Lymphadenopathy is a common clinical disease, and ultrasonography is its primary preliminary diagnostic screening strategy. With an increase in house-raised pets, the annual incidence of cat scratch lymphadenitis is rising. After infection, the characteristics of the disease include abnormal lymph node enlargement in the local drainage, accompanied by low heat sweats, similar to clinical symptoms of malignant disease. The two-dimensional ultrasound results lack specificity. However, garland-like variation can be observed in the enhanced images, which can be used for the differential diagnosis of cat scratch lymphadenitis. In this case, we obtained the ultrasound and computed tomography images of a patient with cat scratch lymphadenitis and compared and analyzed them with the pathological data.

A gastric GIST which causes gastroduodenal intussusception is rare. A Pubmed search only identified 21 published cases of gastroduodenal intussusception due to gastric GIST. Only 2 of them mentioned ultrasound without further analysis. Here, we report a case of gastroduodenal intussusception due to a gastric GIST with multiple imaging especially ultrasound. A 72-year-old Chinese woman was admitted to hospital because of epigastric pain, black stool lasting and occasional vomiting for 2 months. She underwent abdominal ultrasound, endoscopy, and contrast enhanced CT in turn. Abdominal ultrasound revealed a hypoechoic, medium-sized lesion beside pancreatic head. Endoscopy showed a submucosal lesion of gastric fundus overlapping into duodenum. The lesion manifested slight enhancement in the arterial phase on enhanced CT scans. The patient underwent laparoscopic exploration and partial gastrectomy. The histological examination revealed a low-risk gastric GIST of spindle-shaped cell type.

Pure embryonal carcinoma (EC) is a rare malignant tumor that primarily occurs in infants with a sex development disorder and adults aged in their thirties to forties. This tumor behaves more aggressively than other germ cell tumors in the testis, and most of them should undergo surgery or chemotherapy. However, only a few case reports have involved imaging, and most of them are limited. Here, we present a case of pure EC in the testis of a 27-year-old male with multimodal ultrasonography, computed tomography, and magnetic resonance imaging.

The ovaries are normally situated on the lateral aspect of the uterus in a shallow depression called an ovarian fossa. Maldescended ovaries occur when the ovary has not been localized in an intrapelvic location. Maldescended ovaries can be found with a normal uterus and more often with Mullerian duct abnormalities. There is no established association between ovarian tumors and maldescended ovaries. The present case report is a very rare case of mature cystic teratoma of a maldescended right ovary located within the subhepatic region. To bring this into focus in cases with an abnormal dermoid cyst site in a female. The patient should be carefully evaluated for ovarian sites and the possibility of maldescended ovaries should be taken into account. The maldescended ovaries with complicated cysts or with tumor should be included in the differential diagnosis of causes of abdominal pain in females.

Sarcoidosis is a granulomatous disease of unknown etiology that can involve various organs and tissues. The clinical manifestations vary greatly, so it is difficult to make a clear diagnosis of sarcoidosis with just the clinical manifestation and imaging findings. The diagnosis and treatment of a patient with systemic sarcoidosis was reported: a 51-year-old woman presented with a dry cough. Computed tomography (CT), magnetic resonance imaging (MRI), and conventional ultrasonography (US) suggested miliary nodules and inflammatory changes in the lungs, there was mediastinal, retroperitoneal and hilar lymph node enlargement and uneven liver echo, respectively. Positron emission tomography/computed tomography (PET-CT) further suggested that the lesions were distributed throughout the body, including the lymph nodes and muscles of the extremities; thus, systemic lymphoma was considered. Finally, ultrasound-guided biopsy of different sites yielded the same histopathological findings: sarcoidosis. The sarcoidosis in this case is characterized by a large number of involved sites with a wide range, and a variety of imaging data were complete but failed to suggest a diagnosis. Finally, a clear histopathological result was obtained under the guidance of ultrasound. This article reviewed the relevant literature and concluded that ultrasound-guided puncture to obtain histopathological results is a simple and effective method for the diagnosis of sarcoidosis.

