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Biomedical subjects

L V Ackerman

Publications and source records attributed to L V Ackerman.

At least 19 recordsLinked to original sources
PubMed1994

Periosteal Ewing sarcoma.

PURPOSE: To evaluate the imaging and histopathologic findings and clinical course of patients with periosteal Ewing sarcoma (PES). MATERIALS AND METHODS: Conventional radiographs, computed tomographic (CT) scans, and magnetic resonance (MR) images in 10 adolescents and one adult were evaluated for the extent and character of PES. RESULTS: Ten of 11 masses were in the proximal extremities and one in the fibula; nine were diaphyseal and two, metadiaphyseal. Radiographs and CT scans showed a subperiosteal mass that did not invade the medullary cavity, was contiguous with and elevated the periosteum, and produced a Codman triangle and periosteal reaction. No PES exhibited osseous or cartilaginous matrix calcifications. MR imaging and histopathologic examination helped confirm the sparing of cancellous bone and the subperiosteal location. CONCLUSION: PES differs from the more common medullary and soft-tissue Ewing sarcomas in location, marked male predominance, and lack of presenting metastases. Except for the absence of matrix calcifications, PES resembles other periosteal sarcomas in imaging characteristics and a less aggressive clinical course.

Adolescent↗
PubMed1993

Bone metastases as the presenting manifestation of rhabdomyosarcoma in childhood.

Rarely, rhabdomyosarcoma can present with bone pain and bone lesions on radiographs without evidence of a primary tumor. Of 428 children with biopsy-proven rhabdomyosarcoma, four presented with radiographic evidence of bone metastases, but no primary tumor was found on subsequent evaluation. On radiographs, these metastases, located most commonly in the metaphyses of the extremities and in the spine, displayed a destructive or diffusely permeative pattern without sclerotic margins and mimicked the more common neuroblastoma. One patient also had diaphyseal cortical lytic metastases of the tibia. Radiographs defined metastases of the extremities better than the correlative bone scans. In the spine, on T2-weighted magnetic resonance (MR) images, metastases displayed high signal intensity which contrasted with the low-signal-intensity marrow in these pediatric patients. On histopathologic examination, metastatic rhabdomyosarcoma was composed of small cells of variable size, shape, and growth pattern similar to other round cell tumors. A positive desmin immunohistochemical test helped to establish the diagnosis. The radiologist, pathologist, and clinician should be aware of this unusual presentation of rhabdomyosarcoma so that suitable immunohistochemical tests are performed and appropriate chemotherapy given.

Adolescent↗
PubMed1992

Myositis ossificans with atypical clinical, radiographic, or pathologic findings: a review of 23 cases.

Myositis ossificans is a relatively rare, well-defined entity. The 23 cases sent for consultation to two of us (L.V.A. and A.N.) were reviewed. Clinical, radiologic, and microscopic information was reexamined, and special attention was given to features infrequently seen in typical myositis ossificans. Average age at presentation was 23 years, but 1 patient was younger than 2 years, and 2 were younger than 10 years. Due to the uncommon location of 15 lesions and an unusual presentation in 5, the correct diagnosis was not obvious in these cases. A history of trauma was elicited in 8 patients, denied by 7, and was not queried in the remainder. Radiologic studies raised the possibility of a malignant bone-forming tumor in at least three instances; myositis ossificans was originally diagnosed in 6 cases radiologically. In 8 cases, histologic evidence suggested malignancy, including osteosarcoma, either parosteal or extraosseous, in 6. Other diagnoses included epithelioid sarcoma and callus formation. Presentation of these variations from the norm highlights the importance of recognizing the evolution of a nonneoplastic fibro-osseous and cartilaginous entity in which conservative treatment is curative.

Adolescent↗
PubMed1991

Case report 697: Neuropathic arthropathy of the shoulder with no identified cause.

Two cases of neuropathic disease of the shoulder without evidence of a neurological disorder are described. The absence of any neurological disorder led to the cases being initially mistaken for primary neoplasms of bone, lending support to the vascular theory of pathogenesis of this lesion. Careful attention to the radiographic features and knowledge that a neurological disorder need not be present should lead to the correct diagnosis.

Adult↗
PubMed1991

Chondromyxoid fibroma: radiographic appearance in 38 cases and in a review of the literature.

Thirty-eight cases of histologically confirmed chondromyxoid fibroma were reviewed and their radiographic features recorded. These findings, coupled with a review of the English-language medical literature, suggest that this rare, benign bone tumor has a characteristic but not specific radiographic appearance and may often mimic more common tumors. Chondromyxoid fibroma may occur anywhere in the skeleton, but almost half of the cases occur around the knee. The possibility of chondromyxoid fibroma should always be considered when a focal bone lesion is evaluated that has geographic bone destruction, a sclerotic rim, lobulated margins, and septation. The diagnosis of chondromyxoid fibroma is most likely when the patient is in the 2nd decade of life.

