Roentgenologic Appearance Research Articles

Bronchoscopic Diagnosis of Pulmonary Hydatidosis in Patients With Unusual Roentgenologic Appearance

Bronchoscopic Diagnosis of Pulmonary Hydatidosis in Patients With Unusual Roentgenologic Appearance

Bronchoscopic Diagnosis of Pulmonary Hydatidosis in Patients With Unusual Roentgenologic Appearance

Bronchoscopic Diagnosis of Pulmonary Hydatidosis in Patients With Unusual Roentgenologic Appearance

Rounded atelectasis: A pulmonary pseudotumor

Rounded atelectasis is a benign entity that is often misinterpreted as a pulmonary neoplasm. The roentgenologic appearance of a mass is due to an infolding of atelectatic tissue intermingled with pleura, blood vessels, and bronchi. Rounded atelectasis is usually asymptomatic and is commonly associated with chronic pleural disease or pleural effusions. The distinctive radiologic features include a rounded, pleural-based opacity associated with adjacent pleural thickening and volume loss of the affected lobe. The pathognomonic sign is the “comet tail” that results from the crowding of vessels and bronchi as they enter the atelectatic region. Many authors consider this constellation of findings diagnostic. Rounded atelectasis usually remains stable over time; however, slow growth, as well as diminution in size, has been described. A retrospective analysis revealed 7 cases of rounded atelectasis at our institution over a 9-year period. Three were operated on to exclude malignancy, one was confirmed at operation performed for other reasons, and 3 were followed up expectantly. We conclude that recognition of this entity and its radiologic features can be diagnostic and render further workup, including thoracotomy, unnecessary.

Kienbock??s Disease

Kienbock's disease (lunate malacia) is an unusual but not rare cause of wrist pain. It is manifested by avascular necrosis and subsequent disintegration of the lunate. Despite recognition of this disease entity for the past 70 years, its cause is still debated. Most investigators relate it to a stress fracture that leads to devascularization of the major segment of the lunate if the lunate is supplied by one volar vessel. The classification of Kienbock's disease is based on its roentgenologic appearance. Stage 1 consists of small fracture lines. Stage 2 is rarification along the fracture line, usually on the volar pole. Stage 3 shows sclerosis of the bone dorsal to the fracture site. Stage 4 shows sclerosis of the bone dorsal to the fracture site, and collapse and secondary fracture with loss of architectural integrity of the lunate. Stage 5 shows secondary arthritic changes of the radius. Treatment is categorized into two general types. The first is an attempt to allow revascularization of the lunate be relieving the compression forces. This is accomplished by lengthening the ulna and/or shortening the radius, with capitate-hamate fusion; or by shortening the capitate and fusing the capitate and hamate. These procedures are performed in the early stages of Kienbock's disease. The second type of treatment, used in more advanced cases, includes excision of the lunate: replacement of the lunate by prosthesis, with or without capitate shortening and/or capitate-hamate fusion; and various types of intercarpal fusion.

Human chorionic gonadotropin-secreting large cell carcinoma of the lung detected during follow-up of a patient previously treated for gestational trophoblastic disease

A patient is presented whose large cell carcinoma of the lung was detected by an elevated β subunit human chorionic gonadotropin (HCG) titer 2 years after undergoing chemotherapy and remission for metastatic trophoblastic disease. The secretion of HCG was low (3.48 to 14.18 mIu/ml) and intermittent. Roentgenologic appearance of the lesion occurred 4 months after secretion of HCG was detected. HCG-producing tumors of nontrophoblastic origin should be considered when low titers are detected after complete remission of trophoblastic disease.

Solitary In traosseous Neurilemmoma of the Tibia

This is a case report of a 59-year-old woman with a neurilemmoma involving the tibia, a site not previously reported for this tumor. Neurilemmoma, a benign neoplasm which rarely involves bone, arises from the Schwann cells in the nerve sheath. It is a distinct pathological entity separate from solitary neurofibroma, and arises from the connective tissue coats of nerves, but which also involves bone. The incidence of the 2 types of nerve sheath tumors is obscured by the tendency of some authors to use the terms interchangeably. Forty-eight cases of true intraosseous neurilemmoma have been reported in the literature. Of 18 cases of solitary intraosseous neurofibroma primary in bone, all were in the jaw and 6 were malignant. The diagnosis of intraosseous neurilemmoma may be missed because of its rarity and roentgenologic appearance of cystic bone disease which is not distinctive except that it resembles other commonly encountered bone lesions. A positive diagnosis is based only on the microscopic pathology. Complete local resection generally produces an excellent result without recurrence.

Neonatal septic "dislocation" of the hip: true dislocation or pathological epiphyseal separation?

