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I Pandolfo

Publications and source records attributed to I Pandolfo.

At least 37 records · Page 2Linked to original sources
PubMed1997

[Significance of the circumferential involvement of the superior horn tip of the thyroid cartilage in pharyngo-laryngeal cancer].

UNLABELLED: The term "laryngopharyngeal carcinoma" indicates an advanced tumor involving both the supraglottic larynx and the pharynx in which the lesion origin may be difficult to assess. In 1981, Larsson et al. reported on the CT signs useful to distinguish the laryngeal/hypopharyngeal origin of advanced laryngopharyngeal carcinoma. We describe a new CT sign which may serve this purpose, namely the involvement of the thyroid cartilage superior horn tip. The thyroid cartilage superior horn, in fact, is involved early in the lesions originating in the pyriform sinus because of its close anatomic relationship with the posterolateral wall of the hypopharynx. MATERIALS AND METHODS. To assess the significance and specificity of this sign, we examined 15 patients with advanced laryngopharyngeal carcinoma with clinical, endoscopic and surgical evidence suggestive of tumors originating in the pyriform sinus. All CT examinations were performed with contiguous 4 mm slices before and after i.v. administration of iodinated contrast agents. Eighteen patients with surgically confirmed advanced supraglottic carcinoma were also examined. RESULTS: The thyroid cartilage superior horn tip was involved only in 3/18 supraglottic carcinoma patients; transcommissural infiltration of the larynx, involving both pyriform sinuses, was found in 2 of these cases and extensive invasion of the whole thyroid cartilage and of the cricoid ring in 1 case. CONCLUSIONS: The thyroid cartilage superior horn tip is a reliable sign of the pyriform sinus origin of advanced laryngopharyngeal cancer which is both sensitive (100%) and specific (83%). Moreover, this sign could play a major role because it represents, in most cases, the only and earliest sign of cartilage involvement. Finally, the encasement of the thyroid cartilage superior horn tip by abnormal tissue indicates tumor spread beyond the posterior pharyngeal wall. Therefore, these data can be very important for its early detection and useful for subsequent surgical planning.

Adult↗
PubMed1996

Computed tomography visceral adipose tissue volume measurements of Italians. Predictive equations.

OBJECTIVES: To evaluate total visceral adipose tissue (AT) volumes in relation to single slices of visceral AT area measured at different levels and to other simple anthropometric measurements. DESIGN: Only outpatients examined in a metabolic unit were considered; subjects without conditions known to affect AT distribution who gave their informed consent were recruited. SETTING: All subjects were hospitalized in the Department of Internal Medicine of the University of Messina. SUBJECTS: 90 adult subjects of which 18 men and 42 pre- and 30 post-menopausal women. Ages ranged from 18 to 69 years and body mass indexes ranged from 22 to 50. INTERVENTIONS: The AT volume was calculated by computed tomography from the AT area of five scans and from the distances between these scans. RESULTS: AT area at the level of the 2nd-3rd lumbar vertebra had by itself the highest predictive power in men (s.e. = 6.8%), in post-menopausal women (s.e. = 7.4%) and, together with age, in pre-menopausal women (s.e. = 14%). Of the non-radiological parameters it was waist circumference, together with age, which showed the highest predictive power in men (s.e. = 21%), pre-menopausal women (s.e. = 25%) and, together with height, in post-menopausal women (s.e. = 33%). CONCLUSIONS: A single scan measurement at the lumbar level was confirmed to be representative of total visceral AT volume. Waist circumference was the non-radiological parameter that best correlated with volume.

Adipose Tissue↗
PubMed1996

[The angiogram sign in lung consolidation: what is its diagnostic value?].

The angiogram sign in chest CT is the demonstration of normally enhanced pulmonary branches within hypoattenuating lung parenchyma consolidation. In a retrospective review of the chest CT exams performed in a 2-year period, we identified the angiogram sign in 10 patients with lung consolidation; the diagnosis was central lung tumor with obstructive pneumonia in 4 patients, bronchioloalveolar carcinoma in 2 patients, postirradiation fibrosis in 1 patient, tuberculous pneumonia in 1 patient, lung lymphoma in 1 patient and metastasis from pancreatic tumor in 1 patient. The diagnosis was made with cytology and/or surgical specimen in 9 patients and with clinical-radiologic follow-up in 1 patient. The density, air and mucous bronchogram and the volume loss in the consolidated lung were also considered. The consolidated lung density was < 30 HU in 5 patients-one bronchioloalveolar carcinoma, one metastasis from pancreatic carcinoma and 3 obstructive pneumonia cases-, while it was > 30 HU in the extant 5 patients. The air bronchogram sign was observed in 4 cases-one bronchioloalveolar carcinoma, one metastasis, one postirradiation fibrosis and one lung lymphoma-, while a mucous bronchogram was observed in 3 patients with obstructive pneumonia. Lung volume was reduced only in 2 patients-one obstructive pneumonia and one postirradiation fibrosis. In our opinion, the CT angiogram sign must be considered a poorly specific sign, because it can be found in many pathologic processes, both benign and malignant. If associated with the other features of lung consolidation, the CT angiogram sign can help diagnose, together with clinical findings and the patient's history, the pathologic condition. Particularly, the angiogram sign within a hypoattenuated lung consolidation area can be found in obstructive pneumonia, while the angiogram sign within a hypoattenuated consolidation with an air bronchogram probably indicates a mucinous carcinoma with lipidic growth.

