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Biomedical subjects

A Shirkhoda

Publications and source records attributed to A Shirkhoda.

At least 55 records · Page 3Linked to original sources

Malignant melanoma: correlating abdominal and pelvic CT with clinical staging.

Two hundred two patients with malignant melanoma underwent computed tomography (CT) scanning of the abdomen and pelvis. The frequency of metastases in the abdomen and pelvis was correlated with the site, level, and thickness of the primary tumor. The sites of the primary tumors were the trunk (70 patients), the lower extremities (37 patients), the upper extremities (33 patients), the head and neck (29 patients), the eye (nine patients), and the genitourinary tract (six patients). In 18 patients, the primary site could not be identified. In 96 patients, the level and thickness of the primary tumor, based on Clark and Breslow classifications, were correlated with the presence and extent of metastases. CT showed metastases in 122 patients (60%). The head and neck were the most common primary sites associated with metastases (79%), followed by the eye (77%) and genitourinary tract (67%). Thick lesions had the highest frequency of metastases (84%), compared with intermediate (50%) and thin (46%) lesions. Tumors classified as Clark level V had the highest frequency of metastases (87%).

Abdominal Neoplasms↗

Parosteal osteosarcoma: radiologic-pathologic correlation with emphasis on CT.

Parosteal osteosarcoma, a distinct entity in which the neoplasm arises on the bone surface, presents characteristic features. Thorough radiologic and histologic evaluation and early definitive surgery usually result in a favorable prognosis and make limb salvage feasible in many adult patients. Twenty-six patients with proven parosteal osteosarcoma were seen at The University of Texas M. D. Anderson Hospital and Tumor Institute at Houston. All were examined by conventional radiography, 16 by CT, and one by both CT and MR. CT is valuable for the evaluation of tumor invasion of the medullary canal, involvement of the cortex, and extension into the soft tissues, findings frequently not demonstrable by other noninvasive techniques. Additional information is obtained regarding the presence and location of satellite lesions and intralesional radiolucent areas and the relationship of the vascular bundle to the tumor mass. These findings are important for planning both percutaneous biopsy and surgery.

Adolescent↗

Hepatosplenic fungal infection: CT and pathologic evaluation after treatment with liposomal amphotericin B.

Disseminated fungal disease, predominantly involving liver and spleen, developed in eight patients with hematologic malignancies. Because the patients failed to respond to standard antifungal drugs, they were treated with liposomal amphotericin B (L AmpB). Before therapy began, the diagnosis was confirmed histologically and the patients underwent abdominal computed tomography (CT), which indicated hepatosplenomegaly with or without multiple microabscesses in the liver and spleen. After each course of treatment with L AmpB, patients underwent CT, followed by either open or CT-guided percutaneous aspiration biopsy of the liver. Post-treatment CT showed partial regression of lesions in six patients and persistence in two. In all patients a liver biopsy confirmed that the lesions noted after treatment were due to granulomas or focal areas of fibrosis compatible with healing. Thus, the persistence of multiple defects on enhanced scans in two patients was not an indication of persistent abscesses. Clinical response was an additional important factor. Close clinical and pathologic correlation in addition to CT scanning are required in the follow-up of hepatosplenic fungal infections.

Adolescent↗

Diagnostic approach to incidental adrenal nodules in the cancer patient. Results of a clinical, radiologic, and fine-needle aspiration study.

Twenty-three nonfunctioning adrenal nodules were discovered during computed tomographic (CT) evaluation of the abdomen in 16 patients with a variety of primary extra-adrenal malignant neoplasms. In seven cases the adrenal masses were bilateral. Following percutaneous fine-needle aspiration biopsy, pathologic diagnosis was consistent with benign adenoma in seven patients, and with adrenal metastasis in nine. There was no significant difference in age, sex, or incidence of bilateral distribution among these two groups. Three of the adenomas were calcified, and the size of the benign nodules in all patients was less than 3 cm. No calcification was seen in metastatic adrenal nodules, and their sizes ranged between 2 and 20 cm. The clinical and radiologic features of these two groups of patients are evaluated, and a rational approach for the management of adrenal masses is described. The CT images of adrenal adenoma and adrenal metastasis, along with their corresponding cytopathologic features, are illustrated.

Adenoma↗

Computed tomography after adrenalectomy in adrenal cortical carcinoma.

