Sonographically guided percutaneous biopsy of gastrointestinal tract lesions.

OBJECTIVE: Our objective was to evaluate the role and safety of sonographically guided percutaneous biopsy in the diagnosis of digestive tract lesions when the lesions are not suitable to biopsy by endoscopy and safely reachable by sonography. MATERIALS AND METHODS: We performed 42 biopsies in 41 patients (age range, 14-81 years; mean age, 57.5 years). We performed biopsies with real-time sonographic guidance using graded compression, with a 3.5-5-MHz microconvex transducer. In 39 biopsies, core specimens were obtained with an 18-gauge automatic needle gun; fine-needle aspiration biopsy was obtained in 28 patients with a 22-gauge needle and in the other four patients with a 21-gauge needle. In the remaining three patients, a coaxial technique with 20- and 22-gauge needles for cytology was used. RESULTS: In 40 (95.2%) of 42 core biopsies performed, a specific diagnosis was obtained. A positive diagnosis was obtained in 16 (45.7%) of 35 fine-needle aspirations. The lesions were located from the pharynx to the sigmoid colon. Twenty-eight patients had malignant lesions, and 13 had benign lesions. Only one serious complication, bile peritonitis, was observed. CONCLUSION: Percutaneous biopsy with sonographic guidance can be used safely and efficiently to diagnose digestive tract lesions that can be visualized on sonography and are not accessible endoscopically.

[Cacchi Ricci disease. Report of a case]. / Enfermedad de Cacchi Ricci. A propósito de un caso.

OBJECTIVE: To present a case of medullary sponge kidney (Cacchi-Ricci disease) with special reference to the radiologid findings that permit early diagnosis of this rare condition. METHODS: The most relevant clinical features and radiological findings in a patient with Cacchi-Ricci disease are described. RESULTS/CONCLUSIONS: Medullaty sponge kidney, tubular ectasia or Cacchi-Ricci disease is a congenital renal medullary cystic disease that is asymptomatic in most of the cases, but can also present with hematuria, urinary infection or renal colic, with the characteristic spony, porous appearance of the dilated collecting tubules and small calculi in the papilla or renal pyramids on the IVP and, if numerous, also on US. This condition should be distinguished from nephrocalcinosis.

[Echography-guided percutaneous biopsy of pleural lesions and effusions]. / Biopsia percutánea de lesiones y derrames pleurales dirigida por ecografía.

Our experience in the use of ultrasonic echography (UE) is exposed as a guide for directing small lesions and pleural effusions percutaneous lesions with an unknown grounds. We have done pleural percutaneous biopsy using UE as guide in 45 patients. The needle diameter ranges between 17 and 19.5 G. Lesions were benign for 16 patients and malignant for 29. The right result was obtained in 93% of the cases. There were not complications. We conclude that echography-directed pleural biopsy presents an excellent diagnostic profitability, it improves the results obtained with blind biopsy with Cope's needle and it must precede thoracoscopy by means of its less aggressiveness.