Grey-scale and colour Doppler sonography in the evaluation of children with suspected bowel inflammation: correlation with colonoscopy and histological findings.

AIM: To evaluate the correlation of grey-scale and colour Doppler sonography with colonoscopy and histology to detect bowel inflammation in children. MATERIAL AND METHODS: The records of 72 patients with suspected bowel inflammation were reviewed retrospectively. Patients were included in the study if sonography had been performed up to 30 days before colonoscopy. Grey-scale and colour Doppler sonography were used to evaluate bowel wall thickness and vascularity for the detection of distal bowel inflammation. Findings were correlated with colonoscopy and histological findings. The sensitivity and specificity of sonographic wall thickness to detect inflammation was determined. Spearman's coefficient (rs) was used to determine the correlation of Doppler findings with colonoscopy/histology. RESULTS: Sonograms of 372 bowel segments were evaluated and results were correlated with colonoscopy and histological findings of 352 segments. The sensitivity and specificity of sonographic bowel thickness to detect inflammation in the terminal ileum and the right colon were high; in the other segments, specificity was high but sensitivity was low. The correlation of Doppler sonography with colonoscopy and histology to detect inflammation in the terminal ileum was strong (rs: 0.84; p<0.001) and in the other segments, weak to moderate; when the interval between examinations was shorter than 10 days, the correlation was stronger in all segments. Of nine patients with abnormal small bowel sonograms but normal colonoscopies, three had Crohn's disease. CONCLUSION: Sensitivity and specificity of grey-scale sonography to detect inflammation in the terminal ileum and the right colon were high, and the correlation of Doppler with colonoscopy and histology was very strong in the same segments.

Sole pulmonary involvement by Langerhans' cell histiocytosis in a child.

The case of a boy aged 4 yrs and 7 months, with isolated pulmonary involvement by Langerhans' cell histiocytosis is reported. The presentation of the disease was a sudden pneumothorax, with no previous signs of respiratory disease. The case was confirmed by S-100 and MT1 antibody staining, and was treated with pulse steroids and several pleural drainages, until the boy died after a large bilateral pneumothorax.

Carcinoma verrucoso da vulva. / Verrucous carcinoma of the vulva

Sao relatados tres casos de carcinoma verrucoso envolvendo o epitelio vulvar. Eles representam uma variante rara do carcinoma epidermoide, localmente invasiva e radiorresistente. A semelhanca dessa neoplasia com o condiloma torna dificil o diagnostico

Paracoccidioidomicose genital masculina. / Male genital paracoccidioidomycosis

Sao relatados sete casos de paracoccidioidomicose com comprometimento dos orgaos genitais masculinos. Com excecao de um caso, os sintomas pulmonares precederam o envolvimento genital. O epididimo e testiculo foram os orgaos mais frequentemente atingidos. Os aspectos histopatologicos foram ressaltados