RESUMO
Transthoracic parametric Doppler (TPD), unlike conventional ultrasonography, measures signals originating from movements of pulmonary blood vessel walls. In this pilot study, we tested TPD in 15 patients diagnosed with pulmonary embolism on computed tomography pulmonary angiography. Results were mapped to the upper, middle, and lower thirds of the right lung. In the lower third, TPD yielded 100% specificity and positive predictive value for acute pulmonary embolism. If validated in a larger series, this rapid bedside technique might obviate the need for computed tomography in specific cases. This could be advantageous in patients who are unstable, in intensive care, or have allergies to iodinated contrast material.
Assuntos
Embolia Pulmonar/diagnóstico por imagem , Ultrassonografia Doppler , Doença Aguda , Adulto , Angiografia , Angiografia por Tomografia Computadorizada , Feminino , Hemodinâmica , Humanos , Pulmão/diagnóstico por imagem , Masculino , Pessoa de Meia-Idade , Projetos Piloto , Estudos Prospectivos , Artéria Pulmonar/diagnóstico por imagem , Artéria Pulmonar/fisiopatologia , Embolia Pulmonar/fisiopatologia , Veias Pulmonares/diagnóstico por imagem , Veias Pulmonares/fisiopatologia , Sensibilidade e Especificidade , Tomografia Computadorizada por Raios XRESUMO
Li-Fraumeni syndrome is a cancer predisposition syndrome associated with a variety of neoplasms, mainly soft tissue sarcoma, premenopausal breast cancer, brain tumors, adrenocortical carcinoma, and leukemia. Esophageal leiomyomatosis involves the presence of several rare benign neoplastic lesions composed of proliferating smooth muscle cells in the esophageal wall. The current case report presents a patient with recurrent diffuse leiomyomas of the esophagus and confirmed p53 mutation with clinical criteria of Li-Fraumenilike syndrome.
Assuntos
DNA de Neoplasias/genética , Neoplasias Esofágicas/genética , Esôfago/patologia , Genes p53/genética , Leiomiomatose/genética , Mutação , Biópsia , Análise Mutacional de DNA , Endoscopia Gastrointestinal , Neoplasias Esofágicas/diagnóstico , Feminino , Humanos , Leiomiomatose/diagnóstico , Pessoa de Meia-Idade , Tomografia Computadorizada por Raios XRESUMO
A 5 1/2-year-old boy presented with repeated episodes of stridor and cough. Chest radiography demonstrated a widened mediastinum. Evaluation by CT revealed a low-density posterior mediastinal mass initially diagnosed as benign tumor. Histopathological analysis of the resected mass disclosed a malignant chordoma. Our radiological results are described with an analysis of the imaging findings in the medical literature. We present our suggestions for preoperative evaluation of posterior mediastinal tumors.
Assuntos
Cordoma/diagnóstico , Neoplasias do Mediastino/diagnóstico , Mediastino/diagnóstico por imagem , Recidiva Local de Neoplasia/diagnóstico , Pré-Escolar , Cordoma/cirurgia , Tosse/etiologia , Diagnóstico Diferencial , Seguimentos , Humanos , Imageamento por Ressonância Magnética , Masculino , Neoplasias do Mediastino/cirurgia , Mediastino/patologia , Mediastino/cirurgia , Sons Respiratórios , Tomografia Computadorizada por Raios XRESUMO
A case of an actively bleeding mediastinal mass in a 4-year-old boy who sustained multitrauma is described. A computed tomography (CT) scan of the chest upon admission demonstrated a mediastinal mass, which enlarged significantly as seen by repeat CT scan at 3 days with a concomitant drop in serum hemoglobin levels. The lesion was excised, and pathological examination established the diagnosis of a lymphatic-venous malformation containing bloody fluid. Lymphatic-venous malformations are rare vascular malformations and are usually found in the head and neck and less commonly at other sites. Spontaneous bleeding is a known complication, and there are few reports describing posttraumatic hemorrhage. Our case is the first description in the English medical literature of a posttraumatic bleeding mediastinal mixed vascular malformation and includes sequential CT scans illustrating the dynamic nature of hemorrhage.