ABSTRACT
Only 15 cases of fibroepithelial polyp in children have been reported in the world medical literature. Clinical differentiation between this tumor and a malignant ureteral tumor is difficult and often results in unnecessary nephrectomy. We report the sixteenth case of a child with fibroepithelial polyp of the ureter. The lesion was resected, and the kidney was preserved. Optimum treatment of this lesion mandates renal preservation in children. The rationale for this recommendation is explored.
Subject(s)
Polyps/epidemiology , Ureteral Neoplasms/epidemiology , Child , Hematuria/etiology , Humans , Hydronephrosis/etiology , Male , Polyps/complications , Polyps/surgery , Ureteral Neoplasms/complications , Ureteral Neoplasms/surgeryABSTRACT
Two major pulmonary diseases were defined on the basis of lung biopsies in 15 children with acquired immune deficiency syndrome (AIDS) or AIDS-related complex. Pneumocystis carinii pneumonia was observed in eight children, and pulmonary lymphoid hyperplasia in six. One child had nonspecific interstitial pneumonitis. Children with P. carinii pneumonia had more severe hypoxemia, with higher alveolar-arterial oxygen gradients, and higher isomorphic elevations of serum lactate dehydrogenase. Clinically, children with pulmonary lymphoid hyperplasia were older, and had digital clubbing, parotid gland enlargement, and elevated serum IgG levels. Results of serologic assays and lung tissue analysis were suggestive of persistent Epstein-Barr virus infection exclusively in patients with pulmonary lymphoid hyperplasia. Recognition of the clinical and laboratory findings characteristic of each entity may assist in the differential diagnosis without the need of surgical biopsy.
Subject(s)
Acquired Immunodeficiency Syndrome/complications , Lung Diseases/etiology , Acute Disease , Age Factors , Antibodies, Viral/analysis , Antigens, Viral/analysis , Child , Child, Preschool , DNA, Viral/analysis , Failure to Thrive/etiology , HIV Antibodies , Haemophilus Infections/etiology , Herpesvirus 4, Human/isolation & purification , Humans , Hyperplasia/complications , Immunoglobulin G/analysis , Infant , Lung/microbiology , Lung/pathology , Lymphoid Tissue/pathology , Pneumonia, Pneumocystis/etiology , RiskABSTRACT
The spectrum of computed tomographic findings in seven children with diskitis is reported. Paravertebral inflammatory masses, intraspinal (epidural) soft-tissue extension with thecal sac deformity, and psoas involvement with abscess were demonstrated in 7/7, 6/7, and 1/7 patients, respectively. Plain radiographic findings of disk space narrowing and vertebral end-plate destruction were confirmed by CT in all cases. Follow-up CT in two patients revealed persistent bone destruction despite resolution of soft-tissue inflammation and clinical abnormalities. CT proved most useful in the diagnosis of early and atypical cases. The CT spectrum of childhood diskitis may simulate other diseases, including neoplasm, tuberculosis, and disk herniation. While CT is not routinely indicated in typical childhood diskitis, it may confirm the diagnosis in those patients with atypical clinical presentation or nonspecific plain radiographs, and exclude other lesions in patients unresponsive to routine treatment.
Subject(s)
Intervertebral Disc/diagnostic imaging , Spondylitis/diagnostic imaging , Adolescent , Bacterial Infections/diagnostic imaging , Child , Child, Preschool , Female , Humans , Infant , Male , Radionuclide Imaging , Spondylitis/etiology , Tomography, X-Ray ComputedABSTRACT
Gastric volvulus, organoaxial or mesenteroaxial, is an uncommon cause of upper gastrointestinal obstruction in childhood. It may be suspected on plain radiographic examination of the abdomen and confirmed by upper gastrointestinal series. Seven affected children are described. In childhood, gastric volvulus often coexists with mesenteric abnormalities or with lesions that lead to distention of the gastrointestinal tract.
