Biomedical subjects

L B Haramati

Publications and source records attributed to L B Haramati.

24 records · Page 2Linked to original sources

PubMed1995

CT-guided automated needle biopsy of the chest.

OBJECTIVE: The purpose of this study was to determine the diagnostic accuracy and frequency of complications of CT-guided transthoracic needle biopsy done with an automated biopsy system. MATERIALS AND METHODS: Thirty-three consecutive biopsies were performed on 32 patients between February 1992 and July 1994 (mean age, 55 +/- 15 years; 18 men and 14 women). An 18-gauge (n = 28) or 20-gauge (n = 5) needle was used. Core specimens were submitted for pathologic examination in 10% formalin. No cytopathologist or frozen section analysis was available at the time of biopsy. All biopsies but one were performed by one chest radiologist. RESULTS: Thirty-one lung biopsies and two mediastinal biopsies yielded a mean lesion size of 4.0 cm (range, 1.2-13.0 cm). Postbiopsy pneumothorax occurred in three (9%) of 33 biopsies; none of the pneumothoraces required placement of a chest tube. The mean number of needle passes was 1.3 (+/- 0.6). Thirty biopsies (91%) yielded sufficient tissue for pathologic evaluation. The diagnoses included carcinoma in 14 cases, acute or chronic pneumonia in 4 cases, non-Hodgkin's lymphoma in two cases, and Kaposi's sarcoma, plasma cell granuloma, hypersensitivity pneumonitis, Pneumocystis carinii pneumonia, and fibrosis in one case each. One patient with a 1.5-cm nodule stable for 1 year on CT had fibrosis and chronic inflammation found on needle biopsy, and the nodule was considered benign. Overall, biopsies in 12 (80%) of 15 patients without carcinoma were diagnostic. In three patients, the tissue obtained was not representative of the underlying abnormality. The biopsy specimen showed only inflammatory changes in two patients who ultimately had proved carcinoma. One patient with multiple pulmonary infarcts due to tumor emboli showed evidence of only pulmonary infarct on biopsy. Three patients had insufficient tissue for analysis; none of the three had malignant tumor on follow-up. The sensitivity of CT-guided automated needle biopsy of the chest was 84%. CONCLUSION: CT-guided transthoracic needle biopsy of the chest done with an automated biopsy system is safe, with a pneumothorax rate comparable to that of skinny needle aspiration. An overall accurate tissue diagnosis was made in 26 (81%) of 32 patients. Biopsies in 12 (80%) of 15 patients without carcinoma were diagnostic, which compares favorably with the reported accuracy of skinny needle aspiration.

Biopsy, Needle↗

PubMed1993

Lung nodules and masses after cardiac transplantation.

Single or multiple lung nodules or masses were noted at chest radiography in 25 (9.7%) of 257 patients after cardiac transplantation. Two episodes occurred in each of three patients, for a total of 28 (10.9%) episodes in the 257 patients within the first 18 months after transplantation (transplantation performed between July 1987 and December 1990). Bronchoscopy, percutaneous needle biopsy, and open lung biopsy were performed as clinically warranted to establish a diagnosis. Infection was found in 21 instances (8.2%) in 18 patients. The most frequent pathogens were Aspergillus (n = 9 [3.5%]) and Nocardia (n = 7 [2.7%]). Aspergillus was hospital acquired in eight (89%) of nine patients and had a right-sided predominance (20 [74%] of 27 lesions). The nodules or masses appeared a median of 2 months after transplantation for Aspergillus (range, 0.5-12 months) and 5 months for Nocardia (range, 1-10 months). B cell lymphoma manifested as numerous nodules in two patients (0.8%). Although a variety of causes were found for post-cardiac transplantation nodules or masses, the majority (75%) were infectious.

Adolescent↗

PubMed1991

Complications after CT-guided needle biopsy through aerated versus nonaerated lung.

Findings in patients who underwent computed tomography (CT)-guided percutaneous needle biopsy (n = 131) of lung are described. In those in whom the needle traversed aerated lung, complications developed in 51% (40 of 79). The rate of pneumothorax was 46% (36 of 79). In those in whom the needle did not traverse aerated lung (n = 52), minor hemoptysis in one patient (2%) was the only complication (P less than .0001). When a percutaneous CT-guided lung biopsy needle does not traverse aerated lung, the likelihood of complication appears to be slight.

Air↗

PubMedDate not supplied

CT evaluation of mediastinal lymphadenopathy: noncontrast 5 mm vs postcontrast 10 mm sections.

