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    An Unusual Cervical Mass in the Hyoid Bone: Intermediate-Grade Chondrosarcoma
    (Hindawi Ltd, 2019) Caglar, Ozge; Karatag, O.; Avci, A.; Derekoy, Sefa
    We describe a case of a 31-year-old woman with a chondrosarcoma of the hyoid bone. The patient presented with a mass in the left submandibular region. Fine-needle aspiration cytology suggested chondroma, but further imaging investigation with CT revealed an exophytic tumor originating from the body of the hyoid bone. Histopathology of the surgical specimen confirmed the diagnosis of a intermediate-grade chondrosarcoma. Chondrosarcomas account for 11% of all bone cancers. Primary sites of the head and the neck include the nasal cavity, the skull base, the maxilla, the mandible. Chondrosarcomas of the hyoid bone are very rare, with only 23 cases previously reported in the literature.
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    CAN DIFFUSION WEIGHTED MAGNETIC RESONANCE IMAGING DIFFERENTIATE BETWEEN INFLAMMATORY-INFECTIOUS AND MALIGNANT PLEURAL EFFUSIONS?
    (Assoc Royal Soc Scientifiques Medicales Belges, 2015) Karatag, O.; Alar, T.; Kosar, S.; Ocakoglu, G.; Yildiz, Y.; Gedik, E.; Gonlugur, U.
    Aim: To assess exudative pleural effusions with diffusion-weighted magnetic resonance imaging (DW-MRI) in order to determine non-invasive differentiation criteria for inflammatory-infectious and malignant effusions. Materials and methods: Thirty-two patients with pleural effusions underwent DW-MRI with 4 different b values (10, 500, 750 and 1000 s/mm(2)). ADC maps were generated automatically. Signal intensity and ADC values were measured. Following MRI, pleural fluid of 10-15 ml was obtained and analyzed. AUC values were compared for different diffusion levels of ADC and SI measurements. The relationship between ADC values and pleural effusion LDH and total protein levels was examined. Results: The cut-off values obtained from signal intensity and ADC measurements to differentiate exudates with malignant pathology were not found to be statistically significant. In the inflammatory-infectious group, a significant negative correlation was observed between ADC values and pleural fluid LDH measurements in all b values. In the malignant group, a significant positive correlation was observed between ADC values and pleural fluid total protein measurements in b values of 500 and 1000. Conclusion:Infectious/inflammatory and malignant effusions overlap strongly and cannot therefore be differentiated using DW MRI.
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    Intracranial hemorrhage in Kimura's disease: coincidence or consequence?
    (Royal Belgian Soc Ear, Nose, Throat, Head & Neck Surgery, 2010) Karatag, O.; Celebi, I.; Uysal, E.; Karatag, G. Yenice; Basak, M.
    Intracranial hemorrhage in Kimura's disease: coincidence or consequence? Objective: To report an unusual case of Kimura's disease associated with intracranial hemorrhage, the first such report in the literature. Case report: A 38-year-old man presented with chronic neurological disorders and a 10-year history of left cervical soft tissue swellings. Magnetic resonance imaging (MRI) of the cranium showed a subacute/chronic hematoma in the left occipitotemporal lobe and a chronic infarct in the right parietal lobe. Cervical computed tomography (CT) and MRI showed multiple masses on the left side of the neck and parotid gland. Histopathologic examination revealed lymphocyte and eosinophil infiltration, proliferation of hyalinated blood vessels, and interstitial fibrosis. Steroid therapy (2 mg/kg per day) was started and the lesions regressed partially. The masses and some enlarged regional lymph nodes were resected. Conclusions: Intracranial hemorrhage can either be a coincidental finding or complication of Kimura's disease. MRI and CT are effective modalities in radiologic diagnosis of this condition.
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    Role of twinkling artifact in characterization of urinary calculi
    (Ene Ediciones Sl, 2011) Alan, C.; Kocoglu, H.; Kosar, S.; Karatag, O.; Resit Ersay, A.; Erhan, A.
    Introduction: Stone characterization is becoming important before decision of treatment such as percutaneous nephrolithotomy (PCNL) and extracorporeal shock wave lithotripsy (ESWL). Some studies have reported that the twinkling artifact (color-flow ultrasonography artifact) may be useful to detect urinary stones. This study aims to determine whether the presence or absence of the twinkling artifact is correlated with the chemical composition of the stones. Material and method: Patients with renal stones >= 0.5 cm were included in a prospective study. Sixty patients were examined with x-ray film, intravenous pyelography, non-contrast computerized tomography, and color and spectral doppler ultrasonography. The artifact was considered grade 1 when occupied only one portion of the acoustic shadowing and when the artifact occupied the entire acoustic shadowing was considered grade 2. Patients with stones smaller than 2 cm were treated with SWL and patients with stones larger than 2 cm were treated with PCNL. Results: No artifact (grade 0) was detected in 11 subjects, grade 1 in 25 and grade 2 in 24. Significant relationship was found between the increase in twinkling artifact and stone size (p < 0.001). When the relation between the composition of the stones and the twinkling artifact was analyzed, artifact was detected nearly in all of the calcium oxalate dihydrate and calcium phosphate stones; whereas the artifact was detected in more than half of the calcium oxalate monohydrate and uric acid stones. In ESWL group it was observed that as the grade of the twinkling artifact increases, the number of required ESWL sessions decreases (p < 0.001). In PCNL group twinkling artifact was found in all of the patients (100%) with roughly surfaced stones. Conclusion: The roughness of stone surface is the most important factor in terms of formation of the twinkling artifact in kidney stones. This artifact can beat use in anticipating the breakability of the stones of those patients to be treated with applied ESWL. One might anticipate that cases where the size of the stone is larger than 2 cm but no twinkling artifact is detected are calcium oxalate monohydrate, which is one of the stones with highest level of breakability. (C) 2011 AEU. Published by Elsevier Espana, S.L. All rights reserved.