This report deals with the follow-up diagnostic evaluation of 18 patients previously treated for adrenal cortical carcinoma. The role of computed tomography is emphasized. Nine patients had adrenalectomy and the other 9 had adrenalectomy and ipsilateral nephrectomy. The left kidney and adrenal were removed in 8 patients. The patients were evaluated for 2-59 months with an average follow-up of 16 months. Of the 13 patients (72%) who had recurrent or metastatic disease, 8 experienced local recurrence in the adrenal fossa, 2 of whom had associated renal involvement. The recurrence was seen in 5 patients in the left and in 3 patients in the right side. Metastases occurred in the lung (7 patients), liver (3 patients), peritoneum (2 patients), paraaortic lymph nodes (3 patients), and bone (1 patient). At the time of the discovery of recurrence or metastases, 5 patients presented with lung metastases found on chest x-rays, 3 had recurrent Cushing's syndrome or hypertension, 3 had abdominal pain, 1 had weight loss, and 1 was asymptomatic.

Adrenal Cortex↗

Computed tomography of diaphragmatic lipoma.

Five cases of lipomas of the diaphragm are reviewed, and findings on computed tomography and conventional radiography are compared. Due to the high specificity of computed tomography in identifying fat-containing structures, the diagnosis of lipoma was established with certainty. In repeated chest roentgenograms during an average follow-up of 14 months, there was no change in the appearance of the masses in the patients' diaphragms.

Aged↗

Computed tomography of osteosarcoma after intraarterial chemotherapy.

The response to intraarterial cis-diamminedichloroplatinum II (CDP) chemotherapy was evaluated by computed tomography (CT) in 33 patients with pathologically proved osteosarcoma of the long or flat bones. Twenty-one of the 33 patients had a CT scan before chemotherapy was started. In the other 12 patients, a CT scan was obtained after at least two courses of treatment, and additional studies were performed during the course of therapy. In those patients responding to treatment, the posttherapy scan revealed a remarkable decrease or complete disappearance of the associated soft-tissue mass and clear reestablishment of the fat planes between the muscle bundles that had been obscured. There was sharp definition of the peripheral margins of the calcified healing neoplasm, and the calcification in the healing tumor could be differentiated easily from that of the original bone neoplasm. The findings of CT were compared with those of conventional studies and pathologic results. CT was more accurate than conventional studies in detecting healing process and diagnosis of remission.

Adolescent↗

Computed tomography and ultrasonography in splenic infarction.

The computed tomographic (CT) findings in eight patients with splenic infarction are described and correlated with ultrasound (US) in three. The diagnosis was proven in four by splenectomy or autopsy, in three by comparison with CT, having been obtained shortly before infarction, and in two by angiography. In four patients the infarct occurred as a result of hepatic or splenic artery embolization. The CT features of infarction may be difficult to differentiate from those due to trauma, inflammation or tumor, and include either a diffuse, a well circumscribed or an irregularly marginated area of low density within the spleen. Classical wedge-shaped defects are occasionally seen in the periphery of spleen. The ultrasonographic feature is usually that of a hypoechoic or an anechoic area in the spleen. In one patient, it became necessary to perform an ultrasound guided aspiration biopsy to rule out splenic abscess.

Adolescent↗

Sacral abnormalities--computed tomography versus conventional radiography.

Seventeen examples of different pathologic conditions, including malignant and benign tumors, and inflammatory, traumatic, and congenital lesions involving the sacrum, are presented. The value of computed tomography is compared with that of conventional methods with respect to diagnostic evaluation and clinical management of these patients. Computed tomography proved to be more accurate in delineating the extent of bony lesions, diagnosing adjacent soft tissue involvement, evaluating the progress of a lesion, and defining the approach for biopsy of a sacral lesion or determining the feasibility of surgery.

Adolescent↗

Computed tomography of juxtacardiac pheochromocytoma.

The diagnosis of juxtacardiac pheochromocytoma was made with the help of three-dimensional computed tomography, angiography, and radionuclide scintigraphy, and was proved at surgery. If findings on adrenal computed tomography are normal and the clinical and laboratory findings support the diagnosis of pheochromocytoma, the patient should be further investigated by computed tomography or radionuclide-guided computed tomography and angiography to determine the extraadrenal location of this tumor. If the abnormal area is in the mediastinum, it is essential to do either direct coronal computed tomography imaging of the suggestive area or to obtain coronal and sagittal reconstruction images to investigate the relationship of the lesion to the great vessels and cardiac chambers.

