Resection of Biliary Cystadenoma in a Pregnant Woman: A Case Report With Five Years of Follow-Up.

Biliary cystadenomas (BCAs), rare cystic tumors occurring in the biliary system, account for fewer than 5% of cystic lesions in the liver. This case details successful resection in a 29-year-old pregnant woman at seven weeks gestation. Urgent left hemihepatectomy and cholecystectomy removed a mucinous hepatobiliary cystadenoma. Postoperatively, a healthy newborn was delivered by cesarean section. Five-year follow-up showed no recurrence. BCAs present diagnostic challenges due to nonspecific symptoms, and surgical intervention, preferably complete resection, is recommended for potential malignancy, after weighing benefits against complications in critical hepatic vessel lesions.

Clinical and Oncological Outcomes Following Percutaneous Cryoablation vs. Partial Nephrectomy for Clinical T1 Renal Tumours: Systematic Review and Meta-Analysis.

Percutaneous cryoablation (PCA) can be an alternative to partial nephrectomy (PN) in selected patients with stage T1 renal tumours. Existing meta-analyses regarding ablative techniques compared both laparoscopic and PCA with PN. That is why we decided to perform a meta-analysis that focused solely on PCA. The aim of this study was to compare the complications and functional and oncological outcomes between PCA and PN. A systematic literature search was performed in January 2024. Data for dichotomous and continuous variables were expressed as pooled odds ratios (ORs) and mean differences (MDs), both with 95% confidence intervals (CIs). Effect measures for the local recurrence-free survival (LRFS), metastasis-free survival (MFS), cancer-specific survival (CSS) and overall survival (OS) were expressed as pooled hazard ratios with 95% CIs. Among 6487 patients included in the 14 selected papers, 1554 (23.9%) and 4924 (76.1%) underwent PCA and PN, respectively. Compared with the PN group, patients undergoing PCA had significantly lower overall and major postoperative complication rates. There was no difference in renal function between PCA and PN groups. When analysing collective data for cT1 renal carcinoma, PCA was associated with worse LRFS compared with PN. However, subgroup analysis revealed that in the case of PCA, LRFS was not decreased in patients with cT1a tumours. Moreover, patients undergoing robotic-assisted PN had improved LRFS compared with those undergoing PCA. No significant differences were observed between PCA and PN in terms of MFS and CSS. Finally, PCA was associated with worse OS than PN in both collective and subgroup analyses. In conclusion, PCA is associated with favourable postoperative complication rates relative to PN. Regarding LRFS, PCA is not worse than PN in cT1a tumours but has a substantially relevant disadvantage in cT1b tumours. Also, RAPN might be the only surgical modality that provides better LRFS than PCA. In cT1 tumours, PCA shows MFS and CSS comparable to PN. Lastly, PCA is associated with a shorter OS than PN.

Hepatic Hemangioma: Review of Imaging and Therapeutic Strategies.

Hepatic hemangiomas are the most common benign liver tumors. Typically, small- to medium-sized hemangiomas are asymptomatic and discovered incidentally through the widespread use of imaging techniques. Giant hemangiomas (>5 cm) have a higher risk of complications. A variety of imaging methods are used for diagnosis. Cavernous hemangioma is the most frequent type, but radiologists must be aware of other varieties. Conservative management is often adequate, but some cases necessitate targeted interventions. Although surgery was traditionally the main treatment, the evolution of minimally invasive procedures now often recommends transarterial chemoembolization as the treatment of choice.

A proposed protocol for correlation between bone density in hemimandibular hyperplasia radiography and histopathological findings - A retrospective study.

