Incidental Finding Research Articles

Incidental Finding of a Low-Grade Appendiceal Mucinous Neoplasm: A Case Study

Incidental Finding of a Low-Grade Appendiceal Mucinous Neoplasm: A Case Study

Nontarget Analysis and Characterization of a Group of Abundant Polyfluoroalkyl Substances─Fluorinated Benzoylurea Pesticides and Their Analogues and Transformation Products in Fish by LC-HRMS and Chemical Species-Specific Algorithms.

Poly- and perfluoroalkyl substances (PFASs) are a large class of fluorinated chemicals used in various industrial and agrochemical products such as fluorinated benzoylurea (FBU) pesticides. Initiated from an incidental and preliminary finding of three high-abundance FBUs in fish, this study implemented nontarget analysis and characterization for FBUs together with their analogues and transformation products (TPs) in fish using liquid chromatography, high-resolution mass spectrometry, and chemical species-specific algorithms. A total of 23 FBU-relevant compounds were found and tentatively/accurately elucidated with structures, including 18 PFASs and 5 non-PFAS compounds, of which 4 were original FBUs, 8 were FBU analogues, and 11 were FBU-TPs. The total concentrations of FBU-relevant compounds were 0.8-1919.3 ng/g in the fish samples. The analysis strategy and data-processing algorithms can be extended to other fluorine-containing pesticides, and the characterization results provide a new understanding of PFAS pollution and unveil an important source of PFAS pollutants, the agrochemical utilization of FBUs.

Computed Tomography Evaluation of Morphological Types of Femoral Trochlear Dysplasia in Small-Breed Dogs—A Retrospective Study

Abnormal trochlear morphology is one of the most important factors for patellar luxation occurrence in dogs, yet no studies have investigated its prevalence in the general population. This retrospective computed tomography study was designed to evaluate the trochlear groove morphology in four small dog breeds and the prevalence of trochlear dysplasia types according to Déjour’s classification depending on the breed, sex, and medial patellar luxation (MPL) presence and grade. A total of 174 joints (68 healthy, 96 grade II MPL, and 10 grade III MPL) from Mini-Pinschers, Yorkshire Terriers, Pomeranians, and Chihuahuas were included in the study. The morphological type of trochlear dysplasia (TD) was evaluated on axial scans and 3D reconstruction images according to the four-type classification of Déjour, sulcus angle, trochlear depth, and lateral/medial inclination angles. Of all 174 joints, 140 had trochlear dysplasia—all joints with MPL (n = 106) and 50% of healthy joints (n = 34). The classification of Déjour for trochlear dysplasia types (A, B, C, and D) corresponds to the morphology of the femoral trochlea in the studied small breeds of dogs. The results demonstrated three types of trochlear dysplasia according to Déjour: most commonly, type A, followed by type C, and most infrequently, type D. The Déjour type B was an incidental finding. The large proportion of clinically healthy joints with TD (50%) emphasises the significance of early trochlear morphology evaluation for the orthopaedical health of dogs from susceptible breeds, especially in female breeders.

Incidental Finding of a Persistent Right Vitelline Artery in a 13-Year-Old Boy with Acute Appendicitis: A Case Report with Clinico-Pathological Correlation and a Comprehensive Literature Review.

The persistence of fetal vitelline structures may occur. The primary intestinal arterial supply development happens normally in this scenario, but a vitelline vascular remnant (VVR) persists. A 13-year-old boy with a history of severe and intermittent abdominal pain since early infancy presented to the Emergency Department with clinical, analytical, and ultrasonographic findings suggestive of acute appendicitis. There was no evidence of intestinal obstruction. Surgical treatment was indicated. A thick fibrovascular band from the umbilicus to the terminal ileum's mesentery was identified during laparoscopy. A gangrenous cecal appendix was also identified. A regular appendectomy and surgical excision of the band was performed. The histopathological study confirmed that it was a persistent right vitelline artery (VVR) and that the patient had acute gangrenous appendicitis. The patient evolved favorably and is currently asymptomatic and under follow-up. The literature on VVR is scarce. The present manuscript reviews the main characteristics of this embryological insult based on the preceding literature. Standardization of terminology regarding VVR will help better understand this pathology in the future.

Incidental finding of mixed hemoglobinopathy in pregnant woman - Case report

Microcytic and hypochromic anemic syndromes, beta-thalassemia type are usually underdiagnosed. Due to the similarity of clinical manifestations, the need for complementary studies, and the lack of clinical suspicion. This hinders their timely intervention. This study aimed to show a clinical case of an incidental finding of mixed hemoglobinopathy in a pregnant woman. we present the case of a 25-year-old primigravida patient hospitalized in the context of sepsis of urinary origin, associated with encapsulated bacteria. The hemogram reports low hemoglobin and refractoriness to iron treatment. Ferrokinetic studies were normal, the blood smear revealed a varied poikilocytosis, it was suggested to perform hemoglobin electrophoresis, which reported a mixed hemoglobinopathy as an incidental finding.