Angiography↗
PubMed1995

[Computerized tomography in the assessment of metastatic facial adenopathy].

The facial lymph nodes are classified in five groups: mandibular, buccinator, infraorbital, malar and retrozygomatic nodes. This paper reports the CT appearance of neoplastic involvement of these nodes, an unusual and not well documented event. The CT examinations of 62 patients with a history of primary or recurrent cancer of the epidermal structures of the face, oral cavity and sinonasal region were retrospectively reviewed to assess the presence of facial adenopathy. Nine cases of neoplastic involvement of facial nodes were found. Most commonly the buccinator nodes (4 cases) were involved, the infraorbital, mandibular (2 cases) and retrozygomatic nodes (1 case) being less commonly involved. No malar nodes were found. Neoplastic involvement of these nodes was caused by squamous cell carcinoma in 6 cases, by adenocarcinoma in 2 cases and by a lymphoma in 1 case. Normal nodes could not be confidently identified on CT studies. CT diagnosis of neoplastic involvement of facial nodes is based on the presence of a nodular lesion which lies along the lymphatic pathways of the primary neoplasm in an anatomically compatible location. CT diagnosis of facial nodes is very important for treatment planning if the nodes are deep or at a distance from primary cancer. This is especially true for retrozygomatic and buccinator nodes.

Facial Neoplasms↗
PubMed1995

[Computerized tomography in the assessment of obstructive jaundice caused by hepatic hydatid cysts].

This paper reports on the CT findings of obstructive jaundice caused by hydatid cysts of the liver, which are an unusual event occurring in 5-10% of cases. Thus, only a few reports can be found in the literature dealing with the CT features of this syndrome. Eight patients with obstructive jaundice were selected from 87 patients with hydatid disease of the liver and examined with CT. The CT diagnosis of rupture into the largest bile ducts is based upon the demonstration of hepatic hydatid cysts together with intrabiliary hydatid sand, membranes and scolices and/or the identification of parietal discontinuity with communication between the cyst and the biliary tree. Rupture into the largest bile ducts was demonstrated in 7 patients. The following CT patterns were observed: 1) intrahepatic biliary tract dilatation (all cases); 2) extrahepatic biliary tract dilatation (6 cases); 3) cyst wall interruption (5 cases--in 3 of them the communication between the cyst and the dilated bile duct was demonstrated); 4) daughter cysts, fragmented membranes or hydatid sand in the biliary tree (5 cases); 5) hydatid material in the gallbladder (1 case) and, finally, disappearance of the daughter cyst visible on a previous CT examination (1 case). In another patient, the diagnosis of compressive jaundice without biliary communication was suggested because a bulky hydatid cyst was found near the hilum of liver. CT findings were confirmed with ERCP or at surgery. CT failed to reveal small tears with minute biliary radicles, which are usually asymptomatic, whose diagnosis could be made only with preoperative cholangiography. Hydatid cysts of the liver can cause obstructive jaundice because of main bile duct compression or of large bile duct perforation with consequent passage of hydatid material into the biliary tree. This complication should be promptly managed surgically to avoid potentially fatal complications, which makes a preoperative diagnosis essential.

Adolescent↗
PubMed1994

[Computerized tomography in gaseous hypotonic duodenography in the study of the pancreatico-duodenal area].

This study was aimed at assessing the role of CT-hypotonic gaseous duodenography in the study of the pancreatic-duodenal region. Forty-two patients with malignancies in this region were examined with CT of the upper abdomen followed by CT-hypotonic gaseous duodenography (30 pancreatic head cancers, 7 main bile duct and 5 ampullary lesions). In 20 of 28 cases of pancreatic head carcinoma, CT-hypotonic gaseous duodenography yielded more pieces of information than baseline abdominal CT and was also more useful in small pancreatic head cancers, < 4 cm diameter. In 4 of these patients, CT-hypotonic gaseous duodenography better demonstrated the pancreatic lesions which conventional CT had demonstrated poorly. In contrast, CT-hypotonic gaseous duodenography was less useful in main bile duct carcinomas, depicting focal duodenal infiltration in only 1 of 7 cases. In all ampullary tumor patients (5/5), CT-hypotonic gaseous duodenography demonstrated intraduodenal lesions. The authors conclude that CT-hypotonic gaseous duodenography is a useful technique to investigate small pancreatic head cancers and the method of choice to demonstrate ampullary lesions.

Adult↗
PubMed1994

[Bronchiolo-alveolar carcinoma. The computed tomographic picture and histological correlations].

