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Biomedical subjects

A C Friedman

Publications and source records attributed to A C Friedman.

At least 109 records · Page 6Linked to original sources
PubMed1981

Radionuclide imaging and computed tomography in renal oncocytoma.

Renal oncocytoma is an apparently benign neoplasm that is being reported with increasing frequency. It is important to differentiate it from renal-cell carcinoma prior to surgery. Angiographic, CT, and ultrasound studies may suggest the diagnosis but are not pathognomonic. In 4 cases, 99mTc-glucoheptonate imaging of the renal tubules was performed; one patient was also scanned in 131I-orthoidohippurate. There was no evidence of radionuclide uptake by the tumor. Reasons for the lack of success in differentiating renal oncocytoma from renal-cell carcinoma are discussed.

Adenocarcinoma↗
PubMed1981

Computed tomography of abdominal fatty masses.

Computed tomographic (CT) scans of 34 cases of abdominal fatty masses were reviewed retrospectively in order to establish criteria for distinguishing benign conditions from malignant tumors. By evaluating location, attenuation, internal consistency, and margination, it is possible not only to make this distinction but frequently to suggest a specific diagnosis. Abdominal fatty masses that are sharply marginated, homogeneous, and that show CT numbers less than or equal to the patient's normal fat can be considered benign. Malignancy should be suspected when an extrarenal abdominal fatty mass displays one or more of the following characteristics: inhomogeneity, infiltration or poor margination, CT numbers greater than the patient's normal fat, or contrast enhancement. Criteria for distinguishing between angiomyolipoma and liposarcoma are also discussed.

Abdominal Neoplasms↗
PubMed1981

Angiomyolipoma: ultrasonic-pathologic correlation.

Previous reports of angiomyolipoma have emphasized the ultrasonic finding of a very echogenic intrarenal mass. Ten cases of angiomyolipoma for which ultrasound examinations were available were retrospectively reviewed and correlated with their pathologic findings, and, when available, with computed tomographic findings to determine if other sonographic patterns could be recognized. In addition to the typical echodense pattern (six cases), a mixed pattern (two cases) and a low sonodense pattern (two cases) were discovered. To determine if the typical echodense pattern is specific for angiomyolipoma, 42 cases of renal cell carcinoma for which ultrasound examinations were available were also retrospectively reviewed. In two cases of renal cell carcinoma echodense patterns that were indistinguishable from those of angiomyolipoma were found. Two conclusions are reached: (a) there is a spectrum of ultrasonic findings with angiomyolipoma, and (b) the presence of an echodense intrarenal mass, although very suggestive of angiomyolipoma, is not pathognomonic.

Adenocarcinoma↗
PubMed1981

Angiomyolipoma: computed tomographic-pathologic correlation of 17 cases.

The angiomyolipoma is a benign renal tumor composed of fat, smooth muscle, and abnormal blood vessels. The tumor often extends into the perinephric space and often is complicated by intratumoral or perinephric hemorrhage. The CT findings of 17 cases of angiomyolipoma were correlated with their pathologic findings and are described. CT scans usually demonstrate a large fatty mass intermixed with areas of tissue density which may represent nonfatty parts of the tumor or areas of hemorrhage. CT is more sensitive than plain films at detecting the fat within the angiomyolipoma. CT is also useful in identifying perinephric extension and hemorrhage. In those angiomyolipomas composed primarily of smooth muscle or in which intratumoral hemorrhage has obscured the fatty part of the tumor, the CT appearance is indistinguishable from other solid renal tumors.

Adult↗
PubMed1981

Mach bands and pneumomediastinum.

A thin line of apparent radiolucency is a frequent companion outline of the heart borders and the aortic knob. This usually represents a "negative" Mach band. On occasion, such lines can be confused with pneumomediastinum or pneumopericardium, especially if only a single postero-anterior (PA) film is available. Criteria are presented which enable the radiologist to distinguish between these possibilities without depending on other findings.

Absorptiometry, Photon↗
PubMed1980

Cis-platinum (II) diaminedichloride: another cause of bilateral small kidneys.

Cis-platinum (II) diaminedichloride (CPDD) is a new chemotherapeutic agent whose major side effect is renal toxicity. Serial urography may show evidence of a diminution of renal size before there is any clinical evidence of renal failure in patients being treated with CPDD. We recommend that these patients be followed closely with serial radioisotope scanning and/or urography to detect early renal damage.

Adult↗
PubMed1979

A complicated case of aortoduodenal fistula.

Aortoduodenal fistula may occur primarily as a complication of abdominal aortic aneurysm or secondarily after reconstructive surgery of the abdominal aorta. The clinical presentation may be occult, with the classic triad of mass, pain, and bleeding inapparent or overshadowed by signs of infection. A high index of clinical suspicion combined with radiographic and endoscopic examinations will establish the diagnosis.

Aged↗
PubMed1979

Emphysematous pyelonephritis: optimal diagnosis and treatment.

A case of emphysematous pyelonephritis is presented in which computerized tomography (CT) both confirmed the diagnosis and demonstrated extension of the gas to the region of the adrenal glands and inferior cava. The etiology and pathogenesis of emphysematous pyelonephritis is discussed. Radiologic evaluation of this disease should be prompt and noninvasive. Plain films establish the diagnosis, isotope scanning assesses function of the opposite kidney, and CT demonstrates the full extent of the pathological process and confirms the diagnosis. Aggressive treatment is recommended.

Emphysema↗
PubMed1979

Coronary spasm: Prinzmetal's variant angina vs. catheter-induced spasm; refractory spasm vs. fixed stenosis.

