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Huge pelvi-abdominal malignant inflammatory myofibroblastic tumor with rapid recurrence in a 14-year-old boy

World Journal of Gastroenterology 2010年第21期16卷 2698-2701页

作者： Chia-Hsun Lu Hsuan-Ying Huang Han-koo Chen Jiin-Haur Chuang Shu-Hang Ng sheung-fat ko Department of Radiology Chang Gung Memorial Hospital-Kaohsiung Medical CenterChang Gung University College of MedicineKaohsiung Hsien833TaiwanChina Department of Pathology Chang Gung Memorial Hospital-Kaohsiung Medical CenterChang Gung University College of MedicineKaohsiung Hsien833TaiwanChina Department of Pediatric Surgery Chang Gung Memorial Hospital-Kaohsiung Medical CenterChang Gung University College of MedicineKaohsiung Hsien833TaiwanChina

Inflammatory myofibroblastic tumor(IMT) is an uncommon benign neoplasm with locally aggressive behavior but malignant change is *** report an unusual case of pelvic-abdominal inflammatory myofibroblastic tumor with malignant transformation in a 14-year-old boy presenting with abdominal pain and 9 kg body weight loss in one *** tomography revealed a huge pelvi-abdominal mass(30 cm),possibly originating from the pelvic extraperitoneal space,protruding into the abdomen leading to upward displacement of the bowel loops,downward displacement of the urinary bladder,massive central necrosis,a well-enhanced peripheral solid component with prominent peritumoral *** examination confirmed the computed tomographic *** examination revealed proliferative epitheloid and spindle cells,inflammatory cell infiltration and high mitotic *** was strongly positive for anaplastic lymphoma kinase and revealed a high proliferative index(ki-67 = 40%).DNA sequencing and electronic microscopy further confirmed the primitive fibroblastic cell phenotype of the tumor and a final diagnosis of inflammatory myofibroblastic tumor with malignant transformation was *** tumor recurrence was noted 20 d after radical tumor *** our knowledge,this is the largest documented case of IMT in a pediatric patient and the first report of IMT with malignant transformation originating from the pelvic extraperitoneal space.

关键词： Inflammatory myofibroblastic tumor Malignant transformation Pediatric patient Pelvis Extraperitoneal space Computed tomography

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Intraluminal versus infiltrating gallbladder carcinoma:Clinical presentation,ultrasound and computed tomography

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World Journal of Gastroenterology 2009年第45期15卷 5662-5668页

作者： Tze-Yu Lee sheung-fat ko Chung-Cheng Huang Shu-Hang Ng Jiun-Lung Liang Hsuan-Ying Huang Min-Chi Chen Shyr-Ming Sheen-Chen Department of Radiology Chang Gung University College of Medicine Chang Gung Memorial Hospital-Kaohsiung Medical Center Kaohsiung Hsien 833 Taiwan China Department of Pathology Chang Gung University College of Medicine Chang Gung Memorial Hospital-Kaohsiung Medical Center Kaohsiung Hsien 833 Taiwan China Public Health and Biostatistics Consulting Center Chang Gung University College of Medicine Chang Gung Memorial Hospital-Kaohsiung Medical Center Kaohsiung Hsien 833 Taiwan China Department of Surgery Chang Gung University College of Medicine Chang Gung Memorial Hospital-Kaohsiung Medical Center Kaohsiung Hsien 833 Taiwan China

AIM: To compare clinical presentation and ultrasound (US) and computed tomography (CT) sensitivity between intraluminal and inf iltrating gallbladder carcinoma (GBCA). METHODS: This retrospective study evaluated 65 cases of GBCA that were categorized morphologically into the intraluminal-GBCA (n = 37) and infiltrating-GBCA(n = 28) groups. The clinical and laboratory fi ndings, presence of gallstones, gallbladder size, T-staging, nodal status, sensitivity of preoperative US and CT studies, and outcome were compared between the two ***: There were no signif icant differences between the two groups with respect to female predominance, presence of abdominal pain, serum aminotransferases level, T2-T4 staging, and regional metastatic nodes. Compared with the patients with intraluminal-GBCA, those with infiltrating-GBCA were significantly older (65.49 ± 1.51 years vs 73.07 ± 1.90 years), had a higher frequency of jaundice (3/37 patients vs 13/28 patients) and fever (3/37 patients vs 10/28 patients), higher alkaline phosphatase (119.36 ± 87.80 IU/L vs 220.68 ± 164.84 IU/L) and total bilirubin (1.74 ± 2.87 mg/L vs 3.50 ± 3.51 mg/L) levels, higher frequency of gallstones (12/37 patients vs 22/28 patients), smaller gallbladder size (length, 7.47 ± 1.70 cm vs 6.47 ± 1.83 cm; width, 4.21 ± 1.43 cm vs 2.67 ± 0.93 cm), and greater proportion of patients with < 12 mo survival (16/37 patients vs 18/28 patients). The sensitivity for diagnosing intraluminal-GBCA with and without gallstones was 63.6% and 91.3% by US, and 80% and 100% by CT, respectively. The sensitivity for diagnosing inf iltrating-GBCA with and without gallstones was 12.5% and 25% by US, and 71.4% and 75% by CT, respectively. CONCLUSION: In elderly women exhibiting small gallbladder and gallstones on US, especially those with jaundice, fever, high alkaline phosphatase and bilirubin levels, CT may reveal concurrent infi ltrating-GBCA.

