The Experts below are selected from a list of 1071 Experts worldwide ranked by ideXlab platform
Andrzej Lewiński - One of the best experts on this subject based on the ideXlab platform.
-
Interobserver Agreement and Plane-Dependent Intraobserver Variability of Shear Wave Sonoelastography in the Differential Diagnosis of Ectopic Thymus Tissue.
Journal of clinical medicine, 2021Co-Authors: Zbigniew Adamczewski, Magdalena Stasiak, Bartłomiej Stasiak, Magdalena Adamczewska, Andrzej LewińskiAbstract:Shear wave elastography (SWE) has been demonstrated to be a useful tool in the differential diagnosis of Ectopic Thymus tissues (ETs), providing quantitative values of the shear wave stiffness (SWS) of both ETs and adjacent thyroid tissue. However, no data are available on the potential influence of the imaging plane (transverse vs. longitudinal) on the obtained SWS and shear wave ratio (SWR) values in SWE of these tissues. Moreover, no reports on the interobserver repeatability of SWE were published in regard to ETs. The aim of this study has been to evaluate the potential influence of the examination plane-transverse vs. longitudinal-on the SWS and SWR results, as well as to determine whether SWE of ETs is subjected to interobserver variability. SWE was demonstrated to have high inter- and intraobserver agreement in the evaluation of ETs and adjacent thyroid tissue. Significant differences between SWS values, but not SWR values, obtained in the transverse and longitudinal planes were observed. This phenomenon is probably a result of anisotropy-related artifacts and does not reduce the reliability of the method. SWE operators should be aware of the presence of plane-dependent artifacts to properly interpret the obtained results.
-
sonographic and elastographic features of extra and intrathyroidal Ectopic Thymus mimicking malignancy differential diagnosis in children
Frontiers in Endocrinology, 2019Co-Authors: Magdalena Stasiak, Zbigniew Adamczewski, Andrzej Lewiński, Renata Stawerska, Tomasz Krawczyk, Monika TomaszewskaAbstract:Thyroid nodules with ultrasound (US) cancer risk features and extra-thyroid lesions suggesting malignant lymph nodes, require prompt diagnosis, especially in children. The US pattern of intrathyroidal Ectopic Thymus (IET) can strongly suggest papillary thyroid carcinoma (PTC). The extra-thyroid Ectopic thymic tissue (EET) can mimic pathological lymph nodes in US. The aim of the study has been to demonstrate US features and diagnostic methods, allowing finally to confirm the presence of IET and EET in children. The US and elastographic features of 16 Ectopic thymic tissue (ET) lesions were analyzed so as to describe the typical characteristics of ET and to define the best method to differentiate ET and malignant lesions. Among 16 analyzed lesions, 11 lesions were IET, and 5 were EET adjacent to the thyroid connective tissue capsule. Most of IET were located in the middle part of the right lobe and were fusiform or oval in shape. All the lesions were solid, hypoechoic, and heterogeneous with bright internal echoes. Among IET, 73% of lesions had well- or very well-defined margins. In strain elastography of IET lesions, the strain ratio was similar in all lesions, and its value ranged from 0.95 to 1.09. Despite the low prevalence of IET and cervical EET, clinicians and radiologists should be aware of US characteristics of such lesions. The confirmation of their benign character is absolutely required. Elastography is a useful tool to initially differentiate PTC and IET. However, due to high risk of malignancy in thyroid lesions in children, similarity of US features of PTC and IET, and due to the possibility of malignancy in ET, only cytological evaluation provides definitive diagnosis.