Twenty-one CT examinations of 18 patients with a known bronchioloalveolar carcinoma in the lung were retrospectively reviewed to describe the CT features of bronchioloalveolar carcinomas. Surgical specimens were available in 13 cases in which CT-histologic correlation was also obtained. In 5 patients the diagnosis was made with cytology and confirmed with radiologic-clinical follow-up. Three patients were reexamined for relapses 6-20 months after the resection of a localized carcinoma. Carcinomas exhibited 3 radiologic patterns: a) solitary pulmonary nodule (11 cases), b) mass or pulmonary consolidation (3 cases) and c) multicentric or diffuse disease (7 cases). Solitary nodular bronchioloalveolar carcinomas were associated with irregular or spiculated margins in 9 of 11 patients. In some cases internal inhomogeneity due to bubble-like radiolucencies was demonstrated. At pathology, bubble-like radiolucencies correlated with air-containing cystic spaces lined by neoplastic epithelium or patent and dilated bronchi. Some nodules exhibited linear and serpentine internal radiolucencies. Pathology demonstrated them to be consistent with patent intratumoral bronchioles (air bronchiologram) and air-containing neoplastic glandular spaces, respectively. In two cases a perinodular ground-glass halo was demonstrated surrounding the nodule (CT halo sign), due to perinodular lepidic tumor growth. Massive or ground-glass opacity involving a pulmonary segment or a lobe was another CT pattern of bronchioloalveolar carcinoma. An air bronchogram was usually demonstrated within the lesion. In the mucinous type of bronchioloalveolar carcinoma, pulmonary consolidations had a low CT value because of the large amount of intratumoral mucus. The diffuse type of tumor presented as multiple pulmonary nodules or multiple pulmonary consolidations, or both. In two cases multiple nodules were associated with carcinomatous lymphangitis. In conclusion, bronchioloalveolar carcinoma should be considered in the differential diagnosis of solitary pulmonary nodules, multiple pulmonary nodules and chronic alveolar opacities. The diagnosis of a bronchioloalveolar carcinoma is of great value since surgery can help nearly 70% of the patients at this stage recover.

Adenocarcinoma, Bronchiolo-Alveolar↗
PubMed1992

Small bronchogenic carcinomas presenting as solitary pulmonary nodules. Bioptic approach guided by CT-positive bronchus sign.

To evaluate the utility of the CT bronchus sign in making a choice between transbronchial biopsy (TBB) and transthoracic needle aspiration (TTNA) as the first diagnostic procedure in a patient with a solitary pulmonary nodule (SPN), we reviewed the results of TBB and TTNA in 26 patients who had a bronchogenic carcinoma less than 3 cm, studied with thin-section CT. The patients were divided into two groups. Group 1 included ten cases with a third- to fifth-order bronchus sign. Group 2 included two cases with a sixth-order bronchus sign and 14 cases with absence of a bronchus sign. TBB was performed in all the patients; conversely, TTNA was carried out in 22 patients. In group 1, TBB gave a diagnostic yield in eight (80 percent) of ten patients, while TTNA was positive in three (42 percent) of seven patients (p > 0.05). Conversely, in group 2, results of TBB were normal in all the patients, while TTNA gave a diagnosis in 10 (66 percent) of 15 patients (p < 0.05). We think that TBB should be considered the method of choice in diagnosing SPNs associated with a third- to fifth-order bronchus sign; conversely, TTNA is more useful than TBB in diagnosing SPNs in the presence of a more peripheral bronchus sign or with the absence of a bronchus sign. In conclusion, we suggest routine evaluation with thin-section CT of each SPN to optimize diagnostic management.

Biopsy, Needle↗
PubMed1991

Bronchus sign on CT in peripheral carcinoma of the lung: value in predicting results of transbronchial biopsy.

The bronchus sign on CT represents the presence of a bronchus leading directly to a peripheral pulmonary lesion. We investigated the value of this sign in predicting the results of transbronchial biopsy and brushing in 33 consecutive cases of proved peripheral bronchogenic carcinoma studied with thin-slice CT (2-mm-thick sections). The bronchus sign was seen on CT in 22 patients and was absent in 11. Transbronchial biopsy and brushing showed peripheral carcinoma in 13 (59%) of 22 patients in whom the bronchus sign was seen on CT and in only two (18%) of 11 patients in whom it was not seen. The difference is statistically significant (Fisher's exact test, p = .029). When analyzed by the order of involved bronchus, a 90% success rate of transbronchial biopsy and brushing was found in patients in whom the bronchus sign was seen at a fourth-order bronchus (p = .01). This compared with a success of 33% when the bronchus sign was seen at fifth-, sixth-, or seventh-order branches. Our results suggest that the bronchus sign at a fourth-order bronchus is valuable in predicting the success of transbronchial biopsy and brushing. The presence of the sign on CT may be useful in determining if the workup should include transbronchial biopsy and brushing or transthoracic needle aspiration in patients with peripheral lung lesions.

Adult↗