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Biomedical subjects

M S Bankoff

Publications and source records attributed to M S Bankoff.

At least 19 recordsLinked to original sources
PubMed1992

Lymphadenopathy in sclerosing cholangitis: pitfall in the diagnosis of malignant biliary obstruction.

We retrospectively reviewed abdominal computed tomographic (CT) studies from 20 patients with sclerosing cholangitis and found evidence of abdominal lymphadenopathy in 13 patients. Enlargement occurred primarily in areas draining the liver, such as the gastrohepatic ligament or celiac axis (N = 8), the porta hepatis (N = 7), and the pancreaticoduodenal region (N = 2). One patient had reactive adenopathy and retroperitoneal fibrosis. The presence of benign reactive lymphadenopathy in at least one intraabdominal location was confirmed by pathological examination of excised lymph nodes in seven patients. Malignancy was excluded by surgical exploration or clinical follow-up. We conclude that enlarged lymph nodes are a common finding by CT in patients with sclerosing cholangitis. Enlarged reactive lymph nodes in this condition should not be mistaken for evidence of periportal metastasis or cholangiocarcinoma.

Adenoma, Bile Duct↗
PubMed1992

Long-term results after Russe bone-grafting: the effect of malunion of the scaphoid.

Twenty-five patients had Russe anterior corticocancellous bone-grafting between 1973 and 1984 for twenty-six symptomatic established non-unions of the scaphoid. The mean duration of follow-up was eleven years (range, seven to eighteen years). Twenty-one (81 per cent) of the twenty-six scaphoid bones united. We developed two rating scales to evaluate the results of the operation. One scale, based on objective findings, included the radiographic appearance of the wrist, the range of motion, and strength; the other scale, based on subjective findings, comprised function, pain, perception of a decrease in performance because of limitation of motion or strength, and satisfaction. These scales were used to compare the objective and subjective results in patients who had a malunion of the scaphoid in which the lateral intrascaphoid angle was more than 45 degrees convex dorsally between the proximal and distal poles (a so-called flexion or humpback deformity, which results in extension of the proximal fragment of the scaphoid at the radiocarpal joint) with the results in patients who had no such deformity. The lateral intrascaphoid angle was more than 45 degrees in thirteen (50 per cent) of the twenty-six wrists. Although the difference in the objective results between the wrists that had a malunion and those that did not have a malunion was highly significant (p = 0.001), there was no significant difference in the subjective results between the two groups, including satisfaction of the patient (p = 0.39). Twenty-three patients (92 per cent) returned to full-time employment and twenty-two (88 per cent), to sports activities. Twenty-three patients (92 per cent) reported that they had pronounced relief of pain and that the procedure had improved their quality of life. The presence of this deformity of the scaphoid after bone-grafting for a symptomatic non-union was not predictive of a poor long-term subjective outcome.

Adolescent↗
PubMed1991

Computed tomography-guided minithoracotomy for the resection of small peripheral pulmonary nodules.

Small peripheral pulmonary nodules ranging in size from 1 mm to 20 mm were excised in 58 patients. Computed tomography was used to mark the skin overlying the nodules to minimize the surgical exposure needed for operative identification. The nodules were 1 cm or less in maximum diameter in 76% of the patients. Twenty-six patients had single nodules and 32 patients had multiple nodules. The preoperative diagnosis was inaccurate in 67% of the patients. In 61% of the patients in whom malignancy was suspected, no tumor was demonstrated. Conversely, of the 20 patients in whom a malignant nodule was excised, the preoperative diagnosis was correct in only 50%. Thirty-one patients required no further treatment apart from their biopsy and 27 required additional intervention. Small peripheral pulmonary nodules require biopsy for diagnosis. When percutaneous needle aspiration biopsy is unsuccessful, or technically difficult, a computed tomography-guided thoracotomy is an effective and minimally invasive surgical alternative.

Adult↗
PubMed1990

Fine needle aspiration biopsy in the diagnosis of renal angiomyolipoma.

Exclusive reliance on radiographic techniques for the diagnosis of renal angiomyolipoma can lead to misdiagnosis when the histological status is atypical, computerized tomographic findings are equivocal or renal cell carcinoma coexists. We report our experience and those of others in combining fine needle aspiration biopsy and radiological imaging to identify renal angiomyolipoma. Fine needle aspiration biopsy is safe and provides accurate histological diagnosis of renal angiomyolipoma.

Aged↗
PubMed1989

Clinically significant adrenal hemorrhage secondary to metastases. Computed tomography observations.

