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Biomedical subjects

E Breatnach

Publications and source records attributed to E Breatnach.

At least 19 recordsLinked to original sources
PubMed2001

Aggressive multiple myeloma presenting as mesenteric panniculitis.

Mesenteric panniculitis is a rare disease of the bowel mesentery, characterized by tumor-like infiltration by chronic inflammatory cells, fat necrosis, and fibrosis. Reported cases cited clinical presentation ranging from abdominal pain to fever of unknown origin, the majority of which were idiopathic and associated with a benign prognosis. We report the case of a 43-yr-old male who presented with malaise, weight loss, microcytic anemia, and a high erythrocyte sedimentation rate. Radiographic and histological investigations revealed typical features of mesenteric panniculitis. Initial treatment with high-dose oral prednisolone led to rapid and complete resolution of symptomatology, radiographic, and laboratory anomalies. Within 6 months, the patient presented again with anemia, renal failure, and hypercalcemia. A diagnosis of IgA kappa chain myeloma was made. Despite chemotherapy and restoration of normocalcemia, he died from refractory pulmonary edema. This is the first report of a hematological malignancy initially presenting with features of mesenteric panniculitis culminating in an aggressive course and a fatal outcome.

Adult↗
PubMed1997

Lung findings on high-resolution computed tomography in idiopathic ankylosing spondylitis--correlation with clinical findings, pulmonary function testing and plain radiography.

Previous studies on the association of ankylosing spondylitis and abnormalities of the lung parenchyma have been based largely on plain radiography and pulmonary function testing. This study, although uncontrolled, is the first to use high-resolution computed tomography to examine the entire lung parenchyma in ankylosing spondylitis patients, and to correlate the findings with clinical assessment, plain radiography and pulmonary function testing. The study population comprised 26 patients meeting the New York criteria for idiopathic ankylosing spondylitis who attended the out-patient department at our institution. High-resolution computed tomography examination revealed abnormalities in 19 patients (70%): these included interstitial lung disease (n = 4), bronchiectasis (n = 6), emphysema (n = 4), apical fibrosis (n = 2), mycetoma (n = 1) and non-specific interstitial lung disease (n = 12). Plain radiography was abnormal in only four patients and failed to identify any patient with interstitial lung disease. All patients with interstitial lung disease on high-resolution computed tomography had respiratory symptoms and three of the four had evidence of a restrictive process on pulmonary function testing. This study raises, for the first time, the possible association between interstitial lung disease and ankylosing spondylitis, and highlights the use of high-resolution computed tomography in detecting such disease in ankylosing spondylitis patients.

Adult↗
PubMed1997

Plain radiographs and thoracic high-resolution CT in patients with ankylosing spondylitis.

OBJECTIVE: The aims of this study were to identify the spectrum of abnormalities seen on high-resolution CT in patients with ankylosing spondylitis and to compare our findings with reports of plain film pulmonary manifestations of the disease. SUBJECTS AND METHODS: We prospectively studied 26 patients with documented ankylosing spondylitis. All patients underwent plain chest radiography (posteroanterior and lateral views), thoracic helical CT, high-resolution CT, and pulmonary function tests. RESULTS: High-resolution CT revealed abnormalities in 18 patients (69%), whereas plain chest radiography revealed abnormalities in four patients (15%). The most common abnormalities seen on CT were interstitial lung disease (ILD) (n = 4), bronchial wall thickening and bronchiectasis (n = 6), paraseptal emphysema (n = 3), mediastinal lymphadenopathy (n = 3), tracheal dilatation (n = 2), and apical fibrosis (n = 2). CONCLUSION: This study, which describes high-resolution CT findings in patients with ankylosing spondylitis, reveals a spectrum of abnormalities unlike those described in previous reports in which researchers used plain chest radiographs as the sole imaging technique. In addition to apical fibrosis, high-resolution CT revealed nonapical ILD, bronchiectasis, paraseptal emphysema, and tracheobronchomegaly. Of these new findings, we believe that identification of ILD is the most important. We suggest that nonapical ILD should be actively sought as an explanation for pulmonary symptoms developing in patients with ankylosing spondylitis. High-resolution CT should form an integral part of such workup.

Adult↗
PubMed1996

High-resolution chest CT in systemic lupus erythematosus.

OBJECTIVE: The purpose of our study was to identify high-resolution CT (HRCT) findings in patients with systemic lupus erythematosus (SLE) and to determine their significance by correlation with clinical findings, plain chest radiography, and pulmonary function testing. SUBJECTS AND METHODS: Thirty-four patients with documented SLE were prospectively studied. All patients had plain chest radiography (posteroanterior and lateral) thoracic spiral CT, HRCT, and pulmonary function testing performed. RESULTS: HRCT abnormalities were identified in 24 patients (70%), pulmonary function abnormalities were present in only 14 patients (41%), and the plain chest radiograph was abnormal in only 8 patients (24%). The most common CT findings were: interstitial lung disease (n = 11), bronchiectasis (n = 7), mediastinal or axillary lymphadenopathy (n =6), and pleuropericardial abnormalities (n =5). No correlation was found between disease activity, duration of disease, chest symptoms, drug therapy, smoking history, and the presence of abnormal HRCT findings. More importantly, no correlation was found between pulmonary function abnormalities and the presence or grade of interstitial lung disease or bronchiectasis as determined by HRCT. CONCLUSION: The results of this study, the first to describe the HRCT findings in SLE, suggest that airways disease, lymphadenopathy, and interstitial lung disease are common thoracic manifestations of SLE, whereas pleural abnormalities are less common than previously suggested. HRCT evidence of airways disease and interstitial lung disease was frequently present despite an absence of symptoms, a normal chest radiograph, and normal pulmonary function testing. HRCT provides a sensitive and noninvasive technique for detecting pulmonary involvement in SLE, with the added advantage that it can be performed in all patients, including those too compromised to undergo a surgical procedure. In patients with advanced disease, HRCT permits procedures such as bronchoalveolar lavage and lung biopsy to be directed toward areas of particular interest.

