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3.
Med Sci Monit ; 25: 5336-5342, 2019 Jul 18.
Artigo em Inglês | MEDLINE | ID: mdl-31318849

RESUMO

BACKGROUND This study aimed to evaluate superb microvascular imaging (SMI) as an adjunctive imaging method to evaluate mesenteric lymph nodes in children with mesenteric lymphadenitis compared with healthy children. MATERIAL AND METHODS A retrospective study compared children with mesenteric lymphadenitis (n=27) and healthy children (n=30). Lymph node size was determined using grayscale ultrasonography and parameters of lymph node vascularity were compared using color Doppler flow imaging (CDFI) and SMI. The diagnostic performance of ultrasound (US), US combined with SMI, and US combined with CDFI were compared. RESULTS Lymph nodes from children with mesenteric lymphadenitis (n=77) and normal lymph nodes (n=84) were evaluated by SMI, which showed that the least diameter of lymph nodes in cases of mesenteric lymphadenitis was 0.58±0.15 mm and of normal mesenteric lymph nodes was 0.47±0.08 mm (p<0.001). SMI identified 92.6% of abnormal mesenteric lymph nodes while CDFI detected 85.2%. US combined with SMI had the highest sensitivity (81.5%), and specificity (78.9%) compared with US alone (sensitivity, 63.0%; specificity, 64.9%), and compared with US combined with CDFI (sensitivity, 74.1%; specificity, 75.4%). US combined with SMI and US combined with CDFI achieved the same specificity (76.7%), which was higher than that of US alone (66.7%). CONCLUSIONS SMI was superior to color Doppler flow imaging in evaluating the microvasculature in lymphadenopathy in mesenteric lymphadenitis. SMI may be used as an adjunct to grayscale ultrasonography to assist in identifying mesenteric lymphadenopathy in pediatric patients.


Assuntos
Linfadenite Mesentérica/diagnóstico por imagem , Linfadenite Mesentérica/fisiopatologia , Microvasos/diagnóstico por imagem , Criança , Pré-Escolar , China , Diagnóstico Diferencial , Feminino , Humanos , Linfonodos/efeitos dos fármacos , Linfonodos/fisiopatologia , Masculino , Linfadenite Mesentérica/metabolismo , Mesentério/metabolismo , Estudos Retrospectivos , Sensibilidade e Especificidade , Ultrassonografia/métodos , Ultrassonografia Doppler em Cores/métodos
4.
J Vet Intern Med ; 33(4): 1753-1758, 2019 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-31134693

RESUMO

BACKGROUND: Listeriosis is a rare disease in cats with naturally occurring cases usually being identified in individual animals. Listerial mesenteric lymphadenitis has not been described previously in cats. OBJECTIVES: To describe the clinical and histological features of listerial mesenteric lymphadenitis in cats as well as treatment outcome. ANIMALS: Listerial mesenteric lymphadenitis was confirmed in 3 cats by histology, immunohistochemistry, and bacterial culture. RESULTS: The affected cats were young to middle aged and were examined for various clinical signs. On both palpation and abdominal ultrasound examination, all cats had marked mesenteric lymphadenomegaly. Survival was prolonged in all 3 cases. Two of the 3 cats were fed a raw meat-based diet before they developed clinical illness. CONCLUSIONS AND CLINICAL IMPORTANCE: Lymphadenitis caused by listeriosis has a protracted time course and should be a differential diagnosis for abdominal lymphadenopathy in young to middle-aged cats. Feeding of a raw meat-based diet may be a contributing factor for development of listeriosis in cats.