Clinically significant adrenal hemorrhage due to adrenal metastases has rarely been reported. We describe three cases of this unusual entity, two from lung carcinoma and one from sarcoma. Adrenal hemorrhage was bilateral in two patients, and was the presenting manifestation of malignancy in two. A computed tomography diagnosis of hemorrhage within bilateral adrenal metastases was made when adrenal masses rapidly enlarged in one case, and when previously resolving hematomas showed enlargement in a second case. The third case was believed to represent a pheochromocytoma preoperatively. We conclude that significant adrenal hemorrhage can result from adrenal metastases and can be the presenting manifestation of metastatic tumor. In the patient without discernible risk factors for adrenal hemorrhage, underlying malignancy should be considered as a possible cause, even if the hemorrhage is bilateral.

Adrenal Gland Diseases↗
PubMed1989

Parathyroid adenoma associated with neurofibromatosis: correlative scintigraphic and magnetic resonance imaging.

Correlative imaging by dual-isotope thallium/technetium subtraction scintigraphy, computed tomography, and magnetic resonance imaging demonstrated a pathologically proven parathyroid adenoma in a 62-year-old man with known neurofibromatosis, who presented with hypercalcemia and an elevated parathormone level. The association between neurofibromatosis and primary hyperparathyroidism is discussed.

Adenoma↗
PubMed1989

Lymphadenopathy in primary biliary cirrhosis: CT observations.

The authors retrospectively evaluated computed tomographic (CT) scans obtained in 21 patients with primary biliary cirrhosis, 13 of whom subsequently underwent liver transplantation. Evidence of enlarged lymph nodes, primarily in the gastrohepatic ligament and porta hepatis, was seen on CT scans in 17 patients (81%). Lymphadenopathy also occurred in unusual sites for benign adenopathy, including the paracardiac (24%) and mesenteric (19%) lymph nodes. Surgical or autopsy confirmation of enlarged lymph nodes was made in 13 patients, and histologic analysis of the specimens revealed reactive hyperplasia, sinus hyperplasia, sinus histiocytosis, fibrosis, or normal architecture in these enlarged nodes. The authors conclude that lymphadenopathy is a frequent CT finding in primary biliary cirrhosis and that recognition can help prevent misdiagnosis of lymphoma or metastatic disease.

Adult↗
PubMed1988

A comparative study of magnetic resonance imaging versus computed tomography for the evaluation of maxillary and mandibular tumors.

The relative value of magnetic resonance imaging (MRI) versus computed tomography (CT) for imaging benign and malignant lesions of the maxilla and mandible was studied in a group of 16 patients. The imaging methods were evaluated for their ability to detect the lesion and define lesion margins, soft tissue extension, and bone involvement. The abnormality was identifiable with both imaging methods. For benign cystic lesions of either the maxilla or mandible (50%), MRI was overall equal to or better than CT. Magnetic resonance imaging was superior to CT in the evaluation of lesion margins and soft tissue extent of disease, whereas it was equal or slightly inferior to CT in lesion detection and in the evaluation of bone involvement. In the imaging of malignant neoplasms (50%), MRI was overall superior to CT in all four categories reviewed. Magnetic resonance imaging also had the highest rate of correlation with clinical findings, either from physical examination or at the time of surgery.

Adolescent↗
PubMed1987

Mediastinal lymph node evaluation by computed tomography in lung cancer. An analysis of 345 patients grouped by TNM staging, tumor size, and tumor location.

To more clearly characterize the role of computed tomography in staging the mediastinal lymph nodes of patients with lung cancer, we analyzed computed tomographic and surgical findings in the chest in 345 consecutive patients with lung cancer who underwent operative staging. Patients were grouped according to the TNM staging system of the American Joint Commission, central or peripheral location of the primary tumor, lobar location of the tumor, and maximum tumor diameter as determined by computed tomography or gross pathology. One third of patients with abnormal findings on the computed tomographic scan did not have mediastinal lymph node metastases. Mediastinal metastases occurred frequently in patients with central cancers (38%). The predictive value of a negative scan in all patients was high (greater than or equal to 90%) except for patients with central T3 lesions (72%), left upper lobe lesions (83%), and central adenocarcinomas (75%). However, only the differences between central T3 and central T2 or T1 lesions, and between central adenocarcinomas and central squamous cell carcinomas, were unlikely to be due to chance alone (p less than 0.05). None of the lobar differences were statistically significant. The frequency of mediastinal metastases in patients with peripheral lesions was 15% (28 of 192 patients); computed tomography correctly identified enlarged mediastinal lymph nodes in all but seven patients. However, there were no true-positive computed tomographic scans in 59 patients with peripheral lesions 2 cm in diameter or smaller; accordingly, we suggest that computed tomography is not indicated for the sole purpose of mediastinal staging in this group. Ninety-four percent of patients in this series undergoing thoracotomy with a curative intent had a curative resection. Only 4% had unresectable lesions; palliative resections were done in 2%.

Adult↗
PubMed1986

Use of computed tomography in the preoperative evaluation of patients with head and neck tumors.

