Isolated nodular metastases in perirenal space: our experience of nine cases and review of the literature.

AIM: The aim of this paper was to report authors' experience and review of the literature on rare isolated perirenal space metastases from different primary tumors. METHODS: From January 2004 to August 2008 we evaluated retrospectively 9 patients with isolated nodular neoplastic lesions of the perirenal space with computed tomography (CT) imaging and we reported the follow-up after relapse of disease. RESULTS: All the masses resulted being of secondary tumor involvement (melanoma (2/9 cases 22.22%), esophagus-gastric tract adenocarcinoma (3/9 cases 33.33%), gynecological tumor (2/9 cases 22.22%) and gastrointestinal tumor (2/9 cases, 22.22%), diagnosed by biopsy CT-guided (2 cases), or histological post-surgical examination (1 case), or clinical and instrumental follow-up (4 cases) or postmortem examination (2 cases). The lesions were bilateral in 3 cases and monolateral in 6 cases, isolated in four cases and multiple in five cases; they have demonstrated partially necrotic parenchymal density as soft tissues masses, with frequently hypervascularization, with portal venous enhancement. The dimensions of lesions resulted to be between minimal value of about 7-8 mm and maximum value of about 50 mm (mean 29 mm). The patients had generally poor prognosis (death for disease ­ DOD ­ in 5 cases; life with disease - LWD ­ in four cases). CONCLUSION: Isolated perirenal metastases are unusual site of relapse of disease. Our study confirms the utility of CT evaluation of metastatic localization of perirenal space; this technique can also be used for focused biopsies and follow-up. This site of isolated metastases had a poor prognosis.

MR peri-CSF lesions and CSF oligoclonal bands in Italian multiple sclerosis patients.

OBJECTIVES: We investigated the association between brain lesion distribution and the presence of oligoclonal IgG bands (OCBs) in Italian multiple sclerosis (MS) patients. MATERIALS AND METHODS: We retrospectively selected brain magnetic resonance imaging (MRI) uniformly performed in 56 relapsing patients (41 patients OCB positive). RESULTS: Brain lesions in periventricular areas occurred in 92.86% of the patients (100% OCB+ and 73.33% OCB-) (P = 0.004), but we did not find a significant difference for their median volume (P = 0.553) and median number (P = 0.606) between the two groups. Parenchymal lesions occurred in 76.8% of the patients with a similar distribution (P = 1.00) and no significant difference in the median volume (P = 0.818) and number (P = 0.643) between the two groups. CONCLUSIONS: The present study on cohort of Italian MS patients demonstrated a lack of correlation between lesion distribution and OCBs, suggesting that B cells producing them could be localized both in meningeal niches and cerebral parenchyma.

What insights have new imaging techniques given into aggressive forms of MS--different forms of MS or different from MS?

"Aggressive" multiple sclerosis (MS) is still a challenging diagnosis, in spite of the relevant progresses concerning the comprehension of the disease mechanisms, especially through pathology studies and the advent of conventional magnetic resonance imaging (MRI). Some reviews have been already published on their clinical and therapeutical aspects, but no systematic review is available in literature about the neuroradiological features, using both conventional and advanced techniques. In particular, advanced MRI techniques, namely diffusion-weighted and tensor imaging, magnetization transfer imaging, and proton magnetic resonance spectroscopy, are giving new insights to find specific and appropriate radiological parameters that can help in targeting the diagnosis. We report a review of literature on the neuroradiological findings of aggressive forms of MS, focusing specifically on the role of advanced MRI techniques in the diagnostic phase and during follow-up.

[Differences in potential and content of the mucus in the stomach of the rat with avitaminosis A]. / Differenza di potenziale e contenuto di muco nello stomaco di ratto in avitaminosi A.

Vitamin A (vit. A) acts in the synthesis of glycoproteins and in cell surface phenomena of epithelia. Since the glycoproteins of gastric mucus and the integrity of gastric cell membranes are components of gastric barrier (GB), vit. A could play a role in GB. Five groups of rats were used: I) rats fed on vit. A deficient diet; II) rats pair-fed plus a daily oral dose of 45 micrograms vit. A; III) normal rats; IV) rats recovered from avitaminosis A (avit. A) after 20 days of daily oral dose of 300 micrograms vit. A; V) rats pair-fed plus a daily oral dose of 45 micrograms vit. A. We measured: 1) transparietal gastric potential difference (PD) in vivo (by means of agar-KCl electrodes); 2) mucus (by binding of Alcian blue): in gastric mucosa; adherent to gastric mucosa; in gastric lumen; 3) dry weight of the stomach. Avit. A induced: i) a decrease of PD and mucus in mucosa and lumen; ii) an increase of mucus adherent to mucosa; iii) an increase of the percentage of dry weight on wet weight. All parameters were normal after recovery from avit. A. Results suggest that avit. A could reduce either mucus synthesis or its erosion. Moreover avit. A might modify mucus structure and sterical configuration of mucosal cells. The alteration of mucosal cell membranes could decrease PD. In conclusion the modifications of some components of rat GB seem specifically caused by avit. A and suggest a protective role of vit. A.