The role of low-dose computed tomography (LDCT) in surgical planning can be assessed based on the correlation among bone density (BD/HU), radiographic values, and the histopathological appearance of hyperplastic overgrowth in mandibular condyles (hemimandibular hyperplasia/osteochondroma). The aim of this study was to evaluate the correlation between LDCT indices of bone-density measurements in surgical planning and histopathological specimens. The patients incuded in this study underwent detailed radiological evaluation as preparation for further clinical procedures. Excised condyles were evaluated in terms of bone density index using LDCT, and then histopathologically to investigate the accuracy of surgical procedures and set the basis for future surgical planning. An index value between both condyles' bone densities represented the relative difference between the healthy condyle and the side with hemimandibular hyperplasia (HH). Patients with unilateral condylar hyperplasia (UCH) showed a statistical correlation between condyle heads with increased bone density (BD) and scintigraphic (SCI) values (p < 0.001). On the other hand, correlation between BD and histopathological studies alone was significant (p < 0.001). With the increase in BD measured in HU in UCH condyles, the overall value of fibrous cartilage layer thickness decreased (p < 0.001). Furthermore, histopathological evaluation indicated that increased bone density on the UCH side resulted in increased total thickness (p > 0.001). The proposed index measurements in the mandibular condyles based on LDCT/BD can be used to estimate the degree of required surgical resection. Results from LDCT radiographic studies correlate with histopathological specimens more than scintigraphy.

Transarterial Bleomycin-Lipiodol Chemoembolization for the Treatment of Giant Hepatic Hemangiomas: An Assessment of Effectiveness.

This study evaluates the effectiveness of superselective transcatheter arterial chemoembolization (TACE) using a bleomycin-lipiodol emulsion in treating giant hepatic hemangiomas. A retrospective review included 31 patients with a mean age of 53 ± 10.42 years who underwent TACE from December 2014 to October 2022, with follow-up imaging examinations to assess outcomes. Technical success was defined as successful embolization of all feeding arteries, and clinical success was defined as a reduction in hemangioma volume by 50% or more on follow-up imaging. This study observed a 100% technical success rate. Post-embolization syndrome was common, and two cases of asymptomatic hepatic artery dissection were noted. Clinical success was achieved in 80.6% of patients, with significant volume reduction observed in the majority. Conclusively, superselective transcatheter arterial chemoembolization with bleomycin-lipiodol emulsions is presented as a viable and effective treatment option for giant hepatic hemangiomas. With no procedure-related mortality and significant volume reduction in most cases, this method offers a promising alternative to surgical intervention. This study's findings suggest a need for further exploration and validation in larger-scale prospective studies.

Safety, feasibility, and effectiveness of a CT-guided transthoracic lung and pleural biopsy - a single-centre experience with own low-dose protocol.

Purpose: To assess the efficacy and safety of a low-dose, computed tomography (CT)-guided transthoracic biopsy of lung and pleural lesions. Material and methods: A total of 135 low-dose, CT-guided transthoracic lung and pleural lesions biopsies were performed. A cutting needle was utilized in 124 cases, and fine needle aspiration biopsy was performed in 14 cases. In all cases, 14- to 22-gauge biopsy needles were used. Results: Diagnostic material was obtained in 111 (82.2%) patients. In 97 (71.8%) cases neoplastic lesions were found, predominantly adenocarcinoma and non-small cell carcinoma. In 14 (12.6%) cases non atypical cells were reported. Biopsy failed to obtain material suitable for histopathological examination in 24 (17.7%) cases. Complications occurred in 31 patients, including pneumothorax in 28 patients and haematoma in 3 cases. Conclusions: Based on the obtained results, it can be stated that low-dose, CT-guided transthoracic biopsy of lung and pleural tissues is an accurate and safe procedure. Also, it is linked to a low risk of complications such as a small pneumothorax.

Safety and Feasibility of Transarterial Bleomycin-Lipiodol Embolization in Patients with Giant Hepatic Hemangiomas.