-
Table_1_Sonographic and Elastographic Features of Extra- and Intrathyroidal Ectopic Thymus Mimicking Malignancy: Differential Diagnosis in Children.DOCX
2019Co-Authors: Magdalena Stasiak, Zbigniew Adamczewski, Renata Stawerska, Tomasz Krawczyk, Monika Tomaszewska, Andrzej LewińskiAbstract:Thyroid nodules with ultrasound (US) cancer risk features and extra-thyroid lesions suggesting malignant lymph nodes, require prompt diagnosis, especially in children. The US pattern of intrathyroidal Ectopic Thymus (IET) can strongly suggest papillary thyroid carcinoma (PTC). The extra-thyroid Ectopic thymic tissue (EET) can mimic pathological lymph nodes in US. The aim of the study has been to demonstrate US features and diagnostic methods, allowing finally to confirm the presence of IET and EET in children. The US and elastographic features of 16 Ectopic thymic tissue (ET) lesions were analyzed so as to describe the typical characteristics of ET and to define the best method to differentiate ET and malignant lesions. Among 16 analyzed lesions, 11 lesions were IET, and 5 were EET adjacent to the thyroid connective tissue capsule. Most of IET were located in the middle part of the right lobe and were fusiform or oval in shape. All the lesions were solid, hypoechoic, and heterogeneous with bright internal echoes. Among IET, 73% of lesions had well- or very well-defined margins. In strain elastography of IET lesions, the strain ratio was similar in all lesions, and its value ranged from 0.95 to 1.09. Despite the low prevalence of IET and cervical EET, clinicians and radiologists should be aware of US characteristics of such lesions. The confirmation of their benign character is absolutely required. Elastography is a useful tool to initially differentiate PTC and IET. However, due to high risk of malignancy in thyroid lesions in children, similarity of US features of PTC and IET, and due to the possibility of malignancy in ET, only cytological evaluation provides definitive diagnosis.
Zbigniew Adamczewski - One of the best experts on this subject based on the ideXlab platform.
-
Interobserver Agreement and Plane-Dependent Intraobserver Variability of Shear Wave Sonoelastography in the Differential Diagnosis of Ectopic Thymus Tissue.
Journal of clinical medicine, 2021Co-Authors: Zbigniew Adamczewski, Magdalena Stasiak, Bartłomiej Stasiak, Magdalena Adamczewska, Andrzej LewińskiAbstract:Shear wave elastography (SWE) has been demonstrated to be a useful tool in the differential diagnosis of Ectopic Thymus tissues (ETs), providing quantitative values of the shear wave stiffness (SWS) of both ETs and adjacent thyroid tissue. However, no data are available on the potential influence of the imaging plane (transverse vs. longitudinal) on the obtained SWS and shear wave ratio (SWR) values in SWE of these tissues. Moreover, no reports on the interobserver repeatability of SWE were published in regard to ETs. The aim of this study has been to evaluate the potential influence of the examination plane-transverse vs. longitudinal-on the SWS and SWR results, as well as to determine whether SWE of ETs is subjected to interobserver variability. SWE was demonstrated to have high inter- and intraobserver agreement in the evaluation of ETs and adjacent thyroid tissue. Significant differences between SWS values, but not SWR values, obtained in the transverse and longitudinal planes were observed. This phenomenon is probably a result of anisotropy-related artifacts and does not reduce the reliability of the method. SWE operators should be aware of the presence of plane-dependent artifacts to properly interpret the obtained results.
-
sonographic and elastographic features of extra and intrathyroidal Ectopic Thymus mimicking malignancy differential diagnosis in children
Frontiers in Endocrinology, 2019Co-Authors: Magdalena Stasiak, Zbigniew Adamczewski, Andrzej Lewiński, Renata Stawerska, Tomasz Krawczyk, Monika TomaszewskaAbstract:Thyroid nodules with ultrasound (US) cancer risk features and extra-thyroid lesions suggesting malignant lymph nodes, require prompt diagnosis, especially in children. The US pattern of intrathyroidal Ectopic Thymus (IET) can strongly suggest papillary thyroid carcinoma (PTC). The extra-thyroid Ectopic thymic tissue (EET) can mimic pathological lymph nodes in US. The aim of the study has been to demonstrate US features and diagnostic methods, allowing finally to confirm the presence of IET and EET in children. The US and elastographic features of 16 Ectopic thymic tissue (ET) lesions were analyzed so as to describe the typical characteristics of ET and to define the best method to differentiate ET and malignant lesions. Among 16 analyzed lesions, 11 lesions were IET, and 5 were EET adjacent to the thyroid connective tissue capsule. Most of IET were located in the middle part of the right lobe and were fusiform or oval in shape. All the lesions were solid, hypoechoic, and heterogeneous with bright internal echoes. Among IET, 73% of lesions had well- or very well-defined margins. In strain elastography of IET lesions, the strain ratio was similar in all lesions, and its value ranged from 0.95 to 1.09. Despite the low prevalence of IET and cervical EET, clinicians and radiologists should be aware of US characteristics of such lesions. The confirmation of their benign character is absolutely required. Elastography is a useful tool to initially differentiate PTC and IET. However, due to high risk of malignancy in thyroid lesions in children, similarity of US features of PTC and IET, and due to the possibility of malignancy in ET, only cytological evaluation provides definitive diagnosis.
