Diagnosis Of Soft Tissue Swellings Research Articles

Unveiling the unforeseen: Asymptomatic pigmented villonodular synovitis at popliteal fossa

Pigmented villonodular synovitis (PVNS) are rare, locally aggressive, typically benign neoplasms of joints, bursae, and tendon sheaths. Symptoms include pain, stiffness, swelling, recurrent atraumatic hemarthrosis and limitation in range of motion. Our case study presents an asymptomatic PVNS at the popliteal fossa which was purely an incidental finding in a 32-year-old male with a history of trauma while playing football whose MRI was suggestive of Anterior cruciate ligament (ACL), Medial meniscus tear & a focal nodular hypertrophy at posterior aspect of knee. The patient had no significant past history of trauma, swelling, hemarthrosis or similar pain. ACL Reconstruction, Medial Meniscus balancing and marginal excision and biopsy sent for the same. Biopsy suggestive of PVNS (Localised). This case report emphasizes the importance of considering PNVS in the differential diagnosis of soft tissue swelling without pain, swelling or bleeding, and should be considered as a differential diagnosis of soft tissue swellings in the posterior aspect of the knee.

Radiological evaluation of soft-tissue swellings

Background: Soft-tissue swellings (STSs) are commonly encountered by a radiologist in routine practice, either as the principal indication for diagnostic examination or as an incidental finding during an examination performed for other indications. Aims and Objectives: The aim of the study was to design a basic approach for the evaluation of STS with the help of available imaging modalities (ultrasound [USG], computed tomography [CT], and magnetic resonance imaging [MRI]) and analyzes its imaging characteristics so as to arrive at its final diagnosis. Materials and Methods: This prospective study (CTRI/2023/01/048933) was conducted in the Department of Radio-diagnosis, MLBMC, Jhansi, Uttar Pradesh, with 100 cases of STS were primarily evaluated by high-resolution grayscale USG, out of 100 cases, 72 diagnosed on USG and rest equivocal cases were secondarily evaluated with MRI, out of which 25 diagnosed and three cases needed CT evaluation. Three cases were evaluated with MRI+CT scan and finally diagnosed. Diagnosed cases followed by histopathology and surgery. Results: In our study, we found that USG is helpful in benign and superficial STS, as 72/100 cases diagnosed with the help of USG. In equivocal, deeply located, and malignant cases, MRI is more helpful in making a final diagnosis. In our study out of 28 cases, 25 diagnosed on MRI. CT scan used as accessory modality in the diagnosis of STS. Conclusion: USG remains the first-line imaging modality for the assessment of STS. MRI is an excellent modality in equivocal or suspicious lesion for characterisation of nature and extension. CT can be used for the detection of calcification and bone involvement.

Granular Cell Tumors

GCTs (Granular Cell Tumors) are rare, uncommon STTs (Soft Tissue tumors) that may develop at any location in the human body. Though the initial one was identified first as a non-capsulated granular cell myoblastoma of the tongue, they are now identified immunohistochemically as principally of neural Schwann cell origin (S-100 marker positive). Still more rarely, non-neural GCTs are also described that are probably of mesenchymal origin (as evidenced by S-100 marker negativity and vimentin positivity). Though they are more common in females and black people in the third to sixth decades of life, no sex, no race, and no age group are immune to this disease. They are mostly benign and very rarely malignant. Exact history taking, physical examination and laboratory investigations, including histopathological, histochemical, and immunohistochemical examinations, are essential to arrive at a concrete diagnosis, as many other tumors (e.g., malignant melanoma, small cell lung cancer, etc.) in the body resemble GCTs both histologically (granularity) and by biological behavior (benign, malignancy, recurrency at primary and metastatic sites). Benign variants have clinical features depending on location and are universally cured by wide surgical excision. The malignant variant carries a worse prognosis. These rare GCTs are to be kept in mind always in the differential diagnosis of soft tissue swellings anywhere in the body. Their biological and pathological features, differential diagnosis, and therapeutic implications are discussed here, briefly reviewing the available literature.KYAMC Journal Vol. 14, No. 02, July 2023: 96-101.

