Multidetector CT [MDCT] Findings of primary hepatic lymphoma

Objective: The aim of this study was to describe the triphasic multidetector CT [MDCT] finding of primary hepatic lymphoma [PHL]

Materials and Methods: This retrospective study included eighteen patients. Each patient presented with primary hepatobiliary lymphoma without associated lymphadenopathy or other visceral involvement. Triphasic CT scanning was performed on one of two systems [64 MD CT] in 12 patients and [6 MDCT] in 6 patients. All eighteen patients underwent ultrasound percutaneous trucut liver biopsy using 18-gauge biopsy needle. Pathology was confirmed on all cases

Results: Four of eighteen patients presented with a single focal lesion. Thirteen of eighteen patients presented with multiple well defined focal lesions. One patient presented with a diffuse hepatic involvement. On triphasic CT, three patients showed gradual progressive contrast enhancement. Lesions remained isodense to the liver on the arterial phase with mild enhancement in the portal phase and showed washout on the delayed phase in two patients. The remaining thirteen patients showed multiple hypodense non-enhancing lesions

Conclusions: PHL presents a wide spectrum of imaging findings on triphasic MDCT with no characteristic imaging pattern. MDCT can be used for detection of the lesion and biopsy is used for diagnosis. PHL should always be considered in the differential diagnosis of a liver focal lesion either single or multiple

Treatment of postoperative external duodenal fistula using roux-en-y jejunal loop

postoperative external duodenal fistulae are associated with significant mortality and morbidity. Although medical management is followed by closure of fistulae in up to 90% of patients, mortality and mortality rates are sill high among those who would not respond to this treatment. In addition, there is no technical recommendation as regards the surgical intervention as each operative procedure has its own limitations, mortality and morbidity. to evaluate the outcome of using Roux-en-Y jejunal loop for closure and drainage of postoperative external high-output duodenal fistulae. a series of prospective cases from March 1993 to February 1998. Department of Surgery, Faculty of Medicine, Zagazig University. seventeen patients with postoperative external duodenal fistulae, in whom surgical intervention was indicated, were treated using Roux-en-Y jejunal loop anastomosed to the fistula stoma. four patients [23.5%] died in the early postoperative period [30 days]. Morbidity was related to chest infections, intraabdominal infections, multiorgan failure and burst abdomen with a total major complications rate of 58.8%. the Roux-en-Y operation is recommended for difficult fistulae that do not heal with medical management. It is a safe one-stage procedure that is suitable for high-risk patients

Cytogenetic study on workers with asbestosis

The carcinogenic effect of asbestos is well documented, yet its mutagenicity is uncertain. The objective of this study is to investigate the cytogenetic changes among workers with asbestosis. Fifteen workers having asbestosis were matched by age, sex and socioeconomic status with equal number of individuals holding clerk jobs. The selection of both groups was determined by certain criteria. Two cytogenetic assays were applied to the peripheral lymphocytes of both groups; chromosomal aberrations and sister chromatid exchanges [SCE]. The results showed no significant difference regarding chromosomal aberrations frequency. On the other hand, the mean +/- SD of SCE among those with asbestosis was 8.45 +/- 3.71 compared to 6.67 +/- 3.22 among controls, the difference was statistically highly significant [p<0.001]. Our findings suggest that the carcinogenic action of asbestos may be partially attributed as being genotoxic agent