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PubMed2003

Adenoviral bronchopneumonia in an immunocompetent adult: computed tomography and pathologic correlations.

Acute febrile lung disease associated with "patchy ground-glass pattern" on high-resolution computed tomography (HRCT) of the lung in an immunocompromised patient is suggestive of Pneumocystis carinii pneumonia; however, in an immunocompetent young person, it is suggestive of an atypical pneumonia, including viral bronchopneumonia. We studied a 31-year-old man who presented with fever, cough and hypoxemia. HRCT showed bilateral patchy ground-glass opacification. HIV test was negative and lung biopsy specimen grew adenovirus on viral culture. Histopathology of the lung was compatible with bronchopneumonia. In patients without HIV who present with acute lower respiratory infections and patchy ground-glass opacification on HRCT, adenoviral bronchopneumonia should be included in the differential diagnosis.

Adenoviridae Infections↗
PubMedDate not supplied

Intracranial calcification in children on computed tomography.

Pathological intracranial calcifications detected on computed tomography of 83 children during a six-year period were reviewed. The common causes in our series were tuberous sclerosis and intracranial tumors. Other conditions associated with calcification were Sturge-Weber syndrome, neurofibromatosis, Cockayne's syndrome, hypoparathyroidism, arteriovenous malformations, vein of Galen aneurysm, encephalomalacia, cerebral infarcts, subdural hematoma, cerebral infections, birth asphyxia and dihydropteridine reductase deficiency. In two cases (2%), calcifications were idiopathic. The distribution and location of the calcifications in these conditions are discussed.

Adolescent↗
PubMed1990

The diagnosis of mild emphysema. Correlation of computed tomography and pathology scores.

Early and accurate diagnosis of emphysema is said to be invaluable for identification of clinically silent and mild emphysema. Recently, computed tomography (CT) has been much advocated for its efficacy in detailed diagnosis of emphysema, and the results have been compared with the pathology grade of emphysema in resected lung specimens. To assess the ability of high resolution CT scan in detecting and grading mild emphysema, we correlated the high resolution CT scan with the pathology grade of emphysema and the destructive index (DI) of lung specimens from 42 patients undergoing thoracotomy for a solitary pulmonary nodule. The high resolution CT scan and the cut surface of the lung, corresponding exactly to the same plane of the CT scan image, were assessed using the picture-grading system of Thurlbeck and coworkers on a scale of zero to 100. The CT scores for all patients ranged from 12 to 57, with a mean +/- SD of 22.1 +/- 9.6 using 1-mm collimation (n = 35), and from 7 to 46 with a mean +/- SD of 16.5 +/- 8.3 using 5-mm collimation (n = 33). The pathology scores ranged from 10 to 57, with a mean +/- SD of 23.2 +/- 9.8 (n = 42). The DI ranged from 15.4 to 67.1, with a mean +/- SD of 31.4 +/- 10.8 (n = 42). The CT scores using 1-mm and 5-mm collimation correlated significantly with the pathology scores (r = 0.68 and 0.76, respectively, p less than 0.001), and with the DI (r = 0.62 and 0.74, respectively, p less than 0.001). The pathology scores correlated significantly with the DI (r = 0.72, p less than 0.001). We therefore concluded that high resolution CT can help to identify the presence and grading of mild emphysema.

Adult↗
PubMedDate not supplied

[Computed tomography in thoracic pathology].

The fundamental principles of computed tomography (CT), its clinical applications and costs are presented followed by the indications and results in diseases of the mediastinum, the oesophagus, heart and great vessels, and the lung and pleura. The CT scan can give the precise localization and density of mediastinal tumours and be used to distinguish thymomas, goiters, lymph nodes, lymphomas, neurinomas and different bronchogenic and pleuropericardial cystic formations. The operability of oesophageal cancer can also be determined. In cardiovascular diseases, the CT scan is particularly useful to identify inborn anomalies, aneurysms, aortic dissection or caval compression or thrombus formation. In lung diseases, the indications for a CT scan are particularly important in bronchopulmonary cancer, tuberculosis, bronchopathies and chronic lung diseases. In bronchogenic cancer, for example, the CT scan is not only a major diagnostic tool but is also particularly useful in determining the prognosis and for following the effectiveness of treatment. The CT scan can be used to identify both effusions of liquid and gas as well as pleural reactions producing thick membranes of importance for both aetiology and later follow-up. Bronchectasis can be identified on serial sections where the degree of extension can be measured. CT scan is also indicated in patients with emphysema, both for evaluating extension and follow-up. Finally the indications and contraindications for interventional computed tomography, particularly in guiding needle biopsies, is presented.

Cardiovascular Diseases↗
PubMed2001

Computed tomographic-pathologic correlation of gross tumor volume and clinical target volume in non-small cell lung cancer: a pilot experience.