Giant hepatic hemangiomas present a significant clinical challenge, and effective treatment options are warranted. This study aimed to assess the safety and feasibility of transarterial bleomycin-lipiodol embolization in patients with giant hepatic hemangiomas. A retrospective analysis was conducted on patients with giant hepatic hemangiomas (>5 cm). Transarterial chemoembolization (TACE) was performed using 7-20 cc of lipiodol mixed with 1500 IU of bleomycin. Safety outcomes, including post-embolization syndrome (PES), hepatic artery dissection, systemic complications, and access site complications, were evaluated. Radiation doses were also measured. Feasibility was assessed based on the achieved hemangioma coverage. Seventy-three patients (49 female, 24 male) with a mean age of 55.52 years were treated between December 2014 and April 2023. The average hospitalization duration was 3.82 days, and 97.3% of lesions were limited to one liver lobe. The average bleomycin dose per procedure was 1301.5625 IU, while the average lipiodol dose was 11.04 cc. The average radiation dose was 0.56 Gy. PES occurred after 45.7% of TACE procedures, with varying severity. Complications such as hepatic artery dissection (three cases), access site complications (two cases), and other complications (one case) were observed. No treatment-related mortality occurred. Hemangioma coverage exceeding 75% was achieved in 77.5% of cases. The study results suggest that transarterial bleomycin-lipiodol embolization is a safe and feasible treatment option for a heterogeneous group of patients with giant hepatic hemangiomas. This approach may hold promise in improving outcomes for patients with this challenging condition.

Targeted epidural blood patch through a catheter in the treatment of spontaneous intracranial hypotension.

OBJECTIVE: Spontaneous intracranial hypotension (SIH) can be effectively treated by epidural blood patch (EBP) following the primary unsuccessful conservative therapy. Nevertheless, multi-site cerebrospinal fluid (CSF) leaks or those originating at the cervical or thoracic spine remain therapeutically challenging. Therefore, this study aimed to present our experience in the treatment of thoracic CSF leaks using epidural catheters for the EBP infusion. METHODS: Three patients presenting with typical orthostatic headaches were qualified for an EBP procedure. Preoperative MRI scans, myelography, and CT myelography were performed. Additionally, delayed CT myelography was repeated after 3 h to identify the CSF leakage site. Patients were followed-up clinically and radiologically for three months. RESULTS: The CT myelography identified CSF leak at the T2-3 (case 1), T5-12 (case 2), and T3-7 level (Case 3). A 0.06" diameter lumbar drainage catheter (Case 1 and 2) or Abbot's spinal cord stimulation (SCS) catheter (Case 3) was inserted epidurally through the lower thoracic/lumbar single-entry point and advanced into the identified thoracic leak site. The average volume of injected blood was 15.7 ml. No procedure-related complications were observed, and all patients improved clinically. CONCLUSIONS: Epidural catheters remain safe and effective in treating thoracic and multi-site CSF leaks. In addition, Abbot's SCS catheter was found superior to the lumbar drainage catheter due to higher rigidity and bigger diameter despite being shorter than the lumbar drainage catheter.

Non-invasive multi-channel deep learning convolutional neural networks for localization and classification of common hepatic lesions.

PURPOSE: Machine learning techniques, especially convolutional neural networks (CNN), have revolutionized the spectrum of computer vision tasks with a primary focus on supervised and labelled image datasets. We aimed to assess a novel method to segment the liver from the abdomen computed tomography (CT) image using the CNN network, and to train a unique method to locate and classify liver lesion pre-histological findings using multi-channel deep learning CNN (MDL-CNN). MATERIAL AND METHODS: The post-contrast CT images of the liver with a resolution of 0.625 mm were chosen for the study. In a random method, 50 examples of each hepatocellular carcinomas, metastases tumours, haemangiomas, hepatic cysts were chosen and evaluated. RESULTS: The dice score quantitatively analyses the similarity of segmentation results with the training dataset. In the first CNN model for segmenting the liver, the dice score was 96.18%. The MDL-CNN model yielded 98.78% accuracy in classification, and the dice score for locating liver lesions was 95.70%. Additionally, the performance of this model was compared to various other existing models. CONCLUSIONS: According to our study, the machine learning approach can be successfully implemented to segment the liver and classify lesions, which will help radiologists impart better diagnosis.

