Biomedical subjects
Publications and source records attributed to E K Fishman.
A case of aneurysms of saphenous vein coronary artery bypass (CAB) grafts is presented with CT and echocardiography findings. Aneurysms of the bypass graft are rare complications of CAB surgery but many occur due to atherosclerosis, infection, surgical technique, or vasculitis.
Xanthogranulomatosis is a multicentric or systemic proliferative disorder of histiocytes. Two cases of xanthogranulomas are reported, each involving the kidneys. One patient also had concomitant orbital and CNS involvement. Primary renal involvement without associated retroperitoneal masses is an uncommon manifestation of this disorder. The CT appearance of renal involvement in both patients was distinctive and remarkably similar. Both patients had bilaterally enlarged kidneys in which the renal sinus fat was replaced by a fibrotic process that caused mild calicectasis. The clinical and roentgenographic features of xanthogranulomatosis bear a close resemblance to those seen in two fibrosclerosing syndromes: sinus histiocytosis with massive lymphadenopathy and retroperitoneal fibrosis.
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We present two patients with biopsy proven primary intestinal lymphangiectasia in whom CT demonstrated diffuse nodular thickening of small bowel without adenopathy or hepatosplenomegaly. One patient had extensive ascites. Although the CT findings are not specific to lymphangiectasia, they may allow one to suggest the diagnosis in the patient with protein losing enteropathy and help distinguish it from inflammatory bowel disease, lymphoma, celiac disease, or Whipple disease.
Transbronchial needle aspiration of cytopathological specimens has proven useful in the diagnosis and staging of bronchogenic carcinoma, but its value in conditions requiring histologic confirmation has been hampered by the small size of the sample provided. To expand the utility of this procedure, we designed a larger (18 gauge) needle with a beveled stylet with which tissue cores for histologic study can be obtained during rigid bronchoscopy, and we have evaluated the safety and efficacy of this technique. Diagnoses of five neoplastic and three granulomatous diseases were established in eight of the ten patients with this procedure, and there were no complications. These findings suggest that transbronchial needle aspiration biopsy is relatively safe and effective, further extending the bronchoscopic approach to selected patients with mediastinal disease.