Wall Mass Research Articles

Characterization of the calcium component of vulnerable coronary plaque in patients with NSTEMI: Prospective comparison between coronary CT and optical coherence tomography

Acute Coronary Syndrome (ACS) remains a leading cause of mortality worldwide. Several studies have demonstrated a role for Coronary Computed Tomographic Angiography (CCTA) to predict the vulnerability of the plaque. Recent works suggest a role for calcification in this vulnerability. To assess if the CCTA study of the calcium component of plaques can predict plaque vulnerability defined by intracoronary OCT analysis in patients with non-ST elevation myocardial infarction (NSTEMI). Prospective study of consecutive patients with NSTEMI and elevated high-sensitivity cardiac troponin I level > 50 ng/ml from January to October 2018. CCTA was performed before coronary angiography. When CCTA demonstrated significant lesions, coronary angiography was performed with OCT study of three coronary arteries. Apart culprit plaques, vulnerable plaques were defined in OCT by a fibrous screed thickness < 65 microns. Calcified plaques were analysed and classified into 3 groups: vulnerable culprit plaque (VCP), vulnerable non-culprit plaque (VNCP) and stable plaque (SP). Of 1478 patients with chest pain, 257 (17%) had NSTEMI. Among them 44(17%) were without known CAD and among these patients 29(66%-mean age 59 ± 13 years, 73% men) had received coronary angiography and OCT. A total of 123 calcified plaques were identified. Among them, OCT allowed to identify 77 (63%) SP and 47 (37%) calcified vulnerable plaques with 28 VNCP and 19 VCP. After CCTA analysis, predictive factors of vulnerability were identified: longer calcification length, larger calcification volume, higher plaque's Agatston score, lower sphericity index, more spotty calcifications, a more intimal position in the wall ( P < 0.001 for all) and lower calcium mass ( P = 0.003). No significant differences were observed comparing VNCP and VCP ( Fig. 1 ). CCTA study of the calcium component of plaque allows to identify predictors of plaque vulnerability defined by OCT in patients with NSTEMI.

P655 Prognostic value of the new classification of ventricular remodeling in severe aortic stenosis

Abstract Introduction remodeling is defined as the changes produced in the geometry of the left ventricle after damage or overload of the myocardium. The most common classification only considers left ventricle relative wall thickness and mass index, but a new classification includes also end-diastolic volume index. Purpose to determine if the new patterns of ventricular remodeling had clinical relevance according to symptoms or cardiovacular outcomes. Methods patients with severe aortic stenosis (valve area &amp;lt;1cm2) between 2015 and 2018 were included, excluding other concomitant at least moderate valvular diseases. The patients were classified according to the indexed ventricular mass, relative parietal thickness and left ventricular volume. Cardiovascular mortality was analyzed as the primary endpoint. Results we recruited 234 patients with severe aortic stenosis (55% women, age 77 ± 9 years) with a BMI of 29 ± 5, of which 82% were hypertensive, 47% diabetic, 47% dyslipidemic and 19% smokers. 81% were symptomatic. The average time of follow-up was 280 ± 231 days. 1% had eccentric hypertrophy, 7% mixed hypertrophy, 3% dilated hypertrophy, 73% concentric hypertrophy, 15% concentric remodeling; no patient presented normal ventricle or physiological hypertrophy. Dyspnea was the predominant symptom 100% in eccentric, mixed and dilated hypertrophy; 72% in concentric hypertrophy and 85% in concentric remodeling (p = 0.05). Most patients with mixed hypertrophy had NYHA functional class&amp;gt; II: 0% vs 62% vs 37% vs 27% vs 37% (p = 0.008). The group with the highest cardiovascular mortality was mixed hypertrophy (0% vs 43% vs 0% vs 14% vs 11%, p = 0.04), also shown in the survival analysis (Log Rank = 0.009) (Graph 1). Conclusions in patients with severe aortic stenosis, the pattern of mixed hypertrophy was an adverse prognostic marker in our study, although prognostic role of these new remodeling patterns needs to be investigated in future prospective studies. Abstract P655 Figure. Graph 1.: Kaplan-Meier survival function

Abdominal wall endometriosis versus desmoid tumor - a challenging differential diagnosis.

