Question:

What characteristics differentiate a blood clot from a bladder neoplasm such as carcinoma or schwannoma?
1. Hyperdense appearance when compared to skeletal muscle.
2. Presence of adjacent inflammatory fat standing.
3. Lack of contrast enhancement.
4. Presence of T2 hyperintensity.
5. Resolution over time.





Answer:

The correct answers for the question "What characteristics differentiate a blood clot from a bladder neoplasm such as carcinoma or schwannoma?" are:

3. Lack of contrast enhancement.

5. Resolution over time.



Explanation
1. [A blood clot typically will have a density between 30-50 HU, which may be slightly hypodense, isodense or slightly hyperdense when compared to surrounding skeletal muscle, which usually has a density of 40 HU.]

2. [Inflammatory stranding can be seen adjacent to a bladder neoplasm and is a concerning sign for extravesicular extension.]

3. [Lack of contrast enhancement and resolution over time are the two distinguishing features of a blood clot, which help differentiate it from a bladder wall neoplasm.]

4. Blood may have a T2 hyperintense appearance depending on the age of the clot.  However, this is not a specific finding, and T2 hyperintensity is seen in bladder neoplasms [Both schwannomas and carcinomas are usually isointense to skeletal muscle on T1 weighted imaging (T1WI) and isointense to slightly hyperintense to skeletal muscle on T2 weighted imaging (T2WI).]

5. [Lack of contrast enhancement and resolution over time are the two distinguishing features of a blood clot, which help differentiate it from a bladder wall neoplasm.]



From the manuscript:
Bladder Schwannoma - A Case Presentation
Radiology Case. 2012 Dec; 6(12):26-31


This article belongs to the GU section.




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From the manuscript

Bladder Schwannoma - A Case Presentation

Free full text article: Bladder Schwannoma - A Case Presentation

Abstract
Bladder schwannomas are exceedingly rare, benign or malignant, nerve sheath tumors that are most often discovered in patients with a known diagnosis of Neurofibromatosis type 1 (NF1). A few sporadic case reports of bladder schwannoma have been published in urologic, obstetric/gynecologic, and pathologic journals. However, this is the first case report in the radiologic literature where computed tomography imaging and radiology-specific descriptions are discussed. Furthermore, the patient presented in this case is only the fifth published patient without NF1 to be diagnosed with a bladder schwannoma, to the best of our knowledge.






References



1. Wong-You-Cheong JJ, Woodward PJ, Manning MA, Sesterhenn IA. Neoplasms of the urinary bladder: radiologic-pathologic correlation. Radiographics 2006; 26(2):553-80.
Find similar topics on Read this article on PubMed :: Find similar articles on Google scholarScholar :: Search for similar topics with the Radiology specific search engine Radiology search engine


2. Murphey, MD, Smith WS, Smith SE, Kransdorf MJ, Temple HT. Imaging of musculoskeletal neurogenic tumors: radiologic-pathologic correlation. Radiographics 1999; 19(5):1253-80
Get full text
Find similar topics on Read this article on PubMed :: Find similar articles on Google scholarScholar :: Search for similar topics with the Radiology specific search engine Radiology search engine


3. Robert PE, Smith JB, Sakr W, Pierce JM. Malignant peripheral nerve sheath tumor (malignant schwannoma) of urinary bladder in von Recklinghausen neurofibromatosis. Urology 1991; 38:473-476
Get full text
Find similar topics on Read this article on PubMed :: Find similar articles on Google scholarScholar :: Search for similar topics with the Radiology specific search engine Radiology search engine


4. Cummings JM, Wehry MA, Parra RO, Levy BK. Schwannoma of the Urinary Bladder: A Case Report. International Journal of Urology 1998; 38:496-497
Get full text
Find similar topics on Read this article on PubMed :: Find similar articles on Google scholarScholar :: Search for similar topics with the Radiology specific search engine Radiology search engine


5. Gafson I, Rosenbaum T, Kubba F, Meis JM, Gordon AD. Schwannoma of the bladder: A rare pelvic tumour. Journal of Obstetrics and Gynecology 2008; 28(2):241-254
Get full text
Find similar topics on Read this article on PubMed :: Find similar articles on Google scholarScholar :: Search for similar topics with the Radiology specific search engine Radiology search engine


6. Eltoum IA, Moore RJ, Cook W, Crowe DR, Rodgers WH, Siegal GP. Epithelioid Variant of Malignant Peripheral Nerve Sheath Tumor (Malignant Schwannoma) of the Urinary Bladder. Annals of Diagnostic Pathology 1999: 3(5);304-308
Get full text
Find similar topics on Read this article on PubMed :: Find similar articles on Google scholarScholar :: Search for similar topics with the Radiology specific search engine Radiology search engine


7. Wang W, Montgomery E, Epstein J. Benign Nerve Sheath Tumors on Urinary Bladder Biopsy. American Journal of Surgical Pathology 2008; 32(6):907-912
Get full text
Find similar topics on Read this article on PubMed :: Find similar articles on Google scholarScholar :: Search for similar topics with the Radiology specific search engine Radiology search engine


8. Boning L, Gengxi S, Bo Z, Kangfu L, Ianming W, Kunhao F. Neuroradiological findings of intracranial schwannomas not arising from the stems of cranial nerves. The British Journal of Radiology 2004; 77:1016-1021
Get full text
Find similar topics on Read this article on PubMed :: Find similar articles on Google scholarScholar :: Search for similar topics with the Radiology specific search engine Radiology search engine


9. Murovic JA, Kim DH, Kline DG. Neurofibromatosis-associated nerve sheath tumor-case report and review of the literature. Neurosurgical focus 2006; 20(1):E1
Get full text
Find similar topics on Read this article on PubMed :: Find similar articles on Google scholarScholar :: Search for similar topics with the Radiology specific search engine Radiology search engine


10. Merkle EM, Wunderlich A, Aschoff AJ, Rilinger N, Gorich J, Bachor R, Gottfried HW, Sokiranski R, Fleiter TR, Branmbs HJ. Virtual cystoscopy based on helical CT scan datasets: perspectives and limitations. British Journal of Radiology 1998; 71:262-267
Get full text
Find similar topics on Read this article on PubMed :: Find similar articles on Google scholarScholar :: Search for similar topics with the Radiology specific search engine Radiology search engine


11. Kim JK, Park SY, Ahn HJ, Kim CS, Cho KS. Bladder Cancer: Analysis of Multi-Detector Row Helical CT Enhancement Pattern and Accuracy in Tumor Detection and Perivesical Staging. Radiology 2004; 231:725-731
Get full text
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12. Geol H, Kim DW. Laparoscopic Partial Cystectomy for Schwannoma of Urinary Bladder: Case Report. Journal of Endourology 2005 Apr; 19(3):303-6
Get full text
Find similar topics on Read this article on PubMed :: Find similar articles on Google scholarScholar :: Search for similar topics with the Radiology specific search engine Radiology search engine




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