Paracoccidioidomycosis in a liver transplant recipient

ABSTRACT Paracoccidioidomycosis is a granulomatous systemic mycosis that is endemic in Latin America; it is an extremely rare infection following solid organ transplantation. In this study, we describe the first report of disseminated paracoccidioidomycosis in a 3-year-old girl who underwent liver transplantation 2 years previously. The radiologic diagnosis and patient follow-up are described. In addition, we review the clinical evolution and treatment regimens for this infection.

Long-term Results after CT-Guided Percutaneous Ethanol Ablation for the Treatment of Hyperfunctioning Adrenal Disorders

OBJECTIVES: To evaluate the safety and long-term efficacy of computed tomography-guided percutaneous ethanol ablation for benign primary and secondary hyperfunctioning adrenal disorders. METHOD: We retrospectively evaluated the long-term results of nine patients treated with computed tomography-guided percutaneous ethanol ablation: eight subjects who presented with primary adrenal disorders, such as pheochromocytoma, primary macronodular adrenal hyperplasia and aldosterone-producing adenoma, and one subject with Cushing disease refractory to conventional treatment. Eleven sessions were performed for the nine patients. The patient data were reviewed for the clinical outcome and procedure-related complications over ten years. RESULTS: Patients with aldosterone-producing adenoma had clinical improvement: symptoms recurred in one case 96 months after ethanol ablation, and the other patient was still in remission 110 months later. All patients with pheochromocytoma had clinical improvement but were eventually submitted to surgery for complete remission. No significant clinical improvement was seen in patients with hypercortisolism due to primary macronodular adrenal hyperplasia or Cushing disease. Major complications were seen in five of the eleven procedures and included cardiovascular instability and myocardial infarction. Minor complications attributed to sedation were seen in two patients. CONCLUSION: Computed tomography-guided ethanol ablation does not appear to be suitable for the long-term treatment of hyperfunctioning adrenal disorders and is not without risks.

Safety and feasibility of radiofrequency ablation for treatment of Bosniak IV renal cysts

ABSTRACT Purpose To describe our initial experience with radiofrequency ablation (RFA) of Bosniak IV renal cysts. Materials and Methods From 2010 to 2014, 154 renal tumor cases were treated with percutaneous thermal ablation, of which 10 cases (6.4%) from nine patients were complex renal cysts and were treated with radiofrequency ablation. Results All complex cysts were classified as Bosniak IV (four women and five men; mean age: 63.6 yrs, range: 33–83 years). One patient had a single kidney. Lesion size ranged from 1.5 to 4.1cm (mean: 2.5cm) and biopsy was performed on four cysts immediately before the procedure, all of which were malignant (two clear cell and two papillary carcinoma). Mean volume reduction of complex cysts was 25% (range: 10–40%). No patients required retreatment with RFA and no immediate or late complications were observed. The follow-up of Bosniak IV cysts had a median of 27 months (interquartile range [IQR], 23 to 38) and no recurrence or significant loss of renal function were observed. Conclusions Mid-term follow-up of the cases in our database suggests that image-guided percutaneous RFA can treat Bosniak IV cysts with very low complication rates and satisfactorily maintain renal function.

Magnetic resonance imaging of the vagina: an overview for radiologists with emphasis on clinical decision making / Ressonância magnética da vagina: uma visão geral para os radiologistas, com enfoque na decisão clínica

AbstractMagnetic resonance imaging is a method with high contrast resolution widely used in the assessment of pelvic gynecological diseases. However, the potential of such method to diagnose vaginal lesions is still underestimated, probably due to the scarce literature approaching the theme, the poor familiarity of radiologists with vaginal diseases, some of them relatively rare, and to the many peculiarities involved in the assessment of the vagina. Thus, the authors illustrate the role of magnetic resonance imaging in the evaluation of vaginal diseases and the main relevant findings to be considered in the clinical decision making process.

ResumoA ressonância magnética é um método com alta resolução de contraste e por isso muito utilizada na avaliação de doenças ginecológicas pélvicas. No entanto, seu potencial para diagnóstico de lesões vaginais ainda é subestimado, provavelmente em razão da escassa literatura referente ao tema, da pouca familiaridade dos radiologistas com doenças vaginais, algumas delas relativamente raras, e das muitas peculiaridades em um exame para avaliação desta víscera oca. Desta forma, ilustraremos neste estudo o papel da ressonância magnética na avaliação das doenças vaginais e os principais achados relevantes para a conduta clínica.

Criptosseminoma metastático: correlação radiológico-patológica / Metastatic cryptoseminoma: radiologic-pathologic correlation

Descrevemos um relato de caso de um paciente jovem do sexo masculino com tumoração abdominal de crescimento rápido, para cuja elucidação diagnóstica foi fundamental a união dos achadosdos métodos de imagem (tomografia computadorizada e ultra-sonografia) com o raciocínio clínico-radiológico, a fim de aventar a hipótese diagnóstica correta e orientar a terapêutica adequada. Apresentamos a correlação radiológico-patológica, assim como uma breve revisão da literatura relativa a esta entidade nosológica extremamente rara: seminoma metastático oriundode criptosseminoma em testículo pélvico.

We describe a case of a young male with a rapid-growing abdominal mass whose diagnosis required the correct interpretation of imaging findings (computerized tomography and sonography) along with clinical-radiologic reasoning, in order to arrive at the correct diagnostic hypothesis, and, hence, recommend optimal therapy.We hereby present a brief review of the literature and a radiologicpathologiccorrelation of this extremely rare entity: large metastatic cryptoseminoma originated from a small seminoma in a cryptorchid left pelvic testis.

Avaliação do uso do ultra-som intra-operatório na cirurgia hepatobiliar e pancreática / Evaluation the use of intraoperative ultrasonography during hepatobiliary and pancreatic surgery

O propósito do estudo foi avaliar a utilização do ultra-som intra-operatório na cirurgia por neoplasia de fígado, vias biliares e pâncreas comparando achados da avaliação pré-operatória de rotina por meio de métodos de imagem (TC e RMN) utilizando protocolos estado da arte e os achados obtidos por meio da exploração cirúrgica (inspeção e palpação) com os achados do UIO.O UIO modifica positivamente o planejamento cirúrgico em um número significativo de pacientes devendo fazer parte./The purpose of this study was to analyze the use o IOU in the setting of surgery for liver, biliary and pancreatic malignancies. To achieve that, the findings of routine preoperative state-of the-art imaging modalities (CT and MRI) and the findings of surgical exploration (inspection and palpation) were compared to those of IOU. The impact of IOU on preoperative plans based on CT and MRI and on management after surgical exploration were studied as well...

Nefropatia associada ao HIV / Nephropathy associated HIV

A sindrome da imunodeficiencia adquirida (SIDA) envolve varios orgaos parenquimatosos, porem o acometimento renal mostra-se de grande importancia para o prognostico destes pacientes. A ultra-sonografia pode avaliar de modo seguro as alteracoes renais mesmo na ausencia de suspeita clinica.