Search PubMed⌕ Search

Biomedical subjects

E K Fishman

Publications and source records attributed to E K Fishman.

At least 451 records · Page 25Linked to original sources
PubMed1983

Computed tomography and appendiceal abscess: special applicability in the elderly.

Five cases are presented in which appendiceal abscesses were demonstrated by computed tomography (CT) and confirmed at surgery. In another, a feces-filled cecum led to a false positive diagnosis of appendiceal abscess, and this is included as an instructive case. Three of the patients were elderly, with an atypical presentation; in these, CT was especially important in clarifying the diagnosis by including appendiceal abscess in the differential diagnosis of pelvic pathology.

Abscess↗
PubMed1983

The CT appearance of Wilms tumor.

The computed tomographic (CT) findings in 30 Wilms tumors in 25 patients were reviewed and correlated with the pathological findings. Most tumors were quite large at the time of detection (average diameter 11 cm) and were cortical in origin. Peripheral lesions tended to grow exophytically. On the noncontrast studies an inhomogeneous mass with low-density areas (tumor necrosis) was seen. Small, focal calcifications (13.3%) and fat (6.9%) were much more readily identified with CT than with intravenous pyelography. After contrast medium injection, slight enhancement of the tumors was noted, and foci of necrosis became more prominent. A sharp demarcation between the tumor and normal parenchyma (seen in 19 cases) correlated with the pseudocapsule that is often present. Particularly striking was the presence of a persistent, ellipsoid area of increased attenuation corresponding to the compressed uninvolved renal parenchyma seen in 14 cases. Two cases were seen with complete tumor infiltration of the kidney pathologically and on CT. The primary clinical usefulness of CT in Wilms tumor is to detect multiple masses, to determine the extent of tumor, and to evaluate the opposite kidney.

Adult↗
PubMed1983

Low attenuation nodal metastases in testicular carcinoma.

Abdominal and thoracic computed tomography examinations were abnormal in 23 of 57 patients (40.5%) with seminomatous and nonseminomatous testicular tumors. Lymph node metastases measuring less than 30 Hounsfield units (HU) occurred in 10 of these 23 patients (43.5%), five with seminoma, four with mixed germ cell tumors, and one patient with embryonal cell carcinoma. Biopsy material was obtained from low attenuation metastases in four patients. Three patients who had completed chemotherapy had evidence of extensive necrosis, but two of three had persistent tumor. In the fourth patient, a case of untreated mixed germ cell tumor, there were numerous small epithelial-lined cystic spaces. Biopsies from five patients with nodal masses measuring greater than 30 HU showed no necrosis or cystic change. There was no significant correlation between the attenuation characteristics of the metastases and clinical activity of the tumor.

Adult↗
PubMed1983

Sacral abnormalities in Marfan syndrome.

Five women with Marfan syndrome had abnormalities of the sacrum disclosed by computed tomography. Each had evidence of expansion of the central sacral spinal canal and enlargement of sacral foramina associated with extensive bony erosion. Three patients complained of low back pain, two were asymptomatic. Sacral meningoceles were demonstrated in three cases (including two of the three with symptoms). A fourth patient had a thoracic meningocele. The sacral abnormalities are attributed to defective collagen resulting in expansion of weakened dura which leads to pressure erosion of contiguous osseous structures.

Adult↗
PubMed1983

Computed tomography of extracranial nerve sheath tumors with pathological correlation.

Computed tomography was obtained in 15 patients with extracranial nerve sheath tumors, including eight with neurofibromatosis. The studies included two schwannomas, six neurofibromas, four plexiform neurofibromas, and three neurofibrosarcomas. Lesions with attenuation values exceeding 30 Hounsfield units had dense bands of collagen in resected specimens. Eleven of the lesions had attenuation values which were significantly lower than muscle. Histological examination of hypodense lesions revealed five factors contributing to reduced attenuation values: (a) a population of lipid-rich Schwann cells; (b) the presence of adipocytes (transformed fibroblasts) in neurofibromas; (c) entrapment of perineural adipose tissue by plexiform neurofibromas; (d) a coalescence of interstitial fluid to form cystic spaces in schwannoma with Antoni B tissue; and (e) cystic degeneration secondary to infarction or necrosis within neurofibromas and neurofibrosarcomas.

Adolescent↗
PubMed1983

CT evaluation of therapeutic embolization of hepatic hemangiomas.

Computed tomography (CT) was used to monitor the response to therapeutic embolization in two cases of giant cavernous hemangiomas of the liver. Base-line tumor volume and rat of enhancement were calculated. Therapeutic embolization with a detachable balloon or Ivalon microsphere plus a detachable balloon was then performed. CT was repeated to evaluate both change in tumor volume and in rate of enhancement ("fill-in") of the lesion. It was possible to document the response to embolization by changes in the size and the degree of enhancement of the lesions. Thus, CT can be used to document the success or failure of embolization of hepatic hemangiomas.