Lymphoepithelioma-like cholangiocarcinoma (LELCC) is a rare subtype of carcinoma that is poorly reported. We report a case of LELCC in a 28-year-old female with chronic hepatitis B. She underwent secondary microwave ablation for residual tumor following the failure of radiofrequency ablation (RFA). Image fusion technology was used to accurately diagnose that the second lesion represented residual tumor. This case is the second successful application of microwave ablation in the treatment of LELCC. We first reviewed the ultrasonographic features of LELCC. We report this case to improve our understanding of this disease and provide evidence for its clinical treatment.

Granulosa cell tumor of the testis is a rare intermediate stromal cell tumor that can be distinguished in adult and juvenile type. The juvenile type is commonly presented in infants less than a year old-most often during the first 6 months of life and can be associated with ambiguous genitalia and chromosomal anomalies. We report two cases of juvenile granulosa cell tumor (JGCT) of the testis diagnosed in the neonatal period and review the typical sonographic findings of this entity.

Primary squamous cell carcinoma of the thyroid (PSCCT) is a rare clinical disease characterized by rapid growth, high invasiveness, and a poor prognosis. A 66-year-old male patient was admitted due to throat pain and dysphagia. Ultrasound revealed a calcified hypoechoic mass in the right lobe of the thyroid gland, measuring approximately 35.3 ml. Ultrasound and PET-CT both indicated high suspicion of malignancy. The patient underwent contrast-enhanced US-guided biopsy, and the pathological results revealed poorly differentiated squamous cell carcinoma. CEUS was performed regularly during the Chemotherapy combined with pembrolizumab (PD-1) treatment courses. The vital area was significantly reduced with neither recurrence nor cervical lymph node metastasis. Surgical resection and chemotherapy combined with immunotherapy had a significant treatment effect in this case. CEUS is helpful for diagnosis confirmation, biopsy guidance and efficacy evaluation and has important clinical application value.

This paper reports a case of closed reduction internal fixation of pelvic fracture and minimally invasive hemostasis procedure and hematoma catheterization and drainage for the active pelvic bleeding site and giant hematoma, guided by a robot-assisted teleultrasound. In this case, the robot-assisted teleultrasound-guided minimally invasive interventional hemostasis and catheterization utilized a partial master-slave approach. It was preliminarily confirmed that robot-assisted teleultrasound-guided minimally invasive hemostasis and puncture catheterization for hematoma were accurate and effective. The robot-assisted teleultrasound overcomes the reliance on physician experience in ultrasound-guided interventional diagnostics and treatment, and promoting the use of minimally invasive "visualized" technology across any distance.

Appendiceal mucinous neoplasms are relatively rare. Following rupture of a mucinous neoplasms of the appendix, mucus can implant into the scrotum along the congenital or acquired inguinal space. We report a case of a testicular mucinous neoplasm with no preoperative abdominal lesions. Scrotal ultrasound showed an irregular mass in the right testis and inguinal area, with uneven echogenicity (stripe hyperechoic layered distribution) and no obvious blood flow signals. Ultrasound diagnosis was suspected as mucinous neoplasm. Postoperative pathology was confirmed to be low-grade mucinous neoplasm of the testis. Subsequently, the surgeon performed laparoscopic exploration and found that the appendix tumor had ruptured and the peritoneal cavity was implanted, and an appendectomy was performed. Postoperative pathology confirmed a low-grade appendix mucinous neoplasm. The evaluation and discovery of a scrotal mucinous neoplasm requires exploration of the appendix with ultrasound imaging. Even if the inner diameter of the appendix is normal but the presence of ascites, appendiceal mucinous neoplasms need to be considered.

Arteriovenous malformation (AVM) is a kind of congenital endothelial malformation that results from errors in vascular morphogenesis. Here we present a case of maxillofacial AVM in a 19-year-old male for its imaging characteristics on contrast-enhanced ultrasound (CEUS). On conventional ultrasound, the lesion was a large subcutaneous mass with abnormal vasculature. On CEUS, it manifested as a “quick wash-in and slow wash-out” enhancement. Moreover, CEUS showed a much larger range of the lesion than gray-scale imaging, with left ophthalmic artery involved. CEUS enabled real-time observation of the microcirculatory perfusion of the lesion and played a very important role in the detection and evaluation of maxillofacial AVM.