Aim: Abdominal wall endometriosis (AWE) in young women, with previous gynecological abdominal surgery, is the first condition considered by many practitioners when a tumor in the region of the scar appears. AWE seems to be caused by an iatrogenic transfer of endometrial cells at the level of the scar. The onset of the disease may be late in many cases. Despite the fact that the disease could be totally asymptomatic, there are certain risk factors that can be identified during the anamnesis, such as: heredity, menarche at the age of >14 years, menstrual cycle <27 days, delayed menopause, excessive alcohol and caffeine consumption. Suggestive signs include cyclic or continuous abdominal pain caused by a palpable abdominal wall mass with a maximum tenderness in the region of the surgical scar. The differential diagnosis is complex and rare entities like desmoid tumors (DTs) must be taken into consideration. Desmoid tumor, or the so-called aggressive fibromatosis (AF), is a rare fibroblastic proliferation. This tumor can develop in any muscular aponeurotic structure of the body and is considered benign but with a high recurrence rate. DTs can cause local infiltration, subsequently producing certain levels of deformity and potential obstruction of vital structures and organs. The differential diagnosis is challenging in this situations, the imagery exams are useful, especially in detecting the precise location of the tumor. The histological examination of the tumor can state the final and precise diagnosis.

Clinical validation of three cardiovascular magnetic resonance techniques to measure strain and torsion in patients with suspected coronary artery disease

BackgroundSeveral cardiovascular magnetic resonance (CMR) techniques can measure myocardial strain and torsion with high accuracy. The purpose of this study was to compare displacement encoding with stimulated echoes (DENSE), tagging and feature tracking (FT) for measuring circumferential and radial myocardial strain and myocardial torsion in order to assess myocardial function and infarct scar burden both at a global and at a segmental level.Method116 patients with a high likelihood of coronary artery disease (European SCORE > 15%) underwent CMR examination including cine images, tagging, DENSE and late gadolinium enhancement (LGE) in the short axis direction. In total, 97 patients had signs of myocardial disease and 19 had no abnormalities in terms of left ventricular (LV) wall mass index, LV ejection fraction, wall motion, LGE or a history of myocardial infarction. Thirty-four patients had myocardial infarct scar with a transmural LGE extent (transmurality) that exceeded 50% of the wall thickness in at least one segment. Global circumferential strain (GCS) and global radial strain (GRS) was analyzed using FT of cine loops, deformation of tag lines or DENSE displacement.ResultsDENSE and tagging both showed high sensitivity (82% and 71%) at a specificity of 80% for the detection of segments with > 50% LGE transmurality, and receiver operating characteristics (ROC) analysis showed significantly higher area under the curve-values (AUC) for DENSE (0.87) than for tagging (0.83, p < 0.001) and FT (0.66, p = 0.003). GCS correlated with global LGE when determined with DENSE (r = 0.41), tagging (r = 0.37) and FT (r = 0.15). GRS had a low but significant negative correlation with LGE; DENSE r = − 0.10, FT r = − 0.07 and tagging r = − 0.16. Torsion from DENSE and tagging had a weak correlation (− 0.20 and − 0.22 respectively) with global LGE.ConclusionCircumferential strain from DENSE detected segments with > 50% scar with a higher AUC than strain determined from tagging and FT at a segmental level. GCS and torsion computed from DENSE and tagging showed similar correlation with global scar size, while when computed from FT, the correlation was lower.

Unsteady MHD Flow of Cassonnano Fluid with Chemical Reaction, Thermal Radiation and Heat Generation/Absorption

The hydromagnetic mixed convection flow of Cassonnano fluid under the influence of chemical reaction,thermal radiation and heat generation or absorption is investigated. The flow is induced due to unsteady nonlinearly stretching sheet saturated in a porous medium. The governing nonlinear coupled partial differential equations are converted into the system of coupled ordinary differential equations using similarity transformations and then solved numerically via Keller box method. The effects of pertinent parameters on velocity, temperature and nanoparticles concentration as well as wall shear stress, heat and mass transfer rate are analyzed and displayed graphically. The results for skin friction coefficient and local Nusselt number are compared with previously published work and found to be in good agreement. Findings demonstrate that increase in Casson parameter enhanced the friction factor and heat transfer rate. It is noticed that the heat transfer rate is declined with increment in Brownian motion and thermophoresis parameters. The nanoparticles concentration is seen to be higherin generative chemical reaction and opposite effect is observed in destructive chemical reaction. Increase in unsteadiness parameter decreased the fluid velocity, temperature and nanoparticles concentration. The magnitude of wall shear stress is also reduced with increase in unsteadiness and porous medium parameters.

