Sarcoidosis-like disease with pulmonary infestation, meningoencephalitis and transverse myelitis after sigmoid cancer treatment.

We present the case of a 40-year-old male with recent history of moderately differentiated invasive adenocarcinoma of the sigmoid in whom both respiratory and neurological disease developed simultaneously, mimicking diffuse metastatic disease. The broad differential diagnosis and pitfalls (both diagnostic and therapeutic) are described. Pulmonary sarcoidosis as well as neurosarcoidosis occur very rarely after solid cancers.

CT density measurement and H:H ratio are useful in diagnosing acute cerebral venous sinus thrombosis.

BACKGROUND AND PURPOSE: Brain CT is widely used to exclude or confirm acute cerebral venous sinus thrombosis. The purpose of this study was to assess the value of attenuation measurement and the H:H ratio on unenhanced brain CT scans in the diagnosis of acute cerebral venous sinus thrombosis. MATERIALS AND METHODS: This retrospective study evaluated 20 patients with acute cerebral venous sinus thrombosis and 20 age- and sex-matched control participants without thrombosis. Three experienced observers independently evaluated the unenhanced brain CT scan for the presence of cerebral venous sinus thrombosis and measured the attenuation in the dural sinuses. Interreader differences were examined, as well as densities and H:H ratio between patients with acute cerebral venous sinus thrombosis and control participants. RESULTS: A significant difference in the average sinus attenuation was found between patients with acute cerebral venous sinus thrombosis (73.9 ± 9.2 HU) and the control group (52.8 ± 6.7 HU; P < .0001). A similar difference was found for the H:H ratio (1.91 ± 0.32 vs 1.33 ± 0.12 in patients with and without cerebral venous sinus thrombosis, respectively; P < .0001). Optimal thresholds of 62 HU and 1.52 lead to accuracies of 95% for average sinus attenuation and 97.5% for the H:H ratio, respectively. CONCLUSIONS: Hyperattenuation and the H:H ratio in the dural sinuses on unenhanced brain CT scans have a high accuracy in the detection of acute cerebral venous sinus thrombosis.

Hypoplasia of L5 and wedging and pseudospondylolisthesis in patients with spondylolysis: study with MR imaging.

BACKGROUND AND PURPOSE: The association between L5 hypoplasia and bilateral spondylolysis was described earlier on conventional radiographs of the lumbar spine. The purpose of this study was to describe the findings on MR imaging in patients with hypoplasia of L5 and to correlate these findings with the presence of bilateral spondylolysis of L5. MATERIAL AND METHODS: We studied the MR images of 22 patients with hypoplasia and posterior wedging of L5 and with bilateral spondylolysis at L5. The anteroposterior diameter of L4, L5, and S1 were measured and compared. The degree of posterior wedging of L5 was calculated. The degree of anterolisthesis was determined. The intervertebral disks of L4-L5 and L5-S1 were studied. RESULTS: The mean difference between the anteroposterior diameter of L4 and L5 was 3.0 mm, or 8.8% shortening of L5 compared with L4. The mean difference between the anteroposterior diameter of L5 and S1 was 4.4 mm, or 12.3% shortening of L5 compared with S1. The mean percentage posterior wedging was 24.7%. In 13 patients, there was no anterior vertebral slipping. True anterolisthesis grade I was seen in 5 patients and anterolisthesis grade II in 4 patients. Diskarthrosis with disk dehydration of L4-L5 was seen in 20 of the 22 patients. CONCLUSIONS: It is confirmed that hypoplasia of L5 can simulate anterolisthesis. Hypoplasia of the vertebral body of L5 can predict the presence of bilateral spondylolysis.

The acute atraumatic peroneal compartment syndrome, a rare and therefore sometimes unrecognised entity.

Two cases of Acute Peroneal Compartment Syndrome, without history of trauma are presented. One case had a history of prolonged horse-riding with the wearing of tight boots, the other case had a history of prolonged walking. An Acute Peroneal Compartment Syndrome should always be considered in the differential diagnosis of pain in the peroneal region of the lower limb.

Comparative study of the density of particles in suspensions for patch testing.

A simple and reliable method to evaluate the density of particles in patch test suspensions is described. The number of particles per unit volume has been found to vary significantly within a wide range of values. These variations have no relation to the concentration or the molecular weight of the substance, as far as particles larger than 10 micron are concerned. Because the presence of particles is one of the factors which can influence percutaneous penetration and since physical manipulations are able to modify the size of these particles, it is suggested that the kinetics of penetration of haptens through the skin should be revaluated with regard to this special point.