Effects of calcium electroporation, electrochemotherapy, and irreversible electroporation on quality of life and progression-free survival in patients with pancreatic cancer: IREC clinical study.

BACKGROUND: According to the National Cancer Registry, 3486 people (1744 men and 1742 women) were diagnosed with pancreatic adenocarcinoma in Poland in 2018, resulting in 4908 deaths (2396 men and 2512 women). The only chance of successful treatment is through surgical resection, which is possible in only 20-30% of patients (stage I, II and some stage III cases).The remaining 70-80% of patients are those with stage III and IV disease, for whom resection is not possible. Mean survival in these patients is approx. 10.4 months (stage III). In the recent decade, an innovative method called electroporation, which involves destabilization of the cell membrane, has been established. This process can be reversible (RE) or irreversible (IRE), and leads to cell death. The ability to change membrane permeability has led to the development of novel methods involving electrochemotherapy (ECT) and calcium electroporation (CaEP) to treat solid tumors. OBJECTIVES: In this study, both ECT and CaEP will be used to treat pancreatic cancer patients with poor prognosis. For each patient, the best "therapeutic moment" for the procedure will be selected based on the therapeutic protocol. MATERIAL AND METHODS: Patients will receive reversible and irreversible electroporation (control arm-group A), CaEP (active arm-group B), or ECT with intravenous and intratumoral administration of bleomycin (active arm-group C) randomized 1:1:1. RESULTS: The primary endpoints will be progression-free survival (PFS) and patients' quality of life (QOL) assessed using the EORTC-PAN 26 scale. Secondary endpoints will be patient overall survival (OS), body weight, pain level, and levels of biomarkers such as Ca 19-9. CONCLUSION: The Irreversible Electroporation, ELectrochemotherapy and Calcium electroporation (IREC) study is necessary to examine the safety and efficiency of irreversible electroporation, electrochemotherapy and calcium electroporation in pancreatic cancer treatment.

New therapeutic strategy: Personalization of pancreatic cancer treatment-irreversible electroporation (IRE), electrochemotherapy (ECT) and calcium electroporation (CaEP) - A pilot preclinical study.

In this study, irreversible electroporation (IRE), electrochemotherapy (ECT), and calcium electroporation (CaEP) techniques were investigated as new strategies for human pancreatic cancer. Qualification of the patients, best "therapeutic moment" for each patient, safety, and complications after procedures were examined. In this pilot study were included 13 patients in this study, which were operated on in different pancreatic cancer stages. Patients underwent IRE or ECT with intravenous admission of cisplatin or electroporation with calcium intratumoral administration. The IRE procedure was safe for the patients. Medium overall survival for IRE, IRE + CTH, and IRE + CaCl2 was respectively: 16, 29.5, and 19 months comparing to 10 months in control chemotherapy (CTH) group. Thus, IRE, ECT, and CaEP can be effective strategies for pancreatic cancer treatment.

Double VEGF/HGF Gene Therapy in Critical Limb Ischemia Complicated by Diabetes Mellitus.

Critical leg ischemia (CLI) complicated by diabetes mellitus (DM), which is a very common and dangerous disease, represents the ultimate stage of peripheral arterial disease. Patients are treated with antiplatelet drugs, statins and limb revascularization, but a significant number of patients are not candidate for revascularization. Literature shows that in such cases, gene therapy could be a perfect therapeutic option. The aim of our study was to evaluate efficacy of double vascular endothelial growth factor/hepatocyte growth factor (VEGF/HGF) gene therapy in patients with CLI complicated by DM. We observed that 90 days after administration, serum level of VEGF and ankle-brachial index increased significantly (p < 0.001) and rest pain decreased significantly compared with the control group (p < 0.002). Moreover considerable improvement in vascularization was observed in computed tomography angiography (P = 0.04). Based on the results of this study, we suggest that the therapy with pIRES/VEGF165/HGF bicistronic plasmid administration is a safe and effective method of treatment of patients with both CLI and DM. Graphical abstract.