Effects of radiation and chemical reaction on MHD flow past a vertical plate with variable temperature and mass diffusion

This research investigates the effects of radiation, chemical reaction and porosity of the medium on unsteady flow of a viscous, incompressible and electrically conducting fluid past an exponentially accelerated vertical plate with variable wall temperature and mass diffusion in the presence of transversely applied uniform magnetic field. The plate temperature and the concentration level near the plate increase linearly with time. The fluid model under consideration has been solved by Laplace transform technique. The model contains equations of motion, diffusion equation and equation of energy. To analyze the solution of the model, reasonable sets of the values of the parameters have been considered. The numerical data obtained is discussed with the help of graphs and tables. The numerical values obtained for skin-friction, Sherwood number and Nusselt number have been tabulated. It is found that the velocity of fluid increases when the values of permeability parameter, acceleration parameter and radiation parameter are increased. But trend is reversed with the chemical reaction parameter. It means that the velocity decreases when the chemical reaction parameter is increased.

Evaluation of cardiac performance among asymptomatic obese subjects in comparison with normal individual

Background: Obesity constitutes a major health issue in the modern world. The purpose of this prospective study was to assess the effect of obesity on ventricular function by conventional 2D echocardiography and echocardiogram for assessment of early cardiac changes.Methods: In the present study, 50 asymptomatic obese subjects having BMI &gt;30 were compared with 50 normal individuals having BMI in the range 20-24.9 to assess cardiac performance. The study was conducted over a period of 2 years, from 2009 to 2011.Results: There were 20(40%) males and 30(60%) females in both the groups. The ejection fraction was not significantly affected in obese subjects (60.86±1.34%) than normal individual (60.42±1.18%) which was found to be statistically not significant. So, in this study systolic function was not affected. The thickness of left ventricle was significantly increased in obese subjects (1.016±0.113 cm) than normal individual (0.77+0.073 cm) which was found to be statistically significant.Conclusions: The current study revealed increased wall thickness and mass of Left Ventricle (LV), significantly increased risk of LV diastolic dysfunction, evidence of Left Atrial (LA) enlargement associated with diastolic dysfunction, evidence of subclinical LV systolic dysfunction and Right Ventricular (RV) dysfunction among obese subjects in comparison with normal individuals.

Gallbladder adenomyomatosis mimicking carcinoma - a clinical case

Gallbladder adenomyomatosis is hyperplastic cholecystosis of the gallbladder. This is a relatively common and benign cause for diffuse or focal wall thickening. We present a case of a 48-year-old woman with complaints from 3 - 4 years of epigastric pain, abdominal swelling, occurring after eating, with a temporary effect after antispasmodics or antisecretors. There was a reduction in body weight. All laboratory tests were normal. An ultrasound examination revealed a diffusely thickened, stratified gallbladder wall and parenchymal mass in the lumen. Due to clinical suspicion of acalculous cholecystitis, antibacterial treatment was performed, which did not lead to relief of symptoms. The ultrasound picture also did not change. Magnetic resonance imaging showed an image of gallbladder adenomyomatosis. Given the differential diagnostic possibility of gallbladder cancer, a planned cholecystectomy was performed, which, together with histological examination, confirmed the benign nature of the disease. After the surgery, the patient's complaints completely disappeared. Gallbladder adenomyomatosis is a benign and degenerative condition characterized by mucosal proliferation and thickening of the muscle layer. Given the possible premalignant character, cholecystectomy remains the treatment of choice for patients with clinically manifested gallbladder adenomyomatosis.