Schistosoma japonicum causes intestinal schistosomiasis, which affects mainly the rectum and sigmoid colon but rarely the urinary tract. Here we report a rare case of S. japonicum infection of the bladder and ureter, and describe its clinical features and imaging findings. We also put this case in perspective with the literature on S. japonicum infections in humans.

Undescended testis or cryptorchidism is the most common reproductive system disease in children. About 3% of full-term and 30% of premature male infants are born with one or both testicles undescended. Most cryptorchidism is asymptomatic and is occasionally found due to inguinal pain caused by testicular torsion. Herein, we presented a case of pediatric patient with abdominal pain as initial symptom who was found the left inguinal cryptorchidism complicated by testicular torsion, and then spontaneous remission during the color Doppler ultrasonography examination.

The gastrointestinal tract, particularly the colon, represents a rare site of metastatic carcinoma. It is difficult to diagnose because of its nonspecific clinical and imaging features. Herein, we reported the case of a 64-year-old Asian male who presented with a solitary mass on his right colon. We successively performed contrast-enhanced ultrasonography, computed tomography (CT) and colonoscopy. Colonoscopy-guided biopsy revealed inflammatory granulomatous and necrotic tissue. The mass was resected and identified as a metastatic carcinoma of renal cell carcinoma (RCC). The details of the case and review of related articles are presented.

Castleman disease (CD), first described in 1954, is a rare lymphoproliferative disorder. A 20-year-old female patient was treated for a "painless mass below the right ear for 1 year". The imagological examination of the patient showed a soft tissue mass about 2.8 cm in diameter in the right parotid gland. Moreover, the patient underwent a right superficial parotidectomy and facial nerve dissection. The mass in the parotid gland was removed, and CD was confirmed by further pathological examination. Imagological examination contributes to the diagnosis and preoperative evaluation of CD.

We report a rare case of pseudomyxoma peritonei (PMP) originating from right ovarian borderline mucinous tumor in a 79-year-old Chinese female. The patient came to our hospital with complaints of abdominal distention. Ultrasonography (US) showed the jelly-like ascites accumulated in the middle abdomen and pelvic cavity within an internal stripe-like echo. Intraoperative exploration revealed that the flavescent and mucinous material, mucinous ascites was present with right ovarian borderline mucinous tumor. Unilateral oophorectomy was performed followed by evacuation of the mucinous ascites. Histological examination confirmed the clinical diagnosis of PMP.

Schwannoma (syn. neurilemoma, neuroschwannoma) is a benign tumor derived from nerve sheath cells (Schwann cells), which is the most common type of peripheral neurogenic tumors. In this case, a patient with papillary thyroid carcinoma on the left side was found to have a predominantly cystic nodule in the ipsilateral neck level 4 by ultrasonography (US), which mistook for ipsilateral cervical lymph node metastasis and was later found to be a vagal nerve sheath tumor by surgery. The article reviews the pathology, imaging findings and differential diagnosis of schwannomas. A meticulous evaluation and comprehensive differential diagnosis are pivotal to reach correct diagnosis.

Retroperitoneal ectopic pregnancy (REP) is extremely rare and can be easily missed due to its special location. As most REP are close to the major abdominal blood vessels, misdiagnosis can lead to serious consequences, even threatening the patient's life. This report presents a 26-year-old naturally conceived patient who was diagnosed with REP through transvaginal ultrasound and underwent early surgery with good recovery.

The transverse vaginal septum is a rare abnormality of the female genital tract. Conventional combined with contrast-enhanced ultrasound can not only accurately predict the position of the transverse vaginal septum, but also accurately judge the thickness of the septum and whether there are holes in the septum. We reported a case of congenital incomplete transverse vaginal septum diagnosed by conventional and contrast-enhanced ultrasound.

