Subject(s)
Acquired Immunodeficiency Syndrome/complications , Cushing Syndrome/diagnosis , Lipodystrophy/diagnosis , Megestrol Acetate/adverse effects , Acquired Immunodeficiency Syndrome/drug therapy , Adult , Anti-HIV Agents/therapeutic use , Carbamates , Cushing Syndrome/chemically induced , Diagnosis, Differential , Drug Therapy, Combination , Furans , HIV Protease Inhibitors/adverse effects , HIV Protease Inhibitors/therapeutic use , Humans , Lipodystrophy/chemically induced , Male , Megestrol Acetate/therapeutic use , Reverse Transcriptase Inhibitors/therapeutic use , Sulfonamides/adverse effects , Sulfonamides/therapeutic useSubject(s)
Liver Diseases/diagnosis , Puerperal Disorders/diagnosis , Adult , Diagnosis, Differential , Diathermy , Fatal Outcome , Female , Humans , Liver Diseases/therapy , Pregnancy , Puerperal Disorders/therapy , Pulmonary Embolism/diagnosis , Rupture, Spontaneous/diagnosis , Rupture, Spontaneous/therapyABSTRACT
Primary intracerebral lymphoma is an uncommon presenting site for non-Hodgkin's lymphoma. The authors review 28 histopathologically confirmed, consecutive cases, presenting over a 15-year period. The cohort included 20 males and 8 females with a mean age at diagnosis of 54 years (range 27-75 years). Subtotal resection was performed in 8 patients. Radical whole brain irradiation was given to 27 patients. One patient was too unwell to receive treatment and quickly died. Three patients also had chemotherapy. Clinical remission was achieved in 19 patients. Of these, 9 relapsed after a median interval of 18 months. Nine patients (32% total cohort) are still alive and in remission after a median follow-up of 2 years and 10 months (range 11 months to 11 years and 5 months). Cause of death was intracerebral lymphoma in 13 of the 19 patients who died. Median survival was 12 months in this group (range 1 week to 4 years and 9 months). Actuarial 5-year survival for all patients was 19%. The prognosis for patients with primary intracerebral lymphoma treated with radiotherapy alone is poor.
Subject(s)
Brain Neoplasms/pathology , Lymphoma, Non-Hodgkin/pathology , Adult , Aged , Brain Neoplasms/diagnostic imaging , Brain Neoplasms/mortality , Brain Neoplasms/radiotherapy , Cohort Studies , Disease Progression , Female , Humans , Lymphoma, Non-Hodgkin/diagnostic imaging , Lymphoma, Non-Hodgkin/mortality , Lymphoma, Non-Hodgkin/radiotherapy , Male , Middle Aged , Neoplasm Staging , Retrospective Studies , Survival Rate , Tomography, Emission-Computed , Treatment OutcomeSubject(s)
Temporomandibular Joint Disorders , Arthrography/methods , Humans , Magnetic Resonance Imaging/methods , Radiography, Panoramic , Radionuclide Imaging , Temporomandibular Joint Disorders/diagnostic imaging , Temporomandibular Joint Disorders/etiology , Tomography, X-Ray Computed/methods , UltrasonographyABSTRACT
Atlanto-occipital subluxation is a rare but recognized form of subluxation that occurs in rheumatoid arthritis (RA) at the cranio-cervical junction. Magnetic resonance imaging (MRI) clearly demonstrates the bony and soft tissue changes of RA in the cervical spine. We report a single case of atlanto-occipital subluxation in RA demonstrated by MRI.
Subject(s)
Arthritis, Rheumatoid/complications , Atlanto-Occipital Joint , Joint Dislocations/diagnosis , Joint Dislocations/etiology , Magnetic Resonance Imaging , Aged , Atlanto-Occipital Joint/pathology , Female , HumansABSTRACT
Computed tomography (CT) scanning is an accepted first line investigation for suspected lumbar prolapsed intervertebral disc disease (PID). However, it does involve ionizing radiation and any possible reduction in the dose is desirable. A questionnaire was sent to a random selection of 60 CT centres in the UK to confirm that a routine scan of the three lower lumbar levels is current practice in a majority of centres, regardless of symptomatic presentation. All orthopaedic CT referrals over 2 years for suspected lumbar disc disease in Sheffield were studied retrospectively. Of 486 cases, 99 (20%) were shown to have disc disease, of which 16 (3.3%) had disease at the L3/4 level. Of these 16 cases, 11 were suspected clinically. Analysis of the long-term outcome of the five unsuspected cases showed that in none did the CT findings make any significant contribution to this outcome. These results have altered our practice. Two-level scanning is now performed routinely and three-level scanning is only performed when specified clinical or radiological indications are present.
