MRI of diabetic cheiroarthropathy.
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Adolescent↗
Biomedical subjects
Geetika Khanna
Publications and source records attributed to Geetika Khanna.
Imaging of cervical spine injuries of childhood.
Cervical spine injuries of children, though rare, have a high morbidity and mortality. The pediatric cervical spine is anatomically and biomechanically different from that of adults. Hence, the type, level and outcome of cervical spine injuries in children are different from those seen in adults. Normal developmental variants seen in children can make evaluation of the pediatric cervical spine challenging. This article reviews the epidemiology of pediatric cervical spine trauma, normal variants seen in children and specific injuries that are more common in the pediatric population. We also propose an evidence-based imaging protocol to avoid unnecessary imaging studies and minimize radiation exposure in children.
Adolescent↗
Somatostatin receptor subtype 2 is expressed by supratentorial primitive neuroectodermal tumors of childhood and can be targeted for somatostatin receptor imaging.
PURPOSE: Although gliomas predominate among central nervous system (CNS) neoplasms in adulthood, embryonal tumors are the most common malignant brain tumors in children. Despite novel treatment approaches, including improved radiotherapy and high-dose chemotherapy, survival rates remain unsatisfactory. The timely diagnosis of residual or recurrent embryonal CNS tumors and thus the earliest possible time point for intervention is often hampered by inaccuracies of conventional imaging techniques. Novel and refined imaging methodologies are urgently needed. EXPERIMENTAL DESIGN: We have previously demonstrated the use of somatostatin receptor imaging (SRI) in the diagnosis of recurrent and residual medulloblastomas. Here, we evaluated somatostatin receptor type 2 (sst(2)) expression using an antibody in an array of CNS tumors of childhood. Eight high-grade gliomas, 4 atypical teratoid/rhabdoid tumors, 7 supratentorial primitive neuroectodermal tumors (stPNET), 1 medulloepithelioma (ME), and 8 ependymomas were screened. Tumors positive in vitro were additionally analyzed in vivo using SRI. RESULTS: Abundant expression of somatostatin receptor type 2 in stPNET, a ME, and ependymomas warranted in vivo imaging of 7 stPNET, 1 rhabdomyosarcoma, 3 ependymomas, 1 ME, and 1 glioblastoma. Although SRI was positive in 6/7 stPNET, 1 rhabdomyosarcoma, and 1 ME, none of the ependymomas nor the glioblastoma could be imaged using SRI. In selected cases SRI was more sensitive in the detection of relapse than conventional imaging by magnetic resonance imaging and computed tomography. CONCLUSIONS: SRI should be considered in the evaluation of residual or recurrent embryonal CNS tumors, especially stPNET. The strengths of SRI lie in the differentiation of reactive tissue changes versus residual or recurrent tumor, the detection of small lesions, and possibly in the distinction of stPNET from gliomas.
Central Nervous System Neoplasms↗
Solid tumors of childhood.
OBJECTIVE: Cancer is one of the leading causes of death in children. There is the need to have the histologic review of malignancies in children from the Indian sub-continent. METHODS: In the present study, malignant tumors received over 12 years were reviewed and re-classified according to classifications based on prognosis. RESULTS: A total of 472 tumors were received over 12 years. Of these 318 were benign and 154 malignant. The commonest malignant solid tumor was lymphoma followed by pediatric renal tumors. The sarcomas included bone tumors, Rhabdomyosarcoma and synovial sarcoma. There were 13 germ cell tumors, 10 retinoblastomas and six neuroblastomas. CONCLUSION: The review revealed that a definite diagnosis or classification was not assigned in 21 cases in the original reporting. Of these 14 could be assigned a definite category on review and immuno-staining. These included five non-Wilms sarcomas, four Rhabdomyosarcomas, three Ewing's sarcoma/PNETs and two Synovial sarcomas. The study also revealed an unexpected high percentage (11%) of epithelial malignancies in children.
Child↗
Fatal disseminated cryptococcosis in a HIV negative elderly Indian woman--an early diagnosis by polarizing microscopy.
An elderly HIV negative woman with disseminated cryptococcosis is reported. The clinical presentation was unusual. Rapid diagnosis is possible if Maltese crosses are demonstrated on polarizing microscopy of tissue sections or smears. Cutaneous involvement in cryptococcosis is uncommon, however when present, can be a valuable and relatively easily available source of material from which Cryptococci can be demonstrated.
Aged↗
Fine needle aspiration cytology of chondroblastoma--a case report.
Chondroblastoma accounts for less than one percent of osseous neoplasms, and is one fifth as common as giant cell tumor, a lesion with which it is very frequently confused. It has a marked predilection for the epiphysis of long bones. Radiologically, these are lytic lesions with a thin margin of increased density. A majority of chondroblastomas have an entirely benign course and are successfully treated by curettage and bony chip grafts. Clinically, chondroblastomas may be confused with other neoplasms, both benign and malignant. Fine needle aspiration is fast gaining acceptance as an accurate and rapid technique for diagnosing osseous neoplasms. The cytological features of chondroblastoma like individually lying chondroblasts, nuclear grooves, chodroid matrix and chicken-wire calcification are diagnostic of this neoplasm and may allow fine needle aspiration to become a valuable pre-operative technique in the management of these patients.