Splenosis mimicking lymphadenopathy.

Splenosis is an autotransplantation of splenic tissue following traumatic rupture of the spleen or splenectomy. Generally, splenosis is asymptomatic. Therefore, most cases are incidental findings made during surgery, autopsy or after imaging studies for other purposes. Splenosis is a benign phenomenon, but it often shows similarity to the metastatic process. We present a case of asymptomatic intraperitoneal splenosis occurring in a 57-year-old male, in whom computed tomography urography showed lymphadenopathy suggesting a neoplastic process. A reconnaissance laparotomy was performed, and specimens were taken and sent for histopathological examination. The microscopic image of all the collected lesions corresponded to the normal spleen tissue. Due to an increasing number of traffic accidents, it is worth taking abdominal splenosis into consideration in the differential diagnosis of tumor-like changes, especially in patients with a history of splenic trauma or spleen removal. As a result, unnecessary surgery can be avoided in many cases.

Abnormalities of the hallux skin and nail in the course of very rare arteriovenous malformation.

Arteriovenous malformations (AVMs) are usually found in the pelvic area and the brain. These vascular anomalies are rarely reported in the toes. AVMs in the toes may be asymptomatic, but can also cause atypical symptoms. Congenital AVMs can expand as patients age and manifest in adulthood. They may be provoked by injury. Acquired AVM might be caused by iatrogenic factors, venous or arterial catheterization, percutaneous invasive vascular procedures, surgery, or degenerative vascular disorders. An AVM can damage surrounding tissues and can cause destruction of skin, nails and bones. The course of the disease is often unpredictable and diagnosis is usually delayed as a result.

As malformações arteriovenosas (MAVs) são geralmente encontradas na região pélvica e no cérebro.. Essas anomalias vasculares raramente são relatadas nos dedos dos pés. A MAV nesse local pode ser assintomática ou apresentar sintomas atípicos. MAVs congênitas podem evoluir com a idade e se manifestar na idade adulta. O fator provocante pode ser uma lesão traumática. Uma MAV adquirida pode ser causada por fatores iatrogênicos, cateterismo venoso e arterial, procedimentos percutâneos vasculares invasivos, cirurgias e alterações degenerativas vasculares. A MAV pode danificar tecidos adjacentes e pode causar destruição de pele, unhas e ossos. O curso da doença é muitas vezes imprevisível, e como resultado, atrasar o diagnóstico.

Anatomical and Clinical Implications in Neocondyle Stability After a Condylectomy.

: A condylectomy of the mandibular condyle is considered to be the treatment of choice in most cases of condylar head hyperactivity. The aim of the procedure is to remove the growth center of the mandible which is responsible for the mandibular enlargement and asymmetry. This surgical procedure has an impact on the condyle shape and position, but the restoration of mandibular movement and a stable joint position (namely, the proper alignment of the newly shaped condylar head within the condyle fossa) should also be considered important surgical outcomes. In this article, the authors present their own experience in performing condylectomies with an arthroplasty procedure and a special forced suturing technique (FST) in terms of achieving early, accurate mandibular movement and maintaining a stable condyle position in early and late outcomes. MATERIALS AND METHODS: A modified high condylectomy with arthroplasty and FST results had been studied in anatomical, radiological, and clinical model. RESULTS: Early findings after FST are promising. A slight improvement in lateral jaw movement was noted after condylectomy with arthroplasty (P < 0.05) both in early and late follow-up. Incisal opening, mandibular protrusion, and lateral movement were sustained. A stable condyle position within the fossa was achieved in each case of condylectomy with arthroplasty (P < 0.05). CONCLUSIONS: The FST condylectomy and reattachment of the lateral pterygoid muscle in a new, wider position provided an improvement in lateral jaw movement as well as in incisal opening and mandibular protrusion in early follow-up examination compared to the presurgical values. It seems that the FST enabled a better new condylar head position in the glenoid fossa and improved early functional mandibular movement.

