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1.
Eur J Neurol ; 29(9): 2754-2760, 2022 09.
Artículo en Inglés | MEDLINE | ID: mdl-35615966

RESUMEN

BACKGROUND AND PURPOSE: Neurofilament light chain (NfL) is an accepted biomarker of disease activity in multiple sclerosis (MS), but its relationship with magnetic resonance imaging (MRI) activity particularly in reference to lesion location and recurrent activity is not well understood. METHODS: In 139 MS patients who underwent lumbar punctures with follow-up in 25, the relationship between cerebrospinal fluid (CSF) NfL and cranial MRI based on lesion location and lesion number was evaluated. Spearman rank correlation was used to assess the association between CSF NfL and MRI lesion location and lesion counts at baseline and follow-up at 1 year. Multiple linear regression analysis was performed to assess which lesion location was most strongly associated with CSF NfL values. RESULTS: The associations between baseline CSF NfL and lesion location and follow-up lesions were modest, whilst those between baseline MRI and follow-up CSF NfL were greater: periventricular (r = 0.31, p = 0.141), juxtacortical (r = 0.47, p = 0.022), infratentorial (r = 0.71, p ≤ 0.001) and cord lesions (r = 0.60, p = 0.002). All associations, however, improved following adjustment for disease duration and type of MS. Modelling revealed 53% of (log) CSF NfL could be explained by variance in baseline MRI lesion location. CONCLUSIONS: Baseline CSF NfL did not correlate with current or future MRI activity and lesion location. However, baseline MRI activity explained around 53% of the variation in the follow-up CSF NfL, suggesting that the relationship between MRI and CSF NfL is mainly precedent rather than an association, that is one occurring before the other.


Asunto(s)
Esclerosis Múltiple , Biomarcadores/líquido cefalorraquídeo , Humanos , Filamentos Intermedios , Imagen por Resonancia Magnética , Esclerosis Múltiple/líquido cefalorraquídeo , Esclerosis Múltiple/diagnóstico por imagen , Proteínas de Neurofilamentos/líquido cefalorraquídeo
2.
Skeletal Radiol ; 51(6): 1189-1199, 2022 Jun.
Artículo en Inglés | MEDLINE | ID: mdl-34714386

RESUMEN

OBJECTIVE: To determine whether MRI can distinguish atypical cartilaginous tumour/grade 1 peripheral/periosteal chondrosarcoma (ACT/Gd1 PP-CS) from high-grade peripheral/periosteal chondrosarcoma (HG-PP-CS) or dedifferentiated peripheral/periosteal chondrosarcoma (DD-PP-CS). MATERIALS AND METHODS: Retrospective review of patients diagnosed between January 2007 and December 2020 who had undergone resection of PP-CS. Data collected included age, sex, and skeletal location. Histological tumour grades based on surgical resection were classified as ACT/grade 1 PP-CS, HG-PP-CS, or DD-PP-CS. A variety of MRI features were reviewed independently by 2 musculoskeletal radiologists blinded to final diagnosis and compared between the 3 groups. For statistical analysis, HG-PP-CS and DD-PP-CS were combined. RESULTS: Fifty-eight patients fulfilled the inclusion criteria, 31 (53%) males and 27 (47%) females with a mean age at diagnosis of 46.1 years (range 11-83 years), 14 (24%) of whom had an underlying diagnosis of diaphyseal aclasis. Forty-one (70.7%) cases were peripheral and 17 (29.3%) periosteal, 38 (66%) involving the flat bones, 15 (26%) the major long bones, 3 (5%) the spine, and 2 (3%) the bones of the hands and feet. Final histology revealed 33 (57%) ACT/Gd1-PP-CS, 18 (31%) HG-PP-CS, and 7 (12%) DD-PP-CS. Periosteal tumours were 16 times more likely to be HG/DD-CS compared to peripheral tumours (p < 0.001). Intra-medullary tumour extension was predictive of HG/DD-CS (p = 0.004) for both tumour types, while cap thickness (p = 0.04) and a diffuse cap type (p = 0.03) were differentiating features of low-grade and high-grade peripheral CS. DISCUSSION: A variety of features can help differentiate low-grade from high-grade peripheral/periosteal CS, the most significant being origin from the bone surface.


Asunto(s)
Neoplasias Óseas , Condrosarcoma , Adolescente , Adulto , Anciano , Anciano de 80 o más Años , Neoplasias Óseas/patología , Huesos/patología , Niño , Condrosarcoma/diagnóstico por imagen , Condrosarcoma/patología , Femenino , Humanos , Hiperplasia/patología , Imagen por Resonancia Magnética , Masculino , Persona de Mediana Edad , Estudios Retrospectivos , Columna Vertebral/patología , Adulto Joven
3.
Skeletal Radiol ; 50(7): 1275-1290, 2021 Jul.
Artículo en Inglés | MEDLINE | ID: mdl-33386903

RESUMEN

Paget's sarcoma is a rare and particularly aggressive tumour arising within pagetic bone, affecting approximately 1% of patients with Paget's disease during the course of their disease. Most of these tumours are osteosarcomas, but the age profile, skeletal distribution and clinical outcomes differ considerably from conventional osteosarcoma. In this review, we outline the clinical, radiographic/CT, scintigraphic and magnetic resonance imaging features of Paget's sarcoma. We also review the neoplastic and non-neoplastic mimics of Paget's sarcoma that should be considered in the differential diagnosis when encountering an aggressive lesion within pagetic bone.


