Biomedical subjects
Publications and source records attributed to C J Chung.
An ectopic cerebellum, as in Chiari malformations and ectopic cerebellar dysplastic tissue, is a common finding; however, the presence of an organized ectopic cerebellum is exceedingly rare. We describe the MR imaging, surgical, and histologic appearance of an intraspinal ectopic cerebellum in an infant.
Primary ectopic meningiomas are rare, but may be seen in the head and neck region. The temporal bone and its neural foramen are rarely the site of a primary meningioma. This report describes the CT and MRI appearance of an ectopic meningioma arising at the anatomic location of the geniculate ganglion, and discusses the differential diagnosis as well as the possible origin of the tumor.
This report describes a child with hypertrophic pyloric stenosis with persistent vomiting after pyloromyotomy due to a coexistent hypertrophic antral polyp.
Kawasaki disease (mucocutaneous lymph node syndrome) typically presents with fever, rash, lymphadenitis, and mucositis. The colon is rarely involved and, to date, colitis has not been described as the presenting symptom. We report the imaging findings of a child with Kawasaki disease who presented with fever and focal left colitis.
To investigate the safety and efficacy of 0.25% hyperbaric bupivacaine for spinal anaesthesia in Caesarean section, we studied 60 parturients allocated randomly to one of three groups. According to the patient's height, groups 1, 2 and 3 received 3.2-3.6 ml (8-9 mg), 3.6-4.0 ml (9-10 mg) and 4.0-4.4 ml (10-11 mg) of 0.25% bupivacaine in 5% glucose, respectively. Subarachnoid injection was performed in the right lateral decubitus position, and parturients were then turned immediately supine with left uterine displacement. Mean spread of sensory analgesia was significantly higher in group 3 (T2-3) than in groups 1 and 2 (T4-5 in each group). Duration of sensory analgesia was significantly longer in groups 2 and 3 than in group 1. Complete motor block of the lower extremities occurred in all patients but in only one in group 1. Onset time and duration of motor block were not significantly different between the three groups. The incidence of hypotension was significantly higher in group 3 (75%) than in groups 1 and 2 (40% in each group). The efficacy of intraoperative analgesia was significantly greater in groups 2 and 3 than in group 1. The incidence of patients requiring analgesics during operation was significantly lower in groups 2 (25%) and 3 (10%) than in group 1 (70%). There was no difference in neonatal condition between the three groups. Spinal anaesthesia with 3.6-4.0 ml of 0.25% bupivacaine in 5% glucose was satisfactory for Caesarean section.
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OBJECTIVE: The purpose of this study was to identify CT characteristics of rhabdoid tumor of the kidney, a rare, aggressive, malignant neoplasm of unknown origin that occurs mainly in infants and young children. MATERIALS AND METHODS: CT scans of eight children (newborn to 13 years old; mode, 4 months old; six boys and two girls) with histopathologic diagnosis of rhabdoid tumor of the kidney were evaluated retrospectively by two of the authors, who were not blinded to the diagnosis. All eight CT scans were performed with intravenous and oral contrast, and noncontrast intravenous CT scans were available in four cases. The following CT characteristics were evaluated: location of tumor within the kidney; presence of calcification, subcapsular hematoma, multiple tumor lobules, enlarged vessels, vascular invasion, or central tumor necrosis or hemorrhage; visibility of tumor margin; distant metastasis; and primary tumor size. RESULTS: All eight primary tumors (five on the left, one of which had contralateral renal nodules) were central in location and involved the hilum. Calcification outlining the tumor lobule was present in two of the four tumors on noncontrast CT scans. Subcapsular hematoma was seen in five children. Tumor necrosis and hemorrhage were seen in seven children. Tumors were well defined from the renal cortex in four children. Lobules of tumor were seen in seven children. CONCLUSION: CT findings of calcification, subcapsular hematoma, and lobular appearance in a large, centrally located, and heterogeneous renal mass in a child suggest a rhabdoid tumor of the kidney.
Our purpose was to characterize the spectrum of hepatobiliary abnormalities on sonography in children with vertically transmitted HIV infection. Abdominal sonograms were performed on 41 children with HIV infection and correlated with clinical and histopathologic data. Hepatobiliary abnormalities were noted in 26 (63%) children. Hepatomegaly (n = 13) and abnormal hepatic echotexture (n = 13) were the most common abnormalities noted. Preexisting AIDS-related infections or neoplasms were noted significantly more frequently in children with hepatic or biliary abnormalities on sonography (18/26, 69%) than in children without abnormalities (5/15, 33%) (P = 0.0001). Most children with hepatobiliary abnormalities on sonography who underwent hepatic tissue sampling, however, did not have evidence of acute infection or neoplasia. Hepatobiliary abnormalities are frequently noted on sonography in children with HIV infection. Hepatomegaly and abnormal hepatic echotexture are the most frequent sonographic findings and are usually nonspecific.