-
Table_1_Sonographic and Elastographic Features of Extra- and Intrathyroidal Ectopic Thymus Mimicking Malignancy: Differential Diagnosis in Children.DOCX
2019Co-Authors: Magdalena Stasiak, Zbigniew Adamczewski, Renata Stawerska, Tomasz Krawczyk, Monika Tomaszewska, Andrzej LewińskiAbstract:Thyroid nodules with ultrasound (US) cancer risk features and extra-thyroid lesions suggesting malignant lymph nodes, require prompt diagnosis, especially in children. The US pattern of intrathyroidal Ectopic Thymus (IET) can strongly suggest papillary thyroid carcinoma (PTC). The extra-thyroid Ectopic thymic tissue (EET) can mimic pathological lymph nodes in US. The aim of the study has been to demonstrate US features and diagnostic methods, allowing finally to confirm the presence of IET and EET in children. The US and elastographic features of 16 Ectopic thymic tissue (ET) lesions were analyzed so as to describe the typical characteristics of ET and to define the best method to differentiate ET and malignant lesions. Among 16 analyzed lesions, 11 lesions were IET, and 5 were EET adjacent to the thyroid connective tissue capsule. Most of IET were located in the middle part of the right lobe and were fusiform or oval in shape. All the lesions were solid, hypoechoic, and heterogeneous with bright internal echoes. Among IET, 73% of lesions had well- or very well-defined margins. In strain elastography of IET lesions, the strain ratio was similar in all lesions, and its value ranged from 0.95 to 1.09. Despite the low prevalence of IET and cervical EET, clinicians and radiologists should be aware of US characteristics of such lesions. The confirmation of their benign character is absolutely required. Elastography is a useful tool to initially differentiate PTC and IET. However, due to high risk of malignancy in thyroid lesions in children, similarity of US features of PTC and IET, and due to the possibility of malignancy in ET, only cytological evaluation provides definitive diagnosis.
Magdalena Stasiak - One of the best experts on this subject based on the ideXlab platform.
-
Interobserver Agreement and Plane-Dependent Intraobserver Variability of Shear Wave Sonoelastography in the Differential Diagnosis of Ectopic Thymus Tissue.
Journal of clinical medicine, 2021Co-Authors: Zbigniew Adamczewski, Magdalena Stasiak, Bartłomiej Stasiak, Magdalena Adamczewska, Andrzej LewińskiAbstract:Shear wave elastography (SWE) has been demonstrated to be a useful tool in the differential diagnosis of Ectopic Thymus tissues (ETs), providing quantitative values of the shear wave stiffness (SWS) of both ETs and adjacent thyroid tissue. However, no data are available on the potential influence of the imaging plane (transverse vs. longitudinal) on the obtained SWS and shear wave ratio (SWR) values in SWE of these tissues. Moreover, no reports on the interobserver repeatability of SWE were published in regard to ETs. The aim of this study has been to evaluate the potential influence of the examination plane-transverse vs. longitudinal-on the SWS and SWR results, as well as to determine whether SWE of ETs is subjected to interobserver variability. SWE was demonstrated to have high inter- and intraobserver agreement in the evaluation of ETs and adjacent thyroid tissue. Significant differences between SWS values, but not SWR values, obtained in the transverse and longitudinal planes were observed. This phenomenon is probably a result of anisotropy-related artifacts and does not reduce the reliability of the method. SWE operators should be aware of the presence of plane-dependent artifacts to properly interpret the obtained results.