Clinical feature analysis of 30 cases with pulmonary actinomycosis

Objective: To summarize the clinical characteristics of pulmonary actinomycosis and analyze its diagnostic methods. Methods: The clinical symptoms, underlying diseases, imaging characteristics, preliminary diagnosis, diagnostic methods, treatment and prognosis of 30 patients with pulmonary actinomycetes admitted into the First Affiliated Hospital of Zhejiang University School of Medicine during the 10 years (January 2007 to November 2017) were retrospectively analyzed. Results: The 30 patients with pulmonary actinomycetes included were from 47 to 81 years old, with an average age of (59.5±7.8) years, with a course of disease from 5 days to 48 months, and a median course of disease of 1.5 months; 18 patients (60.0%) were complicated with underlying diseases, 10 patients (33.3%) had a history of smoking, 10 patients (33.3%) had a history of alcohol abuse. The main clinical manifestations were cough in 29 cases (96.7%), followed by sputum in 22 cases (73.3%), hemoptysis in 20 cases (66.7%), fever in 12 cases (40.0%), chest pain in 5 cases (16.7%) and shortness of breath in 3 cases (10.0%). Mass, nodules, consolidation, atelectasis can be seen by imaging, there can be a low-density lesion necrosis, formation of voids or vacuoles. Among the 25 patients (83.3%) who underwent bronchoscopy, 14 cases were abnormal, 5 cases showed endotracheal polypoid neoplasms, 9 cases showed endotracheal mucosal inflammatory changes, 2 cases of them showed bronchial foreign body, and 1 case showed broncholithiasis. All cases were diagnosed by pathology. Nine cases (30.0%) were confirmed by bronchoscopic biopsy. Two cases (6.7%) underwent CT-guided percutaneous lung biopsy, 18 cases (60.0%) underwent surgical resection of pathology, and 1 case (3.3%) was diagnosed by puncture of chest wall mass. Sufficient dose and course of penicillin were effective. Surgical excision of the lesion with antibiotics for 2-4 weeks was effective. Conclusion: The clinical manifestation of pulmonary actinomycosis is lack of specificity, obtaining positive pathological specimens is the key to the diagnosis of this disease, the first choice is bronchoscopy and percutaneous lung biopsy.

A Case of Generalized Crystal Storage Histiocytosis Presenting as Soft Tissue Sarcoma: Diagnostic Dilemma

Crystal storage histiocytosis (CSH) is a rare clinical entity. It comprises of benign histiocytes showing accumulation of refractile generally immunoglobulin crystals in the cytoplasm. Accumulation of non-immunoglobulin substances is also described, common being clofazimine, charcot-leyden, and cystine. Here, we present a case of generalized CSH presenting as a chest wall mass in a 62-year-old gentleman. X-ray showed a chest wall mass with destruction of the right sixth rib. Histopathological examination revealed plasmacytoma with the presence of histiocytes showing abundant pink cytoplasm. Bone marrow examination revealed the presence of plasma cells with dense azurophilic granules. The patient was started on chemotherapy for multiple myeloma. It is clinically important to identify these cases as part of published literature since it annotates poor prognosis to the generalised form of CSH compared to localized one. The unusual location, presence of morphologically distinct plasma cells in marrow, made the diagnosis challenging. The case also highlights the role played by immunohistochemistry to arrive at the right diagnosis.

Entropy Analysis on Unsteady MHD Flow of Casson Nanofluid over a Stretching Vertical Plate with Thermal Radiation Effect

This article proposes to study the entropy analysis on an unsteady magnetohydrodynamic flow of Casson nanofluid and convective heat transfer over a time dependent stretching vertical plate. We have treated Buongiorno’s model to characterize the thermophysical properties of nanofluid. The effect of thermal radiation and viscous dissipation of energy for non-Newtonian nanofluid and the external magnetic field are examined. The set of partial differential equations for time dependent flow of nanofluid are reduced to a system of coupled ODEs by a suitable similarity transformation. These reduced equations are solved by employing the fourth order Runge–Kutta-Fehlberg method along with shooting technique. The flow behavior of non-Newtonian Casson nanofluid, heat transfer characteristics, nanoparticle concentration profiles and entropy analysis have been made to understand the impact of different dimensionless parameters. Furthermore, the expression for dimensionless wall shear stress, heat and mass transfer rate over a heated vertical plate have been investigated. The study shows that entropy generation sharply increases with Casson parameter, whereas it increases near the plate with the thermal radiation. The entropy generation measuring through Bejan number has significant impact in aeronautics propulsion and power engineering to predict the efficient performance of the entire system.

Overweight and obesity are associated with cardiac adverse structure remodeling in Chinese elderly with hypertension

There is limited information on the association of overweight and obesity with cardiac remodeling in elderly population. Therefore, we investigated whether overweight and obesity are associated with cardiac geometric structures and function in Chinese elderly. A total of 1183 hospitalized patients (aged 65–99 years) with primary hypertension were collected retrospectively in a cross-sectional study, and divided into underweight, normal weight, overweight and obesity patient groups according to their body mass index (BMI). Cardiac echocardiographic parameters were compared between the groups. BMI was 17.2 ± 1.2, 21.4 ± 1.2, 25.1 ± 1.2, 30.2 ± 2.6 kg/m2 in underweight, normal weight, overweight and obesity groups respectively. Aortic and left atrial diameter, interventricular septal and left ventricular (LV) posterior wall thickness, LV end-diastolic and end-systolic diameter, and indexed LV mass, and prevalence of E/A reversal were higher, while LV ejection fraction and fractional shortening were lower in elderly with overweight or obesity, as compared with whose with underweight or normal weight separately (All P < 0.05). However, multivariable regression analysis showed that overweight and obesity are independently related to increased LV wall thickness, end-diastolic diameter and mass (All P < 0.05). In conclusions, this study demonstrates that overweight and obesity are associated with increased LV wall thickness, end-diastolic diameter and mass in Asian elderly.