The incidence of giant cystic meconium peritonitis (GCMP) in pregnancies following artificial reproductive techniques is rare. We report the first case of GCMP following in vitro fertilization and embryo transfer in China. A 32-year-old woman with a history of bilateral salpingectomy due to ectopic pregnancy attended our in vitro fertilization and embryo transfer program. Meconium peritonitis, polyhydramnios, bowel dilatation, and intra-abdominal calcification were detected by ultrasound at 33 weeks of gestation. Cesarean section due to scarred uterus was performed at 35⁺¹ weeks of gestation. A normal female infant with a distended abdomen was delivered. Emergency laparotomy was performed on the female infant because of the presence of a giant abdominal mass. A 0.2-cm perforation was found in the ileum. Enterostomy could not be performed due to the heavy adhesion. Prenatal diagnosis of meconium peritonitis is possible through careful ultrasonographic examination, and prognosis can be improved through early surgical intervention and intensive postoperative support.

Conventional two-dimensional ultrasonography revealed a hypoechoic mass in the liver of a middle-aged male patient. Enhanced ultrasound suggested intrahepatic cholangiocarcinoma. Enhanced MRI confirmed it as liver cancer. The patient underwent partial liver resection and was pathologically diagnosed as sarcomatoid intrahepatic cholangiocarcinoma. Pulmonary infection occurred one month after surgery. Chest CT suggested left rib metastasis and then radiotherapy was performed. The patient was treated with Lenvatinib after discharge. No recurrence was observed within 36 months. He survived much longer than other patients reported in the literature. The survival of patients with intrahepatic cholangiocarcinoma can be prolonged through early detection and treatments of surgery, radiotherapy and targeted therapy.

Langerhans cell histiocytosis (LCH) is an uncommon disease of unknown etiology, which involves mainly in the bone and skin and rarely the thyroid. Papillary thyroid carcinoma (PTC) is the most common type of thyroid cancer. However, thyroid LCH complicated with PTC is rarer. Awareness of sonographic feature is helpful for clinical managment, especially prior to the surgery. Here, we report two patients who have histologically confirmed thyroid LCH complicated with PTC and summarize these cases with sonographic features including enlargement of the thyroid, multiple hypoechoic nodules with microcalcifications as well as enlarged cervical lymph nodes. The relvent literatures will be reviewed and discussed.

Internal carotid artery dissection (ICAD) is the result of a tear at the intimal layer of the internal carotid artery, which is a common cause of stroke in young and middle age patients. We present multimodal vascular ultrasound findings (include color Doppler flow, power Doppler flow, advanced dynamic flow, superb microvascular and contrast enhanced ultrasound imaging) of a 30-year-old female with ICAD and thrombus in false lumen. To our best knowledge, this is the first report that several superior vascular ultrasound imaging techniques have been used to evaluate ICAD.

Undifferentiated embryonal sarcoma of the liver (UESL) is an aggressive mesenchymal tumor, which presents a low incidence in adults. The low morbidity and atypical clinical manifestations conduce to difficulty in preoperative diagnosis. Imaging manifestations of this tumor is important for its identification. Contrast-enhanced ultrasound (CEUS) was a promising tool to characterize hepatic lesions and proved to have high diagnostic accuracy. The present study reported the CEUS characteristics of UESL in two adult patients, which exhibited peripheral rim hyper-enhancement along with progressively centripetal enhancement and large areas of perfusion defection. Sonographers should be fully aware of this rare disease for better differential diagnosis.

Uterine artery pseudoaneurysm is a rare complication associated with obstetric or gynecological procedures. We described a case report of a primigravid, underwent cesarean section who evolved with massive, intermittent vaginal bleeding requiring multiple blood transfusions. The diagnosis of uterine artery pseudoaneurysm was suspected on transvaginal Doppler ultrasound and confirmed on computed tomography angiography. Due to the patient's stability, age and undefined offspring, superselective uterine artery embolization was chosen for treatment and the procedure successfully performed.

