RESUMEN
Primary intracerebral lymphoma is an uncommon presenting site for non-Hodgkin's lymphoma. The authors review 28 histopathologically confirmed, consecutive cases, presenting over a 15-year period. The cohort included 20 males and 8 females with a mean age at diagnosis of 54 years (range 27-75 years). Subtotal resection was performed in 8 patients. Radical whole brain irradiation was given to 27 patients. One patient was too unwell to receive treatment and quickly died. Three patients also had chemotherapy. Clinical remission was achieved in 19 patients. Of these, 9 relapsed after a median interval of 18 months. Nine patients (32% total cohort) are still alive and in remission after a median follow-up of 2 years and 10 months (range 11 months to 11 years and 5 months). Cause of death was intracerebral lymphoma in 13 of the 19 patients who died. Median survival was 12 months in this group (range 1 week to 4 years and 9 months). Actuarial 5-year survival for all patients was 19%. The prognosis for patients with primary intracerebral lymphoma treated with radiotherapy alone is poor.
Asunto(s)
Neoplasias Encefálicas/patología , Linfoma no Hodgkin/patología , Adulto , Anciano , Neoplasias Encefálicas/diagnóstico por imagen , Neoplasias Encefálicas/mortalidad , Neoplasias Encefálicas/radioterapia , Estudios de Cohortes , Progresión de la Enfermedad , Femenino , Humanos , Linfoma no Hodgkin/diagnóstico por imagen , Linfoma no Hodgkin/mortalidad , Linfoma no Hodgkin/radioterapia , Masculino , Persona de Mediana Edad , Estadificación de Neoplasias , Estudios Retrospectivos , Tasa de Supervivencia , Tomografía Computarizada de Emisión , Resultado del TratamientoRESUMEN
The objective of this study was to review and analyse the chest radiograph (CXR) appearances seen following high dose chemotherapy and autologous bone marrow transplantation (ABMT), and to identify any characteristic patterns. Thirty-one patients underwent ABMT between 1984 and 1989 for high grade lymphoma resistant to conventional chemotherapy. Their case notes and CXRs were reviewed in conjunction with the clinicians. In this small sample of patients, an acute interstitial pattern was seen with pulmonary oedema following bone marrow reinfusion in two cases of the 13 patients showing CXR changes (15%). Otherwise, the CXR changes following ABMT were not specific, although they did alert the clinician to the possibilities of recurrent lymphoma or opportunistic infection, enabling appropriate investigations and treatment to be instituted at an early stage. The complications and CXR changes did not differ greatly from those seen following allogeneic bone marrow transplantation.
Asunto(s)
Trasplante de Médula Ósea , Enfermedad de Hodgkin/diagnóstico por imagen , Linfoma no Hodgkin/diagnóstico por imagen , Radiografía Torácica , Adolescente , Adulto , Protocolos de Quimioterapia Combinada Antineoplásica/uso terapéutico , Terapia Combinada , Resistencia a Medicamentos , Femenino , Enfermedad de Hodgkin/terapia , Humanos , Linfoma no Hodgkin/terapia , Masculino , Persona de Mediana Edad , Edema Pulmonar/diagnóstico por imagen , RecurrenciaRESUMEN
Computed tomography (CT) scanning is an accepted first line investigation for suspected lumbar prolapsed intervertebral disc disease (PID). However, it does involve ionizing radiation and any possible reduction in the dose is desirable. A questionnaire was sent to a random selection of 60 CT centres in the UK to confirm that a routine scan of the three lower lumbar levels is current practice in a majority of centres, regardless of symptomatic presentation. All orthopaedic CT referrals over 2 years for suspected lumbar disc disease in Sheffield were studied retrospectively. Of 486 cases, 99 (20%) were shown to have disc disease, of which 16 (3.3%) had disease at the L3/4 level. Of these 16 cases, 11 were suspected clinically. Analysis of the long-term outcome of the five unsuspected cases showed that in none did the CT findings make any significant contribution to this outcome. These results have altered our practice. Two-level scanning is now performed routinely and three-level scanning is only performed when specified clinical or radiological indications are present.
