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Federico Rea - One of the best experts on this subject based on the ideXlab platform.

  • pulmonary Inflammatory Myofibroblastic Tumour with unusual octreoscan uptake two reports
    European Respiratory Journal, 2010
    Co-Authors: F Calabrese, Andrea Zuin, E Brambilla, P Zucchetta, Francesca Lunardi, Marialuisa Valente, Federico Rea
    Abstract:

    To the Editors: Inflammatory Myofibroblastic Tumour (IMT) is a relatively uncommon lesion and occurs in nearly every site of the body. Patients with IMT are usually asymptomatic, with a solitary nodule or mass detected by routine chest radiograph 1. Many diagnostic procedures can be applied to make the diagnosis: computed tomography (CT) scan to outline nodule growth and perfusion, [18F]-2-fluoro-deoxy-D-glucose (FDG)-PET/CT scan to evaluate metabolic activity and 111In-Diethylene triamine pentaacetic acid (DTPA)-D-Phe1 scan (octreoscan) to investigate somatostatin analogue receptors, often present in a variety of neuroendocrine Tumours (NETs). We present two cases of pulmonary IMT clinically misdiagnosed as carcinoid Tumours due to a positive octreoscan. Case 1 was a 52-yr-old female former smoker who was admitted to our hospital with thoracic pain. The electrocardiogram was completely negative for angina or myocardial infarction. Chest radiograph and CT revealed a left hilar nodule, sharply circumscribed, slightly lobulated, with a mild homogeneous increase of density after enhancement. A whole-body FDG-PET/CT scan showed increased tracer uptake of the lung mass (standardised uptake value (SUV) 25) compatible with a malignant lesion. SUVmax was calculated 50 min after injection and normalised for body weight. After intravenous administration of 111 mBq of [111In]-octreotide, an abnormal, although low, uptake was present in the left lung hilar region (fig. 1a⇓). Bronchoscopy was negative. On the basis of the CT, FDG-PET/CT and octreoscan, a clinical/radiological diagnosis of a carcinoid Tumour, most probably atypical, was postulated. The intraoperative frozen specimen excluded the diagnosis of …

F Calabrese - One of the best experts on this subject based on the ideXlab platform.

  • pulmonary Inflammatory Myofibroblastic Tumour with unusual octreoscan uptake two reports
    European Respiratory Journal, 2010
    Co-Authors: F Calabrese, Andrea Zuin, E Brambilla, P Zucchetta, Francesca Lunardi, Marialuisa Valente, Federico Rea
    Abstract:

    To the Editors: Inflammatory Myofibroblastic Tumour (IMT) is a relatively uncommon lesion and occurs in nearly every site of the body. Patients with IMT are usually asymptomatic, with a solitary nodule or mass detected by routine chest radiograph 1. Many diagnostic procedures can be applied to make the diagnosis: computed tomography (CT) scan to outline nodule growth and perfusion, [18F]-2-fluoro-deoxy-D-glucose (FDG)-PET/CT scan to evaluate metabolic activity and 111In-Diethylene triamine pentaacetic acid (DTPA)-D-Phe1 scan (octreoscan) to investigate somatostatin analogue receptors, often present in a variety of neuroendocrine Tumours (NETs). We present two cases of pulmonary IMT clinically misdiagnosed as carcinoid Tumours due to a positive octreoscan. Case 1 was a 52-yr-old female former smoker who was admitted to our hospital with thoracic pain. The electrocardiogram was completely negative for angina or myocardial infarction. Chest radiograph and CT revealed a left hilar nodule, sharply circumscribed, slightly lobulated, with a mild homogeneous increase of density after enhancement. A whole-body FDG-PET/CT scan showed increased tracer uptake of the lung mass (standardised uptake value (SUV) 25) compatible with a malignant lesion. SUVmax was calculated 50 min after injection and normalised for body weight. After intravenous administration of 111 mBq of [111In]-octreotide, an abnormal, although low, uptake was present in the left lung hilar region (fig. 1a⇓). Bronchoscopy was negative. On the basis of the CT, FDG-PET/CT and octreoscan, a clinical/radiological diagnosis of a carcinoid Tumour, most probably atypical, was postulated. The intraoperative frozen specimen excluded the diagnosis of …

Tarun Jindal - One of the best experts on this subject based on the ideXlab platform.

