RESUMO
Medical records of 55 dogs with a diagnosis of cutaneous mast cell tumour were reviewed. Twenty-seven of the dogs were treated with surgery plus deionized water and the remaining 28 with surgery alone. A survival analysis was performed to determine whether deionized water, as an adjunct to surgery for cutaneous mast cell tumour, affected survival time or time to tumour recurrence. Dogs in which mast cell tumour recurred had a significantly shorter survival time compared with dogs with no recurrence (P = 0.05), regardless of the method of treatment. A significant negative association between tumour recurrence and method of treatment (P = 0.0097) and clinical stage (P = 0.0223) was observed. Dogs treated with surgery and deionized water had a significantly shorter time to recurrence of their mast cell tumour (P = 0.0113). Based on these results, deionized water does not appear to be beneficial in prolonging survival time or time to tumour recurrence for dogs with cutaneous mast cell tumours.
Assuntos
Sarcoma de Mastócitos/veterinária , Recidiva Local de Neoplasia/veterinária , Neoplasias Cutâneas/veterinária , Animais , Cães , Feminino , Concentração de Íons de Hidrogênio , Masculino , Sarcoma de Mastócitos/tratamento farmacológico , Sarcoma de Mastócitos/cirurgia , Neoplasias Cutâneas/tratamento farmacológico , Neoplasias Cutâneas/cirurgia , Análise de Sobrevida , ÁguaRESUMO
One hundred twenty-six cutaneous mast cell tumors obtained by excisional biopsy from 106 dogs were evaluated using immunohistochemical staining for the presence of p53 protein. A standard avidin-biotin immunohistochemical protocol was used incorporating a polyclonal antibody of rabbit origin (CM-1) as the primary antibody. Histopathologic grading of tumors was performed on hemotoxylin and eosin-stained samples. There was a significant difference in the percentage of cells staining positive for p53 for the histopathologic grades (P = 0.0005). Grade III tumors had a significantly greater p53 content than did grade I or II tumors (P < 0.05). Clinical data obtained retrospectively was available for 54 dogs. Tumor recurred in 19 of 54 (35.2%) dogs. Twenty-nine dogs died by the end of the study; 9 of 29 (31.0%) died of mast cell tumor disease. Histopathologic grade showed a significant negative association with survival time. Both clinical stage and histopathologic grade showed a significant negative association with time to recurrence. The percentage of cells staining positive for p53 did not significantly improve the forward analysis. Immunohistochemical detection of p53 did not appear useful in characterizing the clinical association between cutaneous mast cell tumor cellular features and survival time or time to tumor recurrence in dogs.
Assuntos
Doenças do Cão/diagnóstico , Sarcoma de Mastócitos/veterinária , Neoplasias Cutâneas/veterinária , Proteína Supressora de Tumor p53/análise , Animais , Biópsia/veterinária , Doenças do Cão/mortalidade , Doenças do Cão/patologia , Cães , Imuno-Histoquímica , Sarcoma de Mastócitos/diagnóstico , Sarcoma de Mastócitos/mortalidade , Sarcoma de Mastócitos/patologia , Metástase Neoplásica , Recidiva Local de Neoplasia/mortalidade , Recidiva Local de Neoplasia/veterinária , Prognóstico , Coelhos , Estudos Retrospectivos , Neoplasias Cutâneas/diagnóstico , Neoplasias Cutâneas/mortalidade , Neoplasias Cutâneas/patologia , Estatísticas não Paramétricas , Análise de Sobrevida , Proteína Supressora de Tumor p53/imunologiaRESUMO
A 10-year-old, spayed female, mixed-breed dog was referred for evaluation of bilateral hindlimb edema and weakness. Abdominal ultrasonography showed increased echogenicity of the lumen of the caudal vena cava from the level of the urinary bladder to the level of the cranial pole of the right kidney. Bilateral saphenous venograms displayed numerous filling defects in the caudal vena cava, right external iliac vein, right femoral vein, and the right common iliac vein. Extensive venous thrombosis was diagnosed, and the animal was euthanized. Necropsy confirmed the presence of venous thrombosis and revealed a right adrenocortical carcinoma that had invaded the caudal vena cava.