The clinical and roentgenologic appearance of septic dislocation of the hip may be caused by either a true dislocation or a pathological epiphyseal separation due to osteomyelitis. Arthrography of the hip permits differentiation in the neonate. The significance of these two anatomical possibilites is discussed in terms of follow-up and results of neonatal infections about the hip, and a case of pathological epiphyseal separation at the hip diagnosed in the neonatal period by aspiration and arthrography and followed up for 3 years is presented.

The value of the lateral abdominal roentgenogram in the diagnosis of neonatal hepatic portal venous gas (HPVG).

THE VALUE OF THE LATERAL ABDOMINAL ROENTGENOGRAM IN THE DIAGNOSIS OF NEONATAL HEPATIC PORTAL VENOUS GAS (HPVG)DONALD R. KIRKS, M.D., MAJOR, MC and STUART A. O’BYRNE, M.D., MAJOR, MCAudio Available | Share

The Roentgenographic Diagnosis of Diseases of the Thoracic Aorta

The stated purpose of this book is to bring together in one volume the current knowledge about diseases of the thoracic aorta with emphasis on roentgenographic examination. The author succeeds admirably. Three chapters are devoted to roentgenologic methods of examination, complications of these techniques, and their management. There is one chapter on the normal roentgenologic appearance of the aorta and eight chapters on disease states. The illustrations are both good and numerous. The bibliographies after each chapter are extensive and contain references published as recently as 1972. This book is recommended as a ready, concise reference with a good bibliography to angiographers who examine the thoracic aorta frequently or occasionally. It is also valuable to chest roentgenogram readers, particularly for the angiogram and plain film correlations it contains.

Extensive metastatic calcification of the lung in an azotemic patient

An unusual case of extensive pulmonary metastatic calcification occurring during the course of chronic pyelonephritis is described. The important features of this case are as follows: (1) Metastatic calcification appeared to develop in an early state of chronic renal failure when there was neither hypercalcemia, hyperphosphatemia, hyperparathyroidism nor evidence of bone disease. (2) The calcium and phosphate ion product was normal during the last 3 years when the pulmonary metastatic deposits persisted and progressed with the roentgenologic appearance of pulmonary edema. (3) There was calcium carbonate rather than the anticipated calcium phosphate in the deposited material. A review of the literature offers some theoretic explanation for the sites of calcification but no practical explanation for the presence of calcification.

Acute respiratory distress in adults.

Several nonpulmonary conditions may cause acute respiratory distress in adults. A review of 75 such patients revealed that the physiological and pathological patterns were constant, but the roentgenologic appearance was variable. Autopsy findings in one-third of the group consistently included heavy, wet lungs. The varied roentgenologic appearance may be attributed to (a) the position of the patient, since fluid seeks dependent spaces; (b) pre-existing vascular alterations; (c) fluid accumulation which is not radiographically apparent; (d) interstitial fluid accumulation prior to distal air-space filling; and (e) overdistension and fibrosis as the result of positive-pressure therapy and high oxygen concentrations.

The elusive ectopic ureteroceles.

1. A classification of ectopic ureteroceles, modified from Stephens’ classification by the addition of 1 category is presented.2. Stephens’ theory of the embryology of ectopic ureteroceles is the only currently adequate theory.3. Ectopic ureteroceles seen on roentgenograms may display features other than those commonly associated with them. They are consequently difficult to diagnose.4. The roentgenologic appearance of ectopic ureteroceles may change at any time during the examination because of unpredictable dynamic factors.5. The excretory urogram is the most useful examination for diagnosing ectopic ureteroceles. Voiding cystourethrograms, however, should also be done to illustrate pathology not seen on the excretory urogram.6. A full-length roentgenogram should be taken 3-5 minutes after contrast medium injection, before osmotic diuresis has caused the patient to void.7. Whenever an ectopic ureterocele cannot be ruled out, but cannot be seen on conventional roentgenograms, steep oblique or lateral pro...

The Periosteal Counterpart of Benign Osteoblastoma

Two additional cases of the periosteal counterpart of benign osteoblastoma, occurring over the greater trochanter of the femur and on the lower anterior tibia, respectively, are presented. The roentgenologic appearance suggests a benign process, and the histologic features, which are indistinguishable from those of benign osteoblastoma of intramedullary origin, allow differentiation from myositis ossificans restricted to or primarily involving periosteum and parosteal osteosarcoma, in addition to other less common entities which display juxtacortical calcification or ossification.

The roentgenologic appearance of postoperative congenital megacolon (Hirschsprung's disease): A. E. James, Jr., J. B. Greenfield, R. C. Pfister, A. L. Weber, W. H. Hendren and E. B. D. Neuhauser. Amer. J. Roentgen. 109:351–367 (June), 1970

The roentgenologic appearance of postoperative congenital megacolon (Hirschsprung's disease): A. E. James, Jr., J. B. Greenfield, R. C. Pfister, A. L. Weber, W. H. Hendren and E. B. D. Neuhauser. Amer. J. Roentgen. 109:351–367 (June), 1970

Roentgenologic appearance of systemic amyloidosis involving gastrointestinal tract.

