Metastatic pulmonary calcinosis and leukocytoclastic vasculitis in a patient with multiple myeloma.

UNLABELLED: Both leukocytoclastic vasculitis and metastatic pulmonary calcification are conditions that rarely occur during the course of multiple myeloma. We present a multiple myeloma patient that had severe dyspnea due to metastatic pulmonary calcinosis, and ulceronecrotic skin lesions caused by leukocytoclastic vasculitis. After 3 courses of standarddose chemotherapy all skin and pulmonary lesions disappeared. Autologous peripheral stem cell transplantation was performed and during 1 year of follow-up the patient was in complete remission; after 1 year, laboratory test results indicated disease relapse. Although the patient was treated with bortezomib and dexamethasone, the disease progressed. Non-myeloablative allogeneic stem cell transplantation was performed, but despite of all treatment the patient died due to disease progression. CONFLICT OF INTEREST: None declared.

Multi-center transferability of a breath-hold T2 technique for myocardial iron assessment.

BACKGROUND: Cardiac iron overload is the leading cause of death in thalassemia major and is usually assessed using myocardial T2* measurements. Recently a cardiovascular magnetic resonance (CMR) breath-hold T2 sequence has been developed as a possible alternative. This cardiac T2 technique has good interstudy reproducibility, but its transferability to different centres has not yet been investigated. METHODS AND RESULTS: The breath-hold black blood spin echo T2 sequence was installed and validated on 1.5T Siemens MR scanners at 4 different centres across the world. Using this sequence, 5-10 thalassemia patients from each centre were scanned twice locally within a week for local interstudy reproducibility (n = 34) and all were rescanned within one month at the standardization centre in London (intersite reproducibility). The local interstudy reproducibility (coefficient of variance) and mean difference were 4.4% and -0.06 ms. The intersite reproducibility and mean difference between scanners were 5.2% and -0.07 ms. CONCLUSION: The breath-hold myocardial T2 technique is transferable between Siemens scanners with good intersite and local interstudy reproducibility. This technique may have value in the diagnosis and management of patients with iron overload conditions such as thalassemia.

Solitary osteochondroma causing popliteal pseudoaneurysm that presented as a mass lesion.

Osteochondromas are the most frequently occurring bone tumors and can rarely lead to vascular complications. A 14-year-old boy with solitary exostosis of the right femur presented with a mass lesion at the posterior aspect of the thigh. Radiological studies demonstrated a popliteal artery pseudoaneurysm. In this case report, radiological findings of this lesion are reviewed.

Gene therapy: applications in interventional radiology.

Gene therapy is a new and rapidly developing area in medicine. Although it is a new therapy method, recent studies look promising. Since vascular wall is a good target for this treatment, interventional radiologists should become familiar with this new therapy and be involved in this multidisciplinary collaboration.