Appendiceal mucocele is a rare disease. Sometimes it is discovered accidentally and sometimes it resembles acute appendicitis. The incidence is 0.2% to 0.7% of all appendectomies specimens. A case report of A 35-year female presented to the emergency room with a history of progressively increasing abdominal pain on and off for 3 months. Tenderness in the right lower quadrant of the abdomen was noted with a palpable mass in the right iliac fossa. An abdominal ultrasound examination was performed, and the patient was found to have an Appendicular mucocele-onion peel sign (sonographic layering within a cystic mass). The patient underwent surgery, and the diagnosis was confirmed by the histopathological report. If mucocele is treated incorrectly, pseudomyxoma peritonei which is characterized by a malignant process may develop. The term mucocele is widely used in diagnosing both benign and malignant lesions.

Thyroid metastatic tumors are a series of rare clinical disease with an incidence of approximately 1.4-3%, of which metastatic tumor from the digestive system is even rarer. Thyroid metastatic tumor from the digestive system is characterized by a rapid growth tumor with high invasiveness and poor prognosis. Ultrasound (US) and contrast-enhanced ultrasound (CEUS) could provide more information for making diagnosis, determining lesion range, and offering biopsy guidance. Ultrasound-guided core needle biopsy (CNB) should be used instead of fine needle aspiration (FNA) to confirm the pathological diagnosis. Here, we report two cases of thyroid metastatic tumor from the digestive system. By describing these cases, we aimed to assess the clinical value of conventional US and CEUS in the diagnosis and treatment of these tumors.

Lymphoepithelioma-like cholangiocarcinoma (LEL-CC) is an intrahepatic cholangiocarcinoma with a prominent lymphoid infiltrate. According to previous reports, most LEL-CCs are a single lesion with a notably better prognosis compared to typical liver cancers. However, most literature reported pathological features and lacked imaging features, especially that of ultrasound. We report on a 74-year-old female with LEL-CC presented with headache and malaise for six months. We performed superficial ultrasonography, abdominal ultrasonography, hepatic contrast-enhanced ultrasound, positron emission tomography-computed tomography, and ultrasound-guided biopsy. We definitively diagnosed LEL-CC with multiple metastases in the liver, skeleton, and lymph nodes.

Pancreaticoduodenal pseudoaneurysm, accounting for only 2% of visceral aneurysms, is a rare but fatal clinical entity. It is a common complication associated with chronic pancreatitis. We here present a case of a 63-year-old Chinese man, who was diagnosed with pancreaticoduodenal pseudoaneurysm by ultrasound and CT. His past medical history was unremarkable, and no obvious cause of the disease could be found. The patient was treated successfully with endovascular embolization using microcoils with no clinical complications.

Schwannoma in retroperitoneal region is quite rare. In this report, we presented such a rare case of a large size schwannoma in a 23-year-old man admitted with a complaint of mild pain in his right lower abdomen. The abdominal ultrasonography detected a round-shaped heterogeneous hypoechoic mass with a few blood flow signals at the retroperitoneal area inferior to the right kidney. The contrast-enhanced ultrasound demonstrated a well-demarcated hypoechoic mass with minor vascularization. Computed tomography (CT) diagnosed the retroperitoneal mass as a malignant neoplasm. After surgical resection, histopathologic examination revealed that the mass was a benign cellular schwannoma. Besides the rare case of schwannoma in retroperitoneal region, we believe that multimodal sonographic patterns are conducive to the preoperative diagnosis of retroperitoneal neurilemmoma.

The anomalous origin of the left main coronary artery from the right sinus of the Valsalva (ALCA) is rare, and varies significantly in congenital heart disease. Patients are usually asymptomatic, and in most cases, coronary abnormalities are discovered by chance at autopsy after coronary angiography or sudden cardiac death. As a routine physical examination procedure, echocardiography is particularly important for the rapid and sensitive diagnosis of ALCA. We report a case of ALCA using echocardiography. “Seagull sign” is a direct ALCA sign manifesting on the short axis section of the artery with two vessels coming from the right coronary sinus. Based on this case, we propose this specific ultrasound sign as a way to improve the diagnostic rate.