[Invasive infra centimetric breast lobular carcinoma: ultrasonographic features]. / Cancers lobulaires invasifs infracentimétriques: aspects échographiques.

PURPOSE: To evaluate the ability of breast ultrasound to detect and analyze small (less than 1 cm in size) invasive lobular carcinomas. MATERIAL: and methods. A retrospective analysis of 93 small invasive carcinomas measuring less than 10 mm in size diagnosed between 1998 and 2000 in our institution was performed. In this group, 15 invasive lobular carcinomas were identified in 12 patients. All mammograms and ultrasound examinations were reviewed. RESULTS: Twelve cases of less than 10 mm invasive lobular carcinomas were diagnosed. Two lesions in one patient and one in an other patient were not detected at ultrasound and mammogram (multifocal carcinomas). All invasive lobular carcinomas were found as hypoechogenic masses with ill-defined margins and posterior shadowing. Four lesions showed evidence of microlobulations, 6 lesions an hyperechogenic halo and only one showed a vertical axis. The sensitivity of ultrasound in this group was recorded as 80% (12/15). CONCLUSION: The study confirms a high sensitivity of ultrasound examination in detection and characterization of small infiltrative lobular carcinoma.

Unusual mammographic and ultrasonographic findings in fibromatosis of the breast.

Fibromatosis of the breast is an uncommon disease, most often appearing as an aggressive lesion mimicking carcinoma on mammography. We describe, in an asymptomatic 40-year-old woman, an unusual imaging appearance of fibromatosis of the breast mimicking a benign lesion at mammographic and sonographic studies.

[Value of CT guided renal biopsies: retrospective review of 67 cases]. / Intérêt des ponctions biopsies rénales sous contrôle tomodensitometrique: analyse rétrospective de 67 cas.

PURPOSE: To assess the value of the CT guided percutaneous biopsy of renal tumors and to promote the interest of this procedure. MATERIAL AND METHODS: We report a retrospective study of 67 patients (average age, 51 years) who underwent CT guided biopsy of a single renal mass. The average size of tumors was 5 centimeters. The biopsy of tumors was carried out with needles between 16 and 21 gauge by using a conventional CT. Two to three passes per tumor were obtained. RESULTS: Biopsy material was sufficient for diagnosis in 48 cases (72%). A renal cell carcinoma was found in 29 (43%) samples of biopsy. The remainder included 13 metastases or lymphomas (18%). A benign lesion was found in 6 cases (9%). 59 patients had a final diagnosis. Accuracy of the biopsy for histopathologic evaluation was 81%. The average lesion size of failed biopsies was 1.5 centimeters. Morbidity occurred in 13% of cases, without immediate life threatening consequence. CONCLUSION: CT-guided renal biopsy is an effective means of obtaining tissue for the diagnosis of focal renal masses. The indications are renal lesions locally advanced, multimetastatic patients, mass in patients with a single kidney and focal lesions in patients with prior history of malignancy.

[Photostimulation plates or conventional films for bedside chest x-ray in pediatric radiology? A comparative study of quality of image and the dose delivered to patients]. / Plaques photostimulables ou films conventionnels pour les clichés pulmonaires "au lit" en radiopédiatrie? Une étude comparative de la qualité de l'image et de la dose délivrée aux patients.

Image quality and patient doses received during chest bedside examinations performed with conventional (film-screen combination) and photostimulable phosphorus plate systems were compared in a study carried out in 1993 in a French pediatric radiology department. Seventy one children (36 males and 35 females) aged between 9 days and 18 years (average: 43 months) were included in the study. Technical performances of all radiological equipment used were permanently checked through a quality control program. One conventional and 3 "photostimulable" films were performed for each patient included (mAs product selected for "photostimulable" system was progressively reduced down to 60% of that of conventional technique). TLD Lithium Fluoride chips were used to measure entrance surface dose during the examination. Image quality of 284 films (213 "photostimulable" + 71 conventional) was assessed by three independent radiologists. Advantages and drawbacks of both studied imaging techniques are discussed in terms of patient dose reduction and image quality.

[Retrospective analysis of 44 adrenal puncture biopsies under x-ray computed tomographic guidance]. / Analyse rétrospective de 44 ponctions biopsies surrénaliennes sous contrôle tomodensitométrique.

Fourty-four CT-guided adrenal biopsies were performed on 43 patients aged 12-74 years old (mean 57 years). The results (benign adrenal tissue, malignant tissue, and nondiagnostic) were compared with outcomes. Diagnostic samples were obtained in 86% of patients. Among the 37 proved cases with diagnostic results (10 benign, 27 malignant), there were 26 true-positives, 1 false-negatives and 10 true-negatives. CT-guided adrenal biopsy had an accuracy of 82%, a sensitivity of 96%, a negative predictive value of 83%. In the 6 patients with nondiagnostic samples 1 mass proved malignant and two masses proved benign. Seven minor complications occurred in 7 patients (6 pneumothoraces and 1 retroperitoneal hemorrhage). CT-guided adrenal biopsy is a simple safe and well tolerated technique. In oncologic patients, obtaining benign adrenal tissue was highly predictive of benignity.