Assuntos
Carcinoma Adrenocortical/veterinária , Doenças do Cão/diagnóstico , Neoplasias Vasculares/veterinária , Veia Cava Inferior , Trombose Venosa/veterinária , Carcinoma Adrenocortical/diagnóstico , Animais , Doenças do Cão/diagnóstico por imagem , Cães , Edema , Evolução Fatal , Feminino , Membro Posterior , Radiografia , Neoplasias Vasculares/diagnóstico , Trombose Venosa/diagnósticoRESUMO
Although IV injection of contrast material is widely used for detection and follow-up of hepatic metastases on CT, the optimal method of contrast enhancement has not yet been defined. A prospective study was performed in 50 consecutive patients with suspected hepatic metastases. Lesion size and detectability were compared on unenhanced CT scans, scans obtained during a bolus injection of contrast material (early bolus phase), and scans obtained during a rapid infusion after the loading bolus. A total of 60 hepatic lesions were evaluated in 26 patients, 19 with histologic confirmation of metastases and seven with strong supportive evidence. The bolus phase allowed detection of 15% more lesions than did examination during the rapid-infusion phase. Lesion size varied, depending on the timing and method of contrast administration; the largest measurements were obtained during bolus injection of contrast material. In addition, bolus administration of contrast material subjectively resulted in the best lesion detection. Because the three techniques of IV contrast enhancement may produce different size measurements, sequential examinations must be tailored appropriately. Scanning during the bolus phase is technically possible with current CT equipment and is recommended as the primary CT screening examination for hepatic metastases.
Assuntos
Meios de Contraste/administração & dosagem , Neoplasias Hepáticas/secundário , Tomografia Computadorizada por Raios X/métodos , Diatrizoato/administração & dosagem , Diatrizoato de Meglumina/administração & dosagem , Humanos , Infusões Intravenosas , Injeções Intravenosas , Neoplasias Hepáticas/diagnóstico por imagemRESUMO
We report a case in which a focally spared area of pancreatic tissue in a gland otherwise replaced by fat created a "pseudomass" mimicking neoplasm on sonography and CT. The "pseudomass" appearance was related to the anomalous ductal anatomy in pancreas divisum. The spared area of pancreas creating a "pseudomass" was drained by the dorsal duct and the remainder of the pancreas that had undergone relative fatty replacement was drained by the ventral duct.
Assuntos
Pâncreas/anormalidades , Pâncreas/diagnóstico por imagem , Neoplasias Pancreáticas/diagnóstico por imagem , Tomografia Computadorizada por Raios X , Adulto , Colangiopancreatografia Retrógrada Endoscópica , Doença Crônica , Diagnóstico Diferencial , Humanos , Masculino , Pancreatite/complicaçõesRESUMO
New technology has combined the endoscope with ultrasound in an effort to enhance the visualization of the gastrointestinal tract. With a modified standard endoscope that has an ultrasound transducer built into the tip, high frequency ultrasonic beams can be targeted in close proximity to existing lesions. This results in better quality resolution which enhances the evaluation of the targeted lesion. In addition, esophageal wall thickness can be evaluated and assessed as to its role in esophageal function.
Assuntos
Endoscopia/normas , Transtornos da Motilidade Esofágica/diagnóstico , Ultrassonografia/normas , Endoscopia/métodos , Transtornos da Motilidade Esofágica/patologia , Estudos de Avaliação como Assunto , Humanos , Ultrassonografia/métodosRESUMO
Twelve patients with known pancreas divisum underwent thin-section computed tomography (CT) to determine the capability of CT to depict this pancreatic anomaly. Focal pancreatic enlargement was present in five patients. Two distinct pancreatic moieties separated by a fat cleft were noted in three patients; a fourth patient had focal atrophy in the distribution of the dorsal pancreas. The two pancreatic moieties were identified at the same craniocaudal level in all four of these patients. The dorsal duct was depicted in all 12 patients, while the short ventral duct was seen in only five of the 12 patients. Failure of the ventral and dorsal pancreatic ducts to fuse was identified in all five patients in whom both ducts were seen. CT may not enable specific diagnosis of pancreas divisum in the majority of patients. If, however, distinct pancreatic moieties or unfused ductal systems are evident, the diagnosis may be confidently suggested.
