Kimura's disease: an unusual cause of cervical tumour.

An 11 year old Chinese boy developed a unilateral cervical mass associated with pronounced eosinophilia and a marked increase in IgE concentrations. A biopsy sample showed massive eosinophilic tissue infiltration consistent with Kimura's disease. This disorder should be suspected when the clinical triad of painless unilateral cervical adenopathy, hypereosinophilia, and hyper-IgE is present, particularly in male Asian patients.

Wire stent for tracheomalacia in a five-year-old girl.

A wire stent was used successfully to treat life-threatening tracheomalacia in a 5-year-old girl. Wire stents placed bronchoscopically are nonobstructing and have the potential for balloon expansion to accommodate growth.

Nocardia choroid plexitis: CT and MR findings.

We report a case of nocardia choroid plexitis with extension into the parenchyma of the left parietal lobe in a previously well 13-year-old girl. The neuroimaging findings mimicked those of an intracranial neoplasm. This case illustrates the importance of including infectious etiologies in the differential diagnosis of aggressive choroid plexus lesions. The differential diagnosis of enhancing lesions of the choroid plexus in children is discussed.

Spine pain in children.

Spine pain in children as an isolated symptom is infrequently seen in clinical practice. However, as opposed to spine pain in adults, it is accompanied by a relatively higher frequency of pathology. Diagnostic imaging is a necessary follow up to the physical examination and laboratory studies. Standard radiography is usually the initial imaging study. Frequently, however, additional imaging with bone scintigraphy, computed tomography, or magnetic resonance imaging is necessary to add sensitivity and specificity to the clinical presentation. We describe the disease entities, pathophysiology, and imaging characteristics of the varied pathologies responsible for spine pain in children.

Unusual scrotal mass in the neonate.

Ultrasound is an ideal imaging modality that may be used to evaluate scrotal masses. It will frequently detect the presence of a mass, localize its site of origin, and characterize the abnormality. The most valuable information provided by ultrasound is the separation of intra- and extratesticular lesions. The importance of this distinction is understood when it is recognized that the majority of intratesticular lesions are malignant, while more extratesticular lesions are benign. The accuracy in this determination is between 90% and 95%. The overall accuracy in detecting and characterizing soft tissue masses as cystic or solid is in the range of 90% to 100%. Once a solid mass is identified, it is not possible to distinguish benign from malignant. We present the ultrasound findings of a newborn with renal vein thrombosis and a left scrotal enlargement, and discuss its pathogenesis.

Malrotation of bowel: variable patterns with different surgical considerations.

The records of 53 patients with varied roentgenographic patterns of malrotation were reviewed. The patterns were categorized as A-Infantile (Al), A-Adult (Aa), B, C, and D. The differences in form were obvious and each differed clinically, radiographically, and surgically. The differences allowed the development of prognostic insights simply based on the presence and/or position of the ligament of Treitz and the cecum as shown by barium gastrointestinal examination. The literature was reviewed to find supportive or contradictory case material or other data that complemented or devalued the developed system for determining prognosis of patients with varied bowel patterns. The developed prognostic scheme seems to satisfy the requirements of reliability.

Heterotopic Tc-99m MDP uptake secondary to phlebitis.

A patient with blastomycosis complained of pain in his lower back after the administration of amphotericin B and parenteral alimentation via a femoral venous catheter. A bone scan that was performed to exclude bony involvement with blastomycosis showed abnormal tracer accumulation in the right paravertebral region. Computed tomography revealed the venous catheter to lie in the right ascending lumbar vein. There was calcification of a portion of the right psoas muscle. In addition, the epidural venous plexus was calcified from L2 to L4. It was this dystrophic calcification that caused the heterotopic accumulation of bone tracer.

Imaging of sacrococcygeal germ cell tumors.

Sacrococcygeal teratoma is the most common solid tumor in neonates. Malignant sacrococcygeal germ cell tumors also occur in infants and children. Diagnostic imaging studies help confirm the diagnosis of a clinically palpable sacrococcygeal mass, determine its relationship to other structures, and detect metastases. Despite the relative frequency of sacrococcygeal germ cell tumors, characteristics of these lesions as evaluated with computed tomography (CT) and magnetic resonance (MR) imaging have received little attention in radiologic literature. We outline important clinical information, review the spectrum of manifestations of these tumors with traditional imaging studies, and illustrate the value of CT and MR imaging for diagnosis and staging of sacrococcygeal germ cell tumors.

Imaging of the pediatric eye and orbit.

The spectrum of ocular and orbital pathology in the pediatric age group is quite different from that of adults. Imaging studies serve an important role in the diagnosis and management of many of these abnormalities. This review outlines the various abnormalities of the pediatric eye and orbit for which imaging studies are often required, including: infection, neoplasm, inflammation and infiltration, developmental anomalies, and trauma. The computed tomographic appearances of these abnormalities are emphasized. Additionally, the pertinent findings recorded with magnetic resonance imaging, scintigraphy, and radiography are described. Correlation of the results of imaging studies with pertinent clinical information allows the determination of specific diagnoses in most instances of pediatric orbital pathology.

MR features of fleeting CNS lesions associated with Epstein-Barr virus infection.

The magnetic resonance and CT findings in a 10-year-old patient with neurologic abnormalities associated with Epstein-Barr virus infection are reported. Multiple focal lesions of various sizes were demonstrated with involvement at one time or another of both cerebral hemispheres, the right thalamus, the right cerebellar hemisphere, and the right optic nerve. A unique finding was the fleeting nature of the lesions with new lesions appearing as others resolved. The clinical presentation, laboratory studies, and radiologic patterns suggest the diagnosis of immune-related acute disseminated encephalomyelitis associated with Epstein-Barr virus infection.

Periarticular soft tissue calcification and ossification in the septic joint.

We encountered three infants who developed juxta-articular calcification adjacent to the anterolateral aspect of the ilium. All had had drainage of a septic hip using an anterior approach. Calcification was not found among five infants whose septic hips were drained using a posterior approach. Some surgeons who employ the anterior approach facilitate exposure of the joint capsule by elevation of the origins of the sartorius and rectus femoris muscles. We feel this juxta-articular calcification in this setting is a sequla of anterior surgical drainage of the hip in which there has been surgical elevation of the iliac periosteum. It does not imply an unfavorable outcome.