Bilateral Symmetrical Involvement Research Articles

Chest radiography and computed tomography findings of cases with pandemic influenza A (H1N1/09) infection

To review the radiological findings of the chests of swine flu patients whose infections were confirmed clinically and/or by laboratory tests. Materials and methods: This study was conducted in the radiology and infectious diseases departments of a tertiary care hospital, Ankara Training and Research Hospital, Ankara, Turkey. The X-ray and thorax computed tomography (CT) findings of swine flu patients were evaluated. Results: Included were 53 cases of swine flu. Thirty-eight of the patients (72%) underwent an initial chest X-ray and 17 (32%) underwent thorax CT examinations. The mean age of the patients was 41 years; 23 (43%) patients were male and 30 (57%) were female. In the chest X-rays, the most common pathology was patchy consolidations with a prevalence of 27%. Bilateral symmetrical involvement was observed in 42% of the cases. In the thorax CT, patchy consolidations (47%) and ground glass opacification (24%) were the most commonly observed patterns. Bilateral symmetrical involvement was observed in 41% of the cases. Pleural effusion was seen in 29% of the cases and mediastinal lymphadenopathy was observed in 41% of the cases. Conclusion: The most commonly observed radiological pattern of influenza A (H1N1) pulmonary infection is bilateral, symmetrical, patchy consolidations and/or ground glass opacities, predominantly located in middle-inferior zones with central peribronchovascular distribution. Associated mediastinal lymph nodes, pleural effusion, and tree-in-bud patterns should raise the suspicion of superimposed infection.

Neurogenic heterotopic ossification: epidemiology and morphology on conventional radiographs in an early neurological rehabilitation population

To retrospectively evaluate neurogenic heterotopic ossification in an early neurological rehabilitation population (phases B and C) with respect to epidemiology and morphology on conventional radiographs. Over a 4-year period, 1,463 patients treated at a clinic for early neurological rehabilitation were evaluated for clinical symptoms of neurogenic heterotopic ossification. In case of clinical suspicion, plain radiographs of the expected sites were obtained. If heterotopic ossification was detected, the initial and subsequent radiographs were retrospectively analyzed for sites, size, and morphology. Immature lesions were categorized as small (<10mm) or large (10-100mm). The prevalence rate of neurogenic heterotopic ossification was 2.05%. The condition was most common in young male adults. The hip was the most common site accounting for more than half of the cases. Two or more ossifications were seen in 56.7% of the affected patients with approximately two-thirds showing bilateral symmetric involvement of corresponding joint regions. The size of ossifications strongly varied interindividually. Small immature lesions demonstrated less progression in size than large lesions during maturation (P < 0.05). Standard radiographs, as a fast and inexpensive technique, allow the expected size progression of heterotopic ossifications during maturation to be estimated, which is relevant in terms of therapeutic decisions, patient mobilization, and neurological rehabilitation.

Unusual bilateral symmetrical osteolytic metastases visualized by bone scintigraphy.

Bone scintigraphy was performed on a 50-year-old man with squamous cell cancer of the neck after injection of Tc-99m MDP. The images showed multiple sites of osseous metastases. The involvement of both femurs is unusual with bilateral symmetric involvement. The correlative radiographs confirmed osteolytic lesions in the femurs. The patient had hypercalcemia. Bilateral calcification of lung metastases were visible on the bone scan. This case is unusual because of the remarkably symmetric metastases in the femurs and humeri. Although the lesions appear lytic on radiographs, they show significant tracer uptake on bone scan. Hypercalcemia was responsible for the lung calcification, which apparently arose from a parathyroid-like hormone secreted by the tumor.

Benign Symmetric Lipomatosis

To the Editor:— We read with interest the recent report by Comings and Glenchur ( 203 :305, 1968), in which the authors describe a case of bilateral symmetrical involvement of the supraclavicular fossae by lipomatoses. During the past two years we have personally observed 22 individuals with this condition and are presently preparing our information for publication. We have found a high incidence of the following associated conditions: painless symmetrical enlargement of parotid glands, hypertension, diabetes, obesity, and gout. We would be interested to know whether the patient reported by Comings and Glenchur had any of these other elements, which we have come to consider to be a well-defined clinical syndrome.

Lymphosarcoma of the kidney; a case report and description of roentgen findings.

Lymphosarcoma of the kidney has been recorded many times since the original report in 1878 by Turner (6). Most of the cases have been secondary to massive involvement of retroperitoneal lymphoid tissue. There have been occasional reports of cases in which the lesions were largely or completely confined to the renal parenchyma and differentiation from primary disease of the kidney was not accomplished, the true nature of the process being recognized only after surgical or postmortem removal. Most of these cases have been unilateral and have been confused with primary renal neoplasms. A few instances of bilateral symmetrical renal involvement have been described. The clinical picture in these cases has been confusing, and no characteristic clinical or physical findings have been recorded by which the diagnosis was made prior to death or exploration. It is the purpose of this paper to report a case of bilateral diffuse renal lymphosarcomatosis and to describe a roentgen finding which led the authors to suspe...