Assuntos
Pâncreas/anormalidades , Ductos Pancreáticos/anormalidades , Tomografia Computadorizada por Raios X , Adulto , Colangiopancreatografia Retrógrada Endoscópica , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Pâncreas/diagnóstico por imagem , Ductos Pancreáticos/diagnóstico por imagemRESUMO
Dynamic thin-section computed tomography (CT) was used to evaluate renal cell carcinoma in 80 patients. The lesion was correctly staged with CT in 90% of patients. With use of the dynamic technique, the ipsilateral renal vein was depicted in 99% of patients. Extension of the tumor to the renal vein or the inferior vena cava was correctly detected in 18 of 19 patients. Actual depiction of tumor thrombus was a far more accurate indicator of renal vein invasion than was the identification of isolated renal vein enlargement. Dynamic thin-section CT of the kidney should be considered the routine method for comparison studies with other newer cross-sectional techniques in the evaluation of renal cell carcinoma.
Assuntos
Carcinoma de Células Renais/diagnóstico por imagem , Neoplasias Renais/diagnóstico por imagem , Veias Renais/diagnóstico por imagem , Tomografia Computadorizada por Raios X , Carcinoma de Células Renais/irrigação sanguínea , Carcinoma de Células Renais/patologia , Humanos , Neoplasias Renais/irrigação sanguínea , Neoplasias Renais/patologia , Invasividade Neoplásica , Estadiamento de Neoplasias , Células Neoplásicas Circulantes , Veias Renais/patologia , Veia Cava Inferior/diagnóstico por imagem , Veia Cava Inferior/patologiaAssuntos
Obstrução Intestinal/etiologia , Obesidade Mórbida/terapia , Próteses e Implantes/efeitos adversos , Adulto , Feminino , Humanos , Obstrução Intestinal/diagnóstico por imagem , Intestino Delgado/diagnóstico por imagem , Intubação/efeitos adversos , Pessoa de Meia-Idade , Radiografia , EstômagoRESUMO
The members of the Society of Body Computed Tomography were surveyed to determine the most frequently used method of administering contrast material in CT studies of the liver. The respondents represented CT departments performing liver examinations in 22 institutions. No department relied solely on noncontrast scans. In 12 (54%) of 22 institutions, only contrast-enhanced scans were performed. The preferred dose for enhancement was 150 ml of 60% contrast material. Eight (36%) of the 22 respondents obtained images during the administration of a bolus of contrast material, whereas nine (41%) obtained images during the administration of a sustained drip infusion given after a loading bolus. Follow-up in 1987 revealed that two departments had switched to obtaining images during the administration of a bolus. The availability of CT power injectors and refinements in the rapid-scanning capabilities of CT scanners have increased the popularity of obtaining images of the liver during the administration of a bolus of contrast material. Despite this, in many departments, contrast material is still administered via drip infusion in CT studies of the liver.
Assuntos
Meios de Contraste/administração & dosagem , Fígado/diagnóstico por imagem , Tomografia Computadorizada por Raios X/métodos , HumanosRESUMO
Two patients with multifocal idiopathic fibrosclerosis and sclerosing cholangitis developed biliary obstruction due to a fibrotic pancreatic pseudotumor. The masslike fibrosis mimicked pancreatic carcinoma on sonography and cholangio-pancreatography. In one patient sonography was successfully used to assess the response of the pseudotumor to corticosteroid therapy.