Adolescent↗
Gas-forming abdominal wall abscess: unusual manifestation of perforated retroperitoneal appendicitis extending through the superior lumbar triangle.
We present a case of an extensive gas-forming abdominal wall abscess secondary to ruptured retroperitoneal appendicitis in a diabetic patient. Computed tomography (CT) demonstrated a retroperitoneal abscess extending to the abdominal subcutaneous tissue through the superior lumbar triangle pathway, a known anatomical defect of the lumbar musculature. This case not only represents an unusual manifestation of acute appendicitis, but also alerts us to the importance of anatomical considerations in the imaging interpretation of disease extent. The applied anatomy of the lumbar triangle as a conduit of intra-abdominal and retroperitoneal processes into the abdominal wall is reviewed.
Abdominal Abscess↗
Synchronous cystic teratomas of the craniofacial region.
A case of synchronous cystic teratomas presented with the complaints of a slow-growing facial mass and forward protrusion of the right eye since birth. The patient was examined thoroughly and subjected to magnetic resonance imaging (MRI) scan. The MRI scan revealed the presence of two separate cysts in the right orbit and right temporal fossa. The patient was operated by a combined effort of ophthalmologists and otorhinolaryngologists. The cysts were excised and subjected to pathological examination. The histopathological survey revealed both the cysts to be mature cystic teratomas similar to each other. This coexistence of a primary temporal fossa teratoma with an orbital teratoma is the first of its kind and to the best of our knowledge has not been reported before.
Adolescent↗
Imaging of chronic granulomatous disease in children.
Chronic granulomatous disease (CGD) is a rare immunodeficiency disorder. The inability of phagocytic cells to kill catalase-positive organisms, such as Staphylococcus and Aspergillus species, causes recurrent infections, persistent inflammation, and granuloma formation. The imaging findings in nine cases of CGD were studied. Recurrent pulmonary infection was the most common abnormality (seven cases). Its complications included pulmonary abscesses, bronchiectasis, mediastinal abscesses, osteomyelitis, sepsis, and brain abscesses. Suppurative cervical adenitis was the second most common abnormality (four cases) and was also the presenting abnormality in the youngest patient (aged 31 days). Abdominal manifestations included hepatosplenomegaly, recurrent hepatic and splenic abscesses, necrotic mesenteric adenopathy, and gastric outlet obstruction. Osteomyelitis occurred in two cases secondary to hematogenous spread or spread of contiguous infection from the lung. Persistent infections led to formation of chronic inflammatory masses and granulomas in five cases. With improvements in therapy, the prognosis of CGD patients has improved and the general consensus is that most patients will survive into adulthood. Hence, radiologists are more likely to encounter the complications of CGD and should familiarize themselves with the spectrum of imaging findings.
Child↗
Causes of facial swelling in pediatric patients: correlation of clinical and radiologic findings.
Facial swelling is a common clinical problem in pediatric patients. The causes of swelling are diverse, and knowledge of the typical clinical and imaging manifestations and the most common sites of occurrence of these conditions is needed to formulate a differential diagnosis. The general clinical manifestations may be classified into the following four groups: (a) acute swelling with inflammation, (b) nonprogressive swelling, (c) slowly progressive swelling, and (d) rapidly progressive swelling. Conditions that may account for acute swelling accompanied by inflammation include lymphadenitis, sinusitis, odontogenic infection, and abscess. Contrast-enhanced computed tomography is the modality of choice for detection of abscesses requiring surgical drainage. Nonprogressive midfacial swelling is suggestive of a congenital anomaly (eg, a cephalocele, nasal glioma, or nasal dermoid or epidermoid cyst). Slowly progressive swelling may indicate the presence of a neurofibroma, hemangioma, lymphangioma, vascular malformation, or pseudocyst, or of fibrous dysplasia. The differential diagnosis for rapidly progressive facial swelling in association with cranial nerve deficits should include rhabdomyosarcoma, Langerhans cell histiocytosis, Ewing sarcoma, osteogenic sarcoma, and metastatic neuroblastoma.
Adolescent↗
Fibromatosis colli in infants. A cytologic study of eight cases.
OBJECTIVE: To review eight cases of fibromatosis colli and assess their cytomorphologic features. STUDY DESIGN: Cytologic smears from eight patients diagnosed as having fibromatosis colli on fine needle aspiration cytology were reviewed. RESULTS: Cytologic features of fibromatosis colli are bland-appearing fibroblasts and degenerative atrophic skeletal muscle in a clean background. Besides these, we found a large number of muscle giant cells; numerous bland, bare nuclei; and parallel clusters of fibroblasts. Collagen was seen in all cases. CONCLUSION: A confirmatory, noninvasive diagnosis of fibromatosis colli can be made by fine needle aspiration cytology alone; invasive diagnostic and therapeutic measures are best avoided. Excision biopsy may not be necessary and should be reserved for cases with a strong clinicopathologic suspicion of malignancy.
Biopsy, Needle↗
Fine needle aspiration in a case of gastric teratoma.
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Biopsy, Fine-Needle↗