Assuntos
Doenças do Gato/patologia , Listeriose/veterinária , Linfadenite Mesentérica/veterinária , Animais , Doenças do Gato/diagnóstico por imagem , Doenças do Gato/microbiologia , Doenças do Gato/terapia , Gatos , Dieta/veterinária , Listeria/isolamento & purificação , Listeriose/microbiologia , Masculino , Carne , Linfadenite Mesentérica/diagnóstico por imagem , Linfadenite Mesentérica/microbiologia , Linfadenite Mesentérica/terapia , Alimentos Crus , Ultrassonografia/veterinária
5.
J Med Case Rep ; 12(1): 101, 2018 Apr 20.
Artigo em Inglês | MEDLINE | ID: mdl-29673407

RESUMO

BACKGROUND: Angioimmunoblastic T cell lymphoma is a rare malignancy, accounting for only 2% of all non-Hodgkin lymphomas, first described in the 1970s and subsequently accepted as a distinct entity in the current World Health Organization classification. Due to the paucity of this disease, there is still no identifiable etiology, no consistent risk factors, and the pathogenesis remains unclear. CASE PRESENTATION: An 83-year-old Caucasian man presented to an emergency department with palpitations and was found to have atrial fibrillation. During his hospitalization, he was found to have asymptomatic hypercalcemia with corrected calcium of 11.7. Ten days later while in rehabilitation, he started complaining of progressive fatigue and altered mental status was noted. He was found to have a calcium level of 15.5 and was admitted to the intensive care unit for management and further workup. He was found at that time to have, parathyroid hormone: < 1; 25 hydroxyvitamin D: 74; 1,25 dihydroxyvitamin D: 85.4; angiotensin-converting enzyme: 7; parathyroid hormone-related protein: < 2; and multiple myeloma workup was negative. Computed tomography of his chest and abdomen showed extensive retroperitoneal, pelvic, and mesenteric lymphadenopathy in addition to findings suggestive of peritoneal carcinomatosis. A right axillary lymph node biopsy showed immunohistochemical parameters consistent with angioimmunoblastic T cell lymphoma. After a lengthy discussion with his family, it was decided that no further treatment would be pursued. He had an aggressive course at the hospital during which he developed pleural effusions, ascites, and diffuse petechiae within 2 weeks; these were complications from his malignancy. Considering the poor outcomes of his aggressive disease, he decided to enroll in an out-patient hospice. He died within a few months as a result of cardiorespiratory arrest. CONCLUSIONS: This case illustrates a rare presentation of an extremely rare disease; that is, hypercalcemia in a patient who was later found to have angioimmunoblastic T cell lymphoma. Diagnosing angioimmunoblastic T cell lymphoma might be the most challenging part due to the wide array of clinical presentations, of which hypercalcemia accounts for only 1%. As seen in this case, most patients present in advanced stages of the disease with poor prognosis.


Assuntos
Hipercalcemia/sangue , Linfonodos/patologia , Linfoma de Células T/diagnóstico , Linfoma de Células T/patologia , Abdome/diagnóstico por imagem , Idoso de 80 Anos ou mais , Biópsia , Estado Terminal , Evolução Fatal , Hidratação , Humanos , Hipercalcemia/complicações , Hipercalcemia/diagnóstico , Linfoma de Células T/sangue , Linfoma de Células T/complicações , Linfadenite Mesentérica/complicações , Linfadenite Mesentérica/diagnóstico por imagem , Proteína Relacionada ao Hormônio Paratireóideo/sangue , Tomografia Computadorizada por Raios X
8.
JBRA Assist Reprod ; 20(1): 41-3, 2016 Mar 01.
Artigo em Inglês | MEDLINE | ID: mdl-27203306

RESUMO

Mesenteric lymphadenitis is a clinical condition that affects mostly children and teenagers. Its symptoms include fever, severe abdominal pain, nausea, and, in some cases, diarrhea, constipation, and acute abdomen. This paper describes the case of a 16-year-old patient with mesenteric lymphadenitis submitted to an exploratory laparoscopy for suppurative lymph nodes that evolved to a drastic reduction of ovarian reserve. Because of the patients age, she was offered cryopreservation of her ovarian tissue.


