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Biomedical subjects

H Herlinger

Publications and source records attributed to H Herlinger.

At least 73 records · Page 4Linked to original sources
PubMed1985

Granular cell tumors of the esophagus.

An unusual benign multicentric esophageal granular cell tumor (granular cell myoblastoma) associated with 16 other similar tumors in the skin, vulva, breast, and tongue of 1 patient is described. There was a family history of granular cell tumors in the patient's mother; this has not been previously described. The pathologic findings and controversial histogenesis of granular cell tumors are discussed in an effort to delete the erroneous term "myoblastoma" from the radiologist's vocabulary. Granular cell tumors of the esophagus are also specifically reviewed.

Adult↗
PubMed1985

Pseudotumorous pancreatitis.

Chronic pancreatitis can occasionally present as a focal, noncalcified mass, indistinguishable from carcinoma. Radiologic studies in 21 such patients were considered to show carcinoma in 16 and an islet cell tumor in 5 patients. Seventeen of the patients came to laparotomy when a palpable mass was found in each; 9 of the patients had a partial pancreatectomy, and multiple biopsy specimens were taken in 8 patients. Four patients did not come to surgery; in them the diagnosis was based on examination of percutaneous biopsy specimens and follow-up. In all patients the histologic diagnosis was chronic relapsing pancreatitis.

Adenoma, Islet Cell↗
PubMed1985

Coiled-spring sign of appendiceal intussusception.

Appendiceal intussusception has been considered a rare entity that is difficult to diagnose radiographically. However, a characteristic coiled-spring appearance in the cecum with nonfilling of the appendix has been observed on double-contrast barium enema (DCE) examinations in 11 cases of apparent or proved appendiceal intussusception. In two surgically proved cases, the intussusception was precipitated by an appendiceal mucocele and by endometriosis implants in the appendix. In four other cases, the intussusception was transient and the coiled-spring defect in the cecum disappeared with filling of the appendix on the DCE examination (three cases) or on a subsequent barium enema study (one case). The remaining five cases were unproved, although two patients had undergone prior appendectomy and the coiled-spring finding presumably resulted from an intussuscepted appendiceal stump. Only one patient was found to have appendiceal-related symptoms. It appears that appendiceal intussusception often occurs as a transient phenomenon in asymptomatic patients, and that it can be diagnosed on the routine DCE examination by a characteristic coiled-spring defect in the cecum.

Adult↗
PubMed1985

Radiography of the small bowel in patients with gynecologic malignancies.

The records and radiographs of 284 patients with gynecologic malignancy were reviewed to determine the incidence and nature of small-bowel abnormalities. Seventeen percent of the patients had small-bowel studies. Twenty-four percent of patients with ovarian cancer had radiologic examination of the small bowel, and in almost all cases the abnormalities were due to metastatic disease. In patients with cervical cancer, small-bowel radiography was performed in 14% of patients, and in most cases the abnormalities were due to radiation damage. Small-bowel obstruction was found in 20 patients. In the ovarian-cancer group, all obstructions were due to metastatic disease, whereas in the cervical cancer group, obstruction was due to metastases, radiation, or adhesions. The site of obstruction was a useful differential point, since all obstructions due to radiation were in the ileum, whereas 58% of obstructions due to metastases were in the duodenum or jejunum. The radiologic studies interpreted in light of the clinical circumstances were highly accurate in determining the location and nature of small-bowel complications in these patients.

Barium Sulfate↗
PubMed1984

Adenocarcinoma of the esophagus: relationship to Barrett mucosa.

Primary adenocarcinoma of the esophagus is thought to be a rare lesion. However, pathologic records at our institution from 1979 to 1982 show that adenocarcinoma accounted for 17 of 89 (19%) of all primary malignant tumors in the esophagus. All 17 cases arose in Barrett mucosa. In eight cases, there was surgically proved involvement of the gastric cardia or fundus. In six of these cases, there was evidence of esophageal dysplasia and/or carcinoma in situ adjacent to or remote from the proximal margin of the tumor. The pathologic findings therefore strongly suggest an esophageal origin of these lesions with subsequent spread into the stomach. Clinical and radiographic findings at presentation were indistinguishable from those of squamous cell carcinoma. However, 10 patients had long-standing reflux symptoms, and Barrett esophagus had presumably been present for some time prior to the development of malignancy. Since adenocarcinoma evolves through a sequence of dysplasia and carcinoma in situ in pre-existing Barrett epithelium, the best hope for improving survival may be periodic endoscopic surveillance of asymptomatic individuals who have this condition.

Adenocarcinoma↗
PubMed1984

The tube esophagram: a technique for obtaining a detailed double-contrast examination of the esophagus.

