Sonographic findings in aneurysmal bone cyst in children: correlation with computed tomography findings.

PURPOSE: This study compares the value of sonography and computed tomography (CT) in assessing fluid-fluid levels (FFLs) in aneurysmal bone cysts (ABCs) in children. METHODS: Five children 4-13 years old with ABC in pubis, humerus, fibula, calcaneus, and ilium-ischium were studied between January 1995 and December 1996. Plain radiography, sonography, and CT were performed. RESULTS: FFLs were visualized equally or better with sonography than with CT. CONCLUSIONS: We propose that sonography be used to complement plain radiography in the prebiopsy assessment of expansile bone lesions with cortical bone thinning because the presence of FFLs is characteristic of ABC. CT and/or magnetic resonance imaging could be used in indeterminate cases and in complex anatomic locations. Such an approach would save time and reduce costs and discomfort to children.

Osteochondroma post osteomyelitis.

We report a case of radial metaphyseal osteochondroma secondary to osteomyelitis in a premature baby of 28 weeks. This is the second case with these characteristics that has been described in the literature. A possible pathogenesis is related to trauma during drainage of the abscess or following the associated inflammatory process.

Plasma cell granuloma of the lung in childhood: atypical radiologic findings and association with hypertrophic osteoarthropathy.

Three cases of pulmonary plasma cell granuloma in the pediatric age group are presented. Although rare, it is the most frequent primary lung tumor in childhood. In two of the cases, there was a close adherence between the tumor and the surrounding mediastinal structures and diaphragm, a very uncommon feature in these tumors. In the other case, plasma cell granuloma of the lung was seen in association with a clinical-radiological picture of hypertrophic osteoarthropathy, which resolved after excision of the mass. Such an association has not, to date, been reported in the literature, and could constitute an additional finding useful in the differential diagnosis of primary lung tumors in childhood. The literature concerning this issue has been reviewed.

Fine-needle aspiration biopsy in children: experience in 70 cases.

Results of 70 fine-needle aspiration biopsies (FNAB) were evaluated retrospectively in 61 pediatric patients. Over a period of 9 months all mass lesions suspected being malignant were aspirated. Twelve of the 70 aspirations were performed in children having known tumours, in order to exclude recurrence or metastasis. The others were carried out to obtain a diagnosis. Satisfactory specimens were obtained from 58 (83%). There were 21 benign diagnoses, 36 malignant diagnoses, and 1 with suspected malignancy. Correlation of histologic and cytologic diagnoses was possible in 45 cases. The diagnostic sensitivity and specificity were 95% and 80%, respectively. We have found FNAB more accurate in the diagnosis of malignancies than in benign lesions. The results suggest that this is a useful technique for obtaining a first diagnosis of malignancy, as well as for excluding recurrence or metastatic disease.

[Mediastinal tumors in children]. / Tumoraciones mediastínicas en el niño.

Forty patients with primary mediastinal masses, treated at the Children's Hospital "La Fe" between 1971-1983, were review. Malignant neoplasms were the most common pathology in this series (23 cases), followed by benign lesions (10 cases), congenital malformations (five cases) and inflammatory diseases (two cases). Complementary explorations for the preoperative evaluation of theses masses is discussed. Surgical removal was carried out on all tumors. Mortality caused by performing biopsy on lymphomas was high. Two of the five congenital malformations were removed. The other three did not receive any therapy. All patients having benign tumors are alive except one who had a cardiac teratoma diagnosed at necropsy. Eleven of the patients with malignant neoplasms are alive, with a median follow-up time two years and nine months.

[Cavernous hemangioma of the liver (author's transl)]. / Hemangioma cavernoso hepático.

A three-month old asymptomatic infant was incidentally found to have an abdominal mass. Through standard radiological and vascular procedures it was defined as being of hepatic origin, vascular etiology and of benign prognosis. Differences among cavernous hemangioma, hepatoma, metastasis and hemangio-endothelioma are summarized. The importance of angiography is emphasized as an essential procedure previous to the surgical evaluation and therapy.

[Some additional facts about thymus (author's transl)]. / Algo más sobre el timo.

Three cases are presented of eventual diagnostic errors concerning the thymus. In the first case right aberrating lobe appeared radiologically as a tumour of posterior mediastinum. In the second case, the large thymic malleability, enabled it to invade medium mediastinum and to show an extraordinary variability in shape when in decubitus. Finally, a post surgical hematomata, in a patient affected by a cyanogen cardiopathy actually showed some problems of radiological diagnosis with the characteristic thymus regeneration.