CONTEXT: Computed tomographic (CT) scan data are used regularly in radiation treatment planning for patients with lung cancer. To our knowledge, the relationship of the CT images of tumors and their corresponding microscopic extent has not yet been studied in detail. OBJECTIVE: To correlate tumor sizes on CT with tumor sizes measured microscopically (ie, the gross tumor volume [GTV]-clinical target volume margin) in non-small cell lung cancers. DESIGN: Prospective pilot study. SETTING: Single institution. PATIENTS: Patients with operable non-small cell lung cancer were identified preoperatively. INTERVENTIONS: Once the surgical specimen was available, it was oriented with the surgeon and the pathologist. Seven whole-mount, cross-sectional histologic glass slides were made from 5 tumors using formalin fixation and hematoxylin-eosin staining. The pathologist then outlined the cancer-containing area under the microscope (Micro-GTV) and the area of surrounding inflammatory response (Micro-GTV + inflammation). Preoperative CT scans were used for outlining tumor on the corresponding slice (CT-GTV). MAIN OUTCOME MEASURES: Correlation of the areas of Micro-GTV, Micro-GTV + inflammation, and CT-GTV was performed. RESULTS: There was an obvious trend that the CT-GTV was bigger than the Micro-GTV, except in specimen 1, in which the 2 areas were about equal. However, on comparing the values for the CT-GTV and the Micro-GTV + inflammation, the difference between the 2 areas became smaller. CONCLUSIONS: Modern CT scans might overestimate the GTV in non-small cell lung cancer. The GTV-clinical target volume margin could actually be zero or even a negative value. The findings in this small study are interesting and provoking. Further study with a larger number of patients and more rigid quality control is warranted to confirm our findings.

Carcinoma, Non-Small-Cell Lung↗
PubMed1983

Glioblastoma of the cerebellum. Computed tomographic and pathologic considerations.

Cerebellar glioblastoma is a brain malignancy that is often difficult to distinguish from metastatic disease in the elderly before biopsy. The clinical course and computed tomographic appearance of four patients with multiform glioblastoma of the cerebellum are presented and correlated with other reports in the literature. The appearance of a cerebellar hemispheric lesion with little mass effect is described, and the pathology of the tumor is reviewed.

Aged↗
PubMed2006

Hepatocellular adenoma: findings at state-of-the-art magnetic resonance imaging, ultrasound, computed tomography and pathologic analysis.

The purpose of this paper is to describe the most recent concepts and pertinent findings of hepatocellular adenomas, including clinical presentation, gross pathology and histology, pathogenesis and transformation into hepatocellular carcinoma (HCC), and imaging findings at ultrasound (US), computed tomography (CT), and magnetic resonance (MR) imaging.

Adenoma, Liver Cell↗
PubMedDate not supplied

The crazy-paving pattern in granulomatous mycosis fungoides: high-resolution computed tomography-pathological correlation.

The purpose of this report is to describe a further distinctive cause of crazy-paving pattern on thin-section computed tomography in a patient affected by pulmonary granulomatous mycosis fungoides. It was possible to reconcile the crazy-paving appearance on thin-section computed tomography scan with the histopathologic pattern termed acute fibrinous organizing pneumonia pattern.

Biopsy↗
PubMed1999

Comparison of computed tomography and pathologic examination for evaluation of response of primary lung cancer to neoadjuvant therapy.

Twenty-four patients (nine with squamous cell carcinoma, 14 with adenocarcinoma, and one with large cell carcinoma) underwent neoadjuvant therapy followed by surgical resection. The authors studied changes in tumor size, shape, and contrast enhancement on computed tomography (CT), and compared them with results of pathologic examination of surgical specimens. The size of tumors on CT was evaluated according to the criteria of the World Health Organization. Surgical specimens were evaluated histologically on the basis of the area of viable cancer cells. Of 14 patients considered to have a partial response on the basis of World Health Organization criteria, five had pathologic changes of complete response. After therapy, the residual tumors in these five patients showed irregular shapes with concave tumor margins on CT images and no enhancement. The authors found that CT size criteria tended to underestimate the therapeutic effect demonstrated by pathologic examination. On the basis of these results, the authors propose three CT criteria for complete response: 1) more than 50% size reduction, 2) a change in tumor morphologic features from round or oval to irregular after neoadjuvant therapy, and 3) disappearance of contrast enhancement.

Adenocarcinoma↗
PubMed1991

Pleural plaques do not predict asbestosis: high-resolution computed tomography and pathology study.

Pleural plaques can be caused by asbestos exposure, but their predictive value in diagnosing pulmonary asbestosis is uncertain. Similarly, although high-resolution computed tomography (HRCT) can accurately detect parenchymal lung lesions, its ability to detect asbestosis is unknown. In a test of the predictive value of pleural plaques and HRCT, lungs of 29 autopsied patients with bilateral parietal pleural plaques were compared with lungs from 29 age- and sex-matched controls without pleural plaques. Significantly more of the patients with pleural plaques had histories of asbestos exposure (P less than 0.01). One lung from each patient was inflation fixed and air dried. HRCT of the lungs did not show significantly more thickening, lines, or densities in patients with pleural plaques than did controls; and HRCT did not predict a significantly greater likelihood of asbestos-related parenchymal disease in the study group. Gross and histologic examinations showed no significant intergroup differences in the frequency or severity of several forms of emphysema and fibrosis. Average asbestos fiber counts were not significantly higher in the lungs with pleural plaques. We conclude that pleural plaques do not predict asbestosis, and that high-resolution computed tomography accurately detects interstitial and parenchymal lung disease but cannot reliably diagnose asbestosis.