Although double-contrast esophagography is capable of delineating fine surface morphologic detail in the esophagus, it is not possible to obtain an optimal examination on all patients. Tube esophagography is a complementary technique that can provide a more detailed double-contrast examination of the esophagus. This procedure was performed on 45 patients in whom the routine double-contrast study was inconclusive. The tube esophagram contributed significantly to the radiologic evaluation in 33 cases, providing additional information in 23 and actually altering the final radiologic diagnosis in 10. The tube esophagram was particularly useful in depicting the distal esophagus when the initial double-contrast study was suboptimal due to inadequate distension and/or barium pooling that obscured mucosal detail in this region. The tube esophagram is a valuable adjunctive procedure that can lead to a more definitive radiologic diagnosis when the routine double-contrast examination is inconclusive.

Air↗
PubMed1984

Small-bowel enema in the diagnosis of adhesive obstructions.

The small-bowel enema was evaluated in 60 patients in whom a final diagnosis of adhesive obstruction was made by surgery or on the basis of clinical findings. Distinctive radiographic and clinical features were found with single versus multiple bands. While 72% of 32 single-band obstructions were graded as severe, this grading was given to only 34% of 18 obstructions by multiple bands. Extensive adhesions were demonstrated in 10 patients and presented varied radiographic features. The radiographic diagnosis of adhesive obstruction was found to be correct in 36 (87.8%) of 41 patients in whom a surgical diagnosis could subsequently be made. However, an incorrect radiologic diagnosis of obstruction by metastases was made in five patients. They form the basis for a discussion of the differential diagnosis.

Adolescent↗
PubMed1984

Double-contrast examination. Part II: Small intestine.

There is no place in modern radiological practice for the traditional 'barium meal and follow-through'. Selection of patients should be made and a separate and specific small bowel examination should be performed for known or suspected small bowel lesions. The choice between an oral or an intubation method will be influenced by many factors and both, if performed with due care and attention to detail, can produce good diagnostic results.

Adult↗
PubMed1983

Barrett esophagus: reticular pattern of the mucosa.

Barrett esophagus is an acquired condition with progressive columnar metaplasia of the esophagus due to chronic reflux esophagitis. The premalignant nature of this entity is well recognized. However, radiologic diagnosis has been limited by the nonspecificity of findings associated with the condition. We recently reviewed 29 cases of pathologically proved Barrett esophagus. Radiologic examinations revealed hiatal hernias, gastroesophageal reflux, esophagitis, and strictures. None of these findings are diagnostic of Barrett esophagus. In seven cases, however, double-contrast radiography also revealed a delicate reticular pattern in the esophagus. In all but one case, there was an adjacent stricture, and this reticular appearance extended distally a short but variable distance from the stricture. To our knowledge, this unusual reticular pattern has not been described previously, and it represents a valuable radiologic sign of Barrett esophagus. The etiology of this finding is uncertain, but correlation with the gross surgical specimen in one case suggests that it results specifically from areas of "villous" metaplasia in Barrett epithelium. This delicate reticular pattern appears to be a specific radiologic criterion for the diagnosis of Barrett esophagus.

Adult↗
PubMed1982

Thirteen primary adenocarcinomas of the ileum and appendix: a case report.

Adenocarcinomas of the ileum and appendix are uncommon. Multiple synchronous adenocarcinomas of the small bowel without carcinoid features are even more unusual, with only seven reported cases in the literature. The radiologic and pathologic findings are reported in a case with 13 separate, well-documented synchronous primary adenocarcinomas of the ileum and appendix. The value of the double-contrast small bowel enema is emphasized.

Adenocarcinoma↗
PubMed1982

The peroral pneumocolon examination.

The peroral pneumocolon examination is a method for obtaining a double-contrast image of the terminal ileum and right colon by insufflating air through a small catheter inserted into the rectum when orally ingested barium reaches the right colon. The examination is indicated if a detailed view of the ileocecal region is required, particularly when inflammatory bowel disease is suspected, when polyps are present in the right colon, or when patients are unable to tolerate barium enema studies.

Administration, Oral↗
PubMed1982

Double-contrast enema in pelvic endometriosis.

The radiographic findings on barium enema in 42 patients with endometriosis were reviewed and correlated with those at surgical and laparoscopic examination. Radiographic abnormalities were detected in 27 patients. In nine patients, purely extrinsic mass effect was identified; bowel wall involvement in these patients was not present at laparoscopy. In 16 of 18 patients subsequently shown to have bowel wall involvement, mass effect with fine mucosal crenulation was identified. Annular or polypoid involvement was also noted. Mass effect with crenulation, although not entirely specific, appears to be a characteristic finding in patients with bowel wall involvement due to endometriosis.

Adolescent↗