Biomedical subjects
Publications and source records attributed to O S Cigtay.
Three patients with various pectus excavatum deformities in whom radiographic findings suggested hilar and mediastinal masses are presented. Computed tomography of the chest yielded valuable diagnostic information and made it possible to exclude the existence of these masses. Compression deformity of the heart and great vessels by the pectus deformity is the most likely explanation for these findings.
Sharply marginated defects were observed in the scapulae of five patients. In all cases the defects were benigh in appearance and unrelated to symptoms. These patients have been observed up to 5 years without change in the radiographic appearance. Recognition of the benign nature of these defects is important to avoid confusion with pathologic conditions.
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Prolapse of the gastric mucosa into the duodenum must be considered when a round soft tissue mass is seen in the right upper quadrant on scout abdominal film. Gastric prolapse may mimic tumor in the duodenum when the prolapse is large. Examination with barium meal is necessary to exclude prolapse of the gastric mucosa into the duodenum as a cause of epigastric pain and vomiting. Medical treatment is suggested for patients with mild symptoms, but patients with severe symptoms, repeated hemorrhage, anemia, severe intermittent epigastric pain and vomiting due to ball-valve syndrome should have operation.
Seven patients were identified who developed a palpable breast mass following augmentation mammoplasty. Xeromammography showed the "mass" to be a puckering or bulge in the Silastic implant.
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We have reviewed the spectrum of gaseous densities in the soft tissues secondary to a perforated viscus. All patients presented late and most were elderly. The most common surgical procedure was diversion of the fecal stream proximal to the perforation. In our series 4 of 7 patients died in the immediate postoperative period. Knowledge of the mechanism and differential diagnosis of this entity will prevent overlooking this possibility, as occurs too frequently, particularly with subcutaneous emphysema of the leg.
Primary amyloidosis is an interesting clinical entity in which amyloid is deposited in various organs, particularly mesodermderived tissues such as heart, skeletal muscle, skin, connective tissue and bone. A case with multiple lytic bone lesions is presented. Comparison to previous similar cases is made with attention being directed to the typical distribution of lesions about large joints with associated soft-tissue prominence and increase in the articular space. The differentiating radiologic features are compared to those of rheumatoid arthritis, hyperparathyroidism, and lytic metastatic lesions, with particular attention being given to the osteolytic lesions of plasmacytomas associated with multiple myeloma.