Assuntos
Infertilidade Feminina , Linfadenite Mesentérica , Reserva Ovariana/fisiologia , Abdome Agudo/diagnóstico por imagem , Abdome Agudo/etiologia , Adolescente , Criopreservação , Feminino , Humanos , Infertilidade Feminina/etiologia , Infertilidade Feminina/terapia , Linfadenite Mesentérica/complicações , Linfadenite Mesentérica/diagnóstico por imagem , Linfadenite Mesentérica/cirurgia , Ultrassonografia
9.
J Ultrasound Med ; 35(3): 627-35, 2016 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-26892821

RESUMO

Abdominal pain is very common in the pediatric population (<18 years of age). Sonography is a safe modality that can often differentiate the frequently encountered causes of abdominal pain in children. This pictorial essay will discuss the sonographic findings of acute appendicitis, including the imaging appearance of a perforated appendicitis. It will also present the sonographic features of the relatively common mimics of appendicitis, such as mesenteric adenitis/gastroenteritis, intussusception, Meckel diverticulum, and ovarian torsion.


Assuntos
Dor Abdominal/diagnóstico por imagem , Apendicite/diagnóstico por imagem , Enterite/diagnóstico por imagem , Intussuscepção/diagnóstico por imagem , Linfadenite Mesentérica/diagnóstico por imagem , Ultrassonografia/métodos , Dor Abdominal/etiologia , Adolescente , Apendicite/complicações , Criança , Pré-Escolar , Diagnóstico Diferencial , Enterite/complicações , Feminino , Humanos , Lactente , Recém-Nascido , Intussuscepção/complicações , Masculino , Divertículo Ileal/complicações , Divertículo Ileal/diagnóstico por imagem , Linfadenite Mesentérica/complicações , Variações Dependentes do Observador , Doenças Ovarianas/complicações , Doenças Ovarianas/diagnóstico por imagem , Reprodutibilidade dos Testes , Sensibilidade e Especificidade , Anormalidade Torcional/complicações , Anormalidade Torcional/diagnóstico por imagem
10.
Acta Radiol ; 56(2): 228-33, 2015 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-24526755

RESUMO

BACKGROUND: The clinical diagnosis of intussusception remains challenging, because many children with intussusception may present with non-specific signs and symptoms, which overlap with other conditions. Therefore imaging, in particular ultrasonography (US), plays a significant role in the management of these patients. PURPOSE: To evaluate how US can contribute to the diagnosis in clinically suspected intussusception and finding alternative diagnosis. MATERIAL AND METHODS: We retrospectively reviewed reports of US examinations and medical records of 100 patients (51 boys, 49 girls; mean age, 23.0 ± 12.1 months) who underwent abdominal US for clinically suspected intussusception. Each US study was assessed for the presence or absence of intussusception and for a possible alternative diagnosis in cases interpreted as negative for intussusception. RESULTS: Thirty-seven patients had US findings consistent with intussusception, which was confirmed by air enema. In seven patients, US studies were normal. Alternative diagnoses were identified by US for each of the remaining 56 patients, including ileocolitis (n = 20), terminal ileitis (n = 18), mesenteric lymphadenitis (n = 13), choledochal cyst (n = 1), accessory spleen torsion (n = 1), small bowel ileus (n = 1), midgut volvulus with bowel ischemia (n = 1), and hydronephrosis (n = 1). CONCLUSION: With the high sensitivity and specificity of this study we conclude that US is valuable in detecting intussusception and finding the alternative diagnosis.


Assuntos
Doença de Crohn/diagnóstico por imagem , Ileíte/diagnóstico por imagem , Intussuscepção/diagnóstico por imagem , Linfadenite Mesentérica/diagnóstico por imagem , Ultrassonografia/métodos , Diagnóstico Diferencial , Feminino , Humanos , Lactente , Masculino , Reprodutibilidade dos Testes , Estudos Retrospectivos , Sensibilidade e Especificidade
11.
J Comput Assist Tomogr ; 36(1): 26-9, 2012.
Artigo em Inglês | MEDLINE | ID: mdl-22261767

