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J Drouillard

Publications and source records attributed to J Drouillard.

At least 19 recordsLinked to original sources
PubMed1995

CT of small-bowel neoplasms.

The diagnosis of neoplasms of the small intestine remains a difficult challenge owing to their nonspecific clinical presentation. CT is an efficient and contributive tool in their diagnosis and preoperative staging. Enabled by CT, the evaluation of the intramural and extramural portions of such tumors complements the mucosal analysis allowed by barium examination. Strict technical rules should be applied to minimize pitfalls mainly resulting from insufficient bowel opacification. Although characteristic appearances are rare, typical CT findings may suggest a specific diagnosis where lipomas and carcinoid tumors are concerned.

Adenocarcinoma↗
PubMed1995

Pseudo-tumours of the thymus after correction of hypercortisolism in patients with ectopic ACTH syndrome: a report of five cases.

We report the cases of four patients with occult, and one patient with overt, ectopic ACTH syndrome. Cushing's syndrome was cured by removal of the ACTH secreting tumour, op'DDD, ketoconazole or bilateral adrenalectomy. Six to 14 months after remission of hypercortisolism, follow-up computed tomography or magnetic resonance imaging of the thorax revealed in all five patients an anterior mediastinal mass 3-5 cm in length that suggested a thymic carcinoma. Exploratory thoracotomy was performed in four cases and allowed the removal of an enlarged, but normal, thymus. Histological examination revealed no tumour but showed benign thymic hyperplasia with negative immunostaining for ACTH. Thymic enlargement spontaneously disappeared 11 months after its demonstration in the patient who did not undergo thoracotomy. The mechanism of this abnormality is thought to be thymic depletion resulting from high plasma cortisol concentrations followed by 'rebound' thymic hyperplasia when cortisol levels fall. Physicians involved in the management of patients with Cushing's syndrome must be aware of this entity in order to avert a diagnostic thoracotomy.

ACTH Syndrome, Ectopic↗
PubMed1992

[Primary mediastinal choriocarcinoma. Apropos of 3 cases].

We report three cases about the diagnostic imaging features of mediastinal choriocarcinoma and during follow up. Computed tomography proved to be more accurate than plain X ray to show the topography and volume of the mediastinal mass hence providing a better approach for biopsy and surgical ablation of the residual tumoral tissues. However, CT cannot differentiate fibrous tumoral remnants from active malignancies and beta HCG is an important tumoral marker in the follow up.

Adult↗
PubMed1992

[How can intrathoracic lymphatic involvement be assessed: does tomography have a role? What is the contribution of computed tomography and MRI?].

The authors report their analysis of the literature on the evaluation of intrathoracic extension of non-small-cell bronchial cancers to lymph nodes, using tomography, computed tomography and magnetic resonance imaging. The criteria used to assess the metastatic character of a lymph node, the characteristics of the populations studied and the methods of comparison with the clinicopathological "truth" account for the variations of the results published. Tomographs are useless today. The performances of CT and MRI are equivalent, and it is not necessary to associate both techniques. Although its performances are mediocre, CT allows mapping the mediastinal lymph nodes, which is useful to continue the assessment of extension and to make decisions.

Carcinoma, Non-Small-Cell Lung↗
PubMed1992

[Anatomical bases for bronchial arterial revascularization in double lung transplantation].

A study of the bronchial arterial blood supply was conducted to facilitate in surgical attempts of bronchial revascularization in double lung transplantation. This study consisted of 20 cadaveric anatomical dissections of the bronchial arterial blood supply as well as a retrospective review of 50 bronchial arteriograms. The right bronchial tree was supplied by an artery originating from the right intercostal bronchial arterial trunk in 76 to 95% of the cases. This artery also supplied the distal trachea and the carina in over 80% of cases as well as the proximal left bronchial tree via a network of small collaterals found in the subcarinal compartment and adventitial tissues located on the anterior surface of the descending aorta. A common arterial trunk for both the right and left bronchial trees was found in 12 of the 20 dissections (60%). Left bronchial arteries were much smaller and less consistent. Proximity of the bronchial arteries orifices was frequently observed: in 10 of the 20 dissections it allowed simultaneous reperfusion of more than one vessel. To maintain the vascular anastomotic network in between the right and left trees, extensive vascular dissection and carinal resections are prohibited. This will allow revascularization of the whole tracheal bronchial tree via the supply of the origin of the RICBA.

