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Simple Cysts (simple + cyst)
Selected AbstractsDiagnostic evaluation of cystic pancreatic lesionsHPB, Issue 1 2008B. C. VISSER Abstract Background. Cystic pancreatic neoplasms (CPNs) present a unique challenge in preoperative diagnosis. We investigated the accuracy of diagnostic methods for CPN. Material and methods. This retrospective cases series includes 70 patients who underwent surgery at a university hospital for presumed CPNs between 1997 and 2003, and for whom a definitive diagnosis was established. Variables examined included symptoms, preoperative work-up (including endoscopic retrograde cholangiopancreatography (ERCP) in 22 cases and endoscopic ultrasound (EUS) in 12), and operative and pathological findings. Preoperative computed tomography (CT) and magnetic resonance imaging (MRI) scans (n=50 patients; CT=48; MRI=13) were independently reviewed by two blinded GI radiologists. Results. The final histopathologic diagnoses were mucinous cystic neoplasm (n=13), mucinous cystadenocarcinoma (10), serous cystadenoma (11), IPMN (14), simple cyst (3), cystic neuroendocrine tumor (5), pseudocyst (4), and other (10). Overall, 25 of 70 were malignant (37%), 21 premalignant (30%), and 24 benign (34%). The attending surgeon's preoperative diagnosis was correct in 31% of cases, incorrect in 29%, non-specific "cystic tumor" in 27%, and "pseuodcyst vs. neoplasm" in 11%. Eight had been previously managed as pseudocysts, and 3 pseudocysts were excised as presumed CPN. In review of the CT and MRI, a multivariate analysis of the morphologic features did not identify predictors of specific pathologic diagnoses. Both radiologists were accurate with their preferred (no. 1) diagnosis in <50% of cases. MRI demonstrated no additional utility beyond CT. Conclusions. The diagnosis of CPN remains challenging. Cross-sectional imaging methods do not reliably give an accurate preoperative diagnosis. Surgeons should continue to err on the side of resection. [source] Spontaneous rupture of non-parasitic hepatic cystINTERNATIONAL JOURNAL OF CLINICAL PRACTICE, Issue 1 2006G. Poggi Summary Intrahepatic cysts are generally classified as congenital, traumatic, infectious or neoplastic. Non-parasitic hepatic cysts (NPHCs) include simple cysts and adult polycystic liver disease in which the liver is diffusely occupied by cysts. NPHCs usually reach a large size before causing symptoms, unless a complication such as rupture, bleeding, infection, obstructive jaundice or neoplastic transformation occurs. We report the case of a 67-year-old man with spontaneous rupture of simple liver cyst. The clinical pictures and the unusual ultrasound features of this rare condition are discussed. [source] Incidence and growth pattern of simple cysts of the kidney in patients with asymptomatic microscopic hematuriaINTERNATIONAL JOURNAL OF UROLOGY, Issue 2 2003KEN MARUMO AbstractBackground: We examined the incidence and natural history of simple renal cysts found by ultrasonography (US) in patients referred for asymptomatic microscopic hematuria. Methods: Among the 906 patients aged 18,78 years, 743 patients who had undergone US were included in the present study. The natural history of simple renal cysts was investigated in 55 patients who underwent periodical US examinations for more than 3 years. Results: The incidence of simple renal cysts was 4.3% for ages 29 years or younger, 15.3% for ages 30,39, 21.8% for ages 40,49, 23.3% for ages 50,59 and 32.6% for ages 60 years or older; thus the incidence increased in older age groups (P = 0.0005 for men, P = 0.0020 for women). Men tended to have a higher incidence than women. The degree of hematuria did not influence the incidence of renal cysts (P = 0.9044). The annual growth rate of the mean maximum diameter was 4.2% during a 3-year follow-up period in 55 patients and 5.1% during a 6-year follow-up in 31 patients. Conclusion: Since the diameter of a renal cyst may increase by 5% annually, the diameter of the cyst may increase by 1.6 times in 10 years. The scheduling of follow-up examinations depends on the size at the time of disclosure, the effects on calyceal systems, or the suspicion of a concurrent malignant disease. However, the most simple renal cysts may be followed-up at an interval of more than 10 years, once a diagnosis has been established. [source] Apparent wall thickening of cystic renal lesions on MRIJOURNAL OF MAGNETIC RESONANCE IMAGING, Issue 1 2008Vikas Gulani MD Abstract Purpose To show that cystic renal lesions that would otherwise meet criteria for simple cysts can demonstrate perceptible walls or increased wall thickness on MRI, sometimes causing these lesions to be "upgraded." It was hypothesized that thickening of cyst walls on MRI can be artifactual, due to data truncation, applied filtering, and low signal-to-noise ratio (SNR). Materials and Methods k-Space data for a 4-cm cyst were created in a 40-cm field of view (FOV) (512 × 512 matrix). Additional data sets were created using the central 512 × 256 and 512 × 128 points. Noise was simulated so that the cyst SNR was approximately 7, 14, and 20, respectively. Actual wall thickness was set at 0.25 mm, and cyst:wall signal at 1:4. An inverse two-dimensional (2D) fast Fourier transform (FFT) yielded simulated images. A Fermi filter was applied to reduce ringing. Images/projections were examined for wall thickening. Seven patients with initially thick-walled cysts on fat-saturated spoiled gradient-echo (FS-SPGR) images were scanned with increasing resolution (256 × 128 and 256 × 256; four patients were also scanned with 512 × 512). Average wall thickness at each resolution was compared using a two-tailed paired Student's t -test. Results Simulations showed apparent wall thickening at low resolution, improving with higher resolutions. Low SNR and application of the Fermi filter made it difficult to identify ringing as the cause of this thickening. The simulation results were confirmed on seven patients, whose cyst walls proved to be artifactually thickened (P < 0.01). Conclusion Thickening of cyst walls on MRI can be artifactual. Upon encountering thick-walled cystic renal lesions, high-resolution images can be acquired to exclude apparent thickening. J. Magn. Reson. Imaging 2008;28103,110. © 2008 Wiley-Liss, Inc. [source] Long-term outcome after laparoscopic fenestration of symptomatic simple cysts of the liverBRITISH JOURNAL OF SURGERY (NOW INCLUDES EUROPEAN JOURNAL OF SURGERY), Issue 5 2005P. Fabiani Symptoms controlled despite recurrence [source] | ||||||||||