Asunto(s)
Neoplasias Óseas , Osteítis Deformante , Osteosarcoma , Sarcoma , Neoplasias de los Tejidos Blandos , Neoplasias Óseas/diagnóstico por imagen , Humanos , Osteítis Deformante/diagnóstico por imagen
4.
Skeletal Radiol ; 50(12): 2365-2380, 2021 Dec.
Artículo en Inglés | MEDLINE | ID: mdl-34184096

RESUMEN

Soft tissue sarcomas containing a dominant component of haemorrhage are known to be aggressive tumours associated with a poor prognosis. Importantly, the clinical behaviour and imaging characteristics of extensively haemorrhagic soft tissue sarcomas (also termed telangiectatic soft tissue sarcomas) can resemble those of benign haematomas, particularly those that continue to expand over a prolonged period, so-called chronic expanding haematomas (CEH). The following review evaluates the current literature to identify the clinical, imaging and pathological characteristics of telangiectatic soft tissue sarcomas and to determine features that may help distinguish them from CEH. Ultimately, we suggest that lesions with sizeable regions of internal haemorrhage should be regarded with a high degree of suspicion for underlying malignancy and require referral to a tertiary sarcoma centre, where a carefully planned approach to biopsy and follow-up is needed to avoid errors in diagnosis.


Asunto(s)
Sarcoma , Neoplasias de los Tejidos Blandos , Hematoma/diagnóstico por imagen , Humanos , Imagen por Resonancia Magnética , Derivación y Consulta , Sarcoma/diagnóstico por imagen , Neoplasias de los Tejidos Blandos/diagnóstico por imagen
7.
J Psychohist ; 38(3): 214-22, 2011.
Artículo en Inglés | MEDLINE | ID: mdl-21553677

RESUMEN

Extreme resistance to governmental taxation and authority is derived, according to Freud's theory of anal characterology, from premature and harshly coercive toilet training, in which a child is forced unfairly and against its will to surrender the products of his eliminations (which represent money, among other things, in the unconscious) to parental authority. Among these individuals anal eroticism plays a significant role in the psychogenesis of paranoia and conspiracy theorizing, which may represent a defense mechanism erected against repressed fears of passive submission.


Asunto(s)
Libertad , Regulación Gubernamental/historia , Trastornos Paranoides/historia , Política , Impuestos/historia , Historia del Siglo XVIII , Historia del Siglo XIX , Historia del Siglo XX , Historia del Siglo XXI , Humanos , Estados Unidos
8.
Br J Radiol ; 94(1126): 20210236, 2021 Oct 01.
Artículo en Inglés | MEDLINE | ID: mdl-34233485

RESUMEN

The epitrochlear lymph nodes (ELN) are rarely examined clinically and are difficult to identify radiologically in healthy patients. They are, therefore, generally under appreciated as a source of significant pathology. Despite this, enlargement of an ELN is almost always secondary to a pathological process, the differential for which is relatively narrow. The following pictorial review illustrates the spectrum of infectious, inflammatory and malignant conditions affecting the ELN, some of which are quite specific to this location. We also emphasise the importance of distinguishing enlarged ELNs from benign and malignant non-nodal soft tissue masses, which can have very similar clinical presentation and imaging appearances.


Asunto(s)
Ganglios Linfáticos/diagnóstico por imagen , Metástasis Linfática/diagnóstico por imagen , Imagen por Resonancia Magnética/métodos , Infecciones de los Tejidos Blandos/diagnóstico por imagen , Neoplasias de los Tejidos Blandos/diagnóstico por imagen , Adolescente , Adulto , Anciano , Diagnóstico Diferencial , Femenino , Humanos , Ganglios Linfáticos/patología , Metástasis Linfática/patología , Masculino , Persona de Mediana Edad , Infecciones de los Tejidos Blandos/patología , Neoplasias de los Tejidos Blandos/patología
9.
BMJ Case Rep ; 20152015 Apr 09.
Artículo en Inglés | MEDLINE | ID: mdl-25858924

RESUMEN

Infectious mononucleosis, caused by the Epstein-Barr virus (EBV), generally follows a benign, yet protracted course, with the majority of symptoms being systemic somatic symptoms. Rarely, the clinical picture can be complicated by more acute severe haemotological sequelae of the disease, requiring hospitalisation and causing diagnostic uncertainty, particularly when distinguishing between a viral illness and a lymphoproliferative disorder. We describe the case of a young male patient who presented with headache, recurrent epistaxis and severe thrombocytopenia.


Asunto(s)
Epistaxis/virología , Infecciones por Virus de Epstein-Barr/sangre , Mononucleosis Infecciosa/sangre , Mononucleosis Infecciosa/virología , Trombocitopenia/virología , Adulto , Diagnóstico Diferencial , Epistaxis/patología , Infecciones por Virus de Epstein-Barr/patología , Herpesvirus Humano 4/aislamiento & purificación , Humanos , Masculino , Reacción en Cadena de la Polimerasa/métodos , Recurrencia , Trombocitopenia/patología
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