RESUMO

OBJECTIVE: To determine the natural history of incidentally detected misty mesentery on computed tomography (CT) and to correlate the risk of malignancy with size of mesenteric lymph nodes. METHODS: A retrospective review of all CT abdomen/pelvic examinations from January 1, 2004 through December 31, 2008 identified cases of misty mesentery. The largest mesenteric lymph node was measured, and additional areas of lymphadenopathy were identified. Follow-up was obtained by reviewing all subsequent CT examinations, clinical notes, and pathologic specimens. Patients were excluded if they had a known malignancy at the time of initial CT, CT or clinical history revealing a cause for the misty mesentery, or CT follow-up of less than 2 years. RESULTS: Thirty-seven patients with misty mesentery were included. The mean time from the original CT to the latest follow-up was 3.8 years. The largest lymph node measured less than 10 mm in 30 (81%) of 37 patients. All 30 patients demonstrated stable lymph node size, had no other regions with lymphadenopathy, and none developed malignancy. The largest lymph node was 10 mm or greater in 7 (19%) of 31 patients. Three of these patients developed non-Hodgkin lymphoma, 2 of which had other areas of lymphadenopathy. No cases of nonlymphomatous malignancy were identified. CONCLUSIONS: The development of malignancy in patients with incidentally detected misty mesentery correlates with mesenteric lymph node size. Patients with misty mesentery and largest mesenteric lymph node less than 10 mm without additional areas of lymphadenopathy demonstrate a benign course, and no further follow-up may be necessary.


Assuntos
Linfoma não Hodgkin/diagnóstico por imagem , Linfadenite Mesentérica/diagnóstico por imagem , Tomografia Computadorizada por Raios X/métodos , Adulto , Idoso , Idoso de 80 Anos ou mais , Meios de Contraste , Feminino , Humanos , Achados Incidentais , Iopamidol , Linfonodos/diagnóstico por imagem , Masculino , Linfadenite Mesentérica/patologia , Pessoa de Meia-Idade , Estudos Retrospectivos , Fatores de Risco
14.
Obstet Gynecol Clin North Am ; 38(1): 69-83, viii, 2011 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-21419328

RESUMO

Acute pelvic pain in women is a common presenting complaint that can result from various conditions. Because these conditions can be of gynecologic or nongynecologic origin, they may pose a challenge to the diagnostic acumen of physicians, including radiologists. A thorough workup should include clinical history, physical examination, laboratory data, and appropriate imaging studies, all of which should be available to the radiologist for evaluation. Ultrasound is the primary imaging modality in women with acute pelvic pain because of its high sensitivity, low cost, wide availability, and lack of ionizing radiation, particularly when a gynecologic disorder is suspected as the underlying cause. However, other modalities such as computed tomography (CT) and magnetic resonance imaging (MRI) may be very helpful, especially when a nongynecologic condition is suspected.


Assuntos
Dor Pélvica/diagnóstico por imagem , Dor Pélvica/etiologia , Apendicite/complicações , Apendicite/diagnóstico por imagem , Colite/diagnóstico por imagem , Diverticulite/diagnóstico por imagem , Feminino , Humanos , Obstrução Intestinal/diagnóstico por imagem , Linfadenite Mesentérica/diagnóstico por imagem , Gravidez , Complicações na Gravidez/diagnóstico por imagem , Sensibilidade e Especificidade , Ultrassonografia , Cálculos Ureterais/diagnóstico por imagem
15.
Clin Microbiol Infect ; 17(2): 135-9, 2011 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-20148920