  • Primary Retroperitoneal Inflammatory Myofibroblastic Tumour
    Journal of clinical and diagnostic research : JCDR, 2015
    Co-Authors: Tarun Jindal, Rajan Kumar Sinha, Barun Saha, Nilanjan Mitra, Subhabrata Mukherjee
    Abstract:

    Inflammatory Myofibroblastic Tumours are uncommon neoplasms of unknown aetiology. They commonly involve the lung and their occurrence in the retroperitoneum can be considered anecdotal. A 30-year-old female presented with dull aching, intermittent pain in the right flank for six months. There was a history of weight loss of 4kg over six months. There was no history of any medical co-morbidity or past surgical intervention. The clinical examination was normal. Haemogram revealed increased erythrocyte sedimentation rate but the serum biochemistry was within normal limits. Ultrasound examination of the abdomen was suggestive of a heterogeneous mass in close relation to the lower pole of the right kidney. Contrast enhanced CT scan revealed a 5 cm x 6 cm mass in the retroperitoneum, anterior to the right psoas muscle and in close relation to the lower pole of the right kidney. The mass showed contrast enhancement in the arterial phase and the enhancement persisted even in the delayed scan. There was evidence of fat stranding around the mass [Table/Fig-1a&b]. The possibility of a retroperitoneal sarcoma, Castleman’s disease and an Inflammatory mass were considered. As the diagnosis was not certain, a CT guided tru-cut biopsy from the mass was performed which suggestive of an Inflammatory Myofibroblastic Tumour. The metastatic work-up was negative. The patient was taken up for open surgical excision of the mass via right flank approach. At surgery, the mass was well circumscribed and could be separated from the kidney and the inferior venacava by blunt and sharp dissection [Table/Fig-2a-d]. The histopathological examination shows polymorphic cells composed of lymphocytes and plasma cells along with plump spindle cells arranged in fasicular pattern which is consistent with the diagnosis of Inflammatory Myofibroblastic Tumour [Table/Fig-3]. The patient made an uneventful recovery and is well at a follow up of six months. [Table/Fig-1]: (a) Contrast enhanced CT scan showing the enhancing Tumour (yellow arrow) in close proximity to the lower pole of the right kidney (red arrow) and inferior venacava. There was evidence of fat stranding all around the Tumour. (b) The lower part of the ... [Table/Fig-2]: (a) At surgery, the Tumour could be separated from the kidney. (b) The Tumour, after mobilisation following blunt and sharp dissection. (c) The Tumour after excision. (d) The cut section of the Tumour [Table/Fig-3]: The histopathological picture of the Tumour revealing polymorphic cells composed of lymphocytes and plasma cells along with plump spindle cells arranged in fasicular pattern (Haematoxylin & Eosin, 100X) Inflammatory Myofibroblastic Tumour, also known as pseudo Tumour, plasma cell granuloma is a rare neoplasm. It is presumed to occur as a result of trauma, infection, previous surgical intervention, etc [1,2] and most often involves the bladder [3]. The patients usually present with non specific symptoms like pain abdomen, loss of weight, fever. Anaemia, elevated counts and erythrocyte sedimentation rate can also be seen. At imaging, the Tumour usually shows heterogeneous enhancement but again, there are no specific features. Of late, Positron emission tomography has also been reported to be helpful. The Tumour, by the virtue of associated inflammation, has been found to have high standardized uptake value on a 18F- fluorodeoxyglucose positron emission tomography. Though these findings support the diagnosis, histopathological examination along with immunohistochemistry remains the confirmatory investigation [4,5]. The retroperitoneal Inflammatory Myofibroblastic Tumours are extremely rare neoplasms having non-specific symptoms and imaging findings. Surgical removal remains the mainstay of treatment.