Assuntos
Fibrose/diagnóstico , Neoplasias Pancreáticas/diagnóstico , Esclerose/diagnóstico , Colangite , Diagnóstico Diferencial , Humanos , Masculino , Pessoa de Meia-Idade , Pâncreas/patologiaRESUMO
Fifty-one patients with advanced cancer of the esophagus underwent 191 endoscopic palliative procedures, including bouginage, laser therapy, bipolar electrocoagulation, and stent placement. In three patients free perforations developed; these were treated immediately and no sequelae developed. Perforations confined within the tumor mass were diagnosed with CT in two patients and did not require treatment. Methods of endoscopic palliation are discussed with reference to the radiologic studies and techniques. The radiologist must evaluate tumor topography and esophageal wall thickness with computed tomography and esophagography to aid in the choice of palliative therapy. Knowledge of each technique and its risks by the radiologist is essential for useful consultation with the endoscopist before, during, and after the procedure.
Assuntos
Adenocarcinoma/diagnóstico por imagem , Carcinoma de Células Escamosas/diagnóstico por imagem , Neoplasias Esofágicas/diagnóstico por imagem , Perfuração Esofágica/etiologia , Cuidados Paliativos/métodos , Adenocarcinoma/terapia , Carcinoma de Células Escamosas/terapia , Dilatação/efeitos adversos , Eletrocoagulação/efeitos adversos , Neoplasias Esofágicas/terapia , Esofagoscopia/efeitos adversos , Humanos , Terapia a Laser/efeitos adversos , Próteses e Implantes/efeitos adversos , RadiografiaRESUMO
The clinical and radiologic features of 27 patients with renal metastases arising from eight different types of nonlymphomatous primary malignancies are presented. Renal metastases were generally detected late in the course of the malignancy. In 23 patients there were no symptoms referable to the kidney. Urinalysis was normal in nine patients and showed microscopic hematuria in nine, gross hematuria in four, and proteinuria in four. Radiologically, metastases were usually multifocal; however, metastases arising from colon, lung, and breast carcinoma were sometimes large, solitary, and otherwise indistinguishable from primary renal cell carcinoma. Three of four melanoma metastases and three of seven lung metastases infiltrated the perinephric space. Computed tomography was the most sensitive modality, depicting renal metastases in all 24 cases in which it was employed, followed by ultrasound and intravenous urography. In patients with a history of malignancy, renal metastases outnumbered renal cell carcinomas by approximately 4:1. This study indicates that a new renal lesion in a patient with advanced, noncurable cancer is more likely metastatic than primary and that biopsy in this setting is unlikely to be of aid.
Assuntos
Neoplasias Renais/secundário , Adulto , Idoso , Idoso de 80 Anos ou mais , Neoplasias do Colo , Feminino , Humanos , Neoplasias Renais/diagnóstico por imagem , Neoplasias Renais/patologia , Neoplasias Pulmonares , Masculino , Melanoma/secundário , Pessoa de Meia-Idade , Estudos Retrospectivos , Tomografia Computadorizada por Raios XRESUMO
The clinical diagnosis of cervical aortic arch rests on the detection of a pulsatile mass in the supraclavicular fossa. Unfortunately, clinical differentiation of a cervical arch from an aneurysm of the great vessels can be difficult. Dynamic computed tomography (CT) can aid in this differentiation and avert the need for angiography.
Assuntos
Aorta Torácica/anormalidades , Tomografia Computadorizada por Raios X , Adulto , Aorta Torácica/diagnóstico por imagem , Aneurisma Aórtico/diagnóstico por imagem , Diagnóstico Diferencial , Humanos , MasculinoRESUMO
An awareness of potential pitfalls in CT imaging of renal masses helps to reduce needless imaging procedures and surgery.
Assuntos
Carcinoma de Células Renais/diagnóstico por imagem , Doenças Renais Císticas/diagnóstico por imagem , Neoplasias Renais/diagnóstico por imagem , Tomografia Computadorizada por Raios X , Humanos , Rim/anatomia & histologia , Nefropatias/diagnóstico por imagemRESUMO
A Haitian man with acquired immunodeficiency syndrome (AIDS), fever, malaise, and diarrhea is described. A computed tomographic (CT) scan showed a retrogastric mass with an associated ulcer. An upper gastrointestinal tract study showed an ulcer with both benign and malignant features. Endoscopy revealed a malignant-appearing ulcer, but cultures and histologic examinations of surgical biopsy specimens indicated gastric tuberculosis. The relationship between tuberculosis and AIDS is discussed.