Adult↗
PubMedDate not supplied

Practical use of a free-text computer system in pathology.

Free-text is a natural and effective means of communication of clinically valuable information in subjects such as morbid anatomy. Due to recent developments in hardware and software, it is becoming possible for a greater number of pathologists and others to consider the computer as a possible means of storing, retrieving and analysing findings which have been expressed in words. This paper describes some experiments which have been carried out in this area; these suggest that computer-held free-text can yield useful and hitherto unavailable information, but that coded input may be required for some applications.

Brain Neoplasms↗
PubMed1991

[Use of the computer in the pathology department for improvement of the prophylactic medical examination and treatment of newborns and women].

The practice of prognosis of the pathological conditions development in newborns on the basis of placenta examination and the evaluation of results by a computer is described. The same method was used for the determination of the risk groups among the women. The results of cytological diagnosis of some chronic infections on the basis of examination of endocervix and urethra smears are also presented. According to the authors the work performed helped in reducing the children mortality.

Diagnosis, Computer-Assisted↗
PubMed2004

Assessment of tumor hemodynamics in small hepatocellular carcinoma: comparison of Doppler ultrasonography, angiography-assisted computed tomography, and pathological findings.

AIM: We evaluated the usefulness of Doppler ultrasonography (DUS) for the analysis of tumor hemodynamics in small hepatocellular carcinoma (HCC). METHODS: We compared Doppler ultrasound (DUS) findings with angiography-assisted computed tomography (Angio-CT) such as CT during arterial portography and during hepatic arteriography in the evaluation of the intratumoral hemodynamics, and with pathologic findings in 45 small HCC nodules (< or =3.0 cm in diameter) of 43 patients. DUS flow pattern of each nodule was categorized into three types: afferent continuous flow (Type 1), afferent pulsatile flow with afferent continuous flow (Type 2), and afferent pulsatile flow without afferent continuous flow (Type 3). Intratumoral blood supply was determined by Angio-CT, and pathologic findings were evaluated on resected or biopsied specimen. RESULTS: Based on Angio-CT findings, Type 1 nodules showed decreased arterial blood supply (ABS) without decreased portal blood supply (PBS). Type 2 nodules showed unchanged ABS but decreased PBS. Type 3 nodules showed both increased ABS and decreased PBS. DUS findings well represented blood supply of HCC evaluated by Angio-CT. In addition, all Type 1 and 2 nodules were well-differentiated HCC, and all Type 3 nodules were moderately or poorly differentiated HCC; DUS findings well reflected differentiation of HCC. CONCLUSIONS: DUS is a non-invasive imaging method and can be used for the evaluation of the stage of malignancy of small HCC.

Aged↗
PubMed1990

[Computer study of pathologic factors influencing survival in colorectal carcinoma--a multivariant stepwise discriminant analysis].

Five quantitative pathologic parameters and three clinicopathologic parameters in 80 colorectal carcinoma patients with different prognosis were studied with a multivariant stepwise discriminant analysis on computer. The results showed that DNA index (DI), nucleocytoplasmic ratio (NCR), histologic grade and Dukes' stage were significant factors influencing the survival. With these factors, a 4-variable Fisher's discriminant function was established, which could correctly identify 81.25% and 83.75% of the predicted cases (Jacknife Procedure and Reclassification) Sensitivity of the two methods was 87.80%. The results indicate that the multivariant stepwise discriminant analysis on quantitative pathologic parameters combined with clinicopathologic parameters is of value in predicting prognosis of colorectal carcinoma patients.

Adenocarcinoma↗
PubMed1983

A multifunction network of computers in a large pathology department. Integration of word processing, data base management, and general purpose computing using network principles.

We report the strategies for design and implementation of a system of compatible mini- and microcomputers intended to improve efficiency of data handling and research in several clinical and academic divisions of a large university hospital department of Pathology. A dedicated, preprogrammed, multiuser, word processing computer and small standalone word processing stations connected to a general purpose minicomputer, using standard network protocols for communication, permit virtually error-free movement of data between computers doing functionally distinct tasks of word processing, data base management, and general scientific computing. User programming is minimized and is done in a simple, well-known, high-level language. We show that cost, thruput, speed, document volume, document size, revision cycle frequency, data base size, and frequency of use are important design criteria and that existing staff can be trained easily to operate the systems.

Computers↗
PubMed1982

Computer-assisted diagnostic surgical pathology reporting.

A very simple method of computer-assisted reporting of surgical pathology (including gross description, microscopic description, and diagnosis) has been developed. This method is based on a modification of the existing microbiology program and files in the comprehensive MedLab Company Pathlab computer system, with the use of mark sense cards for entering surgical number, gross and microscopic description, diagnosis and pathologist's name. The chief advantages of this system compared with other computerized surgical pathology reporting methods are its speed and simplicity of operation, reduction in clerical time, and production of concise reports for the patients' charts.

Computers↗