OBJECTIVE: Two CT techniques were compared in the assessment of mediastinal lymph nodes: 5 mm thick sections without intravenous contrast medium and 10 mm thick sections with intravenous contrast medium. MATERIALS AND METHODS: Seventy-nine adult patients were examined by chest CT. From the level of the aortic arch through the level of the right middle lobe bronchus 5 mm thick sections were performed without intravenous contrast medium, followed by 10 mm thick sections of the same region with intravenous contrast medium. Two chest radiologists separately reviewed each CT method for each patient. Mediastinal lymph nodes were localized according to the American Thoracic Society scheme. Lymph node diameter was measured on the short axis. RESULTS: The 5 mm thick noncontrast sections permitted identification of more mediastinal lymph nodes than the 10 mm thick contrast enhanced sections (p < 0.01, signed rank test). The 5 mm thick unenhanced sections tended to show slightly (1-2 mm) larger nodes than the 10 mm thick contrast enhanced sections (stations 7, 10R, both reviewers, p < 0.05, signed rank test). Nodes with a short axis diameter > or = 8 mm were identified comparably well using either CT technique. CONCLUSION: The present study indicates that CT of the mediastinum using 5 mm thick sections, without intravenous contrast medium, is an appropriate scanning technique for evaluation of mediastinal lymphadenopathy.

Adult↗

PubMedDate not supplied

Calcification of the ligamentum arteriosum in adults: CT features.

OBJECTIVE: The present study describes the frequency and pattern of ligamentum arteriosum calcification seen on chest CT in adults. MATERIALS AND METHODS: We retrospectively reviewed 402 sequential unenhanced chest CT studies for ligamentum arteriosum calcification, atherosclerotic cardiac or aortic calcification, and granulomatous calcification. The pattern of calcification was characterized as curvilinear, punctate, or clumped. RESULTS: Mean patient age was 60 (+/- 18, range 18-97) years with 214 women (53%) and 188 men (47%). Of these patients 194 (48%) had calcification in the ligamentum arteriosum including 26 (6%) with calcification in the ligamentum arteriosum alone, 108 (27%) with atherosclerotic calcification, 11 (3%) with granulomatous calcification, and 49 (12%) with both. A total of 100 patients (25%) had no calcifications. In the study population 169 patients (42%) had atherosclerotic calcification, 32 (8%) had granulomatous calcification, and 75 (19%) had both. The patterns of calcification for the 26 patients with calcification of the ligamentum arteriosum alone were curvilinear (7 patients, 27%), punctate (17 patients, 65%), and clumped (2 patients, 8%). The pattern of ligamentum arteriosum calcification for the 108 patients with only atherosclerotic and ligamentum arteriosum calcification was curvilinear (28 patients, 26%), punctate (32 patients, 30%), and clumped (48 patients, 44%). The patients without any calcifications and the patients with ligamentum arteriosum calcification formed one group (based on their similarity in age, mean 47 years) with a prevalence of ligamentum arteriosum calcification of 21%. The patients with atherosclerotic and ligamentum arteriosum calcification formed a second group (mean age 71 years) with a prevalence of ligamentum arteriosum calcification of 65%. CONCLUSION: On unenhanced chest CT calcification of the ligamentum arteriosum is a common finding in adults and increases in prevalence with increasing age and atherosclerosis.

Adolescent↗

PubMedDate not supplied

Intrathoracic lymphadenopathy in patients with empyema.

PURPOSE: Our goal was to determine the prevalence of intrathoracic lymphadenopathy on chest CT in patients with empyema. METHOD: We retrospectively identified 27 patients (14 men, 13 women, mean age 43 years) with nontuberculous empyema examined with chest CT. All scans were reviewed by two of three board-certified radiologists for the presence of intrathoracic lymphadenopathy (> or = 1 cm, short axis) in an American Thoracic Society (ATS) nodal station or the internal mammary region. Differences were resolved by consensus. RESULTS: Thirteen (48%) patients with empyema had lymphadenopathy on chest CT. The mean number of enlarged lymph nodes for the patients with lymphadenopathy was 3.2 (SD +/-2.3, range 1-8). The mean size of the largest lymph node was 1.4 cm (range 1.0-2.5 cm). The lymphadenopathy was unilateral and ipsilateral to the empyema in seven (54%), bilateral in five (38%), and unilateral contralateral to the empyema in one. The distribution of lymphadenopathy according to ATS nodal stations was 4R (n = 8), 7 (n = 6), 10R (n = 5); n = 2 each 2R, 10L, 11L; and n = 1 each 11R, 2L, 4L, and 6. Four patients had internal mammary lymphadenopathy. Pleural fluid and smooth pleural thickening were present in each case. Four patients had follow-up CT after treatment. There was a decrease or resolution of the lymphadenopathy in each case. CONCLUSION: Intrathoracic lymphadenopathy is a common CT finding in patients with empyema and occurred in 48% of this series. In patients with smooth pleural thickening and pleural effusion, intrathoracic lymphadenopathy should not be used as a criterion to differentiate empyema from malignant or tuberculous pleural effusion.

Adolescent↗