatic tumor: fat-saturation sequence detects extracellular fat while chemical shift imaging identifies microscopic or intracellular lipids [1].
    [Show full text]
  • Pathological Aspects of Hepatocellular Tumors 77 4 Pathological Aspects of Hepatocellular Tumors
    Pathological Aspects of Hepatocellular Tumors 77 4 Pathological Aspects of Hepatocellular Tumors Hale Kirimlioglu, MD, Anthony J. Demetris, MD, and Michael A. Nalesnik, MD CONTENTS HEPATOCELLULAR ADENOMA HEPATOCELLULAR CARCINOMA FIBROLAMELLAR HCC CLEAR CELL HCC SCLEROSING HCC COMBINED HCC AND CHOLANGIOCELLULAR CARCINOMA SARCOMATOID HCC HEPATOBLASTOMA REFERENCES 1. HEPATOCELLULAR ADENOMA Hepatocellular adenoma (HA) is an uncommon and benign tumor of the liver, seen most often in young women of childbearing age with a history of oral contraceptive use (Table 1) (1). The longer the duration of intake of oral contra- ceptives, the higher the risk of developing hepatic adenoma (2). Anabolic steroid use also is associated with HA, and an example of this lesion arising in conjunc- tion with growth hormone therapy for Turner’s syndrome has been reported (3). An association of liver cell adenoma and various genetic metabolic disorders (such as glycogen storage diseases types I, III, or IV, galactosemia, tyrosinemia, and, rarely, diabetes mellitus or familial adenomatous polyposis) also has been reported (4–9). From: Current Clinical Oncology: Hepatocellular Cancer: Diagnosis and Treatment Edited by: B. I. Carr © Humana Press Inc., Totowa, NJ 77 78 Kirimlioglu et al. Table 1 Neoplastic Hepatocellular Lesions: Selected Features Clinical features Pathological features HA Usually single, rarely Clonal growth of normal multiple; associated appearing hepatocytes with birth control pills; with arterial vasculature may bleed and otherwise bland trabecular
    [Show full text]
  • "Gastrointestinal Pathology"
    ' -.. CALIFORNIA TUMOR TISSUE REGISTRY "GASTROINTESTINAL PATHOLOGY" Study Cases, Subscription A November 2007 California Tumor Tissue Registry c/o: Department of Pathology and Hum110 Anatomy Lorna Linda University School of Medicine 11021 Campus A'•eoue, AR 335 Lorna Linda, California 92350 (909) 558-4788 FAX: (909) 558-0188 E-mail: [email protected] Web page: www.c!tr.org Web site & Case of the Month: www.cttr.org Target audience: Practicing pathologists and pathology residents. Goal: . To acquaint the panicipant with the histologic features ofa variety of benign and malignant neoplasms and tumor-like conditions. Objectives: The. panicipant will be uble to recognize morphologic features of a variety of benign and malignant neoplasms and rumor-like conditions and relate those processes to pertinent references in the medical literature. Educational methods and media: Review ofrepresentative glass slides with associated histories. Feedback on consensus diagnoses from participating pathologists. Listing of selected references from the medical literature. Principal faculty: Weldon K. Bullock, MD Donald R. Chase, MD CME Credit: Lorna Linda University School of Medicine designates this continuing medical education activity for a maximum of2 hours of Category I ofthe Physician's Recognition Award ofthe American Medical Association. CME credit is offered for the subscription year only. Accreditation: Lorna Linda University School of Medicine is accredited by the Accreditation Counci l for Continuing Medical Education (ACCME) to sponsor continuing medical education for physicians. 2 Study Cases, November 2007, Subscription A Contributor: LLUMC Pathology Group (mp) Case No. 1 - November 2007 A Lorna Linda, CA Tissue from: Small bowel Accession #30652 Clinical Abstract: A 74 year old woman had a past history of endometrioid adenocarcinoma of the vagina.
    [Show full text]
  • Hepatocellular Adenoma
    Liver Specialty Evening Conference Matthew M. Yeh, MD, PhD Professor of Pathology Adjunct Professor of Medicine University of Washington, Seattle Case History • A 65 year-old man presents with abdominal pain and abnormal liver tests. • Images of the abdomen reveals a liver mass. • History of non-invasive low-grade urothelial carcinoma 2 months ago, s/p TURP. • No underlying liver diseases or cirrhosis. • AFP: Normal. MR Images in Arterial Phase Non-cirrhotic liver with segment 8/4 lesion. Arterial phase hyperenhancment. Courtesy of Dr. Neeraj Lalwani, UWMC, Seattle MR Images in Venous Phase Non-cirrhotic liver with segment 8/4 lesion. Subtle washout on venous phase. Courtesy of Dr. Neeraj Lalwani, UWMC, Seattle MR Images in Delayed Phase Non-cirrhotic liver with segment 8/4 lesion. Delayed phase also shows subtle washout on venous phase. Courtesy of Dr. Neeraj Lalwani, UWMC, Seattle MR Coronal Image in the Delayed Phase Non-cirrhotic liver, lesion within segment 8/4 associated with PV thrombosis. Suspicion of liver primary vs. metastasis Courtesy of Dr. Neeraj Lalwani, UWMC, Seattle Case • A CT-guided liver biopsy was performed. Differential Diagnosis • Benign liver lesions – Hepatocellular – Biliary – Miscellaneous • Malignant liver lesions – Primary • Hepatocellular • Biliary • Other – Metastatic Differential Diagnosis • Benign liver lesions – Hepatocellular – Biliary – Miscellaneous • Malignant liver lesions – Primary • Hepatocellular • Biliary • Other – Metastatic 6th most common cancer Hepatocellular Carcinoma Risk Factors Traditional Recently Recognized • HBV • HCV • Metabolic • Cirrhosis syndrome and • Alcohol obesity • Aflatoxin • Hemochromatosis • Alpha-1-antitrypsin deficiency • Hepatocellular adenoma Malignant Liver Neoplasms in Non-Cirrhotic Liver Modified from Dr. Zachary Goodman, with permission Malignant Liver Neoplasms in Cirrhosis Modified from Dr.
    [Show full text]