[Liver cirrhosis of alcoholic etiology complicated by the spontaneous bacterial peritonitis].

The case of spontaneous bacterial peritonitis (SBP) in the patient, with alcoholic cirrhosis, is presented in the article. Clinical observation demonstrates diagnostic hardships of latent clinical course of alcoholic cirrhosis, complicated SBP. Clinical observation demonstrated diagnostic consequence of ultrasound elastometry.

In vivo differential diagnosis of prostate cancer and benign prostatic hyperplasia: localized proton magnetic resonance spectroscopy using external-body surface coil.

Localized proton-stimulated echo acquisition mode (STEAM) spectroscopy was performed in seven patients with benign prostatic hyperplasia (BPH), six patients with prostate cancer, and seven healthy volunteers to determine whether citrate levels detected using a saddle-type external-body surface coil (two loops of 13 cm x 17 cm) could reliably discriminate BPH from prostatic cancer. Relative area ratios of citrate level to choline plus creatine or citrate to lipid signal were compared with postoperative pathologic histology findings. The metabolic signals were well detectable as much as the line width of water resonance was ranging from 5 to 9 hz. Average SNRs of citrate in BPH and prostate cancer were 11.4 and 1.9, respectively. The major finding was consistently lower citrate levels in prostate cancer compared with BPH and normal prostate central gland. This was significantly (p < 0.01) reflected by lower mean citrate/[creatine+choline] peak area ratio and citrate/lipid peak area ratio observed for region of cancer (0.446 +/- 0.063, 0.097 +/- 0.030) compared with BPH (1.458 +/- 0.107, 0.786 +/- 0.162) and normal central gland (1.418 +/- 0.129, 0.175 +/- 0.011), respectively. These studies demonstrate the potential of citrate spectrum detected by an external-body surface coil as an in vivo marker for discriminating prostate cancer from BPH.

Localized in vivo proton spectroscopy of renal cell carcinoma in human kidney.

In order to obtain proton magnetic resonance spectra from the renal tumor in human kidney we performed localized magnetic resonance spectroscopy using a saddle-type flexible surface coil. Five patients biopsy-proven as renal cell carcinoma at different stages were put in supine/lateral position to minimize motion artifacts while acquiring the spectrum. Water-suppressed 1H spectra were obtained with localized stimulated echo acquisition mode (STEAM) (20/13.7/2200; TE/TM/TR) and point resolved spectroscopy (PRESS) (288/2200; TE/TR) sequences. The principal resonances in the tumor STEAM spectrum were sorbitol (3.85 ppm), trimethylamines (TMA) (3.25 ppm), two unidentified signals (2.8 and 2.2 ppm), and lipid (0.9-1.8 ppm). In the PRESS spectrum using a long echo time (288 ms), two well localized signals, TMA at 3.25 ppm and lactate at 1.35 ppm were observed from a patient with a tumor at advanced stage. Interestingly only TMA at 3.25 ppm was observed from the patient with a low grade tumor. The spectral patterns of the tumor patients were different from those of normal kidney.

Esophageal involvement by cutaneous T-cell lymphoma, mycosis fungoides type: diagnosis by endoscopic biopsy.

A patient with long-standing cutaneous T-cell lymphoma, mycosis fungoides type (CTCL-MF), developed dysphagia, odynophagia, and weight loss. Endoscopic biopsy of esophageal mucosa demonstrated involvement by CTCL-MF. Although extracutaneous spread of CTCL-MF is common, esophageal involvement is unusual and to our knowledge has not previously been diagnosed antemortem.