Renal cell carcinoma presenting as femoral neuropathy.
Explore the source record for details and available documents.
Carcinoma, Renal Cell↗
Biomedical subjects
S Apter
Publications and source records attributed to S Apter.
Primary striated muscle lymphoma presenting in an amputation stump.
Explore the source record for details and available documents.
Amputation Stumps↗
Castleman's disease. An uncommon computed tomographic feature.
A case of localized intrathoracic Castleman tumor demonstrated, on CT scan, calcifications in a circumferential distribution. The prevalence of calcifications in Castleman's disease and the differential diagnosis of the above unusual CT findings are discussed.
Adult↗
Villonodular synovitis of the shoulder in the elderly.
Villonodular synovitis of the shoulder developed in two elderly patients. Huge soft tissue mass, marked joint effusion, and radiographs demonstrating severe osteoarthritic changes characterized these patients. Localized shoulder muscle atrophy accounts for residual painfree limitation of active shoulder motion following synovectomy of the shoulder joint.
Aged↗
Right ventricular thrombus and pulmonary arteritis in Behçet's disease.
Prolonged fever, splenomegaly and right ventricular thrombus are rare manifestations of Behçet's disease. We report a 15-year-old boy with Behçet's disease who presents with these unusual manifestations.
Adolescent↗
Ultrasonography in the staging of Hodgkin's disease: lymphangiographic correlation.
The contribution of ultrasonography (US) to the staging of Hodgkin's disease was studied in 45 patients. US findings were compared with lymphangiograms (LAG) performed in the same period. In 93% of the patients there was good correlation between the two examinations. In 7% (three patients) there was a discrepancy: LAG showed retroperitoneal node involvement while with US this was negative. There were no false-positive US examinations. We therefore suggest that US be used as the primary method in the initial evaluation of Hodgkin's disease and LAG be performed only when US is negative.
Hodgkin Disease↗
Asymptomatic long-standing idiopathic hypoparathyroidism discovered following delivery of a healthy infant.
A case of long-standing idiopathic hypoparathyroidism that remained asymptomatic during pregnancy is described in a 25-year-old primipara. Clinical signs including carpopedal spasm, convulsions, and acute psychosis developed after the patient gave birth to a healthy infant. In contrast to previous reported cases, no signs of osteitis fibrosa cystica were found in the infant. This is believed to be the first such case described.
Adult↗
Diagnosis of osteoid osteoma using computerized tomography.
A thirty-seven-year-old male with Osteoid Osteoma of the proximal ulna is described. He had suffered from pain in his elbow for two and a half years prior to diagnosis. Computer Tomography demonstrated and localised the nidus which was surgically removed.
Adult↗
CT demonstration of urinary bladder displacement causing medial deviation of the distal ureter.
Medial displacement of the lower end of the ureter is usually indicative of a mass lesion in the pelvis. We present two women in whom medial deviation of a distal ureter was shown by computed tomography to be caused by a full bladder itself indented by the posteriorly situated uterus.
Adult↗
Urinomas caused by ureteral injuries: CT appearance.
BACKGROUND: We report the computed tomographic (CT) features of urinomas caused by ureteral injuries which are often not clinically suspected, causing delay in diagnosis. METHODS: CT studies of 12 patients with ureteral injury were reviewed. Ureteral injuries were iatrogenic in 9 patients and traumatic in the remaining three. CT was performed between 2 and 139 days (average = 33 days) after the insult. The most common presenting symptoms were severe abdominal pain and fever. All CT studies were performed before and after intravenous contrast administration. In 11 of 12 cases, delayed scanning was added 15 min to 5 h later. RESULTS: The sites of injury were the proximal ureter in two patients, the middle ureter in three, the distal ureter in two, and the ureteral anastomosis in five. The urinomas appeared as confined water-density fluid collections in seven patients, as free fluid (urinary ascites) in two, and as both in three. Extravasation of contrast from the ureter was observed on early scans in six patients and on delayed scanning only in the other six. The density of the opacified urinoma measured 80-200 HU. Ipsilateral hydronephrosis was observed in seven patients. Ureteral injuries were treated conservatively in eight patients and surgically in four. CONCLUSION: Ureteral injuries after iatrogenic or penetrating trauma often are diagnosed with considerable delay. The presence of ascites or localized fluid collections in symptomatic patients after abdominal surgery or penetrating trauma should raise the possibility of a ureteral injury and prompt delayed scanning.
