Biomedical subjects
Publications and source records attributed to A Dana.
Lymphography revealed the nature of diffuse lymph node involvement in systemic mastocytosis with diffuse bone involvement and hematological signs, similar to that seen in some malignant hematological diseases or in osteomyelosclerosis. The final stages of transformation into acute lymphoblastic leukemia must also be considered.
Primary sarcomas of the kidney are extremely uncommon and the results of their angiographic study are rarely reported. A study of five cases that were confirmed histologically demonstrates the absence of specific clinical and urographic findings. Arteriographic appearances are variable and not related to the histological type. The poorly vascularized forms are traditionally the most frequent (2 out of 5 cases) but are not fundamentally different from adenocarcinomas. The diagnosis can be suspected, however, when there is an infiltrating peripheral tumor extending well beyond the capsule. The hypovascularized pseudocystic forms raise the same arteriographic problems as the adenocarcinomas. Arteriography can diagnose malignancy, but the diagnosis of sarcoma is usually impossible before operation.
The superior mesenteric artery was found to be displaced posteriorly in 5 patients with intraperitoneal masses. In 3 cases, the mass was a mesenteric tumor, and in the 2 other cases a tumor arising from the retroperitoneal area which had grown into the mesentery. The authors emphasize, therefore, the value of defining the position of the superior mesenteric artery in the sagittal plane for the topographic diagnosis of intraperitoneal masses. This investigation does not, however, eliminate the possibility of a retroperitoneal origin of the tumoral mass.
The authors underline the value of selective superior mesenteric arteriography in the diagnosis of Meckel's diverticulum. In the ten cases reported, seven were found to have a Meckel's diverticulum on operation, while it was absent in the other three. Arteriography was able to diagnose its presence correctly in sex patients, gave a false positive diagnosis in three cases, and was considered to be normal in the last case in which a Meckel's diverticulum was present. Valid radiological signs are extravasation of the contrast medium into the lumen of the digestive tract and the presence of a vitellin artery dividing into a vascular network. The single fact of a hypervascularized zone at the end of the superior mesenteric artery dividing into a vascular network. The single fact of a hypervascularized zone at the end of the superior mesenteric artery without definite artery formation is not as valid and its interpretation is difficult.
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On the basis of a review of 186 cases of carcinoma of the kidney studied by arteriography in the Department of Radiology for Diseases of the Urinary Tract at Necker Hospital, the authors drew the following conclusions: 1. The diagnosis of carcinoma could be affirmed in the very great majority of cases and suspected in the others. 2. There were no instances of a reassuring false diagnosis (cyst). 3. A precise, rigourous and faultless technique, perfectly demonstrating the exteriorised part of the mass and attentive, thorough and careful interpretation of the films obtained, in particular with regard to the mass in its exteriorised portion, are always essential in order to obtain such results. In particular, the presence of a vascularisation of a discontinuous opaque band at the periphery of the mass in its exteriorised part indicates a strong suspicion of a necrotic malignancy and under no circumstances is an unreserved diagnosis of a cyst possible. 4. Diagnostic errors in the sense of false positives involving certain "thick-walled" cysts should be eliminated by pre-operative needle puncture. 5. The authors conclude by describing the method of radiological exploration which they feel to be desirable in practice following the discovery of a renal mass by intravenous pyelography.
The authors have reviewed the case-reports of 160 patients with urinary tract tuberculosis in whom a complete radiological examination of the lower urinary tract had been performed. They analyze the frequency and significance of any prostatic lesions and describe the most effective investigational procedures for demonstrating such lesions. They were observed in about 50% of patients as opacification of the prostatic cavities, and can be clearly demonstrated in the large majority of cases by micturition cystography after intravenous urography, provided a satisfactory technique hs been used. In those cases where intravenous urography does not permit an effective micturition study, retrograde opacification is necessary, preferably by suprapubic cystography, and in some well-defined cases, by retrograde uretrography. The search for any prostatic affection is not a t a speculative study as it can explain some of the symptoms presented by the patient, and enable specific therapy to be prescribed.
The radiological signs of malignant mammary tumours in men, which are similar to those observed in women, are reviewed. Several points have to be remembered, however; the common retro-mammillary location, the frequent nodular character, the skin involvement and the usual mamillary retraction, and, finally, the absence of characteristic microcalcifications. The interest of mammography to rate T in the TNM classification is also mentioned.