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Lymphadenopathy is an important characteristic of POEMS syndrome, and a Castleman disease (CD)-like pathologic change in the lymph nodes is one of the major diagnostic criteria. However, the characteristics of lymphadenopathy in POEMS still have not been completely elucidated. The lymph node biopsies are available only for a small proportion of patients. A simple and safe way is needed to rule CD in or out. This study aimed to analyse the features of lymphadenopathy and estimate the role of imaging methods, including computed tomography (CT) and positron emission tomography-CT (PET/CT), in the diagnosis of lymphadenopathy in patients with POEMS syndrome. We conducted a retrospective analysis of 23 patients with confirmed POEMS syndrome. All of the patients received chest and abdominal CT scan and/or superficial ultrasound examinations. Four patients underwent PET/CT examinations, and 6 patients received lymph node biopsies. Enlarged lymph nodes (short diameter ≥ 1 cm) were found in 48% (11/23) of patients, but only 1 patient had an enlarged lymph node with a diameter ≥ 2 cm. Lymph nodes with CD-like pathologic changes from 2 patients showed increased maximum standard uptake values (SUV(max)) of (18)F-deoxyglucose ((18)FDG) on PET/CT, while lymph nodes with reactive pathologic changes from 2 other patients showed a normal metabolic PET/CT profile. The extent of lymph node enlargement in patients with POEMS was less than that in patients with CD per se. We draw the conclusion that most of the enlarged lymph nodes had diameters ≤ 2 cm, which is less than that in cases of CD per se and PET/CT may be helpful in determining whether enlarged lymph nodes are characterized by CD-like changes or not.

Objective To provide a retrospective assessment of clinical characteristics of the patients with gastric glomus tumors and the imaging features of the tumors on multidetector row computed tomography (MDCT). Methods Consecutive patients with gastric glomus tumor which was confirmed by postoperative pathology from January 2004 to January 2012 in a tertiary hospital were included in the study. The MDCT images and medical records of the patients including the imaging features of the tumor on MDCT such as its location, number, shape, growth pattern, size, density and enhancement pattern were retrospectively reviewed. Results Altogether ten patients were included in the study, including seven women and three men, with a mean age of 46.6 years (range 25–67 years). Most patients had nonspecific clinical symptoms. All lesions were located at the gastric antrum, with a mean diameter of 2.7 cm. The gastric glomus tumor showed strong enhancement at the arterial phase, a progressive filled-in enhanced pattern and prolonged enhancement during multiphasic scans. Conclusions Gastric glomus tumor is clinically an extremely rare disease. The combination of tumor location, size and the characteristic enhancement pattern of the subepithelial lesion may suggest a diagnosis of gastric glomus tumor.

POEMS syndrome is a rare plasmacyte-associated disease, one of the major diagnostic criteria of which is sclerotic bone lesion. To detect bone lesions in POEMS syndrome, which imaging method should be routinely applied and what characteristics they display are still unconfirmed. We analyzed clinical data and imaging characteristics of bone lesions in 22 patients with POEMS using multimodal methods, including conventional X-ray, computed tomography (CT), magnetic resonance imaging (MRI), and positron emission tomography/computed tomography (PET/CT). Images on X-ray and CT exhibited plaque-like high-density for osteosclerotic lesions and punched-out low-density appearance for osteolytic ones. X-ray had advantage in detecting bone lesions in skull, extremity long bones, clavicle, and scapula, while CT could display sharp outline of lesions and was more sensitive than X-ray in detecting the small lesions. Osteosclerotic lesions on MRI demonstrated decreased signal intensity on both T1 and T2-weighted sequences, while osteolytic lesions or osteolytic part of mixed lesions showed high signal intensity on T2-weighted sequences. MRI had same sensitivity as CT, but with superiority in distinguishing the active osteolytic lesions from the osteosclerotic ones. PET-CT showed (18)F-FDG uptake was normal in the majority of osteosclerotic lesions, and slightly increased in mixed ones, but obviously elevated in osteolytic ones. PET/CT was less sensitive in detecting osteosclerotic lesions than in detecting osteolytic ones. In conclusion, to detect bone lesions in POEMS, conventional X-ray scan should be first performed, further followed by more sensitive CT or MRI. PET-CT is optional when the osteolytic lesions are suspected.

To study the magnetic resonance imaging (MRI) in the wrist joint of coal miners who work in excavation and vibration department.Forty-three coal miners with the hand-arm vibration disease served as the observation group while 20 workers who were not working in the vibration department acted as the control group. The patients in the observation group were divided into five subgroups according to the time when they received vibration. The regularity of the development of signs and symptoms of MRI was observed and analyzed.The hydroarthrosis was most found in MRI. There were significant difference in hydroarthrosis (chi(2) = 8.80, P0.01), osteoporosis and osteomyelitis (chi(2) = 3.91, chi(2) = 5.01, P0.05 respectively) between the observation group and the control group. The edema of bone marrow and the avascular necrosis of ossa carpi were found only in the observation group and not found in the control group. The hydroarthrosis and the edema of bone marrow occurred most in the early stage of vibration. The signal in the edema of the bone marrow of the distal end of the radius was decreased in the GE sequence T(2)WI with the specificity.(1) Changes in the wrist joint occur in the early stage of the vibration work, and can be found in the MRI. (2) The edema of the bone marrow of the distal end of the radius is of great value in the diagnosis of the hand-arm vibration disease.