Adolescent↗
PubMed1988

Digital radiography of the gastrointestinal tract.

The gastrointestinal tract lends itself quite well to digital imaging. Since fluoroscopy is already employed, the images can easily be obtained in digital format and several manufacturers have now developed systems for commercial use. Because of the type of pathology as well as the inherent subject contrast, it would appear the resolution requirements for digital imaging of the gastrointestinal tract are less than in other organ systems. The necessary resolution level is already technically available and feasible without significant cost. Digital imaging also holds promise of at least a modest reduction in radiation dose to the patient, as well as a reduction in costs, although these factors are operator dependent. However, digital imaging provides a latitude in performing the examination that is not available with screen-film systems. Finally, there is promise that by acquiring gastrointestinal images in digital format, manipulation of the images may help increase diagnostic accuracy by improving both technical and perceptive components of diagnosis. Not only will simple image manipulation be helpful but there is even potential for computer-assisted evaluation of gastrointestinal images.

Colitis, Ulcerative↗
PubMed1987

Digital gastrointestinal imaging: the effect of pixel size on detection of subtle mucosal abnormalities.

Five radiographs of double-contrast colon examinations demonstrating subtle mucosal changes of inflammatory bowel disease and five radiographs of healthy colonic mucosa were selected and digitized to four levels of resolution. Pixel sizes of 0.1 mm, 0.2 mm, 0.4 mm, and 0.8 mm were used. Ten radiologists interpreted the images, which were displayed on laser-printed film. Analysis of variance with repeated measures was performed and receiver operator characteristic curves were determined. The results demonstrate that the sensitivity in detecting subtle mucosal abnormalities improved as the resolution improved, with the best sensitivity at the highest resolution; more experienced readers detected details well even at the poorer levels of resolution; the resolution necessary for successfully evaluating the colonic mucosa was lower than expected; and given low noise levels, the matrix size used in conventional television fluoroscopy would be adequate for mucosal evaluation.

Colon↗
PubMed1986

Metastatic and pseudomalignant osteoblastoma: a report of two unusual cases.

Two unusual cases of osteoblastoma with different responses to radiation therapy are reported. A 15-year-old boy with an aggressive osteoblastoma of the ilium was treated initially with curettage and subsequently with radiation and systemic chemotherapy. The patient died 35 months after his initial presentation with distant metastases which were verified at autopsy. A 12-year-old girl developed a lesion of the femur with clinical and histologic features of aggressive osteoblastoma. Amputation was recommended at the time of recurrence, but the patient declined and radiation therapy was given. The patient was alive and well 14 years after her initial presentation. These cases highlight the biologic diversity of osteoblastoma-like lesions and illustrate the difficulties which may be encountered in attempting to differentiate between benign and malignant forms of this tumor.

Adolescent↗
PubMed1986

Breast lesions: differential diagnosis using digital subtraction angiography.

To evaluate its potential for differentiating benign from malignant breast lesions, digital subtraction angiography of the breast (DSAB) was performed in 23 women with mammographic evidence of disease, and the results were compared with surgical biopsy findings. The DSAB technique employed breast immobilization with modest compression and bolus injection; following the injection of contrast material, 30-40 sequential subtraction images were obtained over a 5-minute interval. The average technical settings were 50 k Vp and 10 mAs, resulting in an estimated radiation dose to the breast of 0.05 mrad (0.5 mu Gy) per exposure. DSAB consistently demonstrated retention of contrast material and abnormal vasculature in malignant lesions but not in benign lesions. In the 22 breast lesions for which there was histopathologic correlation, DSAB correctly categorized eight of nine malignant and 11 of 13 benign lesions. Although this series is small, the initial results of DSAB suggest its potential for differentiating benign from malignant lesions.

Adenocarcinoma↗
PubMed1985

Differentiation between benign and malignant disease of the breast using digital subtraction angiography of the breast.

The authors have investigated digital subtraction angiography (DSA) for the differential diagnosis of breast lesions detected initially by mammography. Eighteen patients scheduled for biopsy first underwent digital subtraction angiography of the breast (DSAB). Criteria for malignancy included the presence of abnormal vessels and a "blush" in the area of the lesion. A total of 17 lesions are currently available for histopathologic correlation. Although this is a small series, the initial results of DSAB suggest its potential utility for differentiating between benign and malignant lesions.

Angiography↗