PURPOSE: To identify conditions associated with abdominal lymphadenopathy in children with vertically-transmitted human immunodeficiency virus (HIV) infection. METHODS: Abdominal computed tomography (CT) scans were performed on 29 children over an eight-year period. The presence or absence of abdominal lymphadenopathy (> 10 mm in diameter) was prospectively evaluated at the time of CT. Clinical and histopathologic data in these children was reviewed. RESULTS: Abdominal lymphadenopathy was noted in eight (28%) children. The lymphadenopathy was isoattenuating relative to adjacent muscle in all cases. The most common specific associated diagnosis was systemic infection with Mycobacterium avium intracellulare (three children). One child had disseminated Kaposi sarcoma while four children had no known associated systemic infection or neoplasm. CONCLUSIONS: Abdominal lymphadenopathy was noted at CT in 28% of all HIV-infected children studied with CT and represented a nonspecific finding. The presence of lymphadenopathy should raise the suspicion of disseminated mycobacterial infection; however, it may also be observed in the absence of known systemic infection or neoplasm.
With the routine use of computed tomographic imaging, intrinsic involvement of the genitourinary tract in newly diagnosed non-Hodgkin's lymphoma is seen in as many as 10 percent of patients. Incidental discovery of an extranodal, extra-lymphatic lesion in the genitourinary tract without clinical or radiographic evidence of disease elsewhere, however, is an uncommon occurrence. The clinical presentation and imaging findings in 4 patients with initial manifestation of lymphoma isolated to the kidney, ureter, bladder, and adrenals, respectively, are presented. These patients had no evidence of lymphoma elsewhere, and imaging studies mimicked the more common neoplasms affecting these organs.
In-111 labeled leukocyte scintigraphy is a sensitive test for the diagnosis of prosthetic vascular graft infections. However, several causes of false-positive results have been reported. The authors describe a case of uninfected lymphocele around a synthetic vascular graft in a patient who showed an infected graft on In-111 labeled leukocyte scintigraphy.
A case of adrenal myelolipoma is reported in a patient in whom symptoms of hematuria and flank pain developed after the patient had sustained blunt trauma. Adrenal myelolipomas are usually found incidentally at autopsy. However, the symptomatic presentation of this patient was probably caused by traumatic intratumor hemorrhage. The etiology and pathogenesis of these tumors are discussed in relation to their occasional symptomatic presentation and to their differential diagnosis.
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To determine the sensitivity and specificity of the indium-111-(111In) labeled leukocyte scan for prosthetic vascular graft infection in patients treated with antibiotic therapy, a retrospective study was performed. Of 41 consecutive 111In-labeled leukocyte scans performed to evaluate possible vascular graft infection, 23 scans were performed in patients treated with antibiotics. The average duration of antibiotic therapy was 21 days. Twelve positive and 11 negative scans for graft infection were found. By surgical and autopsy correlation of all positive cases, and clinical correlation (of all negative cases), there were 10 true-positive, 11 true-negative, 2 false-positive, and no false-negative scans for graft infections, for an overall sensitivity of 100% and specificity of 85%.
Rhabdoid tumor of the kidney is a highly malignant tumor seen in the neonatal population with a characteristic clinical course. There are no known radiologic features to differentiate rhabdoid tumor of the kidney from other renal tumors; however, this report presents a newborn infant with rhabdoid tumor of the kidney who had a normal prenatal ultrasound at ten days prior to birth, followed by an abnormal prenatal ultrasound one day prior to birth. Observation of such a rapid development of a tumor in the kidney in a fetus or an infant should raise the possibility of a highly malignant tumor such as a rhabdoid tumor.
A case of bilateral fallopian tube filling defects found on hysterosalpingography performed on a patient for infertility work-up is presented. Repeat hysterosalpingography performed 4 years later showed no change. Microsurgical resection revealed the defects to be fallopian tubal polyps of endometrial origin.
Ventilation-perfusion imaging was performed on a patient with chronic intermittent atelectasis of the right lung and revealed a mismatch simulating a pulmonary embolus in the right lung. A pulmonary arteriogram revealed no evidence of embolic disease; however, there was reduced capillary phase opacification of the right lung and increased pulmonary artery pressure. The findings are consistent with an isolated right pulmonary artery hypertension secondary to prolonged atelectasis causing an apparent mismatch on the ventilation-perfusion scan.
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