Biomedical subjects

E K Fishman

Publications and source records attributed to E K Fishman.

At least 433 records · Page 24Linked to original sources

PubMed1984

Comparative tumor dose from 131I-labeled polyclonal anti-ferritin, anti-AFP, and anti-CEA in primary liver cancers.

Results of dosimetric studies are reported for 30 patients with hepatoma and 5 patients with primary hepatic cholangiocarcinoma who received treatment with 131I-labeled polyclonal antibodies. Studies included liver and tumor volume computations from X-ray CT scans, in vivo quantitation of the activity of radiolabeled antibodies in hepatic tumors and normal liver tissue, and effective half-life measurements. Twenty-two patients with hepatoma were administered 131I-labeled polyclonal anti-ferritin. Five hepatoma patients, who were AFP-positive, were administered anti-alpha-fetoprotein (AFP). Three patients with AFP-positive hepatomas received both 131I-labeled anti-ferritin and anti-AFP in a bolus. The five cholangiocarcinoma patients were treated with 131I-labeled anti-carcinoembryonic antigen (CEA). For administered activities of 30 mCi on day 0 and 20 mCi on day 5, mean values of the radiation dose to hepatomas were approximately 1100 rads for anti-ferritin, 350 rads for anti-AFP, and 960 rads for the combination of anti-ferritin and anti-AFP. Polyclonal anti-ferritin has, therefore, become the antibody of choice in the treatment of hepatoma. The radiation dose to cholangiocarcinomas from 131I-labeled anti-CEA and administered activities of 20 mCi on day 0 and 10 mCi on day 5 was approximately 620 rads. Total-body irradiation for these injection schedules ranged from 30 to 50 rads.

Adenoma, Bile Duct↗

PubMed1984

CT diagnosis of hemopericardium in acute dissecting aneurysm of the thoracic aorta.

Acute hemopericardium was diagnosed preoperatively by computed tomography in three patients with acute dissection of the thoracic aorta. The CT findings consisted of pericardial thickening measuring between 14 and 21 mm, with attenuation values ranging between 26 and 62 Hounsfield units on unenhanced scans. In addition to the hemopericardium, CT also confirmed the diagnosis of Type I or Type II dissection in each case.

Aged↗

PubMed1984

CT demonstration of colovesical fistulae secondary to diverticulitis.

Colovesical fistula, a not infrequent complication of diverticulitis, can be difficult to demonstrate by commonly used diagnostic imaging modalities. We present four cases in which computed tomography was used to detect the presence of such a fistula. Computed tomography readily detected air within the bladder earlier and without equivocation when compared with other imaging techniques. It was useful also in the assessment of the extent and the degree of pericolonic inflammation, thus playing an important role in preoperative surgical planning and postoperative follow-up.

Aged↗

PubMed1984

Intrabronchial lesion on computed tomography secondary to blood clot.

A case of a blood clot simulating an intrabronchial neoplasm on computed tomography is presented. Although an intrabronchial lesion in a patient with hemoptysis is usually a malignancy, other etiologies must be considered. Computed tomography is an excellent modality for detecting and evaluating intrabronchial pathology but bronchoscopy is necessary for tissue diagnosis.

Adult↗

PubMed1984

Computed tomography of adult neuroblastoma.

The computed tomographic (CT) findings in five adult patients with neuroblastoma and in one with ganglioneuroblastoma are presented. Four patients had abdominal and thoracic disease, one had abdominal disease only, and one had isolated chest involvement. The CT findings are nonspecific and may be confused with lymphoma. Nevertheless, multifocal presentation, particularly if it includes the posterior mediastinum and association with diffuse or focal bone involvement, when present, should suggest the diagnosis and lead to appropriate laboratory and histopathologic workup.

Abdominal Neoplasms↗

PubMed1984

Jugular venous thrombosis: diagnosis by computed tomography.

Thrombosis of the internal jugular vein (TIJV) was diagnosed by CT in five patients. Clinical presentations included unexplained fever (four patients), swollen neck (three patients), and mediastinal widening (one patient). Factors contributing to TIJV included placement of a central venous catheter (three patients) and neck surgery (two patients). In two patients left TIJV occurred after right sided venous catheterization. The CT findings consisted of enlargement of the thrombosed vein, a nonenhancing filling defect in the lumen of the affected vessel, an enhancing vessel wall, and opacification of collateral venous channels.

Abscess↗

PubMed1984

The role of computed tomography of the chest in the management of small-cell lung cancer.