Asunto(s)
Desplazamiento del Disco Intervertebral/diagnóstico por imagen , Vértebras Lumbares/diagnóstico por imagen , Tomografía Computarizada por Rayos X , Adulto , Anciano , Humanos , Estudios Retrospectivos , Factores de Tiempo , Reino UnidoAsunto(s)
Enfermedades del Colon/diagnóstico por imagen , Tuberculosis/diagnóstico por imagen , Úlcera/diagnóstico por imagen , Adulto , Canal Anal/diagnóstico por imagen , Enfermedades del Colon/complicaciones , Humanos , Masculino , Radiografía , Tuberculosis/complicaciones , Úlcera/complicacionesAsunto(s)
Síndrome de Inmunodeficiencia Adquirida/complicaciones , Síndrome de Cushing/diagnóstico , Lipodistrofia/diagnóstico , Acetato de Megestrol/efectos adversos , Síndrome de Inmunodeficiencia Adquirida/tratamiento farmacológico , Adulto , Fármacos Anti-VIH/uso terapéutico , Carbamatos , Síndrome de Cushing/inducido químicamente , Diagnóstico Diferencial , Quimioterapia Combinada , Furanos , Inhibidores de la Proteasa del VIH/efectos adversos , Inhibidores de la Proteasa del VIH/uso terapéutico , Humanos , Lipodistrofia/inducido químicamente , Masculino , Acetato de Megestrol/uso terapéutico , Inhibidores de la Transcriptasa Inversa/uso terapéutico , Sulfonamidas/efectos adversos , Sulfonamidas/uso terapéuticoRESUMEN
A case of salmonella aortitis and aneurysm formation with subsequent necrosis of the arterial wall is described. Computed tomography is beneficial in diagnosis and management and should be carried out early in the course of illness.
Asunto(s)
Aneurisma Infectado/patología , Aneurisma de la Aorta/patología , Aortitis/patología , Infecciones por Salmonella/patología , Tomografía Computarizada por Rayos X , Aneurisma Infectado/diagnóstico por imagen , Aneurisma de la Aorta/diagnóstico por imagen , Aortitis/diagnóstico por imagen , Femenino , Humanos , Persona de Mediana Edad , Necrosis , Rotura Espontánea , Salmonella typhimurium/aislamiento & purificaciónRESUMEN
Three cases of sacral arachnoid diverticula causing bony erosion are described. Two of these filled with contrast medium after the initial myelogram was completed, and were only apparent on delayed CT.
Asunto(s)
Aracnoides/diagnóstico por imagen , Divertículo/diagnóstico por imagen , Femenino , Humanos , Masculino , Persona de Mediana Edad , Mielografía , Región Sacrococcígea , Raíces Nerviosas Espinales/diagnóstico por imagen , Tomografía Computarizada por Rayos XRESUMEN
Portal and splenic venous thrombosis is a rare but well recognised complication of pancreatic carcinoma and pancreatitis. We report a series of five patients with pancreatic disease in whom CT detected this complication. The appearances on CT are of an enlarged vein with a centre of lower attenuation which does not enhance following intravenous contrast injection, ring enhancement and opacification of collateral veins. Splenic vein thrombosis following pancreatitis should be considered in all patients with pancreatic disease as this complication is increasingly recognised as a cause of upper gastrointestinal haemorrhage from varices.
Asunto(s)
Enfermedades Pancreáticas/diagnóstico por imagen , Vena Porta/diagnóstico por imagen , Vena Esplénica/diagnóstico por imagen , Trombosis/diagnóstico por imagen , Humanos , Enfermedades Pancreáticas/complicaciones , Neoplasias Pancreáticas/complicaciones , Neoplasias Pancreáticas/diagnóstico por imagen , Trombosis/complicaciones , Tomografía Computarizada por Rayos XRESUMEN
Atlanto-occipital subluxation is a rare but recognized form of subluxation that occurs in rheumatoid arthritis (RA) at the cranio-cervical junction. Magnetic resonance imaging (MRI) clearly demonstrates the bony and soft tissue changes of RA in the cervical spine. We report a single case of atlanto-occipital subluxation in RA demonstrated by MRI.
Asunto(s)
Artritis Reumatoide/complicaciones , Articulación Atlantooccipital , Luxaciones Articulares/diagnóstico , Luxaciones Articulares/etiología , Imagen por Resonancia Magnética , Anciano , Articulación Atlantooccipital/patología , Femenino , HumanosRESUMEN
Technetium-99m sodium pertechnetate scintigraphy is an established method for evaluating organ perfusion and can be applied to the investigation of suspected testicular ischaemia due to acute torsion. One hundred and six consecutive scrotal investigations have been analysed qualitatively and quantitatively using a computer-based comparison of the perfusion slopes over each testis. Decreased vascularity on the symptomatic side only occurs in torsion and quantitative analysis is needed to detect it reliably. Increased vascularity on the symptomatic side can usually be detected qualitatively and occurs in orchitis, tumours, trauma and resolved torsion. Distinction between the causes of increased vascularity is aided by the clinical data. A halo of increased activity surrounding a relatively cold centre was seen in chronic torsion, some tumours and hydrocoeles. The test is both sensitive and specific for acute torsion but its usefulness is limited if it is not available at all hours. The test is useful, also, in confirming a diagnosis that does not require emergency operation and in identifying chronic torsion which is an indication for contralateral orchidopexy.