Dual-Energy Computed Tomography in Loosening of Revision Hip Prosthesis: A Comparison Between MARS and non-MARS Images.

PURPOSE: The aim of the study was to assess potential endoprosthesis loosening in patients after revision total hip arthroplasty, based on monochromatic dual-energy computed tomography (DECT) images obtained with and without metal artifact reduction software (MARS) and comparison with the clinical examination and hip function. MATERIALS AND METHODS: Twenty-five consecutive patients underwent DECT examinations. Two monochromatic data sets were generated: with MARS (75-keV MARS) and without MARS (140-keV non-MARS) and evaluated for signs of loosening, using a dedicated radiological score. The Harris Hip Score (HHS) was used to evaluate patients' hip function. RESULTS: The mean radiological score for loosening in the non-MARS group was 16.2, in the MARS group 17.0 and was significantly higher (P < 0.001). Radiological loosening evaluation in non-MARS images correlated with the HHS score (ρ = 0.43, P = 0.03), whereas there was no correlation between MARS images and HHS (ρ = 0.15, P = 0.47). New MARS-related artifacts, which hinder implant-bone interface evaluation, were found in 75-keV MARS images ("pseudo-loosening" in 33 of 34 prostheses, "ground-glass blurring" in 20 of 32). CONCLUSIONS: High-energy monochromatic DECT images are superior to low-energy DECT MARS images in assessment of the potential loosening and correlate better with the clinical examination outcomes. For revision total hip arthroplasty evaluation, 2 data sets should be assessed inseparably because of extra artifacts in MARS images.

The anatomical relation of the extracranial internal carotid artery in the parapharyngeal space.

BACKGROUND: The proximity of the internal carotid artery to the pharyngeal wall poses a risk of injury during nasopharyngeal surgery. OBJECTIVES: The aim of this study was to assess the distances between the extracranial internal carotid artery (ICA) and the pharyngeal wall. MATERIAL AND METHODS: Measurements were taken on certain levels of the pharynx using computed tomography angiography (angio-CT) scans of 97 patients. One-tailed Student's t-test for independent variables and a comparison of expected values for dependent pairs of observations were applied. RESULTS: The shortest distance between the ICA and the pharyngeal wall was 1.1 mm. The ICA is closer to the pharyngeal wall at the epiglottis apex level (16.46 ±0.89 mm) than to the Eustachian tube (ET) (19.8 ±0.62 mm) (p < 0.0005). In women, the ICA is closer to the ET (19.44 ±0.78 mm) than in men (20.17 ±0.96 mm) (p = 0.04). In women, the right ICA is closer to the pharyngeal wall than the left ICA at the level of the lower margin of the 2nd cervical corpus vertebra (C2) (right: 17.6 ±1.8 mm; left: 20.7 ±1.7 mm) (p = 0.002) and at the level of the epiglottis apex (right: 15.2 ±1.7 mm; left: 17.4 ±1.4 mm) (p = 0.028). The bifurcation of the common carotid artery (CCA) is higher in men (19.48 ±2.19 mm below the C2) than in women (21.82 ±1.02 mm) (p < 0.001). When the bifurcation is at the level of the epiglottis apex, the ICA is closer to the pharyngeal wall (12.3 ±1.69 mm) than in other cases (16.46 ±0.89 mm) (p = 0.005). In men, the higher the bifurcation is, the closer the ICA is to the pharyngeal wall at the level of the lower margin of the C2 (p = 0.003). CONCLUSIONS: The risk of ICA incision during surgery differs between the pharyngeal levels, genders and sides of the neck. The ICA may be much closer to the pharyngeal wall than described in the literature.