RESUMO

Disseminated Mycobacterium avium complex (MAC) infection is a rare but severe disease mostly seen in patients with AIDS. It has been previously described in patients suffering from other kinds of immunodeficiency (e.g. primary immunodeficiency diseases in children or hairy cell leukaemia). We report two cases of disseminated MAC disease in young women with extended granulomatosis that revealed a new form of severe immunodeficiency syndrome. Both clinical observations initially appeared to be very similar to WHIM syndrome (Warts, Hypogammaglobulinemia, Infection, Myelokathexis), a rare immunodeficiency disease correlated with CXC chemokine receptor 4 (CXCR4) mutation leading to an impaired internalization of the receptor upon its ligand CXCL12. We investigated the CXCR4 status of the lymphocytes in both patients and found a severe defect in CXCL12-promoted internalization but no mutation of its gene. Moreover, myelokathexis was not noted in bone marrow biopsies and therefore a diagnosis of WHIM syndrome could not be assessed. This immunodeficiency syndrome associated with CXCR4 dysfunction was responsible for severe MAC infection in our patients, with a fatal outcome in one case. It may be possible that these patients would have benefited from early antimycobacterial infection or azythromycin prophylaxis.


Assuntos
Síndromes de Imunodeficiência/complicações , Síndromes de Imunodeficiência/diagnóstico , Complexo Mycobacterium avium/isolamento & purificação , Infecção por Mycobacterium avium-intracellulare/diagnóstico , Infecção por Mycobacterium avium-intracellulare/imunologia , Receptores CXCR4/imunologia , Evolução Fatal , Feminino , Histocitoquímica , Humanos , Linfadenite Mesentérica/diagnóstico por imagem , Linfadenite Mesentérica/patologia , Microscopia , Infecção por Mycobacterium avium-intracellulare/patologia , Tomografia por Emissão de Pósitrons , Radiografia , Receptores CXCR4/genética , Receptores CXCR4/metabolismo , Pele/patologia , Adulto Jovem
16.
Vestn Rentgenol Radiol ; (3): 45-8, 2011.
Artigo em Russo | MEDLINE | ID: mdl-22288133

RESUMO

The paper pools the experience of ultrasound assessment of acute mesadenitis in children with acute abdominal pain syndrome. It reviews the literature on its etiology, pathology, and diagnosis and treatment principles. B-mode and Doppler echograms made by general practice ultrasound diagnosticians are shown. The technique is demonstrated to be effective and of informative value in the early stages of diagnosis in the patient contingent in question.


Assuntos
Abdome Agudo , Linfonodos/diagnóstico por imagem , Linfadenite Mesentérica , Cavidade Peritoneal/diagnóstico por imagem , Ultrassonografia , Abdome Agudo/diagnóstico por imagem , Abdome Agudo/etiologia , Abdome Agudo/fisiopatologia , Adolescente , Criança , Pré-Escolar , Diagnóstico Diferencial , Diagnóstico Precoce , Humanos , Lactente , Linfonodos/patologia , Linfonodos/fisiopatologia , Linfadenite Mesentérica/complicações , Linfadenite Mesentérica/diagnóstico por imagem , Linfadenite Mesentérica/fisiopatologia , Ultrassonografia/métodos , Ultrassonografia/normas
18.
J Ultrasound Med ; 26(5): 581-4, 2007 May.
Artigo em Inglês | MEDLINE | ID: mdl-17459999

RESUMO

OBJECTIVE: Abdominal lymph nodes are frequently visualized by sonography in the pediatric population. The term "mesenteric lymphadenitis" is frequently used in the radiologic literature to describe this finding, whereas in the pediatric literature, this term is reserved for specific inflammation of the lymph nodes. The purpose of this study was to compare by sonography the incidence of appearance of enlarged abdominal lymph nodes (EALNs) in healthy children compared with that in children with abdominal pain of various causes. METHODS: In 200 patients referred for abdominal sonography for various indications, the presence of EALNs, their location, and size were registered. The patients were divided into 3 groups: those with abdominal pain due to an acute abdominal condition (group 1), those with abdominal pain without an acute abdominal condition (group 2), and asymptomatic patients (group 3). RESULTS: Enlarged abdominal lymph nodes greater than 5 mm were detected in 83.3% of group 1 patients, 73.8% of group 2 patients, and 64% of group 3 patients. A significant statistical difference was found between patients with abdominal pain and asymptomatic children only for lymph nodes of 10 mm and larger (P = .0117). No statistically significant difference was seen in the presence of lymph node clusters between the patients with abdominal pain and asymptomatic children. There was a tendency of increased EALN occurrence with age, peaking at 10 years, with a decrease later. CONCLUSIONS: Enlarged abdominal lymph nodes are frequently encountered in asymptomatic children and should not always be considered abnormal. Enlarged abdominal lymph nodes exceeding 10 mm in their shortest axis in children with abdominal pain may represent mesenteric lymphadenitis of various causes.