Adolescent↗
Typhlitis as a rare cause of a psoas abscess.
Typhlitis is a life-threatening necrotizing process of the cecum associated with leukemia patients who have undergone chemotherapy. We present a rare complication of typhlitis in a boy with leukemia, in whom a right psoas abscess developed secondary to the inflammatory process of the cecum, with an emphasis on the computed tomographic findings of this severe and potentially life-threatening complication. Typhlitis should be added to conditions of the gastrointestinal tract that cause a psoas abscess such as Crohn's disease, diverticulitis, appendicitis, colorectal carcinoma, and appendiceal tumor.
Adolescent↗
Perforations of the rectosigmoid colon induced by cleansing enema: CT findings in 14 patients.
BACKGROUND: We report the computed tomographic (CT) features of colorectal perforations caused by cleansing enema. METHODS: We reviewed the medical records and CT studies of all patients with colorectal perforations caused by a cleansing enema. RESULTS: Fourteen patients (10 men, four women; average age = 80 years) were included in the study. The most common presenting symptoms were severe abdominal pain and fever. CT was performed within 48 h after the event in most patients. Extraluminal air in the perirectal fat was the most frequent finding on CT and was present in all patients. Additional findings were extraperitoneal ( n = 9), intraperitoneal ( n = 3) and /or subcutaneous ( n = 3) air, free fluid ( n = 9), extraluminal feces ( n = 8), and focal bowel wall thickening ( n = 4). No leak of contrast from the rectum was observed in any patient including the one patient in whom contrast was administered rectally. Ten patients were treated by surgery; five recovered and the other five died. The other four patients were treated conservatively and all four died. CONCLUSION: The diagnosis of colorectal perforation can be made on CT. Because the diagnosis is not always suspected by the clinician, the radiologist may be the first to suggest it. Therefore, the radiologist should be familiar with the CT features of a potentially lethal, rectally induced perforation.
Abdominal Pain↗
Importance of accurate preoperative diagnosis in the management of aggressive angiomyxoma: report of three cases and review of the literature.
BACKGROUND: Aggressive angiomyxoma is a benign but locally aggressive tumor that occurs mostly in young women. Because excision is often incomplete, the risk of local recurrence is high. This report describes differences in presentation and the importance of accurate preoperative diagnosis of this rare neoplasm. METHODS AND RESULTS: We describe three cases with different presentations. Two were initially misdiagnosed, and local recurrence necessitated reoperation. Accurate diagnosis in the third case was followed by complete excision, with no recurrence. CONCLUSION: Aggressive angiomyxoma should be considered in the differential diagnosis of young women who present with a well-defined mass in the pelvic tissue. Accurate preoperative diagnosis should alert the surgeon to the need for wide excision, which is essential for prevention of local recurrence.
Adult↗
Postoperative pneumoperitoneum as detected by CT: prevalence, duration, and relevant factors affecting its possible significance.
BACKGROUND: To determine the prevalence and duration of postoperative pneumoperitoneum as detected on computed tomography (CT) and to evaluate factors that influence postoperative pneumoperitoneum. METHODS: One hundred three CT examinations of 89 patients performed after abdominal surgery for various indications were prospectively collected and reviewed. The presence and volume of free air were noted and correlated with patients' sex, age, and habitus, with the time interval between surgery and CT, with the type of surgery, and with the presence of drains. RESULTS: Pneumoperitoneum was seen in 44% of examinations performed in the first 3 days after surgery and in 30% between the 4th and 18th postoperative days. The prevalence and volume of free air decreased with the time interval between surgery and CT. It was not detected in any of the 11 examinations performed beyond the 18th postoperative day. The volume of free air in the majority of examinations did not exceed 10 mL and ranged from 0.2 to 10 mL in 19 patients (66% of patients with free air). Larger volumes of free air, ranging from 10 to 20 mL and from 20 to 40 mL, were observed in 5 (17%) and 4 (14%) patients, respectively, and only one patient had more than 40 mL of free air. Free air was found significantly more often in male and in asthenic patients; age had no significant effect. Free air was more prevalent in the presence of drains. The type of surgery did not significantly influence the prevalence of postoperative pneumoperitoneum, although it was noted slightly less often after laparoscopic surgery than after open laparotomy. CONCLUSIONS: Pneumoperitoneum is a common phenomenon after abdominal surgery, decreasing in frequency with time. The air is most often residual and not a sign of disruption of the gastrointestinal tract. Obesity, female sex, and occurrence of free air several weeks after surgery are factors suggestive of a leak, but the significance of a postoperative pneumoperitoneum on CT should be determined mainly by the clinical setting.