Prevalence and characteristics of microspurs in patients with spontaneous intracranial hypotension compared to the general population.

In patients diagnosed with spontaneous intracranial hypotension (SIH), microspurs are considered the culprit lesion in most ventral dural leaks (type I). The imaging characteristics of discogenic spurs, and their prevalence in the general population has not been reported in the literature. This observational case-control study was conducted comparing the prevalence and characteristics of discogenic microspurs between SIH patients with a type I leak treated at a tertiary hospital between 2013 and 2023 and an age-and sex matched cohort of trauma patients. Each group consisted of 85 patients (mean age 51.6 years ± 11.9 years), 74% (58/85 patients) were female. The prevalence of discogenic microspurs in the control group and SIH group was 31.8% and 90.6%, respectively.The mean length of the culprit microspur responsible for a dural leak was larger compared to the mean length of all co-incidental microspurs from both the SIH and the control group not causing a dural leak (2.6mm versus 1.6mm, p<0.001).Our multivariate logistic regression revealed that an increasing length of a microspur (OR 1.942, CI 1.35-2.80, p<0.001) and a narrower diameter of the spinal canal (OR 0.85, CI 0.76-0.96, p=0.008) were predictive for a dural tear. A discogenic microspur is a common incidental finding and may be found in almost one third of the general population. The length of the culprit microspur and the diameter of the spinal canal are distinct morphological characteristics for type I associated CSF leaks. CI = Confidence interval; CSF = Cerebrospinal fluid; CT = Computed tomography; ED = Emergency department; MRI = Magnetic resonance imaging; OR = Odds ratio; SD = Standard deviation; SIH = Spontaneous intracranial hypotension.

Co-occurrence of bronchiectasis, airway wall thickening, and emphysema in Chinese low-dose CT screening.

To assess the co-occurrence of incidental CT lung findings (emphysema, bronchiectasis, and airway wall thickening) as well as associated risk factors in low-dose CT (LDCT) lung cancer screening in a Chinese urban population. Data from 978 participants aged 40-74 years from the Chinese NELCIN-B3 urban population study who underwent LDCT screening were selected. CT scans were reviewed for incidental lung findings: emphysema, bronchiectasis and airway wall thickness. Emphysema was defined in three ways (≥ trace, ≥ mild, or ≥ moderate) depending on severity. Participants were described and stratified by presence or absence of incidental lung findings. Logistic regression analyses were performed to examine the relationship between participant characteristics and CT findings. Mean age was 61.3 years ± 6.8 and 533 (54.6%) were female. 48% of participants had incidental lung findings: 19.9% had emphysema (≥ mild), 9.2% had bronchiectasis, and 35.7% had airway wall thickening. Among 978 participants, 2.1% showed all three findings. Multivariable analysis showed that higher age (OR: 1.06; 95% CI: 1.04-1.08; p < 0.001), male sex (OR: 1.68; 95% CI: 1.14-2.47; p = 0.008) smoking history (OR: 1.76; 95% CI: 1.02-3.03; p = 0.04 for former smokers; OR: 2.45; 95% CI: 1.59-3.78; p < 0.001 for current smokers), and the presence of respiratory symptoms (OR: 1.42; 95% CI: 1.01-2.00; p = 0.04) were associated with the risk of having at least one incidental lung findings. When different definitions of emphysema were used, the results remained consistent. In a Chinese urban population undergoing LDCT lung cancer screening, 48% had at least one incidental CT lung finding, which was associated with higher age, male sex, questionnaire-based respiratory symptoms and smoking history. Question Reporting of incidental lung findings that indicate lung disease risk lacks consensus in the cancer screening setting and needs evidence of co-occurrence in general populations. Findings Almost half of the 978 participants had at least one incidental lung CT finding; these were associated with older age, male sex, respiratory symptoms, and smoking history. Clinical relevance Incidental lung findings and related risk factors are often observed in low-dose CT lung cancer screening, and careful consideration of their relevance should be given to their inclusion in future screenings.

Case report: Incidental finding of Ascaris lumbricoides in oral cavity. Atypical presentation

Case report: Incidental finding of Ascaris lumbricoides in oral cavity. Atypical presentation

Clonal Hematopoiesis of Indeterminate Potential and its Association with Treatment Outcomes and Adverse Events in Patients with Solid Tumors.