Adrenal Gland Neoplasms↗

Current diagnostic approach to adrenal abnormalities.

Cross-sectional imaging of the adrenal glands is described, and examples of pheochromocytoma, bilateral adrenal hyperplasia, aldosteronoma, and metastasis are presented. The clinical diagnosis and radiologic findings of these and other adrenal lesions are discussed. Noninvasive and invasive procedures, and their usefulness in diagnosing adrenal abnormalities, are reviewed, and the value of computed tomography, ultrasonography, radionuclide scintigraphy, and angiography are analyzed.

Adrenal Gland Diseases↗

Computed tomography after partial hepatectomy.

Twenty-two patients with surgically resectable malignant primary liver neoplasm or hepatic metastases were examined by computed tomography both before and after surgery. The anatomic modifications created by the surgery, including right lobectomy, left lobectomy, segmentectomy, and wedge resections were evaluated. Computed tomography depicted changes in the liver contour, usually after right or left lobectomy as well as secondary effects of these changes in the adjacent organs. With knowledge of these postsurgical modifications, the reparative ability of the liver can be appreciated.

Hepatectomy↗

Computed tomography in recurrent or metastatic colon cancer: relation to rising serum carcinoembryonic antigen.

Twenty patients with Stage Duke B or C adenocarcinoma of the colon or rectum who have undergone radical surgical resection and demonstrated rising serum carcinoembryonic antigen (CEA) during follow-up are the subject of this study. In all cases, while there was a continuous and progressive elevation of serum CEA, CT examination of the abdomen and pelvis was performed. Abnormal CT findings were demonstrated in 19 patients and included pelvic mass, liver metastases, and periaortic or mesenteric lymphadenopathy. There was one normal CT scan in a patient who subsequently developed metastases in the sacrum. Based on the observations in these patients, it is concluded that in routine follow-up after colorectal surgery, rising serum CEA should be considered a warning sign and warrants additional investigation by CT.

Adenocarcinoma↗

Abdominal and pelvic computed tomography in leukemic patients.

Fifty-two patients with different types of leukemia [27 chronic lymphocytic leukemia (CLL), 10 acute myeloblastic leukemia (AML), eight acute lymphoblastic leukemia (ALL), four chronic myelogenous leukemia (CML), and three hairy cell leukemia (HCL)] had abdominal and pelvic CT. The radiographic features are reviewed to evaluate the role of CT in diagnosis and management of these patients. The highest incidence of lymphadenopathy was observed in CLL followed by HCL and ALL. Other findings included splenomegaly, hepatomegaly, ascites, pleural effusion, microabscesses in liver and kidney, and visceral involvement, i.e. intestine, bladder, and bone.

Adolescent↗

Leiomyosarcoma: computed tomographic findings.

The computed tomographic (CT) findings in 118 patients with the diagnosis of leiomyosarcoma were reviewed. The tumor masses visualized in these patients were often quite large; extensive necrotic or cystic change was a frequent finding. Calcification was not observed in these tumors. The liver was the most common site of metastasis in these patients, with marked necrosis of the liver lesions a common finding. Other manifestations of tumor spread included pulmonary metastases, mesenteric or omental metastases, retroperitoneal lymphadenopathy, soft-tissue metastases, bone metastases, splenic metastases, and ascites. The metastatic lesions were often centrally necrotic. Although the CT appearance of leiomyosarcoma is not specific, these findings, when present, suggest consideration of this diagnosis.

Adolescent↗

Soft-tissue hemorrhage in hemophiliac patients. Computed tomography and ultrasound study.

Fifty-four hemophiliac patients underwent a total of 94 studies using computed tomography (CT), ultrasound, or both. Not only common bleeding sites such as the iliopsoas muscles but also several unusual sites were encountered: these included the iliac bone, bowel wall, mesentery, rectus abdominis muscle, retroperitoneum, bladder wall, and scrotum. Both modalities gave comparable results, and each was helpful in (a) establishing the diagnosis, (b) evaluating the extent of bleeding and its effect on adjacent organs, and (c) demonstrating regression after treatment.

Abdomen↗