-
sonographic and elastographic features of extra and intrathyroidal Ectopic Thymus mimicking malignancy differential diagnosis in children
Frontiers in Endocrinology, 2019Co-Authors: Magdalena Stasiak, Zbigniew Adamczewski, Andrzej Lewiński, Renata Stawerska, Tomasz Krawczyk, Monika TomaszewskaAbstract:Thyroid nodules with ultrasound (US) cancer risk features and extra-thyroid lesions suggesting malignant lymph nodes, require prompt diagnosis, especially in children. The US pattern of intrathyroidal Ectopic Thymus (IET) can strongly suggest papillary thyroid carcinoma (PTC). The extra-thyroid Ectopic thymic tissue (EET) can mimic pathological lymph nodes in US. The aim of the study has been to demonstrate US features and diagnostic methods, allowing finally to confirm the presence of IET and EET in children. The US and elastographic features of 16 Ectopic thymic tissue (ET) lesions were analyzed so as to describe the typical characteristics of ET and to define the best method to differentiate ET and malignant lesions. Among 16 analyzed lesions, 11 lesions were IET, and 5 were EET adjacent to the thyroid connective tissue capsule. Most of IET were located in the middle part of the right lobe and were fusiform or oval in shape. All the lesions were solid, hypoechoic, and heterogeneous with bright internal echoes. Among IET, 73% of lesions had well- or very well-defined margins. In strain elastography of IET lesions, the strain ratio was similar in all lesions, and its value ranged from 0.95 to 1.09. Despite the low prevalence of IET and cervical EET, clinicians and radiologists should be aware of US characteristics of such lesions. The confirmation of their benign character is absolutely required. Elastography is a useful tool to initially differentiate PTC and IET. However, due to high risk of malignancy in thyroid lesions in children, similarity of US features of PTC and IET, and due to the possibility of malignancy in ET, only cytological evaluation provides definitive diagnosis.
-
Table_1_Sonographic and Elastographic Features of Extra- and Intrathyroidal Ectopic Thymus Mimicking Malignancy: Differential Diagnosis in Children.DOCX
2019Co-Authors: Magdalena Stasiak, Zbigniew Adamczewski, Renata Stawerska, Tomasz Krawczyk, Monika Tomaszewska, Andrzej LewińskiAbstract:Thyroid nodules with ultrasound (US) cancer risk features and extra-thyroid lesions suggesting malignant lymph nodes, require prompt diagnosis, especially in children. The US pattern of intrathyroidal Ectopic Thymus (IET) can strongly suggest papillary thyroid carcinoma (PTC). The extra-thyroid Ectopic thymic tissue (EET) can mimic pathological lymph nodes in US. The aim of the study has been to demonstrate US features and diagnostic methods, allowing finally to confirm the presence of IET and EET in children. The US and elastographic features of 16 Ectopic thymic tissue (ET) lesions were analyzed so as to describe the typical characteristics of ET and to define the best method to differentiate ET and malignant lesions. Among 16 analyzed lesions, 11 lesions were IET, and 5 were EET adjacent to the thyroid connective tissue capsule. Most of IET were located in the middle part of the right lobe and were fusiform or oval in shape. All the lesions were solid, hypoechoic, and heterogeneous with bright internal echoes. Among IET, 73% of lesions had well- or very well-defined margins. In strain elastography of IET lesions, the strain ratio was similar in all lesions, and its value ranged from 0.95 to 1.09. Despite the low prevalence of IET and cervical EET, clinicians and radiologists should be aware of US characteristics of such lesions. The confirmation of their benign character is absolutely required. Elastography is a useful tool to initially differentiate PTC and IET. However, due to high risk of malignancy in thyroid lesions in children, similarity of US features of PTC and IET, and due to the possibility of malignancy in ET, only cytological evaluation provides definitive diagnosis.