  • Inflammatory Myofibroblastic Tumour
    The European respiratory journal, 2010
    Co-Authors: Tarun Jindal, Atin Kumar, Ranjit Kumar
    Abstract:

    To the Editors: We read with great interest the article by Calabrese et al. 1, recently published in the European Resipiratory Journal , in which the authors report two cases of pulmonary Inflammatory Myofibroblastic Tumour with unusual uptake on octreoscan. Calabrese et al. 1 report that both the Tumours revealed high uptake values (of 25 and 22) on [18F]-2-fluoro-deoxy-d-glucose (FDG)-PET/computed tomography (CT). We agree with the findings of these authors as we also have experience …

Jürgen Floege - One of the best experts on this subject based on the ideXlab platform.

  • Macrophage activation syndrome in a patient with pulmonary Inflammatory Myofibroblastic Tumour
    Allergy Asthma & Clinical Immunology, 2012
    Co-Authors: Christoph Kuppe, Saskia Westphal, Eva Bücher, Marcus J Moeller, Bernhard Heintz, Marion E Schneider, Jürgen Floege
    Abstract:

    We describe for the first time a case of macrophage activation syndrome (MAS) in a patient with a history of Inflammatory Myofibroblastic Tumour (Inflammatory pseudoTumour, IPT) of the lung and thoracic spine. The patient was admitted to the intensive care unit with a history of prolonged remitting fever, hepatosplenomegaly, bilaterally enlarged thoracic lymph nodes and an acute severe Inflammatory response syndrome (SIRS). Up-regulated cytokine production (e.g. IL-1ß and IL-6), increased levels of ferritin and circulating soluble interleukin-2 receptor (sIL-2R, sCD25) led to the differential diagnosis of MAS. Bone marrow aspiration, the main tool for a definite diagnosis, revealed macrophages phagocytosing haematopoietic cells. Immunosuppressive therapy with corticosteroids and cyclosporine was an effective treatment in this patient.

Andrea Zuin - One of the best experts on this subject based on the ideXlab platform.

  • pulmonary Inflammatory Myofibroblastic Tumour with unusual octreoscan uptake two reports
    European Respiratory Journal, 2010
    Co-Authors: F Calabrese, Andrea Zuin, E Brambilla, P Zucchetta, Francesca Lunardi, Marialuisa Valente, Federico Rea
    Abstract:

    To the Editors: Inflammatory Myofibroblastic Tumour (IMT) is a relatively uncommon lesion and occurs in nearly every site of the body. Patients with IMT are usually asymptomatic, with a solitary nodule or mass detected by routine chest radiograph 1. Many diagnostic procedures can be applied to make the diagnosis: computed tomography (CT) scan to outline nodule growth and perfusion, [18F]-2-fluoro-deoxy-D-glucose (FDG)-PET/CT scan to evaluate metabolic activity and 111In-Diethylene triamine pentaacetic acid (DTPA)-D-Phe1 scan (octreoscan) to investigate somatostatin analogue receptors, often present in a variety of neuroendocrine Tumours (NETs). We present two cases of pulmonary IMT clinically misdiagnosed as carcinoid Tumours due to a positive octreoscan. Case 1 was a 52-yr-old female former smoker who was admitted to our hospital with thoracic pain. The electrocardiogram was completely negative for angina or myocardial infarction. Chest radiograph and CT revealed a left hilar nodule, sharply circumscribed, slightly lobulated, with a mild homogeneous increase of density after enhancement. A whole-body FDG-PET/CT scan showed increased tracer uptake of the lung mass (standardised uptake value (SUV) 25) compatible with a malignant lesion. SUVmax was calculated 50 min after injection and normalised for body weight. After intravenous administration of 111 mBq of [111In]-octreotide, an abnormal, although low, uptake was present in the left lung hilar region (fig. 1a⇓). Bronchoscopy was negative. On the basis of the CT, FDG-PET/CT and octreoscan, a clinical/radiological diagnosis of a carcinoid Tumour, most probably atypical, was postulated. The intraoperative frozen specimen excluded the diagnosis of …