关键词：临床表现超音波浸润胆囊腔内断层电脑癌

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Survival outcome of lobar or segmental transcatheter arterial embolization with ethanol-lipiodol mixture in treating hepatocellular carcinoma

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World Journal of Gastroenterology 2005年第18期11卷 2792-2795页

作者： Yun-Chung Cheung sheung-fat ko Shu-Hang Ng Siu-Cheung Chan Department of Diagnostic Radiology Chang Gung Memorial Hospital at Keelung and at Kaohsiang 5 Fu Hsing Street Kwei Shan Tao Yuan Hsien Taiwan China

AIM: To evaluate the clinical outcome and cost-effectiveness of transcatheter arterial ethanol-lipiodol embolotherapy on hepatocellular carcinoma (HCC).METHODS: One hundred patients with HCC who were treated only by lobar or segmental transarterial embolization (TAE) with ethanol-lipiodol mixture wereenrolled in this study. The 1st- and 2nd-year survival rates were analyzed to evaluate the feasibility of its method. These outcomes of our patients were individually correlated to the Child-Pugh classification and the computed tomographic features of ***: The overall 1st- and 2nd-year survival rates were 72% and 46%, respectively. The patients were classified into three groups according to their liver function status: 68 patients as Child-Pugh class A, 26 as Child B, and 6 as Child C. Child A had better survival rate than the Child B and/or C. The 1st-year survival rates of patients with Child A-C were 84%, 50%, and 33.3% respectively and the 2nd-year survival rates were 55.5%, 28.5%, and 33.3%, respectively. According to the computed tomographic features, solitary HCC with maximum diameter less than 5 cm had the best outcome with the 1st-year survival rate of 100% and the 2nd-year survival rate of 71.4%, while solitary HCC with maximum diameter over 5 cm and multiple HCC had the 1st-year survival rates of 75% and 63.7%, respectively, and the 2nd-year survival rates of 33.3% and 44.4%, respectively. Only one patient was complicated with abscess formation and was cured with antibiotic therapy. No mortality resulted from the procedures ***: TAE with ethanol-lipiodol mixture is an economic, safe and feasible method for treating HCC, especially for the patients with smaller solitary HCC or with liver function status of Child-Pugh class A.

关键词：动脉栓塞乙醇混合物肝细胞癌治疗方法

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Calcified reticulate rind sign:A characteristic feature of gossypiboma on computed tomography

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World Journal of Gastroenterology 2005年第31期11卷 4927-4929页

作者： Yi-Ying Lu Yun-Chung Cheung sheung-fat ko Shu-Hang Ng Department of Diagnostic Radiology Chang Gung Memorial Hospital Taiwan China College of Medicine and School of Medical Technology Chang Gung University Taiwan China

We herein report a gossypiboma resulting from a retained surgical swab, which had been left in peritoneum for 20years after appendectomy. CT revealed a cystic mass with a calcified reticulate rind. Subsequent surgery and pathological examination showed a gossypiboma. A simple experiment, using a barium-soaked surgical swab demonstrating similar CT appearance, supported our postulation that calcium deposition on the reticulated fibers of a surgical swab could generate such a characteristic 'calcified reticulate rind' sign. We believe that identification of this CT sign facilitates the diagnosis of gossypibomas.

关键词：石灰网状外壳床表现 X线断层摄影术 CT检查手术治疗

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Retrotracheal thymoma masquerading as esophageal submucosal tumor

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World Journal of Gastroenterology 2005年第20期11卷 3165-3166页

作者： sheung-fat ko Yuan-Hsiung Tsai Hsuan-Ying Huang Shu-Hang Ng Fu-Ming Fang Yeh Tang Ming-Tse Sung Ming-Jang Hsieh Departments of Radiology Chang Gung University Chang Gung Memorial Hospital at Kaohsiung Kaohsiung Hsien Taiwan China Departments of Pathology Chang Gung University Chang Gung Memorial Hospital at KaohsiungKaohsiung Hsien Taiwan China Departments of Oncology Chang Gung University Chang Gung Memorial Hospital at Kaohsiung Kaohsiung Hsien Taiwan China Departments of Thoracic Surgery Chang Gung Memorial Hospital at Kaohsiung Kaohsiung Hsien Taiwan China

A 42-year-old man presented with a two-year history of progressive dysphagia and hoarseness. Esophagogram and endoscopy revealed submucosal mass effect on the upper esophagus. Computed tomography and magnetic resonance imaging revealed an elongated mass in the retrotracheal region of the lower neck with extension to the posterior mediastinum. Partial tumor resection and histopathological evaluation revealed a WHO type B2 thymoma. Adjuvant radiation and chemotherapy were subsequently administered resulting in complete tumor regression. To our knowledge, this is the first report of ectopic retrotracheal thymoma with clinical and imaging manifestations mimicking those for esophageal submucosal tumor.

关键词：胸腺肿瘤食道肿瘤肿瘤入侵病理机制

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