The roentgenologic findings in 24 patients with known gastrointestinal deposition of amyloid are reviewed. The most significant finding was motor dysfunction, manifested by esophageal reflux and weak motor activity, gastric retention, intestinal dilatation or segmental dilatation and contraction, diminished motility, prolonged transit, and, eventually, obstruction. Scleroderma and ischemia of the bowel can also produce these changes, but these diseases often can be differentiated clinically from amyloidosis, and a diagnosis of amyloid can be easily confirmed by biopsy of the involved organ or by rectal biopsy.

The roentgenologic appearance of postoperative congenital megacolon (Hirschsprung's disease).

The primary treatment of congenital megacolon is definitive surgery. Of the various operative modifications that have been described, the 3 basic techniques are the Swenson pull through, the Duhamel, and the Soave operations.This article describes the roentgenologic appearance of the 3 basic operations and their most common modifications.Barium enema examination performed in a postoperative patient is an excellent method to assess the surgical correction as well as the failures and complications.To properly evaluate postoperative Hirschsprung’s disease, the roentgenologist must be acquainted with the expected anatomic changes and their roentgenographic manifestations. The etiology of postoperative problems following surgical repair of Hirschsprung’s disease may be demonstrated by the roentgenologic principles and techniques discussed.

The roentgenologic appearance of sclerosing cholangitis.

Abstract Primary sclerosing cholangitis is a rare disease of unknown etiology. While the condition can be recognized at surgery when the accessible portion of the extrahepatic biliary system is involved, patchy and/or intrahepatic involvement can only be recognized radiographically. Characteristic signs include strictures of variable length, decreased arborization, and a beaded appearance of the bile ducts. Five cases of primary sclerosing cholangitis are presented. The recently recognized association with ulcerative colitis is emphasized.

Endemic fluorosis in Punjab (India).

Abstract The results of an epidemiologic, clinical and biochemical study of endemic fluorosis in Punjab (India) are summarized. This condition is due to chronic fluoride intoxication resulting from ingestion of large quantities of fluoride in the drinking water over a number of years. It produces a well defined disorder affecting the teeth, the skeletal system and secondarily the nervous system. The results of dental surveys in 358 villages are described, as correlated with water fluoride levels. The details of skeletal changes as observed in a large series by gross examination, roentgenologic appearance, histopathologic changes and alterations of chemical composition are recorded. The pattern of neurologic deficit conforms to a radiculomyelopathy and is due to compression of the spinal cord and nerve roots. Significantly high levels of fluoride were found in the blood, urine and bones of these patients and in the drinking water samples of the affected population. It has not been possible thus far to define the safe lower limit of fluoride in the drinking water. No significant alterations in thyroid, adrenocortical or parathyroid functions were noted. Scrum enzyme levels are mostly normal except for the serum alkaline phosphatasc level which is slightly raised.

Carcinoma of the Lung and Dysphagia

In order to determine the frequency of dysphagia in primary carcinoma of the lung we reviewed the records of 615 consecutive hospital admissions which took place over a 9$$-year period; the incidence was 2.2 per cent in 405 proved cases. The mechanism is esophageal involvement and compression by subcarinal and periesophageal lymph nodes. Dysphagia is not an early symptom; it indicates advanced disease and usually forecasts inoperability. Even in some cases when dysphagia is not present, the esophagogram can be of help in assessing the involvement of periesophageal nodes and hence inoperability. The roentgenologic appearance varies from compression of the esophagus to one of involvement of the esophageal wall and occasionally to that of a circumferential lesion. Lung carcinoma should be considered in the differential diagnosis of all patients with midesophageal dysphagia.

Roentgenologic features of lymphoid hyperplasia of the small intestine associated with dysgammaglobulinemia.

In 1966 Hermans and his co-workers (1) reported eight cases of dysgammaglobulinemia associated with nodular lymphoid hyperplasia of the small intestine. Characteristically, these patients demonstrated an unusual susceptibility to infection, chronic or intermittent diarrhea, reduced concentration of gamma globulins, and roentgenologic evidence of nodular defects in the intestine. Since that report, two more patients have been observed with this combination of findings. The present report is primarily concerned with the roentgenologic appearance of these nodular defects in 10 patients. These tiny, nodular, filling defects are usually evident on films of the upper part of the small intestine and are located primarily in the duodenum and jejunum, although they may also be seen in the terminal part of the ileum and the right colon. Clinical Study All the 10 patients (6 men and 4 women) gave a history of either unusual susceptibility to infection or chronic diarrhea which had persisted for various periods. The ...