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Effect of Lesion Size in the Diagnosis of Hepatic Hemangioma with Tc-99m Erythrocyte Scintigraphy

Aim: Diagnosis of the hepatic hemangiomas is sometimes difficult by means of computed tomography (CT) or ultrasound (USG). This kind of lesions can be accurately identified by Tc-99m labeled erythrocyte -red blood cell (RBC) imaging. However there are controversial results about small lesions (<1.5 cm). Aim of this study is to evaluate the effect of lesion size in the diagnosis of liver hemangioma by using Tc-99m labeled RBC scintigraphy. Material and Method: Forty-two patients who had liver lesions with the suspicion of hemangioma were retrospectively evaluated. Tc-99m RBC scintigraphy results of the patients were compared with 3-24 months clinical or USG follow-up or morphological imaging methods (dynamic computerized tomography or magnetic resonance imaging (MRI)). Results: Twenty seven of 42 patients had follow-up and their diagnosis was confirmed. Sensitivity, specificity, accuracy, positive and negative predictive value of Tc-99m RBC scintigraphy according to follow up results were 92%, 66%, 89%, 96% and 50%, respectively. Two false negative lesions were smaller than 1.5 cm (10 mm, 13 mm). One of the 3 patients with small lesion who came for follow- up had true positive result. Existence of small lesions in the study made the specificity and negative predictive value decreased. Discussion: Although small sized (<1.5 cm) hemangiomas sometimes can also be visualized with Tc-99m RBC scintigraphy, this technique is very sensitive especially for large lesions.

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Factors Affecting Success and Complication of Percutaneous Nephrolithotomy

Aim: Percutaneous nephrolithotomy (PNL) is the first choice renal stones especially larger than 2 cm, and high success rates can be achieved after PNL. But several severe complications may be occurred. In this study, factors which affect the success rate and complications were investigated. Material and Method: Between July 2004 and August 2007, 176 patients (102 men/74 women) underwent PNL operation. Because of the bilateral renal stones PNL was performed in two separate sessions of 9 patients. Percutaneous access was doing in prone position. Discussion: Stone size and location, access number, the need for additional treatment and surgical experience can be listed as factors affecting the success of the PNL process. Especially in experienced hands it is possible to get good results with lower complication rates.

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A Rare Localization of Desmoplastic Fibroblastoma: Chest Wall

July 2013 12 Views
Desmoplastic fibroblastoma is a rare, benign, soft tissue tumor. It predominantly occurs within the subcutaneous tissue or muscle. Desmoplastic fibroblastoma usually appears in various locations, including the upper and lower extremities, posterior neck, upper back, abdominal wall and hip. Herein, we present a 17-year- old male patient who had a desmoplastic fibroblastoma on the chest wall. The diagnosis is histologically verified and differentiated from other soft tissue tumors.The rare localization of this lesion in the chest wall is particularly interesting.
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