Despite the wide application of computed tomography (CT) in the diagnosis and management of lung cancer, the role of this diagnostic modality in the management of small-cell lung cancer (SCC) has not yet been defined. We therefore compared information gained from routine chest radiography (CXR) and CT scans performed on 32 patients with SCC who were treated on an intensive chemotherapy-radiotherapy protocol. Seventy-nine pairs of CXRs and CT scans were retrospectively reviewed. We found that although CT delineates a greater extent of intrathoracic disease in each of nine anatomic areas evaluated than does CXR, agreement between CT and CXR was significant for all areas except the pericardium. Pericardial thickening was seen only on CT scan and is more frequent in SCC patients than has previously been appreciated, but both its etiology and prognostic significance are unclear at this time. CT also allowed interpretation of disease status in cases where radiation-induced fibrosis made interpretation of the CXR impossible. We do not recommend routine use of chest CT at time of diagnosis of SCC, but we recommend that its use be reserved for evaluation of new symptoms or suspected relapse, or when radiation fibrosis on CXR is severe.

Carcinoma, Small Cell↗

PubMed1984

CT of xanthogranulomatous pyelonephritis: radiologic-pathologic correlation.

A clinical-radiologic-pathologic correlation study was performed in 18 (17 female) patients with xanthogranulomatous pyelonephritis (XGP) with CT scans available for analysis. Presenting signs and symptoms included pain (66%), urinary frequency (66%), dysuria (66%), nocturia (66%), palpable mass (56%), leukocytosis (50%), and fever (50%). The duration of symptoms was usually relatively short (less than 6 months), considering the extent of the pathologic process. In 14 patients, the disease was diffuse; the kidney was enlarged with preservation of the reniform outline in 13. The renal pelvis, lined with sheets of lipid-laden macrophages and surrounded by a marked fibrotic reaction, was contracted in 11 and contained pelvic calculi in 12. The parenchyma was replaced by multiple, rounded, low-density areas on CT that corresponded to dilated calices and/or inflammatory tissue. These areas had enhancing rims (10 cases) that corresponded to preserved, compressed normal parenchyma and/or inflammatory tissue. There was CT identification of unsuspected extension through the renal capsule with involvement of the perirenal space in 11 patients, the pararenal spaces in 13, and the psoas muscle in six. The pararenal space and the psoas muscle were often extensively involved with minimal perirenal disease in six patients, a reflection of chronic indolent infection. There were four cases of focal XGP that appeared on CT as low-density mass lesions with wall enhancement surrounding dilated, stone-filled calices or as focal masses occupying one pole of a duplication. Extensive pararenal disease was present in two of the four cases of focal XGP. The preoperative diagnosis of XGP was suspected in only 44% of cases. It is concluded that CT should play a role in diagnosis and preoperative planning to demonstrate the extent of extrarenal disease that is poorly depicted by other means.

Adolescent↗

PubMed1984

Lymphadenopathy in celiac disease: computed tomographic observations.

Lymphadenopathy in patients with celiac disease is generally viewed with alarm due to the association between celiac disease and intestinal lymphoma. Four patients with celiac disease are described in whom significant mesenteric and paraaortic adenopathy was demonstrated by computed tomography (CT). The subsequent clinical course of these patients revealed no evidence of lymphoma. In two patients with longstanding celiac disease and recent relapse, exploratory laparotomy revealed reactive hyperplasia in the enlarged glands; in one patient this was associated with intestinal ulceration, and in the other no underlying pathology was found. Follow-up CT scans in both these patients demonstrated regression of the findings with clinical improvement. In the other two patients, CT was performed as part of the initial evaluation. Follow-up CT in one of these patients revealed almost complete regression of the adenopathy after institution of a gluten-free diet. The other, with a 2 year duration of CT-documented abdominal adenopathy prior to diagnosis, became asymptomatic with weight gain for over 1 year after institution of a gluten-free diet.

Adult↗

PubMed1984

Desmoid tumors in Gardner syndrome: use of computed tomography.

Desmoid tumors are known to be associated with Gardner syndrome and, when located in the mesentery, can contribute to morbidity and mortality. Computed tomography (CT) was used to evaluate six patients with Gardner syndrome who, after colectomy, complained either of abdominal pain or of palpable masses. In five patients, desmoids of the mesentery, abdominal wall, and paraspinous muscles were diagnosed; four of these were later proven surgically. The sixth case, with both CT and subsequent surgery negative for desmoid lesions, is included to illustrate the ability of CT to replace exploratory surgery in certain instances. CT provides a relatively noninvasive means of assessing and following patients with Gardner syndrome after colectomy and delaying or preventing further surgery or, if necessary, providing a surgical "road map" to optimize unavoidable procedures.

Adult↗

PubMed1984

Computed tomography of the spleen and liver in sickle cell disease.

The spleen was assessed in 10 patients with sickle cell disease studied with computed tomography (CT) for abdominal pain and/or unexplained fever. Patients with homozygous sickle cell anemia were found to have small, densely calcified spleens with occasional low-density infarcts. Five of six had hepatomegaly, and there was one case each of hepatic abscess, infarcts, and hemochromatosis. All patients with heterozygous sickle cell disease were found to have splenomegaly, with a variety of findings including acute hemorrhage, acute and chronic infarcts, rupture, and possible sequestration. It was concluded that CT is useful for evaluating the status of the spleen and liver in symptomatic patients with sickle cell disease.