Anastomosis, Surgical↗
PubMed1991

Diagnosis and categorization of small bowel neoplasms: role of computed tomography.

A retrospective study of 35 patients with small bowel neoplasms studied by computed tomography (CT) was performed. The tumor detection rate was 80%. Using the findings reported in the literature, an adequate histological diagnosis could be performed in 69% of the cases by CT. Lipomas, leiomyomas, leiomyosarcomas, and carcinoid tumors were well-recognized, but adenocarcinomas and lymphomas were often mistaken one for the other. An accurate preoperative staging was performed in 61% of the cases. CT failed to detect 75% of the invaded lymph nodes, 25% of the liver metastases, and 25% of the tumoral growth beyond the bowel wall. Despite major limitations in preoperative staging, a good detection rate and some features allowing a specific diagnosis advocate using CT along with the barium examination when clinical history suggests a small bowel tumor.

Adenocarcinoma↗
PubMed1990

[Imaging of malignant lymphoma of muscular sites].

Seventeen cases of muscular lymphoma are reported (5 primary non-Hodgkin lymphoma, 11 secondary NHL, 1 secondary Hodgkin's disease). The psoas or gluteus muscle was involved in 10 cases, and the lower limb was affected in the remaining 7 cases. Nine cases of muscular extension of bone NHL are also reported. On sonograms these lesions were always large and less echogenic than adjacent structures, with no signs of necrosis before treatment. US and CT patterns were comparable for both primary and secondary lesions, regardless of the type of lymphoma or whether or not there was any previous bone lesion. Associated lymphomatous lesions were observed in 14 cases. On angiograms, muscular lymphomatous involvement presented a hypovascular pattern. While ultrasonography is an excellent monitoring technique for soft tissue lymphomas (specially for the lower limbs), a major contribution of CT is the detection and the follow-up of deep or thoracic wall lesions.

Adolescent↗
PubMed1990

[Tomodensitometric aspects of brain lymphomas: apropos of 19 cases. Brain lymphoma].

The authors present the results of CT studies for 19 patients with cerebral lymphoma (including 12 primary tumors). CT appearances varied considerably, because 5 of the 12 primary lymphomas presented as multifocal lesions, and lesion sites included the corpus callosum (3 cases), the central caudate nucleus (4 cases), the posterior fossa (3 cases), and the cerebral hemispheres (6 cases). These findings are in agreement with literature data. Although a solitary, hyperdense and homogeneous lesion in the corpus callosum or the central caudate nucleus is indicative of cerebral lymphoma, numerous other aspects are possible and owing to the increasing frequency of this pathology should suggest this diagnosis. There is no specific appearance for secondary lymphomas, but diagnosis is often facilitated by concomitant systemic involvement.

Adult↗
PubMed1990

[Contribution of x-ray computed tomography and MRI to the surgical diagnosis of bronchial cancers. Comparative evaluation of x-ray computed tomography, MRI and thoracotomy in 111 cases].

Computed tomography and magnetic resonance imaging have respectively decreased the incidence of exploratory thoracotomy by 11.6% to 5.7% then 5.3% after their successive inclusion in the assessment of the operability of lung cancers. Based on a systematic comparison of CT and MRI with exploratory thoracotomy in 111 patients, the yield, sensitivity and positive predictive value of these examinations was assessed in relation to tumour extension to various sites: to the chest wall, for which the sensitivity was poor (38% for CT, 54% for MRI) with a moderate predictive value (71% for CT, 77% for MRI); to the mediastinum with improved sensitivity (69% and 72%) but an uncertain predictive value (61% and 72%). The sensitivity and predictive value were then measured for lymph node involvement: N1: moderate sensitivity (69% and 76%) but a good predictive value (95% and 92%); N2 and N3: good sensitivity (79% and 93%) but a poor predictive value (70% and 66%). Apart from a few particular indications specific to MRI, especially in the apex, left hilum and in contact with the atrium, the efficacy of these two investigations is very similar. However, their lack of specificity means that certain exploratory thoracotomies are still justified in order to assess the operability of the tumour. A surgical or mediastinoscopic anatomical assessment is still necessary for a good classification of lymph node extension of lung tumours.