Assuntos
Dor Abdominal/diagnóstico por imagem , Dor Abdominal/etiologia , Linfonodos/diagnóstico por imagem , Linfadenite Mesentérica/complicações , Linfadenite Mesentérica/diagnóstico por imagem , Adolescente , Criança , Pré-Escolar , Feminino , Humanos , Lactente , Masculino , Reprodutibilidade dos Testes , Sensibilidade e Especificidade , Ultrassonografia
19.
Bratisl Lek Listy ; 106(6-7): 201-2, 2005.
Artigo em Inglês | MEDLINE | ID: mdl-16201735

RESUMO

The purpose of our study is to emphasize the central role of ultrasound (US) in finding the cause of abdominal pain in children. Ultrasound of the lower abdomen quadrant should be considered in all cases in which the clinical signs and symptoms are not diagnostic of appendicitis. There is a wide range of clinical syndromes and diseases which can easily be diagnosed using a high resolution ultrasound with adjunct of color and power Doppler. The spectrum of abnormalities includes appendicitis, mesenteric lymphadenitis, infectious ileocecitis, Crohn's disease, intussusception, ovarian cysts, and encysted cerebrospinal fluid. One of the most common causes of acute abdominal pain in children is acute terminal ileitis (infectious ileocecitis) with mesenteric lymphadenitis. Ultrasound is the best tool to rapidly differentiate this disease from acute appendicitis, and prevent unnecessary laparotomy (Ref. 12).


Assuntos
Abdome Agudo/etiologia , Apendicite/diagnóstico por imagem , Infecções Bacterianas/diagnóstico por imagem , Doenças do Ceco/diagnóstico por imagem , Gastroenterite/diagnóstico por imagem , Ileíte/diagnóstico por imagem , Adolescente , Doenças do Ceco/microbiologia , Ceco/diagnóstico por imagem , Criança , Pré-Escolar , Diagnóstico Diferencial , Feminino , Gastroenterite/microbiologia , Humanos , Ileíte/microbiologia , Íleo/diagnóstico por imagem , Masculino , Linfadenite Mesentérica/diagnóstico por imagem , Ultrassonografia
20.
Arch Pediatr ; 12(3): 288-90, 2005 Mar.
Artigo em Francês | MEDLINE | ID: mdl-15734126

RESUMO

Abdominal pain is uncommon in patient with Epstein-Barr infection and is usually attributed to an enlargement of the liver or spleen. We report on an 8-year-old girl with a pseudoperitonitis due to a mesenteric lymphadenitis associated with Epstein-Barr infection. Outcome was favourable without surgery. We review the different causes of abdominal pain occurring during Epstein-Barr infection.


Assuntos
Dor Abdominal/etiologia , Mononucleose Infecciosa/complicações , Linfadenite Mesentérica/complicações , Linfadenite Mesentérica/etiologia , Dor Abdominal/diagnóstico por imagem , Doença Aguda , Anticorpos Antivirais/análise , Criança , Feminino , Seguimentos , Herpesvirus Humano 4/imunologia , Herpesvirus Humano 4/isolamento & purificação , Humanos , Imunoglobulina M/análise , Mononucleose Infecciosa/diagnóstico , Linfadenite Mesentérica/diagnóstico , Linfadenite Mesentérica/diagnóstico por imagem , Radiografia Abdominal , Fatores de Tempo , Tomografia Computadorizada por Raios X , Resultado do Tratamento
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