Adolescent↗

PubMed1984

Excretory urography and computed tomography in the initial evaluation of patients with cervical cancer: are both examinations necessary?

One hundred ten patients with carcinoma of the cervix were studied to determine if both excretory urography and computed tomography are needed for routine evaluation. Computed tomography gave more information in 25 patients and the excretory urogram was more informative in 10 patients. Thirty-five hydroureters were detected by computed tomography, whereas excretory urography identified 21. The hydroureter in its entirety was seen more often using computed tomography, and the site of obstruction was identified in 29 of 35 cases. The superiority of computed tomography was particularly evident in patients with stage IIB or more advanced lesions. In stage I-IIA lesions, both techniques yielded the same information about the urinary tract. It was concluded that routine use of both examinations is not indicated. Excretory urography is currently sufficient in evaluation of stage I or IIA lesions, while computed tomography obviates excretory urography in patients with advanced cervical cancer (IIB-IVB).

Female↗

PubMed1984

Computed tomography in the evaluation of cervical thorotrast granuloma.

Two cases of cervical thorotrast granulomas (thorotrastomas) were evaluated with computed tomography. Computed tomography provided delineation of the precise extent of disease and the relationships of the larynx and carotid vessels to the thorotrastoma. This was helpful in planning surgical management. Computed tomography is of use in determining the extent of thorotrastomas and in planning their treatment.

Extravasation of Diagnostic and Therapeutic Materi↗

PubMed1984

Pneumatosis intestinalis: role of computed tomography in diagnosis and management.

Four patients with pneumatosis intestinalis (PI) demonstrated by computed tomography are presented. Computed tomography delineated the location and extent of PI more accurately than plain abdominal radiographs and demonstrated any coexisting abdominal pathology. Lung window settings were important in the detection of intramural air and obviated the need for intraluminal contrast to outline the circumferential pattern of PI. In one patient PI would have been overlooked entirely using only conventional abdominal window settings. This technical observation could have potential clinical significance in the investigation of patients with suspected intestinal ischemia or gangrene where the appearance of intramural air is an ominous prognostic sign.

Adult↗

PubMed1983

Computed tomographic diagnosis of obturator foramen hernia.

Computed tomography was performed on a patient presenting with cryptic small bowel obstruction. A correct preoperative diagnosis of obturator foramen hernia was arrived at based on the recognition of a loop of ileum protruding between the pectineus and external obturator muscles.

Aged↗

PubMed1983

Computed tomography of calcified liver masses.

Our retrospective study of 230 computed tomographic (CT) studies of hepatic masses yielded 28 cases (12.2%) which contained calcification. Calcific deposits were noted in 9 of 59 patients (15.3%) with hepatocellular carcinoma (HCC), 15 of 82 patients (18.3%) with liver metastases from colorectal carcinoma (MCRC), 2 of 71 patients (2.8%) with noncolonic liver metastases, and 2 of 18 patients (11%) with a benign liver mass. The patterns of calcification in HCC and MCRC were highly variable and exhibited some overlap. Although the CT demonstration of calcification in HCC and MCRC is not uncommon, particularly in patients who have undergone radiotherapy or chemotherapy, we could identify no specific diagnostic pattern.

Adenocarcinoma↗

PubMed1983

Computed tomography of endometriosis.

Six examples of pelvic masses due to endometriosis were detected by computed tomography (CT) in a group of women aged 30-43. Lower abdominal or pelvic pain was the chief complaint in four cases. The ileum and rectosigmoid were routinely opacified with contrast material prior to examination. Endometriosis exhibited a variety of findings including a constricting rectosigmoid mass, a lesion of the pelvic side wall, bowel wall implants, and posthysterectomy pelvic masses. There was no standard CT density; the lesion near the pelvic side wall appeared solid, one cul-de-sac mass appeared solid, and a second had a mixed cystic and solid appearance. Discrete adnexal endometriosis appeared as thick-walled cystic masses (two cases) or as a simple cyst (one case). Bowel wall involvement and the pelvic side wall lesion were not successfully identified by ultrasound. It is concluded that CT can play a role in the diagnosis of endometriosis.

Adult↗

PubMed1983

CT demonstration of the phrenic nerve.

Twenty-four consecutive patients examined with whole lung computed tomography (CT) using a high resolution scanner were evaluated for detection of the phrenic nerve. The phrenic nerve was considered to be demonstrable when a 1-3 mm rounded structure was identified adjacent to the pericardium on at least two contiguous sections. The phrenic nerve was thus indicated in 13 patients, eight children and five adults. The nerve was found on the left side in 11 patients, the right side in one patient, and bilaterally in one patient. It is important to recognize the normal course of the phrenic nerve on CT in patients being evaluated for pulmonary metastases.

Adolescent↗