Adult↗
PubMed1983

Transverse colon volvulus: diagnosis and treatment.

Although considered rare, transverse colon volvulus (TCV) may actually comprise as many as 10% of all cases of colon volvulus. Correct identification clinically is necessary in order to reduce the high mortality. Unlike the treatment of sigmoid volvulus, conservative treatment of TCV is thought to be inadequate. Furthermore, simple proximal colostomy may lead to bowel necrosis. Bowel resection, rather than detorsion procedures, is advocated. The barium or diatrizoate enema examination can readily differentiate TCV from sigmoid and cecal volvulus if one pays careful attention to detail.

Adult↗
PubMed1983

Villous hypertrophy of the small bowel in a patient with glucagonoma.

Mucosal thickening in the small bowel was seen on computed tomography (CT) in a patient with a pancreatic glucagonoma. A small bowel series demonstrated multiple fine filling defects throughout both jejunum and ileum associated with moderate fold thickening and prolonged transit time. Villous hypertrophy was indeed identified in a resected segment of jejunum. Elevated blood levels of enteroglucagon have previously been associated with small intestinal villous hypertrophy. Careful scrutiny of the bowel pattern on CT scans may suggest abnormalities which may then be confirmed by conventional barium studies. Such observations may change the evaluation of a clinical problem.

Adenoma, Islet Cell↗
PubMed1982

Computed tomography of benign hepatic tumors.

Computed tomography (CT) was performed on five patients with focal benign liver lesions: two cases of focal nodular hyperplasia (FNH) and three cases of hepatic adenoma (HA). All five patients had low density lesions seen best on noncontrast scans. Focal nodular hyperplasia often presents as an asymptomatic, well circumscribed lesion with a central, stellate, fibrous scar. Hepatic adenoma, which is associated with the use of oral contraceptives, is a smooth bordered mass that exhibited foci of hemorrhage in two of our three cases. Both of these benign liver lesions enhance to a variable degree of following intravenous contrast medium administration. It is concluded that a specific diagnosis of FNH or HA may be suggested when appropriate CT findings are detected.

Adult↗
PubMed1982

Ischemic colitis demonstrated by computed tomography.

Computed tomography (CT) performed on two patients with abdominal pain showed irregular, segmental thickening of the submucosa of the colon that proved to be due to ischemic colitis. In one case, CT showed narrowing of the lumen of the right colon by a polypoidal mass that was clearly the CT analog of thumbprinting. In the second case, CT was used as an alternative to barium studies to monitor the course of the patient. It is concluded that CT can be useful in the diagnosis and management of colonic ischemia.

Aged↗
PubMed1982

The sonographic "scar sign" in focal nodular hyperplasia of the liver.

The sonographic features of focal nodular hyperplasia of the liver as reported in the literature and nonspecific. However, a linear cluster of bright echoes was detected in the nodules of two of our patients with surgically proven focal nodular hyperplasia. Pathologically this finding correlated closely with the gross appearance of the characteristic fibrotic scar of focal nodular hyperplasia. When present, this "scar sign" should suggest the diagnosis of focal nodular hyperplasia, particularly in the typical clinical setting.

Adult↗
PubMed1981

Pneumoscrotum after colonoscopy.

A case of pneumoscrotum after colonoscopy is reported. The patient recovered uneventfully with careful observation. This complication ws the result of perforation of retroperitoneal bowel by the colonoscope. As such, prophylactic antimicrobial therapy may be indicated.

Aged↗
PubMed1979

Renal cell carcinoma diagnosed in three generations of a single family.

Sixteen families have been reported in which hypernephromas have developed in several members of either one or two generations. This is the first reported instance in which three generations of one family were affected (the patient, the maternal aunt, and the maternal grandmother). For the first time, a complete review of the literature is included.

Adenocarcinoma↗
PubMedDate not supplied

Does CTAP prior to hepatic resection improve patient survival rates?

The purpose of our study was to compare survival rates of colon carcinoma patients who had undergone attempted curative hepatic resection based on liver staging by computed tomographic angiography (CTA) or portography (CTAP) with previously reported survival rates of patients who underwent similar surgery without preoperative CTAP evaluations. A total of 404 CTAP studies performed at three institutions were reviewed. Of this group, 197 had colon carcinoma. Sixty-nine of the colon patients went to surgery. Actuarial adjusted yearly survival rates were calculated for the prior CTAP colon group and compared to historical controls. The control survival data were taken from reports published prior to the CTAP era. Our study demonstrated no difference in the 1-year survival data between the groups. However, the CTAP patients had greater survival in years 2-4. This greater survival may be multifactorial but in part due to better surgical selection caused by CTAP.

Actuarial Analysis↗