Liquid biopsy is increasingly being used in oncology for tumor molecular characterization. CHIP is a common incidental finding in cfDNA, and its prevalence increases with age. This study builds on growing evidence of common CHIP variants in patients with solid tumors. The results suggest a possible clinical impact of CHIP on treatment outcomes from immunotherapy or chemotherapy. This may have implications for treatment selection for patients with solid tumors.

The role of renal ultrasound and its correlation with biomarkers in the medical screening of apparently healthy individuals in a Nigerian University

Kidney ultrasound is a noninvasive diagnostic exam that uses images to assess kidney size, shape, location, and blood flow. It uses B-mode imaging for easy renal anatomy assessment and is often used for renal interventions. Clinical laboratory tests assess kidney function, focusing on glomerular filtration rate (GFR) and proteinuria. Serum creatinine is more accurate than urea, but urea is increased earlier in renal disease. Usmanu Danfodiyo University Sokoto (UDUS) students undergo routine pre-admission checks for visual acuity and body mass index (BMI), but kidney sonographic and laboratory investigations are not conducted. Hence, the need for this study. The research aimed at evaluating the sonographic findings of the kidneys and their correlation with biochemical markers among apparently healthy medical students in UDUS. A cross-sectional study was conducted on 50 apparently healthy medical students. Data was collected for sonographic and laboratory investigations and recorded on a data capture sheet. The study found incidental discoveries among the students, despite no symptoms. Laboratory results were normal, possibly due to protein-rich diets and physical activity. Sonographic results were significant compared to biochemical indices, but serum creatinine and right kidney bipolar length with BMI and gender were insignificant. In conclusion, renal ultrasound plays an important role in assessing the kidneys and should be the first line in diagnostic investigation. This study helped in revealing the renal status of the students.

Incidental finding of a congenital left ventricular diverticulum

Left ventricular diverticulum is a rare abnormality for which diagnosis is often delayed due to its asymptomatic character. Multimodal imaging can help in diagnosis of this potentially confusing condition. We present a 48-year-old female patient with a medical history of a paradoxical thromboembolic events who benefited from the closure of a patent foramen oval in another center. She presented a year later at our department for a lower back pain where an incidental finding of a congenital left ventricular diverticulum was made on a contrasted computed tomography scan.

A rare case of double lipoma of the corpus callosum: a clinical case report

INTRODUCTION: Intracranial lipoma is an extremely rare congenital anomaly accounting for less than 0.1% of intracranial tumors, and is due to abnormal differentiation of the meninx primitiva. It is not considered to be a true neoplasm. AIM: To present a clinical case of double lipoma of the corpus callosum with parts of which belonging to two different types of lipomas. The article discusses a variant of intracranial lipoma — lipoma of the corpus callosum. There are two main types of corpus callosum lipomas: curvilinear and tubulonodular. As a rule, the first type is asymptomatic and is an incidental finding during examination. The second type is often associated with abnormal development of the frontal lobes, eyes, calcifications, and also with hypogenesis or agenesis of the corpus callosum. Conservative management is recommended, since the surgical intervention is associated with a high risk of complications due to tight adjacency of lipomas to the neighboring tissues, which contain important neurovascular structures. CONCLUSION: The presented clinical example demonstrates an incidental finding: an unusual variant of double lipoma with an asymptomatic course. Such a variant was not found in the literature. It was decided to carry out treatment of the main disease without any actions for double lipoma of the corpus callosum.

Diagnosis and Optimal Surgical Treatment Strategy Selection for Asymptomatic Large Cardiac Myxomas: Review of Modern Approaches and Own Clinical Case Presentation

Cardiac myxoma (CM) is the most common primary tumor of the heart and can be asymptomatic for a long time. CMs have an increased risk of systemic embolization, intracardiac obstruction, transient ischemic attacks, and strokes, potentially leading to patient disability and/or sudden cardiac death. The aim. To highlight the data of modern scientific literature and demonstrate a case of plastic reconstruction of the heart after resection of a large tumor. Materials and methods. We report a case of incidentally discovered left atrial myxoma in a 67-year-old woman with no significant medical history. Transthoracic echocardiography revealed a large mass located in the left atrium. An open surgical intervention was performed, during which the giant CM was completely removed. Histopathological examination confirmed the diagnosis. The patient was discharged on the 7th day of the postoperative period without any complaints. Also, we carried out a comprehensive search and analysis of previously published cases of asymptomatic myxomas and methods of their surgical treatment in the scientific literature of the main electronic databases. Results. In our proposed report, a satisfactory clinical outcome was obtained in a patient with giant myxoma who underwent open cardiac surgery. According to the current literature, transthoracic echocardiography, computed tomography and magnetic resonance imaging of the heart are the gold standards for the diagnosis of heart neoplasms, which corresponded to our diagnostic algorithm. In the opinion of most specialists, the minimally invasive approach is a promising and attractive treatment method for surgeons, however, a complete median sternotomy remains the standard approach in patients with CMs. Conclusions. Asymptomatic CM is a rare incidental finding with a high probability of serious adverse cerebral and cardiovascular events. Early diagnosis of CM is crucial to prevent life-threatening complications, and the most valuable tool is transthoracic echocardiography. The strategy of surgical treatment varies depending on their size and anatomical localization, in particular, resection of large and septal myxomas is usually performed through median sternotomy.