Computed tomography (CT) is a sensitive, noninvasive radiographic technique which can produce detailed cross-sectional images of any anatomic region. The amount and accuracy of the information it provides far exceeds that produced by conventional radiographic techniques. The chemosurgeon can find CT scanning invaluable in his preoperative evaluation of patients with large, invasive head and neck tumors of cutaneous origin.

Aged↗
PubMed1986

Computerized tomographic evaluation of tumors of the nasopharynx and maxillary sinus: potential impact on results of treatment.

A review of 23 consecutive patients with tumors of the nasopharynx and maxillary sinus seen over a two-year period was carried out. The purpose was to assess the value of computerized tomography (CT) in the definition of tumor extension to contiguous structures and its effect on treatment selection and management.CT was found to be very useful in detailing bone and soft-tissue invasion. In 11 of 15 patients with nasopharyngeal cancer and in the eight patients with maxillary sinus tumors, the selection of treatment and the techniques of irradiation were influenced by the CT findings.There is a high degree of accuracy in the evaluation to the nasopharynx and maxillary sinus by CT. This improvement in pretreatment assessment of the tumors enables adequate treatment to be offered. Since most of the failures of treatment are a result of local recurrence, improvement in local control is likely to result in improved survival.

Humans↗
PubMed1985

Congenital pericardial defect diagnosed by computed tomography.

Complete or partial absence of the pericardium is a relatively rare disorder. While physical examination, electrocardiogram, and chest x-ray may suggest the diagnosis, definitive noninvasive diagnosis has until recently not been possible. In the patient described in the present report, the basis for chest pain initially attributed to myocardial ischemia was established noninvasively by computed tomographic examination of the chest to be congenital absence of the left pericardium. Experience with this patient emphasizes the fact that one of the known bases for nonischemic chest pain--congenital pericardial defects--can be precisely defined by contrast-negative computed tomographic imaging.

Adult↗
PubMed1985

CT detection of necrotising enterocolitis.

Necrotising enterocolitis may occur as a complication of granulocytopenia of any aetiology. The clinical presentation may be non-specific and the diagnosis therefore depends heavily on radiographic findings, particularly changes seen by CT. In immune-compromised patients being investigated for possible abdominal sources of fever, CT may be particularly helpful in elucidating bowel sources of infection. Two cases of necrotising enterocolitis demonstrated by CT are presented. The two cases were in immune-compromised patients with malignant disorders who presented with fever. The CT findings of this disorder are presented.

Adult↗
PubMed1984

Hemochromatosis simulating hepatoma by computed tomography.

Computed tomography of the liver in hemochromatosis characteristically demonstrates diffusely increased attenuation. We report a patient with this disorder who presented with such a finding over the right lobe of the liver and a benign, large lower density area occupying the other lobe, closely simulating malignancy. Biopsies of the liver showed prominent fibrosis of the left lobe as compared with the right lobe, which probably accounts for the attenuation difference.

Adult↗
PubMed1984

Computed tomography differentiation of pyelonephritis and renal infarction.

Acute renal infarction and acute pyelonephritis can have identical clinical presentations. Most of the computed tomography findings seen in acute renal infarction are similar to those in acute pyelonephritis, except for the characteristic cortical rim sign seen in acute infarction. This finding differentiates these two disorders. This sign may be subtle and not appreciated unless searched for diligently with appropriate computed tomography imaging at varying window settings with particular attention to the subcapsular region.

Acute Disease↗
PubMed1984

Combined posteroanterior subepicardial fat simulating the echocardiographic diagnosis of pericardial effusion.

The location and relative size of echo-free spaces observed by cardiac ultrasound have been considered reliable signs for distinguishing pericardial fat from fluid; spaces that are exclusively anterior have been considered to represent fat, while spaces that are exclusively or predominantly posterior have been considered to represent fluid. In the present study, the location and relative size of echo-free spaces in eight patients suggested the diagnosis of pericardial effusion; evaluation by computed tomography or thoracotomy, or both, in six and necropsy in two, however, disclosed that these echo-free spaces--posterior as well as anterior--were exclusively due to fat. Age appeared to be as important a predisposing factor as obesity in the accumulation of excess subepicardial fat. No M-mode or two-dimensional features were found to be reliable in differentiating fat from fluid, although excessive amplitude of the posterior pericardial echo on the M-mode study favored the diagnosis of fat. Thus, the finding of echo-free spaces by cardiac ultrasound, even when the posterior space is isolated or larger than an accompanying anterior space, is not necessarily indicative of pericardial fluid. In elderly patients, in particular, posterior echo-free spaces due to fat may invite an incorrect diagnosis of pericardial effusion or pericarditis. In patients in whom echo-free spaces represent an unexpected finding of cardiac ultrasound examination, computed tomography of the chest may be helpful in establishing whether they are due to fat or fluid.

Adipose Tissue↗