An analysis of 2,394 selective coronary angiograms yielded 23 examples of coronary artery spasm. Of these, nine occurred in patients with Prinzmetal's variant angina and 14 were instances of catheter-induced spasm. Angiographic criteria can distinguish between the spasm of variant angina and catheter-induced spasm. The latter is usually asymptomatic, almost invariably in the right coronary artery, at the catheter tip, smooth, concentric, and less than 2 mm long. The former can occur in any coronary artery at a distance of 1--4 cm from the catheter tip, is usually irregular and eccentric, and is associated with angina, ST segment elevation, hypotension, and dysrhythmia. Response to nitroglycerin is often, but not always, complete in both. Stenoses that seem to be fixed in patients with Prinzmetal's angina should be suspected to be spasm even if unresponsive to nitroglycerin, especially when the rest of the vessel is normal. Additional pharmacologic manipulation and even recatheterization may be necessary to prove the dynamic nature of the lesion and avoid unnecessary surgery.

Adult↗
PubMed1978

The fabella sign: fabella displacement in synovial effusion and popliteal fossa masses. Normal and abnormal fabello-femoral and fabello-tibial distances.

Posterior displacement of the fabella is a reliable sign of synovial effusion or mass which may be applied even when inflammation or post-traumatic edema obscures the extrasynovial fat lines of the knee joint. The fabella normally moves posteriorly as the knee is flexed, but correlation of fabella position with degree of flexion defined ranges of normal and abnormal fabella position which are useful in diagnosis. If all lateral views are obtained with the knee flexed over a standard angle bolster, fabella position is standardized and fabella displacement readily detected without need for measurement. With experience, fabella displacement is readily apparent in non-standard positions as well. Normal fabella position does not rule out small effusion or effusion which is confined to the suprapatellar pouch because the knee is extended.

Adolescent↗
PubMed1978

The normal and abnormal left superior intercostal vein.

A study of 500 normal erect posteroanterior chest radiographs was undertaken to determine the incidence of visualization and size of the left superior intercostal vein in normal individuals. The vein produces a small "nipple" lateral to the aortic knob on 1.4% of normal erect posteroanterior chest films; its diameter can be up to 4.5 mm in normal patients. Dilatation of the vein beyond 4.5 mm is a useful sign of a circulatory abnormality warranting further study. Dilatation may be due to absence of the inferior vena cava, hypoplasia of the left innominate vein, congestive failure, portal hypertension, Budd-Chiari syndrome, or superior or inferior vena caval obstruction. The differential diagnosis of an enlarged left superior intercostal vein includes mediastinal mass, especially lymphadenopathy, and aneurysm of the arch of the aorta.

Adult↗
PubMedDate not supplied

Papillary renal cell carcinoma: ultrasonic/pathologic correlation.

Papillary renal cell carcinoma represents a separate clinicopathologic entity distinguished from nonpapillary renal cell carcinoma by angiography, microscopic pathology, and biological behavior. We correlated retrospectively 11 surgically proven papillary renal cell carcinomas with ultrasound patterns and gross pathologic findings. In addition, we reviewed retrospectively 65 surgically proven cases of nonpapillary renal cell carcinoma for sonographic patterns. Seven of 11 (64%) of the papillary tumors were less echogenic than the ipsilateral renal cortex (hypoechoic). Only 23% of the nonpapillary tumors were hypoechoic. These data suggest that renal papillary carcinoma tends to be hypoechoic on ultrasound. In most of the papillary cases, this hypoechoic pattern was due to a large central area of cystic necrosis within the tumor.

Adenocarcinoma↗
PubMedDate not supplied

Gastrografin versus dilute barium for colonic CT examination: a blind, randomized study.

Fifty patients receiving oral contrast medium the day of their CT examinations were studied to evaluate colonic opacification. Two groups were given small volumes (20 versus 30 ml) of nondilute diatrizoate meglumine/diatrizoate sodium (Gastrografin) the night prior to examination and were compared with groups receiving no contrast medium (control) or a large volume (600 ml) of dilute barium the night prior to examination. Frequency of total colonic opacification was as follows: 30 ml Gastrografin, 92%; 20 ml Gastrografin, 71%; dilute barium, 46%; and control, 9%. Significant artifact was infrequent in all groups. Administration of small volumes of nondilute Gastrografin is a well tolerated, inexpensive, and effective method for opacifying the colon for CT.

Barium Sulfate↗
PubMedDate not supplied

Computed tomography of high density renal cysts in adult polycystic kidney disease.

In a review of abdominal CT in patients with adult polycystic kidney disease 24 patients were found to have single or multiple high density renal cysts on nonenhanced studies. All cases showed well defined, homogeneous high density cysts (56-98 HU), with smooth contours, sharp interfaces with renal parenchyma, and lack of contrast enhancement. The benign nature of these lesions was established by tissue examination in five patients and follow-up CT in four others. In the remaining 15 patients the benign nature of these lesions was assumed based on the constellation of CT and clinical findings.

Acute Kidney Injury↗
PubMedDate not supplied

Intravascular bronchioloalveolar tumor: CT and pathologic correlation.

Intravascular bronchioloalveolar tumor of the lung is an unusual neoplasm that usually presents as multiple pulmonary nodules in asymptomatic young women. The course of the disease is often indolent with some patients eventually dying of respiratory failure secondary to progressive tumor infiltration of the pulmonary interstitium. The cell of origin appears to be an endothelial cell, and epithelioid hemangioendothelioma of liver or other soft tissues is a pathologically identical neoplasm. Open lung biopsy is necessary for diagnosis. The radiologist should be aware of this tumor and suggest the diagnosis in the appropriate clinical setting.

Adult↗