Hypoechoic Tumor Research Articles

A CASE REPORT OF TUMOR FORMING PANCREATITIS

A 72-year-old man was admitted to our hospital because of upper abdominal pain and weight loss. Abdominal ultrasonography revealed a 4×4 cm hypoechoic tumor in the head of pancreas. Selective celiac angiography showed encasement of the posterior superior pancreatoduodenal artery. Pancreatoduodenectomy was carried out under a diagnosis of pancreatic cancer. The resected specimen showed that the tumor was stony-hard and 4 cm in diameter. Histological examination denied pancreatic cancer and demonstrated severe chronic pancreatitis. We report a case of so called “tumor forming pancreatitis” which is occasionally differentiate from pancreatic cancer.

Bright echogenic foci in early prostatic carcinoma: sonographic and pathologic correlation.

One hundred sixty patients with biopsy-proved clinical stage A or B prostatic carcinoma were examined with high-resolution transrectal ultrasonography prior to radical prostatectomy. All tumors showed either a hypoechoic or isoechoic echo pattern. However, 11 patients demonstrated evidence of focal bright echogenic areas at the periphery or within the center of a hypoechoic tumor. Coarse echogenic foci seen in seven patients corresponded pathologically to calcified corpora amylacea in benign tumors of the prostate gland either at the edge of the tumor or scattered throughout the tumor. Seven patients showed a fine, stippled echogenic pattern within the lesion. On a pathologic level, this pattern represented high-grade tumors with extensive central comedonecrosis and calcifications in five patients and an unusual deposit of small intraluminal crystalloid deposits in two patients. Combinations of echo patterns were observed in three patients. This study demonstrates that echogenic foci can be seen within predominantly hypoechoic tumor nodules. Coarse bright echoes, usually at the periphery of the tumor, suggest calcifications in benign prostate glands. Tumor calcifications and intraluminal prostatic crystalloid deposits were located more centrally and had a finer stippled sonographic appearance.

Zur Diagnostik von Speicheldrüsenlipomen

8 patients with 9 lipomas of the salivary gland were reviewed retrospectively. The clinical diagnosis, the sonomorphology and the appearance in CT were analysed. By means of palpation none of the lipomas was specifically diagnosed. Usually sonography is the first imaging method in superficial salivary gland tumors. Therefore the knowledge of the sonomorphology is important for indicating CT. Sonographically a lipoma of the salivary gland should be suspected, if an oval shaped, slightly hypoechoic tumor with a typical feathered appearance and good compressibility is visualized. All lipomas of the salivary glands could be delineated sonographically. Due to their negative homogeneous attenuation values lipomas can be diagnosed specifically in CT. This enables the head and neck surgeon to avoid an operation in patients with no or minor complaints.

Radiographic characteristics of benign liver tumors: Focal nodular hyperplasia and hepatic adenoma

The imaging characteristics of focal nodular hyperplasia are varied. Unenhanced computed tomography reveals the attenuation of these lesions, in general, to be slightly less than that of normal liver; after contrast enhancement, their attenuation is equal to (isodense) or greater than (hyperdense) that of normal liver. This, of course, depends on the rate at which the contrast material is injected and the timing of scans after its injection. Central scar, a helpful finding when present, was not noted as a common finding at the time of computed tomography or ultrasound examination. Ultrasound examinations, in general, showed these lesions to be homogeneous, isoechoic or hypoechoic tumors. The angiographic findings revealed them, in general to be more vascular than the normal liver with an intense, homogeneous capillary stain. Hypovascular focal nodular hyperplasia does occur, but rarely. The blood supply to these tumors was most commonly from peripheral vessels, in contrast to previous reports of a central blood supply being more common. The technetium-99m sulfur colloid liver-spleen scan is often the key to the diagnosis of focal nodular hyperplasia. The majority of these tumors at the time of liver-spleen scanning will be seen as areas of normal or increased uptake; this is a reliable clue to the diagnosis of focal nodular hyperplasia. lf the radionuclide scan is not diagnostic, however, the combined findings of CT, ultrasound and angiography often are. Hepatic adenomas also clearly have a varied imaging presentation. The angiographic findings show these tumors to be hypervascular with small areas of hypovascularity within them. Blood is supplied to the adenomas by peripheral vessels in most cases, and there is no intense capillary stain. Computed tomography shows hepatic adenomas, in general, to be hypodense in the absence of contrast enhancement. Yet on contrast enhanced scans, they are complex lesions with multiple ranges of attenuation located within them. Acute hemorrhage can be seen in approximately half the unenhanced CT scans. By sonography, hepatic adenomas, in general, display intrinsic areas that are isoechoic, hyperechoic, and hypoechoic; and they are invariably nonhomogeneous lesions. These tumors appear as focal defects in all cases on technetium-99m sulfur colloid liver-spleen scans.

High-frequency scrotal sonography.

High-frequency real-time sonography has enhanced accuracy in the diagnosis of scrotal abnormalities. Results of 48 scrotal scans of 92 testes are presented. There were 22 testicular lesions, nine seminomas, four embryonal cell carcinomas, one case of metastatic prostatic carcinoma, one benign "keratin cyst," three testicular infarcts, three atrophied testes, and one case of testicular torsion. Hypoechoic tumors and infarcts have a similar appearance. Extratesticular abnormalities included spermatoceles, varicoceles, epididymitis, hydroceles, and a scrotal hematoma. Sonography accurately distinguished between testicular and extratesticular masses in all cases in this series and pathologic correlations were obtained for all testicular masses. Simultaneous real-time contact scanning and palpation facilitated accurate diagnosis.