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D Hulnick

Publications and source records attributed to D Hulnick.

9 recordsLinked to original sources
PubMed1990

Ileocecal tuberculosis: CT and radiologic evaluation.

The CT and radiologic findings in 11 patients (five with AIDS and six without AIDS) with ileocecal tuberculosis are described. On CT scans, five cases showed mild circumferential wall thickening of the terminal ileum and cecum, thickening of the ileocecal valve, and a few regional nodes. One case presented as nonspecific small-bowel obstruction. In five patients a more characteristic CT appearance was detected: preferential thickening of the ileocecal valve and medial wall of the cecum, exophytic extension engulfing the terminal ileum, and massive lymphadenopathy with low-density areas consistent with caseation necrosis. Patients with AIDS had a more severe form of involvement than those who did not have AIDS. Barium studies showed ileocecal changes consistent with an inflammatory process. In conjunction with barium enema, CT is helpful in the initial evaluation of ileocecal tuberculosis, showing the location and extent of intestinal and mesenteric involvement in most cases. Characteristic CT findings are seen when the inflammatory process is severe.

Acquired Immunodeficiency Syndrome↗
PubMed1988

Epithelioid hemangioendothelioma. A rare tumor with variable prognosis presenting as a pleural effusion.

The chest x-ray film a 22-year-old man showed a large right-sided pleural effusion that was grossly hemorrhagic when aspirated. A computerized tomographic scan showed a complex mass with cystic components contiguous with the diaphragm. On thoracotomy the mass was found to be arising from the diaphragm and had the consistency of an organizing hematoma. Pathologic studies showed the mass to be an epithelioid hemangioendothelioma. This rare tumor has never been reported previously as arising from the diaphragm. It has a variable prognosis, but surgery remains the treatment of choice. In this report, we review the clinical and pathologic characteristics of this unusual tumor, as well as the distinctive roentgenographic findings with which it presented.

Adult↗
PubMed1988

Carcinoma of the colon: detection and preoperative staging by CT.

This report analyzes the detection rate and role of CT in the preoperative evaluation of 90 consecutive, proved cases of colon carcinoma. In this study, the overall detection rate was 84%; however, the rate varied from 68% in unprepared colons to 95% in clean colons that were adequately distended with air. Sensitivity of detection depends mainly on the size of the lesion and the quality of the examination. CT was less sensitive than barium enema in detection, but it had a similar specificity in differentiating neoplastic lesions from inflammatory lesions. On the basis of our criteria of staging, CT evaluation resulted in a sensitivity of 55% for local invasion, 73% for regional nodes, and 79% for liver metastases. Compared with Dukes classification, CT correctly staged 64% of all patients but showed significant variations in staging different groups with lower results in the Dukes A, B, and C patients. CT, however, showed a sensitivity of 81% and a positive predictive value of 100% in detecting Dukes D lesions. In general, although negative CT findings do not help in staging a colonic tumor, positive findings are highly indicative of neoplastic spread. We believe that this feature justifies the use of CT in the preoperative evaluation of colonic tumors.

Adult↗
PubMed1987

Cecal diverticulitis: evaluation with CT.

The findings of computed tomographic (CT) examinations in seven patients with cecal diverticulitis are described and correlated with those of barium studies. The CT findings were linear and streaky densities in the pericecal fat compatible with pericecal inflammation (seven cases), intramural abscess (one case), thickening of the cecal wall (two cases), and cecal diverticulum (one case). Barium studies, available in four patients, led to a correct diagnoses of diverticulitis in two cases. CT scanning is a sensitive means by which to detect cecal diverticulitis. The radiographic appearance of the disease, however, mimics that of appendicitis, unless more specific findings such as cecal diverticula or intramural abscess with adjacent inflammation is detected. CT and barium study are complementary methods of examination that improve our ability to diagnose cecal diverticulitis and its complications.

Adult↗
PubMed1987

Cytomegalovirus esophagitis in AIDS: radiographic features in 16 patients.

Cytomegalovirus is one of the more common opportunistic organisms implicated in the development of esophagitis in patients with AIDS. A review of the radiographic features of 16 proved cases of cytomegalovirus esophagitis showed a spectrum of abnormalities related to the severity of the inflammatory process. Seven patients had a mild form of esophagitis with segmental involvement characterized by granular mucosa, superficial erosions, and poorly defined, shallow ulcerations. Nine patients had more severe esophagitis with solitary or multiple deep ulcers and a background of normal mucosa. The deep ulcerations were oval in shape and varied in size. Some projected intraluminally and had a thin rim of radiolucency at the base. Short-term follow-up examinations showed progression of the disease in four patients, no change in one patient, and regression without specific therapy in one patient. Although these radiographic features are highly suggestive of cytomegalovirus esophagitis, the diagnosis requires histologic confirmation.

Acquired Immunodeficiency Syndrome↗
PubMed1986

CT of appendicitis.

The CT findings of 38 consecutive patients with acute appendicitis are analyzed, described, and illustrated. CT showed intraabdominal disease in 92% of patients and made a specific diagnosis of appendicitis in 79% of cases. The most common CT findings were pericecal inflammation (68%), abscess (55%), calcified appendicolith (23%), and an abnormal appendix (18%). CT had a sensitivity similar to that of contrast enema examinations, but it correlated much better with the surgical findings in detecting the precise nature, extent, and location of the disease process. Normal CT does not exclude appendicitis, since mild forms without periappendiceal disease may escape detection.

Acute Disease↗
PubMedDate not supplied

Computed tomography of intramural intestinal hemorrhage and bowel ischemia.

The CT findings of eight patients with intramural intestinal hemorrhage are described and illustrated. Two patients had ischemic bowel disease: in the other six cases pertinent clinical histories led to an accurate diagnosis. Computed tomography demonstrated similar findings consisting of circumferential and symmetrical wall thickening homogeneous in density, a slightly narrowed intestinal lumen, and sharp outer contour. The disease had a segmental distribution affecting different parts of the intestinal tract. In six patients edematous and congestive mesenteric changes were seen and in two patients intraperitoneal blood was detected. An adequate history and careful clinical evaluation are crucial in differentiating the more benign forms of intramural hemorrhage from bowel ischemia.

Adult↗
PubMedDate not supplied

Computed tomography of the abnormal appendix.

This report describes the CT features of 29 abnormal appendices visualized during abdominal CT examinations. There were 22 cases of acute appendicitis, five mucoceles, and two mucinous adenocarcinomas of the appendix. The inflammed appendix appeared either as a fluid-filled slightly distended structure or as a collapsed small tubular structure. It was visualized on either cross or longitudinal sections and showed slight circumferential wall thickening. Periappendiceal inflammation was detected in 19 cases and intraluminal appendicoliths in six cases. Mucocele appeared as a larger fluid-filled round, oval, or tubular structure having a thin, sharp wall, low density contents, and no periappendiceal inflammation. Mucinous carcinoma appeared either as a single or as multiloculated, irregular shaped cystic lesion with solid elements. Infiltration of cecum and terminal ileum was seen in one case. In five cases the abnormal appendix was not recognized initially and was identified only after repeat 5 X 5 mm sections were obtained. During CT examination, demonstration of an abnormal appendix establishes the source of the abdominal pathology and helps greatly in the differential diagnosis.

Acute Disease↗