Kui Hyang Kwon

Magnetic Resonance Imaging of Breast Cancer and Correlation with Prognostic Factors

Background: Prognostic factors of breast cancer have been used for the prediction of clinical outcome or selection of patients for complementary treatment. Some of the imaging features of breast cancer, e.g. magnetic resonance imaging (MRI), are associated with these prognostic factors. Purpose: To evaluate the relationship between dynamic enhanced MR features and prognostic factors of clinical outcome of breast cancer. Material and Methods: A total of 136 patients with 151 breast cancers underwent 1.5T dynamic MR imaging with the use of a dynamic T1-weighted three-dimensional fast low-angle shot (FLASH) subtraction imaging technique. Morphological and kinetic analyses of MR features were evaluated using the American College of Radiology (ACR) Breast Imaging Reporting and Data System (BI-RADS) MRI lexicon. Pathological prognostic factors were correlated with MR imaging characteristics, including tumor size, histological grade, lymph node status, expression of estrogen receptor (ER), expression of progesterone receptor (PR), expression of c-erbB2, determination of Ki-67 index, and microvascular density (MVD), using univariate and multivariate statistical analyses. Results: Based on univariate and multivariate analyses, spiculated tumor margins correlated significantly with lower histological grade (I–II) and positive PR expression. Rim enhancement was significantly correlated with high histological grade, presence of axillary lymph node metastasis, large tumor size, increased Ki-67 index, and increased MVD. Early peak enhancement, as seen on the first scan after contrast medium injection, was correlated with negative ER expression. Conclusion: The presence of a lesion with a spiculated margin may predict a relatively good prognosis, and the presence of a lesion with rim enhancement may predict a relatively poor prognosis.

Acute Diffuse Phlegmonous Esophagogastritis: A Case Report

Acute phlegmonous infection of the gastrointestinal tract is characterized by purulent inflammation of the submucosa and muscular layer with sparing of the mucosa. The authors report a rare case of acute diffuse phlegmonous esophagogastritis, which was well diagnosed based on the typical chest computed tomographic (CT) findings and was successfully treated. A 48-yr-old man presented with left chest pain and dyspnea for three days. Chest radiograph on admission showed mediastinal widening and bilateral pleural effusion. The patient became febrile and the amount of left pleural effusion is increased on follow-up chest radiograph. Left closed thoracostomy was performed with pus drainage. A CT diagnosis of acute phlegmonous esophagogastritis was suggested and a surgery was decided due to worsening of clinical condition of the patient and radiologic findings. Esophageal myotomies were performed and the submucosal layer was filled with thick, cheesy materials. The patient was successfully discharged with no postoperative complication.

Homocystinuria presenting with portal vein thrombosis and pancreatic pseudocyst: a case report.

Abstract Homocystinuria is a rare, inherited metabolic disease frequently associated with severe multisystemic involvement such as dislocated lenses, skeletal deformities, mental retardation, and premature vascular occlusion. Arterial and venous thromboembolic events present frequent and life-threatening complications in homocystinuric patients. It has been suggested that mild homocystinemia would be a risk factor for vascular disease.

Magnetic Resonance Imaging of Metaplastic Carcinoma of the Breast: Sonographic and Pathologic Correlation

Metaplastic carcinoma of the breast is a rare disease. We describe the MRI findings with the correlative sonographic and pathologic features of two cases. On MRI, T2‐weighted images demonstrate a relatively well‐defined mass with high signal intensity cystic components. Dynamic enhancement subtraction images showed an early enhancing and delayed washout peripheral rim and non‐enhancing internal components. A microlobulated, isoechogenic mass with cystic components was seen sonographically, and was histopathology related to necrosis and cystic degeneration. Although these features are not unique, metaplastic carcinoma should be included in the differential diagnosis for breast masses.

Bilateral Breast Enlargement: An Unusual Presentation of Superior Vena Cava Obstruction in a Hemodialysis Patient with Fibrosing Mediastinitis

A 67-year-old woman with end-stage renal disease presented with profound edema of both breasts. The presence of a patent hemodialysis basilic transposition fistula and superior vena cava obstruction (SVC), due to fibrosing mediastinitis, was demonstrated by the use of fistulography. Endovascular treatment with a balloon and stent caused immediate resolution of the breast edema.

Synchronous bilateral mucinous carcinoma of the breast: case report

A mucinous carcinoma of the breast is a well-differentiated rare histological type of invasive ductal carcinoma, having a lower frequency of metastasis to an axillary lymph node and a better survival rate. Bilateral breast cancer has an overall incidence of 4% to 20% in patients with primary operable breast cancer. Few reports exist in the clinical literature characterizing a synchronous bilateral mucinous carcinoma of the breast. We report the characteristic imaging findings of a bilateral mucinous carcinoma of the breast.

An incidentally detected hepatic subcapsular hematoma in a very low birth weight newborn: a case report

IntroductionA hepatic subcapsular hematoma in a neonate shows a non-specific presentation such as the presence of an abdominal mass without symptoms of hemorrhage and is clinically less distinguished as compared to cases detected during an autopsy.Case presentationA neonate was delivered by vaginal delivery after 29 weeks and three days gestation with breech presentation. In a laboratory study, there were slightly increased levels of liver enzymes but the platelet count and hemoglobin level were normal. An abdomen ultrasonography and CT image demonstrated the cystic mass containing an internal thin septum with compression of the lateral margin of the right hepatic lobe and Morisons pouch. A CT image showed an irregular low-density lesion in the dome of liver that was suspected parenchymal laceration.ConclusionWe have described the sonographic and CT findings of an incidentally detected subcapsular hematoma of the liver in a neonate who showed a breech presentation, very low birth weight and was premature.