Abdomen↗
Complications after laparoscopic gynecologic procedures: CT findings.
Laparoscopic gynecologic surgery has gained worldwide popularity in the past few years, but complications of this new technique do occur. We encountered three patients who developed major complications after laparoscopic gynecologic procedures including perforation of the sigmoid colon, urinary bladder, and ureter. We report the computed tomographic findings of these cases and the diagnostic dilemmas they posed.
Adult↗
Widespread abdominal venous thrombosis in paroxysmal nocturnal hemoglobinuria diagnosed on CT.
Paroxysmal nocturnal hemoglobinuria is a rare disorder characterized by pancytopenia. One of the main manifestations of this disease is development of widespread life-threatening venous thrombosis, which may involve multiple abdominal veins. We describe two patients with paroxysmal nocturnal hemoglobinuria with clinically unsuspected portal, splenic, and mesenteric venous thromboses that were diagnosed on computed tomography. This complication should be clinically suspected in patients suffering from paroxysmal nocturnal hemoglobinuria who present with abdominal pain, and it should be sought by the radiologist on pre- and postcontrast computed tomography.
Abdomen↗
Urinary excretion of orally ingested gastrografin on CT.
Renal excretion of orally ingested gastrografin has rarely been reported on computed tomography (CT). We studied the unenhanced scans of 82 patients with bowel disorders or perforation to assess the prevalence of urinary contrast material (CM) in various bowel diseases. We also assessed the clinical significance of this sign. In addition, we reviewed the unenhanced CT scans of 100 randomly selected patients without bowel diseases as a control group. Twenty-nine of the 58 patients with bowel diseases, six of nine with free perforation, and one of 15 with covered perforation had CM in the urinary tract. None of the 100 without bowel disease showed urinary CM. Statistical analysis was done by using the Fisher's exact test. The prevalence of urinary CM was highest in inflammatory bowel disease, radiation enteritis, and free perforation (p < 0. 0001). This study shows that the CT finding of orally ingested gastrografin in the urinary tract differentiates patients with bowel disease from those without.
Administration, Oral↗
Polysplenia syndrome detected in adulthood: report of eight cases and review of the literature.
BACKGROUND: To present the computed tomographic (CT) features of the abdominal anomalies consistent with polysplenia syndrome in adults. Awareness of these abnormalities may avoid misdiagnosing characteristic findings as separate pathological processes. METHODS: Imaging studies, mainly abdominal CT scans, of eight patients were reviewed. Attention was directed to the location of the multiple spleens, stomach, and liver and to the possible presence of a short pancreas, malrotation of the intestine, and venous anomalies. We also reviewed the CT findings of 15 adult patients described in the literature. RESULTS: Three men and five women underwent CT for various unrelated conditions. The most common findings were multiple spleens along the greater curvature of the stomach, which were located in the right upper quadrant in six patients. The inferior vena cava was seen on the left side in seven subjects, with azygos/hemiazygos continuation in six. A preduodenal portal vein was present in seven subjects. The liver was in the midline in four patients and on the left side in two. A short pancreas was seen in four patients, intestinal nonrotation in five, and dextrocardia in two. The prevalence of these anomalies was similar to that of the reviewed cases. CONCLUSIONS: CT proved to be an excellent imaging modality in the diagnosis of the abdominal anomalies. Some of these (a short pancreas, multiple spleens, and azygos continuation) can simulate pathological processes. Hence the importance of recognizing these CT findings as part of a syndrome.
Abnormalities, Multiple↗