Transbronchoscopic versus surgical resection of tracheobronchial granular cell myoblastomas. Suggested approach based on follow-up of all treated cases.

The case of a 31-year-old patient with a granular cell myoblastoma causing significant obstruction of the distal trachea is presented. A review of the literature suggests that size may help in deciding whether bronchoscopic removal or surgical resection should be performed. Fifty-four percent of the tumors removed bronchoscopically whose follow-up was described showed recurrent disease. All tumors removed bronchoscopically whose diameter was 1 cm or greater recurred. The correlation of full-thickness involvement of the tracheal wall with increasing tumor size appears to explain the failure of bronchoscopic treatment of these tumors. A suggested surgical approach to these rare tumors is proposed.

Allergic reaction to Patent Blue Violet during lymphography.

A case of an allergic reaction to Patent Blue Violet dye used for the purpose of lymphangiography is reported. The clinical findings were urticarial reaction, edema of the eyelids and lips, and hypotension. Previous sensitization to triphenylmethane dyes, in drugs and other chemicals was likely, but not proven. Such commonly used compounds have been compiled in a Table. History of a previous hypersensitivity reaction to these compounds is not a contraindication for lymphangiography but should call for emergency planning and possible premedication.

Radiologic manifestations of pelvic lipomatosis.

Ten male patients with pelvic lipomatosis are herein reported and the clinical and radiological features of the disease are reviewed. The main criteria for the preoperative diagnosis of pelvic lipomatosis include: a) radiolucency of the pelvic soft tissues with a normal to slightly increased vascularity on pelvic arteriography; b) deformity and anterior deviation of the urinary bladder together with various degrees of obstructive uropathy; and c) tubular narrowing of the rectum and upward displacement of the sigmoid colon and small intestine. The associated symptoms are usually variable degrees of dysuria, constipation, and frequently hypertension. Surgical excision of the pelvic lipomatous tissue is of limited value in the management of this disease.

Protracted yet variable major pulmonary artery compression in sarcoidosis.

A case of thoracic sarcoidosis showing diffuse mediastinal lymphadenopathy was followed for a 6-month period with serial chest radiographs, perfusion lung scans, and pulmonary angiograms. Significant extrinsic pressure upon major pulmonary arteries from large lymph nodes of sarcoidosis was seen to cause marked restriction in pulmonary parenchymal perfusion on both scanning and angiography.