Biomedical subjects
Publications and source records attributed to A G Vesnin.
Real-time sonography was carried out in 273 patients with metastatic lesions in the liver. Sonographic patterns of hepatic metastases were identified. Relationships between sonographic semiotics and patterns of primary tumor are discussed.
The only method of preoperative visualization of spread of the process in the soft tissues (phlegmons, abscesses etc.) is the ultrasonic examination which was used in 32 patients. The diagnostic significance of echography in chronic osteomyelitis was 50%, suppuration in the soft tissues was 92.3%.
Clinico-roentgenologic data on 33 cases of aneurysmal cyst of the bone (flat bones--12, spinal cord--21) were assessed. Such peculiarities of the aneurysmal cyst of flat bones as large size, cellular--trabecular structure and a peripheral periosteal "shell" were identified. Vertebral cysts involved processes, arches and body resulting in compression fracture. They sometimes extended to adjacent vertebrae and ribs. Vertebral cysts should be differentiated mainly from giant-cell tumors, metastases and myeloma.
Altogether 145 patients with malignant lymphomas were examined using indirect radionuclide and direct x-ray lymphography. Coincidence of the results was noted in 87.6% of the cases. Divergencies in the interpretation of the status of retroperitoneal lymph nodes were noted in 18 patients. An analysis of divergencies of the results of radio- and x-ray lymphography made it possible to determine the cause of differences in the results of the investigation of these two types and to arrive at the right conclusion in 12 out of 18 cases. The combined use und analysis of the results of both methods made it possible to raise the accuracy of lymphographic diagnosis and to improve the determination of stages of malignant lymphomas.
The study using clinico-roentgenological data on 62 patients was concerned with the effectiveness of mammography in evaluating radiation response. Tumor regression was registered in 58 cases. Changes in the X-ray picture in the course and after treatment as well as X-ray signs of radiation injury are described. Mammography proved more reliable than clinical examination in evaluating the degree of tumor regression.
The paper deals with a study of lymphographic data on 204 cases of pediatric malignant lymphomas: primary Hodgkin's disease--150 and non-Hodgkin's lymphomas--54. The frequency of retroperitoneal lymph node involvement was nearly identical in both study groups (68.0 and 68.5%, respectively). In Hodgkin's disease, lymph node lesions developed gradually and were asymmetric; a total involvement of lymph nodes was more frequent in non-Hodgkin's lymphomas, the X-ray patterns of affected nodes being identical. The study failed to establish any lymphographic signs pathognomonic for certain histologic types characteristic of Hodgkin's disease and non-Hodgkin's lymphomas. Lymphography should be carried out in all cases of stage I--II Hodgkin's disease, while in stages III and IV its role is limited to determining the size of irradiation fields.
The results of studies conducted by the Center's staff for early detection of breast cancer are discussed. About 5,000 females are examined at the Center yearly, with clinical, mammographic and thermographic procedures being used. During five screenings, breast cancer was detected in 56 cases (8.9%-by thermography alone, 16%-clinical examination, 26.8%-mammography alone and 48.2%-mammography plus clinical examination). "Minimal" breast cancer (less than 1 cm in dia.) was detected in 19 cases (33.9%). 76.5% of "minimal" cancers were detected with the aid of mammography.
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Lymphogenous dissemination of malignant ovarian tumor was studied by means of direct radiopaque lymphography in 113 primary patients. Lymph node metastases were detected in 63 cases (55.8%). Positive lymphographic results matched histological findings on distant lymph nodes in 76.0 +/- 8.7 and negative in 96.3% +/- 3.7 of cases. Most frequent sites of metastases were regional paraaortal lymph nodes (87.7%). Pelvic nodes were affected in 63.2%; since in 10.5% of cases separate metastases were found, it may be supposed that these lymph nodes are regional to ovaries, too. Inguinal nodes ranked third as metastatic sites (17.5%). Frequency of metastatic dissemination was found to depend on histological pattern of tumor tissue: they occurred in 46.3% cases of epithelial tumors, 73.9% - germinogenous and 50.0% of tumors of genital cord stroma. Metastases into lymph nodes were detected in 28.6% of patients with stage I tumors. Control lymphograms showed metastases in regression following chemotherapy in 56.6% of patients.
The clinicoroentgenological data in 45 cases (20 males and 25 females, average age 50.3 years) of soft tissue liposarcomas, histologically subdivided into 28 myxoid, 12 polymorphic and 5 round-cell tumors were compared. The means case history was 3.2 years (3.8 years--for myxoid and 2.2 years for polymorphic and roundcell liposarcomas). In 95.6% of cases, tumor sites were in the musculare of the extremities, more frequently, legs. Tumors were rather large in size (average 16.5 cm). Myxoid tumors developed slowly, causing no pain. The radiograms of these tumors showed multiple tumor nodes, reduced shadow density, structural heterogeneity, distinct contours, infrequent cutaneous infiltration and secondary changes in bones. Signs of malignancy were indistinct in angiograms. Clinically and roentgenologically, round-cell liposarcomas resembled most other types of soft tissue sarcomas. Polymorphic tumors had many features in common both with myxoid and round-cell neoplasms.
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A comparative estimation of the results of dispensary observation, based on the data of only gynecological study and effective dispensary control with the organization of high-risk groups and application of the complex diagnostics system, proved the rationale to raise the question on the need of effective recognition of patients with ovarian tumors. The effective dispensary control was found to enable the detection of ovarian tumors with an adequate reliability in 93.6%; (versus 22.0% without using a detailed examination), unsuspected ovarian tumors being found clinically in 3.0%. There were not only benign but also proliferating and malignant tumors in early stages among effectively revealed ovarian tumors.
In 160 children with Hodgkin's disease, lung involvement was studied. In 14.4%, lung lesions were diagnosed at the first admission and an additional 7.5% of the patients developed lung lesions in the course of the disease. As a rule lung involvement was observed in advanced disease. It has been stated that there is no particular difference in the response to treatment in any particular type of lesion, spread either by contiguity of dissemination. Of all methods of treatment, combination chemotherapy (MOPP programme) showed the best results. In our series of children it was not possible to show any advantage to favour irradiation as against combination chemotherapy in the treatment of lung lesions.
The roentgenologic features of Hodgkin's disease were studied in 105 patients under 14 years of age. The mediastinal and hilar nodes were involved in 64.7% of patients. Some consistency of extent and pattern of disease was observed in that mediastinal lymphatic lesions could be associated with cervico-supra-clavicular and retroperitoneal lesions. There was lung infiltration in 14.3% of patients and the frequency of this lesion dependent on the histological type. It was commoner in nodular sclerosis, mixed cellularity and lymphocytic depletion. Lung infiltration usually developed in continuity with the lymphatic gland lesion and only rarely in a metastasis-like form.
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