Metastatic pulmonary calcification as a rare complication of end-stage renal disease with coexistence of pulmonary metastases from renal cell carcinoma: case report and literature review.

PURPOSE: We present a case of metastatic pulmonary calcification (MCP) in an asymptomatic patient with chronic kidney disease after renal transplantation and nephrectomy due to renal cancer. Chest computed tomography (CT) revealed bilateral, diffuse, centrilobular ground-glass opacities and heterogeneous, high-density areas distributed throughout the lungs, predominantly in the upper and middle lobes. Unusually, in our patient the metastatic calcification coexisted with pulmonary metastases from renal cell carcinoma associated with end-stage renal disease. To our knowledge, such coexistence has not been previously described. CASE REPORT: CT, particularly high-resolution chest computed tomography (HRCT), plays an important role in detection and follow-up of MPC findings, which include ground-glass opacities and partially calcified nodules or consolidations, predominantly in the upper lung zones. Correct diagnosis is important because misdiagnosis may lead to improper or unnecessary treatment and/or procedures. CONCLUSIONS: MPC is a rare condition that results from calcium deposition in the normal pulmonary parenchyma. MPC commonly occurs in patients with end-stage chronic kidney disease due to abnormalities in calcium and phosphate metabolism. It is worth pointing out that despite the fact that the condition is called metastatic, it is a relatively benign lung disease with a generally good long-term prognosis.

Reliability of computed tomography scans in the diagnosis of chronic rhinosinusitis.

BACKGROUND: Paranasal computed tomography (CT) has become the investigation method of choice to confirm or exclude the diagnosis of chronic rhinosinusitis (CRS) on the basis of its ability to deliver objective data regarding the presence of inflamed mucosa or polyps. OBJECTIVES: The aim of the study was to assess the reliability of CT scan findings among untreated CRS patients without the presence of polyps in a nasal endoscopy. MATERIAL AND METHODS: Among patients with clinically demonstrated CRS considered for surgery, 93 subjects who had had 2 CT scans performed at different time points in the diagnostic process were enrolled into the study. Paranasal sinus involvement on both CT scans was scored using the Lund-Mackay (L-M) and modified Lund-Mackay scales. Both CT exams served to assess the extent of the potential endoscopic sinus surgery. RESULTS: The time interval between CT scans ranged from 31 to 1,162 days (mean: 338 days). The L-M scores from the 1st CT examination correlated statistically with the results of the 2nd CT (r = 0.86; p < 0.05). When compared to the 1st scan, the L-M score in the 2nd CT scan remained the same in 36 patients (39%), increased in 23 patients (25%) and decreased in 34 patients (36%). There was no statistically significant correlation between the change in the L-M scores and the time interval between CT examinations. CONCLUSIONS: The present study indicates that mucosal thickening within paranasal sinuses among untreated patients with CRS is stable over shortand middle-time intervals, regardless of the initial intensity of the disease. The time delay between the CT examination and qualification for surgery does not influence the decision regarding the performance of the operation. The results suggest the conclusion that repeating CT scans in symptomatic, untreated patients with CRS should be seriously considered.

Palpable mass of the neck in the course of Takayasu arteritis.

Takayasu arteritis is a rare, idiopathic inflammatory disease of the aorta and its major branches, usually affecting young women of Asian descent. In the course of the disease stenosis, occlusions as well as dilatations and aneurysms of vessels occur. Because of many possible localizations of pathological changes, the symptoms have a wide range, but the most common are a weak pulse or its absence on the brachial artery and a difference in systolic pressure above 10 mm Hg between the upper extremities. Here we present a case report of a young woman with Takayasu arteritis, who presented a palpable mass in the back of her neck, significantly diminished after treatment with glucocorticoids.