Diffuse interstitial lung disease due to AA amyloidosis.
A man developed interstitial lung disease and nephrotic syndrome due to AA amyloidosis. There was no evidence of an underlying disease predisposing to amyloidosis.
Biomedical subjects
Publications and source records attributed to M Brauner.
A man developed interstitial lung disease and nephrotic syndrome due to AA amyloidosis. There was no evidence of an underlying disease predisposing to amyloidosis.
Standard radiography of the chest shows pulmonary infiltration and is determinant for the diagnosis of chronic diffuse infiltrative lung diseases. Since lung biopsy is an invasive exploratory technique, using computed tomography (CT) in the diagnostic approach is perfectly justified as a direct prolongation of plain radiography. CT identifies patients who, in spite of normal chest X-ray films, do have pulmonary infiltration. It is superior to radiography in suggesting the correct aetiological diagnosis, as it provides signs that are more discriminant than the radiographic signs. It also gives a better approach to the localization of lesions, thereby helping in guiding lung biopsies. Finally, once the diagnosis has been made CT remains useful in evaluating the effects of treatment of pulmonary lesions and in detecting possible complications.
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Four patients with macronodular tuberculosis of the liver were examined with ultrasonography. The findings included 1 case with multiple hypoechoic areas and 3 cases with a solitary lesion, one hypoechoic mass without calcifications, and two partially calcified masses. Some ultrasound features are suggestive: a mass with irregular calcifications, ascites, spleen enlargement with defects, enlarged nodes, and complete resolution of the lesions in a few months with effective antituberculous therapy. The first case was also examinated with computed tomography.
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A retrospective study was carried out in 160 patients explored by ultrasound guided cytopuncture and hepatic microbiopsy for focal lesions of liver over a 5 1/2 year period. Results are analyzed as a function of clinical and ultrasound findings, the frequency of unexpected histology (20 cases) being emphasized and justifying the wide use of hepatic microbiopsy.
The case reported involved a large villous adenoma of the gallbladder with areas of carcinoma in situ, investigated by ultrasonography and CT. These imaging methods highly sensitive in the detection of such lesions are virtually non specific in terms of their nature and only the large size of the lesion should lead to suspicion of malignant change.
The authors report 7 serious haemorrhagic complications of transparietal liver biopsies and define the place of ultrasonography in the prevention of certain accidents, in the diagnosis and assessment of hepatic lesions and in follow-up of the subsequent course.
Two cases of isolated traumatic rupture of gallbladder are reported, including results of ultrasound and CT scan imaging, and the relevant literature reviewed. Preoperative diagnosis is suggested by presence of a perivesicular collection. Fine needle puncture aspiration of the collection provides confirmation of diagnosis if a bilious or biliohemorrhagic fluid is withdrawn.
Two cases of abdominal sarcoidosis with radiologic signs are presented. One patient had signs of a calcified splenic pseudo-tumor without other evidence of sarcoidosis, the other a typical pulmonary lesion with parietal infiltration of duodenum on esophagogastroduodenal follow-through radiography. Radiologic forms of splenic and gastroduodenal sarcoidosis reported in the literature are reviewed.
Ultrasound examination in 8 patients with occlusive jaundice demonstrated non-lithiasic extrahepatic intracanalar obstacles, a malignant tumor in 4 and a non-tumoral process (granuloma on suture thread, ball sludge, hemobilia in 2 cases) in the other 4. Analysis of echographic data suggested possible differential diagnosis criteria for these two types of occlusion.
Seven cases of cirrhosis with non-tumoral nodules on ultrasound imaging are reviewed. Comparison of ultrasound and histopathologic data provided information on mode of formation and pathologic significance of these images. They correspond usually to a particular distribution of fibrosis and steatosis, exceptionally to regenerating nodules. Nodule formations seen on ultrasound images are independent of histopathologic criteria defining micro- and macro-nodular cirrhosis. Ultrasound guided cytohistology is the only examination allowing their distinction from true tumoral lesions.
In reference to 4 severe cases of oligo-amnios of the second trimester of pregnancy, the authors advocate a method in order to improve the pre-natal diagnosis by intra-amniotic injection of a normal saline solution. This method facilitates the morphological exploration of the fetus by sonogram and enables to obtain a fetal karyotype by umbilical or amniotic tap. The potential risk of this technique are described.
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A semeiologic and anatomic code for ultrasound imaging data has been in use for 3 years. A simple index, it allows coding under specific headings of almost all ultrasound record sheets and can be modified as a function of the requirement of different departments. It is also perfectly well adapted for inclusion in a data-processing system.
Ultrasound images in 6 patients with hyperechogenic "pseudo-nodules" of diaphragmatic origin were analyzed. In each case the findings corresponded to variations in curve of right diaphragmatic dome on radiology, but these diaphragmatic bumps were not associated routinely by a pseudo-nodule. A semiologic explanation for the formation of the ultrasound image is suggested.
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