Carcinoma, Bronchogenic↗
PubMed1989

[Delayed duodenal perforation caused by transhepatic biliary endoprosthesis].

Three cases of duodenal perforation which occurred after the placement of a biliary endoprosthesis, are reported. One intraperitoneal perforation required an immediate surgical intervention. The two other cases have been treated endoscopically and by transhepatic drainage, respectively. The mechanism of this delayed complication is discussed and the impact caused by the shape of the Carey-Coons endoprosthesis (Porges-Roche) analysed.

Aged↗
PubMed1988

Extraretroperitoneal abdominal malignant fibrous histiocytoma.

Seven cases of extraretroperitoneal abdominal malignant fibrous histiocytoma (MFH) are reported. The anatomic distribution was as follows: liver (2 cases), spleen with gastric and pancreatic involvement (1 case), mesentery (1 case), right mesocolon (1 case), left mesocolon (1 case), and urachus (1 case). These bulky lesions were often extensively necrotic; calcifications were seen in 2 cases. All 7 cases were investigated by ultrasonography (US) and computed tomography (CT). Barium studies were performed in 4 cases, and angiography in 3 cases.

Abdominal Neoplasms↗
PubMed1988

Bronchogenic carcinoma staging: CT versus MR imaging. Assessment with surgery.

One hundred and twenty patients with bronchogenic carcinoma were prospectively studied by both computed tomography (CT) and magnetic resonance imaging (MRI) during the 2 weeks preceding thoracotomy or mediastinoscopy. MRI scans included contiguous axial and coronal slices. Results of CT and MRI studies were compared with the surgical and pathological findings on the basis of the TNM classification. Although no significant difference was found between the two imaging methods for the evaluation of tumour extent, MRI appears to be a valuable imaging technique for left upper lobe and apical neoplasms. Comparison between the two techniques for mediastinal node evaluation showed that sensitivity of MRI is superior to CT in the left paratracheal, aortopulmonary and subcarinal node areas.

Adult↗
PubMed1988

[Imaging of renal metastases].

Metastases are the most frequent malignant tumors of the kidney, but these lesions are of late onset in neoplastic disease. The 19 cases reported here were all investigated with various imaging techniques (CT 12 cases, ultrasonography 12 cases, urography 8 cases, angiography 2 cases, MRI 1 case). The most common primary malignancies were lung cancer, melanoma and cancer of the contralateral kidney. In this series, 8 of the lesions were solitary, and 9 were unilateral. Tumor vascularity was evaluated in 15 cases: 14 of these lesions were hypovascular. The differential diagnosis includes small cysts, lymphoma, bilateral renal cancer, multiple small abscesses and multiple small infarcts.

Adult↗
PubMed1988

[Contribution and limits of x-ray computed tomography and magnetic resonance imaging in evaluating the extent of primary cancers of the bronchi].

The authors report the contribution and the limits of CT and MRI in the thoracic and extrathoracic staging of bronchogenic carcinoma. From data of a personal study and of the literature, findings and performances of CT and MRI are reported and compared for the evaluation of mediastinal and parietal extension and in the detection of nodes and metastases. Their respective places and indications are underlined.

Carcinoma, Bronchogenic↗
PubMed1987

Hepatic lipomas: ultrasound and computed tomographic findings.

Five cases of solitary hepatic lipoma are described. These rare tumors have ultrasound (US) and computed tomographic (CT) characteristics that suggest the diagnosis. As imaged by US, hepatic lipomas always correspond to a highly echogenic, well-limited lesion with posterior attenuation. Precontrast CT scans reveal a low-density lesion (-20 to -70 HU); following contrast material injection, the tumor density may either remain negative (pure hepatic lipoma) or become positive (limit, 40 HU) when there is an associated adenomatous component. Hepatic lipomas involve no risk of degeneration, and follow-up by US is sufficient. A case of lipoma of the falciform ligament and a case of a hepatic pseudolipoma are also described; sonograms were negative in both instances, and CT was required for diagnosis.

Adipose Tissue↗