Shigeo Tobayama - One of the best experts on this subject based on the ideXlab platform.
-
rebound enlargement of an Ectopic cervical Thymus mimicking relapse of lymphoblastic lymphoma
International Journal of Hematology, 2011Co-Authors: Tadashi Matsubayashi, Shinichi Shimizu, Hironobu Kitazawa, Rie Matsubayashi, Shigeo TobayamaAbstract:A previously healthy 6-year-old boy was referred to our hospital with a tumor in the right upper mediastinum on chest X-ray. Physical examination showed no abnormal respiratory sounds, hepatosplenomegaly, or palpable tumor. On MRI, a right mediastinal tumor, 37 9 38 9 25 mm in size, with low intensity on T1-weighted images and high intensity on T2-weighted images was seen. A left-sided cervical mass, 27 9 29 9 10 mm in size, and several small lesions were seen in the liver and kidneys; all were of intensities similar to those of the mediastinal tumor (Fig. 1a, b). On histopathological examination of the biopsied samples from the mediastinal tumor, diffuse proliferation of medium-sized atypical lymphocytes with scant cytoplasm and fine chromatin was seen (Fig. 2); immunohistochemistry was positive for CD79a, CD10, and CD34, and negative for CD3, CD7, and CD20. Bone marrow aspiration showed a normocellular marrow with 5.4% lymphoblasts, suggesting involvement of lymphoma cells. These findings led to a diagnosis of precursor B-cell lymphoblastic lymphoma (LBL) stage IV. After the induction phase of chemotherapy (vincristine, cyclophosphamide, daunorubicin, L-asparaginase, and prednisolone), all of the tumors disappeared on MRI (Fig. 1c, d), and lymphoblasts were undetectable in the bone marrow. The patient subsequently received chemotherapy that included an early intensification phase, a central nervous system prophylaxis phase, a late intensification phase, and a maintenance phase. Follow-up MRI revealed no tumor at the beginning of maintenance chemotherapy, but the cervical mass re-emerged at the ninth month (Fig. 1e, f), at which time the mass was 35 9 40 9 11 mm in size and larger than at the onset of LBL. An ultrasound of the neck detected a lobulated, low-density structure with hyperechoic lines. The patient was asymptomatic. The reappearance of the enlarged cervical mass was initially suspected to be a relapse of LBL. An open biopsy was performed. On histopathological examination of the mass, normal thymic tissue with no evidence of lymphoma cell involvement was seen (Fig. 3). Flow cytometry confirmed cells positive for CD3, CD4, CD7, and CD8, and negative for CD10, CD19, and CD20. The cervical mass was diagnosed as an Ectopic Thymus. In accordance with the protocol, chemotherapy was continued for the following 6 months. The patient achieved complete remission, and the Ectopic Thymus remained unchanged in size 7 months after chemotherapy. The MRI and ultrasound can be used to diagnose Ectopic Thymus. MRI is the most accurate diagnostic method, showing slightly higher signal intensity than that of muscle on T1-weighted images and signal intensity close to that of fat on T2-weighted images. Ultrasound is the most convenient and non-invasive diagnostic modality. Ultrasound examination of normal thymic tissue shows multiple echogenic linear structures and foci. In the present patient, the ultrasound characteristics were potentially compatible with those of cervical Ectopic Thymus. However, it was difficult to differentiate a relapse of LBL from a non-neoplastic lesion as MRI revealed close similarities between the mediastinal LBL and the cervical mass. Therefore, a biopsy was performed to allow histopathological confirmation and surface marker analysis. T. Matsubayashi (&) H. Kitazawa R. Matsubayashi Department of Pediatrics, Seirei Hamamatsu General Hospital, 2-12-12 Sumiyoshi, Naka-ku, Hamamatsu, Shizuoka 430-8558, Japan e-mail: matr@sis.seirei.or.jp
Tomasz Krawczyk - One of the best experts on this subject based on the ideXlab platform.
