Imaging findings of Gorlin-Goltz syndrome.

A 15-year-old girl was referred to a dentist complaining of parageusia, bad taste in the mouth, which started 9 months ago. Panoramic X-ray and non-enhanced computed tomography scan revealed multiple bilateral unilocular cysts in the mandible and maxilla, along with calcification of anterior part of the falx cerebri. She was eventually diagnosed with Gorlin-Goltz syndrome based on imaging and histopathologic finding of keratocystic odontogenic tumor.

Renal vascular Doppler ultrasonographic indices and carotid artery intima-media thickness in diabetic nephropathy.

INTRODUCTION: Diabetes is one of the common causes of renal insufficiency and is responsible for about one third of cases requiring renal transplantation. Conventional sonography provides limited information regarding the severity and prognosis of disease. The present study was carried out to evaluate the renal vascular Doppler indices role in determining renal dysfunction and carotid artery atherosclerosis. METHODS: Fifty five patients with diabetic nephropathy (albuminuria more than 300mg/24 hours) were enrolled into this cross-sectional study. Renal interlobar arterioles were studied using resistive (RI) and pulsatility (PI) indices of Doppler ultrasonography, in addition to conventional kidney length and renal parenchyma thickness. Intima-media thickness of common carotid artery (CCIMT) was also assessed just before the bifurcation. Serum creatinine (sCr), urine albumin and lipid profile were measured using standard methods. Estimated glomerular filtration rate (eGFR) was calculated by the Modification of Diet in Renal Disease formula. RESULTS: The renal interlobar arterioles' RI was positively and linearly correlated with the sCr and albuminuria levels (P<0.039 r= +0.320 and P=0.047, r= +0.287). There were negative linear correlations between eGFR and the renal interlobar arterioles' RI (P<0.001, r=-0.539) and PI (P<0.045, r= -0.328). The mean CCIMT was more than 0.7 mm in 90% of the studied patients. No correlation was found between CCIMT and renal ultrasonographic and Doppler findings. CONCLUSION: Although Doppler ultrasonographic indices of renal interlobar arteriols show the severity of renal dysfunction in patients with diabetic nephropathy, these indices do not have any advantage over the simple and cost effective biochemical parameters.

Bilateral primary breast lymphoma in a teenage girl with multi-organ involvement.

We present 16 years old girl with primary breast lymphoma involving the both breasts simultaneously and co-incidence of central nervous system (CNS) involvement which originated from the breast, in addition to evidence of lymphoma in multi-organ such as skin, mediastinum and some abdominal viscera. Bilaterality has been observed in some series, but reports are few and series are often very small. Radiologic features may be indistinguishable from those of the other breast malignancies, but it can be concluded that primary involvement of the breast with lymphoma should be considered when breast mass or inflammatory changes occur in a patient without any previously diagnosed lymphoma. The clinical behavior, imaging and therapeutic procedures are discussed. The findings of this report may have clinical impact on oncologists or that may alter the disease concept of bilateral breast lymphoma.

Renal vascular Doppler resistance after extracorporeal shock wave lithotripsy.

OBJECTIVES: Extracorporeal shock wave lithotripsy (ESWL) is mainly an alternative for other therapeutic methods such as surgery and endourology to treat urinary tract calculus. Although it is safe and effective, it has undesirable effects on renal function. Diagnostic techniques such as color Doppler ultrasonography create a new attitude toward renal function. The aim of this study was to evaluate renal vascular resistance change before and after extracorporeal shock wave lithotripsy. METHODS: During the present study, vascular resistive index (RI) of renal intralobar artery was measured before, 30 min, and 1 week after ESWL using Doppler ultrasonography. RESULTS: Thirty minutes after ESWL, RI was significantly increased from primary value of 0.62 ± 0.05 to 0.66 ± 0.06 (p = 0.0001). There was no correlation between increase of RI and patients' age. Following up the patients revealed that mean RI did not return to pretreatment level after 1 week (p < 0.05). The RI level in the old patients (3 patients who were 60 years or older) was higher than that of the younger ones (19 patients who were younger than 60 years) after 1 week (0.76 ± 0.05 vs. 0.64 ± 0.06). There was no meaningful relationship between ESWL voltage or number of shocks and RI variation before and after ESWL. CONCLUSION: Following ESWL, patients are at risk of renal tissue damage due to increase of primary RI level. Measuring RI variations using ultrasound techniques after ESWL may provide helpful information to clinical detection of renal tissue damage.