Gynecomastia, as an Extremely Rare Presentation of Chest Wall Lymphoma: A Case Report and Review of the Articles

Male breast enlargement as gynecomastia may be as a sign of underlying systemic diseases. Male breast malignancy is also considered in differential diagnosis. We present a young man with primary chest wall lymphoma as gynecomastia, without pre-existing problem or other disease. Here, we present his clinical manifestation, management, and his early outcome. Chest wall lymphoma as an initial presentation of isolated chest wall mass in males is a rare clinical entity and its presentation as gynecomastia is even extremely unusual. © 2019 Tehran University of Medical Sciences. All rights reserved. Acta Med Iran 2019;57(4):276-279.

Numerical study of the hydrodynamic parameters influencing internal corrosion in pipelines for different elbow flow configurations

Oil–water two-phase flow is common in the ocean engineering, petroleum, and chemical industries, among others. In the transportation process, the elbow system – as a paramount component – usually suffers from internal corrosion. In order to investigate the corrosion-prone characteristics of elbow systems, the volume of fluid (VOF) method and the renormalization group (RNG) k-ε model were used to study the oil–water flow in three different elbow configurations. The results indicate that the maximum wall shear stress and mass transfer coefficient are located at the intrados of the elbow for all flow configurations. Nevertheless, for horizontal-upward and horizontal-horizontal elbow flows, water does not come into direct contact with the intrados of the elbow, meaning it is much less susceptible to corrosion. Thus, a multiparameter model which also takes into account the water-volume fraction is necessary for characterizing the corrosion process. When this was combined with an analysis of the water wetting process, the horizontal-downward elbow flow was found to exhibit the largest corrosion risk among the three configurations examined, the horizontal-upward elbow flow was the least susceptible and the horizontal-horizontal elbow flow was in the middle.

Magnetohydrodynamics (MHD) axisymmetric flow and heat transfer of a hybrid nanofluid past a radially permeable stretching/shrinking sheet with Joule heating

The main interest of the present work is to fundamentally investigate the flow characteristics and heat transfer of a hybrid Cu-Al2O3/water nanofluid due to a radially stretching/shrinking surface with the mutual effects of MHD, suction and Joule heating. The surface is permeable to physically allow the wall mass fluid suction. Tiwari and Das model of nanofluid is used with the new thermophysical properties of hybrid nanofluid to represent the problem. A similarity transformation is adopted to convert the governing model (PDEs) into a nonlinear set of ordinary differential equations (ODEs). A bvp4c solver in MATLAB software is employed to numerically compute the transformed system. The numerical results are discussed and graphically manifested in velocity and temperature profiles, as well as the skin friction coefficient and heat transfer rate with the pertinent values of the dimensionless parameters namely magnetic, Cu volume fraction, suction and Eckert number. The Eckert number has no impact on the boundary layer separation while the higher value of the suction parameter may affect the heat transfer performance. The presence of dual solutions (first and second) is seen on all the profiles within a limited range of the physical parameters. The stability analysis is executed, and it is validated that the first solution is the real solution.

The electrical determinants of increased wall thickness and mass in left ventricular hypertrophy

IntroductionLeft ventricular hypertrophy (LVH), defined as an increased left ventricular mass (LVM), can manifest as increased wall thickness, ventricular dilatation, or both. Existing LVH criteria from the electrocardiogram (ECG) have poor sensitivity. However, it is unknown whether changes in wall thickness and mass, respectively, can be separately detected by the ECG. MethodsPatients undergoing cardiovascular magnetic resonance and resting 12-lead ECG were included. Exclusion criteria were clinical confounders that might influence the ECG, including myocardial scar. Advanced ECG (A-ECG) analysis included conventional ECG measures and amplitudes, derived vectorcardiographic and polarcardiographic measures, and singular value decomposition of waveform complexity. A-ECG scores for 1) increased LVM index (LVMI), and 2) increased global wall thickness index (GTI) beyond the upper limit of normal in healthy volunteers, respectively, were derived using multivariable logistic regression. The area under the curve (AUC) and its bootstrapped confidence interval (CI) for each score were compared to those of conventional ECG-LVH criteria including Cornell voltage, Cornell product, and Sokolow-Lyon voltage criteria. ResultsOut of 485 patients (median [interquartile range] age 51 [38–61] years, 54% female), 51 (11%) had increased LVMI and 65 (13%) had increased GTI. The A-ECG scores for increased LVMI (AUC [95% CI] 0.84 [0.78–0.90]), and increased GTI (0.80 [0.74–0.85]) differed, and had a higher AUC than the conventional ECG-LVH criteria (p < 0.001 for all). ConclusionsIncreased LVMI differed from increased GTI in its electrocardiographic manifestation by A-ECG. New A-ECG scores outperform conventional ECG criteria for LVH in determining increased LVMI and GTI, respectively.