Pronounced mediastinal emphysema after restorative treatment of the lower left molar—a case report and a systematic review of the literature

This case report presents an iatrogenic induced mediastinal emphysema after restorative treatment of the lower left second molar, aimed to highlight the potential life-threatening consequences, and providing diagnostics and treatment concepts of complicated dental induced emphysema based on literature review. A 74-year-old female patient was admitted to the emergency department due to a fall on her shoulder. Additional finding was a significant swelling of the face and neck. In the computer tomography of the head, neck, and thorax, a humerus fracture and pronounced soft tissue emphysema from the infraorbital region to the mediastinum was detected. The patient reported that she had been treated by her dentist 4 days earlier. The treatment had to be discontinued after beginning of a pronounced swelling. Other reasons for the emphysema could be excluded out on an interdisciplinary teamwork. The patient was monitored as an inpatient for 5 days and received intravenous antibiotic therapy. This case report shows the rare complication of pronounced mediastinal emphysema after root canal treatment. Emphysema should always be a differential diagnosis of soft tissue swelling and, in case of doubt, a general medical presentation should be made.

Rice body formation in a case of subdeltoid bursa tuberculosis: An uncommon presentation

Rice bodies looking like swelling on specific magnetic resonance sequences are an unusual presentation of subdeltoid tuberculous inflammatory involvement. Rice bodies represent the infarcted or sloughed off synovium due to the inflammatory process. We present a case of a 21-year-old male patient who complained of a soft-tissue swelling around the right shoulder presumed to be a lipoma. The aim of presenting this case is to expand the differential diagnosis of soft-tissue swelling around the shoulder whenever such a condition is encountered.

Accessory Breast Tissue (Mamma Aberrata) as a Rare Differential Diagnosis of Soft Tissue Swelling in the Axilla

Axillary swelling is a common problem in pediatric practice and radiology. It is usually caused by lymph node swelling on the basis of lymphadenitis or lymphoma. In rare cases, it is caused by soft tissue tumors (rhabdomyosarcoma, lipoma, fibroma), vascular lesions (angiodysplasia, aneurysms), or an inflammation of sweat glands ([Table 1]).

Schwannoma in Masquerade

Neurilemmoma is a rare nerve tumor seldom included in the list of differential diagnosis of soft tissue swelling in maxillofacial region. Arrival at a clinical diagnosis of schwannomas is rarely possible as there are hardly any characteristic clinical features to help in its and it is mostly established by histopathologic examination. We report an interesting case which had presentations similar to a sebaceous cyst but finally turned out to be a schwannomma.

Applications of ultrasonography in the diagnosis of soft tissue swellings of the cervicofacial region

To determine the accuracy, sensitivity, specificity and prediction values of ultrasound as a means of diagnosis of cervico-facial soft tissue swellings. We carried out ultrasonographic evaluation of 76 consecutive cases of cervico-facial soft tissue swellings that presented at the Obafemi Awolowo University Teaching Hospital Complex, Ile-Ife, Nigeria from August 2002 to November 2003. The patients' demographics and relevant clinical information were obtained. Ultrasonographic evaluation was done using the B-mode transcutaneous ultrasonic imaging device with a transducer frequency of 5MHz. All the lesions were subjected to histopathological examination. There were 43(56.6%) males and 33(43.4%) females whose ages ranged from 2 weeks to 70 years (mean +/- SD; 22 +/- 19.7 years). Histologically, tumours constituted the highest percentage of swellings (35.5%), followed by cysts (26.3%). Males were more predominant in all classes of swellings except benign tumours. The accuracy of ultrasound in the diagnosis of pleomorphic adenoma was 80% and 100% for both adenocarcinoma and hemangioma. It was also 100% for majority of the cysts and HIV associated salivary gland swellings. The sensitivity of ultrasound in the diagnosis of pleomorphic adenoma was 80% and 100% for adenocarcinoma, hemangioma, all the cysts and HIV associated swellings. Ultrasound was also 100% specific in the diagnosis of monomorphic adenoma and hemangioma. Ultrasound is a useful diagnostic tool for cervicofacial soft tissue swellings. The accuracy of diagnosis is enhanced by the characteristics of the probe and the experience of the sonologist.

The differential diagnosis of soft tissue swelling of the palmar aspect of the metacarpal region

The differential diagnosis of soft tissue swelling of the palmar aspect of the metacarpal region

The value of computed tomography in the diagnosis of soft-tissue swellings of the hand

Twenty patients with palpable swellings of the hand were investigated by computed tomography. The results, when compared with the pathological findings, lead us to consider this a technique of considerable value in the assessment of this kind of disease. The importance of angiography and, occasionally of magnetic resonance imaging, are also stressed.