Incidental Finding of an Early-Stage Intrauterine Pregnancy at Autopsy.

Incidental Finding of an Early-Stage Intrauterine Pregnancy at Autopsy.

ARDS as the First Manifestation of Latent Multiple Myeloma: A Case Report

Acute respiratory distress syndrome (ARDS) is a medical emergency characterized by severe hypoxemia and alveolar-capillary damage leading to non-cardiogenic pulmonary edema. While commonly associated with severe infections, it can also reveal underlying conditions such as hematological diseases. Multiple myeloma, a plasma cell cancer, is often complicated by severe infections due to the immunosuppression it induces, but its association with ARDS remains rare and poorly understood. This relationship could be explained by shared immune, inflammatory, and vascular mechanisms. We report the case of a 61-year-old man admitted for severe pneumonia complicated by ARDS. Imaging and biological investigations led to the incidental discovery of latent multiple myeloma, with lytic bone lesions and hematological abnormalities. The objective of this article is to explore the underlying pathophysiological mechanisms of this association, analyze its clinical implications, and propose a multidisciplinary approach for managing this rare and complex condition.

Incidental secondary finding of a fundic gland-type adenocarcinoma in ESD specimen: a case report

Incidental secondary finding of a fundic gland-type adenocarcinoma in ESD specimen: a case report

Incidental finding of ectopic pancreatic tissue in gastric wall during laparoscopic sleeve gastrectomy: a case report

Ectopic pancreatic tissue, or heterotopic pancreas, is a rare congenital anomaly defined by the presence of pancreatic tissue outside its usual location and without vascular or ductal continuity with the main pancreas. It is often asymptomatic and typically discovered incidentally during imaging or surgical procedures. We report the case of a 41-year-old female undergoing laparoscopic sleeve gastrectomy for morbid obesity (BMI: 44 kg/m²), during which a 17×9 mm nodular lesion was identified on the anterior stomach wall. Histopathological analysis confirmed ectopic pancreatic tissue, classified as Heinrich type I. This case highlights the importance of recognizing incidental findings during bariatric surgery and the need for thorough pathological evaluation to rule out malignancy or other complications.

Solid pseudopapillary neoplasia of the pancreas: incidental finding with increased frequency

Solid pseudopapillary neoplasia of the pancreas: incidental finding with increased frequency

Intraperitoneal Inflammatory Myofibroblastic Tumour: A Rare Intermediate Tumour of Paediatric Age Group

This case report highlighted a 9 month old child with failure to thrive. Incidental finding of left sided abdominal mass during elective admission for magnetic resonance imaging brain. Radiological investigation followed by histopathological examination revealed the presence of an inflammatory myofibroblastic tumour in abdomen. These were rarely reported intermediate tumours with a strong tendency for recurrence.

The natural history of untreated X-linked nephrogenic diabetes insipidus with mutation in the vasopressin V2 receptor gene.

Nephrogenic diabetes insipidus (NDI) results from the kidneys' inability to concentrate urine. We describe a 6-month-old male with a history of poor weight gain who presented with an incidental finding of hypernatremia (155mEq/L) during an episode of acute gastroenteritis. The arginine vasopressin (AVP) test, along with molecular analysis revealing the M272R mutation in the AVP receptor 2 (AVPR2) gene, confirmed the diagnosis of congenital NDI. Interestingly, this mutation was also identified in the patient's maternal grandfather, who had never been diagnosed or treated for NDI despite a history of polydipsia, polyuria, and evidence of chronic kidney disease (CKD), severe bilateral hydronephrosis, hypertension, and severe bladder dysfunction. Early intervention with hydrochlorothiazide in the infant resulted in a significant reduction in urinary output and improved growth. The untreated grandfather's case highlights the potential severity of untreated NDI and the benefits of timely therapeutic intervention. This report contributes to the limited long-term data on congenital NDI, emphasizing the critical role of early detection and consistent management in preventing severe complications such as CKD, hydronephrosis, and bladder dysfunction. Regular follow-up, including renal ultrasound and monitoring of renal function, is essential for effectively managing NDI and improving patient outcomes.