-
sonographic and elastographic features of extra and intrathyroidal Ectopic Thymus mimicking malignancy differential diagnosis in children
Frontiers in Endocrinology, 2019Co-Authors: Magdalena Stasiak, Zbigniew Adamczewski, Andrzej Lewiński, Renata Stawerska, Tomasz Krawczyk, Monika TomaszewskaAbstract:Thyroid nodules with ultrasound (US) cancer risk features and extra-thyroid lesions suggesting malignant lymph nodes, require prompt diagnosis, especially in children. The US pattern of intrathyroidal Ectopic Thymus (IET) can strongly suggest papillary thyroid carcinoma (PTC). The extra-thyroid Ectopic thymic tissue (EET) can mimic pathological lymph nodes in US. The aim of the study has been to demonstrate US features and diagnostic methods, allowing finally to confirm the presence of IET and EET in children. The US and elastographic features of 16 Ectopic thymic tissue (ET) lesions were analyzed so as to describe the typical characteristics of ET and to define the best method to differentiate ET and malignant lesions. Among 16 analyzed lesions, 11 lesions were IET, and 5 were EET adjacent to the thyroid connective tissue capsule. Most of IET were located in the middle part of the right lobe and were fusiform or oval in shape. All the lesions were solid, hypoechoic, and heterogeneous with bright internal echoes. Among IET, 73% of lesions had well- or very well-defined margins. In strain elastography of IET lesions, the strain ratio was similar in all lesions, and its value ranged from 0.95 to 1.09. Despite the low prevalence of IET and cervical EET, clinicians and radiologists should be aware of US characteristics of such lesions. The confirmation of their benign character is absolutely required. Elastography is a useful tool to initially differentiate PTC and IET. However, due to high risk of malignancy in thyroid lesions in children, similarity of US features of PTC and IET, and due to the possibility of malignancy in ET, only cytological evaluation provides definitive diagnosis.
-
Table_1_Sonographic and Elastographic Features of Extra- and Intrathyroidal Ectopic Thymus Mimicking Malignancy: Differential Diagnosis in Children.DOCX
2019Co-Authors: Magdalena Stasiak, Zbigniew Adamczewski, Renata Stawerska, Tomasz Krawczyk, Monika Tomaszewska, Andrzej LewińskiAbstract:Thyroid nodules with ultrasound (US) cancer risk features and extra-thyroid lesions suggesting malignant lymph nodes, require prompt diagnosis, especially in children. The US pattern of intrathyroidal Ectopic Thymus (IET) can strongly suggest papillary thyroid carcinoma (PTC). The extra-thyroid Ectopic thymic tissue (EET) can mimic pathological lymph nodes in US. The aim of the study has been to demonstrate US features and diagnostic methods, allowing finally to confirm the presence of IET and EET in children. The US and elastographic features of 16 Ectopic thymic tissue (ET) lesions were analyzed so as to describe the typical characteristics of ET and to define the best method to differentiate ET and malignant lesions. Among 16 analyzed lesions, 11 lesions were IET, and 5 were EET adjacent to the thyroid connective tissue capsule. Most of IET were located in the middle part of the right lobe and were fusiform or oval in shape. All the lesions were solid, hypoechoic, and heterogeneous with bright internal echoes. Among IET, 73% of lesions had well- or very well-defined margins. In strain elastography of IET lesions, the strain ratio was similar in all lesions, and its value ranged from 0.95 to 1.09. Despite the low prevalence of IET and cervical EET, clinicians and radiologists should be aware of US characteristics of such lesions. The confirmation of their benign character is absolutely required. Elastography is a useful tool to initially differentiate PTC and IET. However, due to high risk of malignancy in thyroid lesions in children, similarity of US features of PTC and IET, and due to the possibility of malignancy in ET, only cytological evaluation provides definitive diagnosis.
