Solitary intramedullary neurosarcoidosis: role of MRI in early detection.

BACKGROUND: Intramedullary neurosarcoidosis may be the first manifestation of the disease and may mimic a tumor clinically and radiographically. Two patients who presented with cervical intramedullary lesions on magnetic resonance imaging (MRI) scans were found to have neurosarcoidosis. CLINICAL PRESENTATION: Two patients with negative past medical history presented with progressive myelopathic features, and intramedullary cervical lesions were detected on MRI scan; the diagnosis was made on biopsy of the lesions. Early therapeutic intervention led to a favorable outcome. CONCLUSION: Intra-medullary neurosarcoidosis, especially in the cervical cord, can be the initial presentation of the disease, mimicking a tumor. MRI scan, biopsy, and, in fewer cases, angiotensin-converting enzyme levels can help with the diagnosis and may lead to a favorable outcome.

Pyloric stenosis.

In this study, pyloric stenosis appeared to be a commonly occurring, independent, entity probably resulting from antral pyloric canal gastritis rather than from an ulcer crater per se. An appropriate term might be stenosing pyloritis. Intraoperative effects on the pyloric sphincter from glucagon and atropine administration and stimulation of the vagi and gastric pacemaker were not detectable in a limited study on four cases. A local autonomy of sphincteric action was noted which was not affected by trunkal vagotomy.

Supradiaphragmatic aspects of benign pancreatic disease.

A classification of supradiaphragmatic extension of benign pancreatic disease is proposed based on 74 cases from the literature and three new cases. The three main categories include pleural accumulation of amylase-rich fluids, direct extension of the pseudocyst, and fistula formation.