Adult↗
PubMed1995

Ileal loop conduit volvulus: a rare but reversible cause of bilateral ureteric obstruction.

Conduit volvulus is a very rare complication of ileal loop diversion. To date it has not been described in association with parastomal herniae. We report two such cases. Antegrade nephrostogram established the diagnosis and nephrostomy drainage facilitated spontaneous resolution of the volvulus with return to baseline renal function in both patients. Percutaneous drainage was the only intervention required in one case. For the second patient, percutaneous decompression permitted elective surgical refashioning of the conduit following clinical stabilization. Conduit volvulus in association with a parastomal hernia is a potentially reversible cause of renal impairment in patients with urinary diversions. The diagnosis depends on accurate radiological evaluation. The initial treatment of choice is percutaneous drainage with elective surgery when the patient's clinical status has improved.

Aged↗
PubMed1995

Imaging of small cell carcinoma of the oesophagus.

Four cases of oesophageal small cell carcinoma are described. Radiological features at presentation included oesophageal strictures in association with bulky intrathoracic and intraabdominal lymphadenopathy. The subject is reviewed and the radiologically relevant features are emphasized.

Aged↗
PubMed1994

Computed tomography of the retroperitoneum in patients with femoral neuropathy.

The authors illustrate the value of computed tomography (CT) of the retroperitoneum in patients presenting with femoral nerve signs. They describe 28 such patients, examined at a tertiary-care hospital between June 1990 and January 1993, in whom CT of the retroperitoneum contributed significantly to the diagnosis. The patients, 19 males and 9 females, ranged in age from 11 to 81 years. CT showed disease of the psoas compartment in 17 cases; the condition was due to a malignant lesion in 9 cases and was secondary to infection in 5 and to other causes in 3. Disease of the iliacus compartment was shown in 11 cases; it was due to a malignant lesion in 6 cases and was secondary to hemorrhage in 2, to infection in 1 and to a bursa in 1. The diagnostic features of the diseases encountered are discussed, and the importance of performing CT early is stressed.

Adolescent↗
PubMed1993

The American Thoracic Society lymph node map: a CT demonstration.

It is now a decade since the American Thoracic Society (ATS) lymph node map was first described. Recently it has been upgraded to include supraclavicular and superior diaphragmatic lymph nodes. By standardising terminology the map aids in the provision of a more valid data base to evaluate diagnostic techniques and therapeutic protocols. Despite these potential benefits the map has failed to gain widespread use amongst European radiologists. This essay illustrates the relationship of the nodal stations to normal anatomy utilizing calcified nodes on CT scans. The ease with which the map can be applied to cross-sectional anatomy is emphasized. It is hoped that the images will act as a teaching aid to promote greater acceptance and use of the ATS map. The relationship of the nodal stations to the new American Joint Classification of disease extent is also outlined.

Biopsy↗
PubMed1992

Imaging of the mediastinum and hila.

This review covers the papers that we believe represent the most interesting and innovative developments in hilar and mediastinal imaging over the past year. One of the most exciting of these is the expanded role for sonography in imaging extracardiac mediastinal pathology. A number of reports highlight its use in directing mediastinal biopsy, for tissue characterization, and for staging lymphoma. The comparative merits of CT and MR imaging in staging bronchogenic carcinoma have been further clarified. The past year has also seen further attempts to characterize tumor versus postobstructive pneumonitis or collapse using MR imaging and CT. Other useful clinical work includes the documentation of signs distinguishing paramediastinal lung masses from primary mediastinal pathology. References are also made to clinically relevant aspects of MR scanning and advances in imaging of the airway, particularly cine and high-resolution CT of the trachea.

Diagnosis, Differential↗
PubMed1991

Pleural granulocytic sarcoma: CT characteristics.

The CT findings in a case of granulocytic sarcoma of the pleura are presented and correlated with pathology sections. CT features included diffuse, circumferential pleural thickening, multiple pleural fluid locules and mediastinal adenopathy. Similarities with the appearance of mesothelioma and metastatic pleural disease are discussed and the literature reviewed.

Humans↗
PubMed1986

The role of computed tomography in acute and subacute mediastinitis.

Acute and subacute infection in the mediastinum, though rare, is associated with a substantial mortality which increases with delay in diagnosis. The conventional radiographic and computed tomographic studies of 14 patients with proven infective mediastinitis were reviewed in an attempt to identify their relative roles in its diagnosis. Signs of infection demonstrated by computed tomography (CT) included abscess formation, mediastinal masses, soft tissue collections contiguous with other infected compartments and areas of diffuse mediastinal infiltration with fat plane loss without prominent lymphadenopathy. The anatomy and extent of the infection was well delineated by CT in all patients. In nine cases this information affected clinical management, facilitating percutaneous drainage of the abscess in three. In five patients, information from CT did not alter clinical management.

Acute Disease↗