Assuntos
Síndrome da Imunodeficiência Adquirida/complicações , Gastropatias/complicações , Tuberculose Gastrointestinal/complicações , Adulto , Gastroscopia , Humanos , Masculino , Gastropatias/diagnóstico por imagem , Gastropatias/patologia , Tomografia Computadorizada por Raios X , Tuberculose Gastrointestinal/diagnóstico por imagem , Tuberculose Gastrointestinal/patologiaRESUMO
Pelvic hematomas following prostatic biopsy are rare. We describe 2 cases of hematomas occurring in the prevesical space (space of Retzius) following transrectal biopsy. Computed tomography (CT) was useful in defining the extent of the hematoma and showing density changes related to the age and suppuration of the hematoma. While cystography has been used to diagnose prevesical hematomas, CT better assesses the size of the hematoma and changes that may occur over time.
Assuntos
Hematoma/etiologia , Próstata/patologia , Doenças da Bexiga Urinária/etiologia , Biópsia/efeitos adversos , Hematoma/diagnóstico por imagem , Humanos , Masculino , Pessoa de Meia-Idade , Tomografia Computadorizada por Raios X , Doenças da Bexiga Urinária/diagnóstico por imagemRESUMO
The radiologist needs to be aware of the varied appearance of hepatic mass lesions and be prepared to recommend the most cost-effective imaging approach. In this article, the authors discuss their hepatic imaging experience, common pitfalls, and current recommendations.
Assuntos
Hepatopatias/diagnóstico , Biópsia por Agulha/métodos , Meios de Contraste , Diagnóstico Diferencial , Erros de Diagnóstico , Artéria Hepática/diagnóstico por imagem , Humanos , Hepatopatias/diagnóstico por imagem , Neoplasias Hepáticas/diagnóstico por imagem , Neoplasias Hepáticas/secundário , Espectroscopia de Ressonância Magnética , Tomografia Computadorizada de Emissão , Tomografia Computadorizada por Raios X , UltrassonografiaRESUMO
Although vast differences exist among the many pelvic malignancies, several unifying concepts emerge from this discussion. First, there is a different role for diagnostic imaging for each type of pelvic malignancy. The radiologist should be aware that although the radiographic findings may be similar, the clinical impact varies greatly with a particular tumor. Second, although clinical staging is notoriously inaccurate, nevertheless diagnostic imaging techniques only improve upon but do not replace it because of false-positive and false-negative results. Third, because of the high false-negative rates of most of the modalities in use, negative studies do not in fact rule out the presence of disease. A surgical procedure may still be needed. Finally, several new techniques, including MRI and transrectal or transurethral ultrasound, may improve the accuracy rates. These developments will probably further enliven the controversies surrounding the radiologic evaluation of pelvic malignancies.
Assuntos
Neoplasias Pélvicas/diagnóstico por imagem , Feminino , Humanos , Linfografia , Espectroscopia de Ressonância Magnética , Masculino , Neoplasias Ovarianas/diagnóstico , Neoplasias Ovarianas/diagnóstico por imagem , Neoplasias da Próstata/diagnóstico , Neoplasias da Próstata/diagnóstico por imagem , Tomografia Computadorizada por Raios X , Ultrassonografia , Neoplasias da Bexiga Urinária/diagnóstico , Neoplasias da Bexiga Urinária/diagnóstico por imagem , Neoplasias do Colo do Útero/diagnóstico , Neoplasias do Colo do Útero/diagnóstico por imagem , Neoplasias Uterinas/diagnóstico , Neoplasias Uterinas/diagnóstico por imagemRESUMO
The authors present their algorithmic approach to the detection, characterization, and staging of renal masses. Based on classification of urographic findings, the patient may be triaged to the appropriate cross-sectional or invasive imaging modality that will result in the most cost-effective management.