Subject(s)
Intervertebral Disc Displacement/diagnostic imaging , Lumbar Vertebrae/diagnostic imaging , Tomography, X-Ray Computed , Adult , Aged , Humans , Retrospective Studies , Time Factors , United KingdomABSTRACT
The objective of this study was to review and analyse the chest radiograph (CXR) appearances seen following high dose chemotherapy and autologous bone marrow transplantation (ABMT), and to identify any characteristic patterns. Thirty-one patients underwent ABMT between 1984 and 1989 for high grade lymphoma resistant to conventional chemotherapy. Their case notes and CXRs were reviewed in conjunction with the clinicians. In this small sample of patients, an acute interstitial pattern was seen with pulmonary oedema following bone marrow reinfusion in two cases of the 13 patients showing CXR changes (15%). Otherwise, the CXR changes following ABMT were not specific, although they did alert the clinician to the possibilities of recurrent lymphoma or opportunistic infection, enabling appropriate investigations and treatment to be instituted at an early stage. The complications and CXR changes did not differ greatly from those seen following allogeneic bone marrow transplantation.
Subject(s)
Bone Marrow Transplantation , Hodgkin Disease/diagnostic imaging , Lymphoma, Non-Hodgkin/diagnostic imaging , Radiography, Thoracic , Adolescent , Adult , Antineoplastic Combined Chemotherapy Protocols/therapeutic use , Combined Modality Therapy , Drug Resistance , Female , Hodgkin Disease/therapy , Humans , Lymphoma, Non-Hodgkin/therapy , Male , Middle Aged , Pulmonary Edema/diagnostic imaging , RecurrenceABSTRACT
A case of salmonella aortitis and aneurysm formation with subsequent necrosis of the arterial wall is described. Computed tomography is beneficial in diagnosis and management and should be carried out early in the course of illness.
Subject(s)
Aneurysm, Infected/pathology , Aortic Aneurysm/pathology , Aortitis/pathology , Salmonella Infections/pathology , Tomography, X-Ray Computed , Aneurysm, Infected/diagnostic imaging , Aortic Aneurysm/diagnostic imaging , Aortitis/diagnostic imaging , Female , Humans , Middle Aged , Necrosis , Rupture, Spontaneous , Salmonella typhimurium/isolation & purificationABSTRACT
Portal and splenic venous thrombosis is a rare but well recognised complication of pancreatic carcinoma and pancreatitis. We report a series of five patients with pancreatic disease in whom CT detected this complication. The appearances on CT are of an enlarged vein with a centre of lower attenuation which does not enhance following intravenous contrast injection, ring enhancement and opacification of collateral veins. Splenic vein thrombosis following pancreatitis should be considered in all patients with pancreatic disease as this complication is increasingly recognised as a cause of upper gastrointestinal haemorrhage from varices.
Subject(s)
Pancreatic Diseases/diagnostic imaging , Portal Vein/diagnostic imaging , Splenic Vein/diagnostic imaging , Thrombosis/diagnostic imaging , Humans , Pancreatic Diseases/complications , Pancreatic Neoplasms/complications , Pancreatic Neoplasms/diagnostic imaging , Thrombosis/complications , Tomography, X-Ray ComputedABSTRACT
Three cases of sacral arachnoid diverticula causing bony erosion are described. Two of these filled with contrast medium after the initial myelogram was completed, and were only apparent on delayed CT.
Subject(s)
Arachnoid/diagnostic imaging , Diverticulum/diagnostic imaging , Female , Humans , Male , Middle Aged , Myelography , Sacrococcygeal Region , Spinal Nerve Roots/diagnostic imaging , Tomography, X-Ray ComputedABSTRACT
Technetium-99m sodium pertechnetate scintigraphy is an established method for evaluating organ perfusion and can be applied to the investigation of suspected testicular ischaemia due to acute torsion. One hundred and six consecutive scrotal investigations have been analysed qualitatively and quantitatively using a computer-based comparison of the perfusion slopes over each testis. Decreased vascularity on the symptomatic side only occurs in torsion and quantitative analysis is needed to detect it reliably. Increased vascularity on the symptomatic side can usually be detected qualitatively and occurs in orchitis, tumours, trauma and resolved torsion. Distinction between the causes of increased vascularity is aided by the clinical data. A halo of increased activity surrounding a relatively cold centre was seen in chronic torsion, some tumours and hydrocoeles. The test is both sensitive and specific for acute torsion but its usefulness is limited if it is not available at all hours. The test is useful, also, in confirming a diagnosis that does not require emergency operation and in identifying chronic torsion which is an indication for contralateral orchidopexy.