Subcutaneous bronchogenic cyst of the chest wall

Abstract Bronchogenic cysts are rare, congenital malformations of the foregut, most commonly located in the mediastinum. Subcutaneous bronchogenic cysts are exceedingly rare. We report an 11-month-old boy who presented with an asymptomatic chest wall mass. He underwent surgical excision and final histopathology was consistent with a bronchogenic cyst. To our knowledge, this is the first reported case of a chest wall subcutaneous bronchogenic cyst in a child.

Effect of wall stiffness, mass and potential interaction strength on heat transfer characteristics of nanoscale-confined gas

The interactive thermal wall model is applied in three-dimensional molecular dynamics simulations to investigate the combined effect of the wall force field, the wall stiffness, the wall atom mass and the wall/gas interaction potential strength on the heat transfer characteristics of static rarefied argon gas within a nanochannel. By increasing the wall stiffness, a reduction in the heat flux through the gas medium occurs which leads to a higher temperature jump. As the wall atom mass is increased up to twice the argon atom mass, the heat flux is enhanced notably and a minimum temperature jump can be found at this point. Further increase in the wall atom mass results in reducing the heat flux and consequently increasing the temperature jump. The increment of the wall/gas interaction potential strength up to four times the one of gas/gas interactions is shown to enhance the heat flux and to reduce the temperature jump until it eventually vanishes. Furthermore, it is found that under such conditions, the density profile experiences a second peak. A further increase of this parameter is found to have a negligible effect on the heat flux through the gas medium and it only increases the second peak in the density profile.

Unusual Presentation of Myeloid Sarcoma in a Patient With Usher Syndrome

Abstract A 45-year-old woman with Usher syndrome, associated congenital deafness, progressive blindness due to retinitis pigmentosa, and latent autoimmune diabetes presented to the emergency department with malaise, dizziness, and pelvic pain following removal of an intrauterine device. A posterior vaginal wall mass was found on examination. Laboratory values demonstrated anemia, thrombocytopenia, and an elevated white blood cell count, raising concern for infection and potential onset of diabetic ketoacidosis. This prompted a peripheral blood smear review, which showed 60% monocytic blasts. A subsequent vaginal mass biopsy showed a myeloid sarcoma. Molecular studies demonstrated an NPM1 mutation in exon 12 without FLT3 mutation or internal tandem duplication. While a diagnosis of acute myeloid leukemia with mutated NPM1 was considered, cytogenetics revealed a complex karyotype with evidence of clonal evolution, consistent with acute myeloid leukemia with myelodysplasia-related changes. In addition to an unusual presentation of myeloid sarcoma, this case posed significant questions regarding management and pursuit of hematopoietic stem cell transplantation. Usher syndrome is genetically and clinically heterogeneous. While it is not known to be associated with increased risk of malignancy, mutation of genes associated with Usher syndrome has been identified in acute leukemia. Our case raises the question as to whether potential germline predisposition should be considered in a patient with a previously unassociated congenital syndrome.

CT and MRI features of tumors and tumor-like lesions in the abdominal wall.

Masses involving the abdominal wall are common in clinical practice and have many etiologies, including tumors and tumor-like lesions. Abdominal wall tumors include primary and secondary tumors, the former of which constitute a heterogeneous group of soft tissue tumors with their own unique spectrum. Tumor-like lesions, such as hernias, are more common and must be distinguished from true tumors. Medical imaging is valuable for discovering, diagnosing, and evaluating the extent of abdominal wall masses. With the increasing application of computed tomography (CT) and magnetic resonance imaging (MRI), determining a diagnosis or narrowing the differential diagnosis is often possible, thus facilitating effective management. In this article, we comprehensively review the spectrum of common abdominal wall masses and present the CT and MRI features of typical cases in our hospital. A systematic stepwise diagnostic approach is also proposed for clinical practice.