The impact of prematurity on postnatal growth of different renal compartments.

AIM: In humans, nephrogenesis ceases before birth, but the renal medulla compartment continues to develop after birth. We aim to evaluate the relative growth of different renal compartments in preterm babies compared with age-matched term babies, and explore the impact of premature birth on postnatal renal maturation, remodelling and possible long-term implications. METHODS: This retrospective study compared the renal ultrasonographic images between preterm babies and term infants. Ultrasound images were obtained at 32 weeks (preterm), 37 weeks and at 6 months of age. Kidney volume, length, renal cortex and medulla thickness were measured and compared between preterm and term babies. RESULTS: Preterm babies were lighter in body weight and shorter for crown-heel length at age-matched 37 weeks. All kidney growth parameters were also smaller compared with term babies. However, by 6 months of age kidney volume and length measurements were no longer significantly different between the two groups though preterm babies were still significantly lighter and shorter. The catch-up of the overall kidney growth in preterm babies was mainly attributed to the hypertrophic growth of the renal cortex while the postnatal renal medulla growth was disrupted. This trend continued as the renal cortical thickness became significantly larger while the medulla became smaller in preterm babies at 6 months of age, compared with age-matched term baby. CONCLUSIONS: In preterm babies, the renal cortical region undergoes accelerated growth after birth while the renal medulla growth lags behind. Further investigations will be necessary to determine whether this has a negative impact on renal function later in life.

Spectrum of imaging appearances in Australian children with central nervous system hemophagocytic lymphohistiocytosis.

Hemophagocytic lymphohistiocytosis (HLH) is a rare multisystem disorder characterised by the proliferation and infiltration of lymphocytes and histiocytes. Central nervous system (CNS) infiltration is particularly devastating. Neuroradiological findings have been reported predominantly as individual case reports due to the rarity of the condition. To our knowledge there have been no published studies of imaging in Australian patients. This study aimed to retrospectively describe and illustrate the MRI appearances of CNS involvement by HLH in a cohort of seven Australian children from two paediatric centres between 2000 and 2011. MRI appearances demonstrate intersubject and intrasubject variability over time, likely reflecting the severity of CNS infiltration and associated demyelination. Familiarity with MRI patterns is important for assessing and monitoring disease activity.

Pulmonary metastases from cervical adenocarcinoma regress to a 'hole' lot of nothing.

A 38-year-old woman with recurrent metastatic cervical adenocarcinoma developed innumerable bilateral solid and cavitating pulmonary metastatic nodules. After chemotherapy with paclitaxel and carboplatin, all these nodules regressed to air filled cystic structures with imperceptible walls, pneumatoceles. Immunocompromised patients require close monitoring for development of these as they may be complicated by secondary infection, pneumothorax formation or develop into a tension pneumatocele.