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H I Libshitz

Publications and source records attributed to H I Libshitz.

At least 55 records · Page 3Linked to original sources
PubMed1992

Multiple myeloma: appearance at MR imaging.

Magnetic resonance (MR) imaging examinations of the lumbar spine and clinical and laboratory findings in 32 patients with multiple myeloma were reviewed. On T1-weighted images, signal intensity (SI) of the vertebrae approximated that of muscle in 14 cases and was intermediate (between the SIs of muscle and fat) in 18. Definite foci of decreased SI were seen in eight cases (25%), and foci of increased SI, representing fatty infiltration, were seen in 12 (38%). On T2-weighted images, SI approximated that of muscle in 17 cases and was intermediate in 15. Definite foci of increased SI were seen in 17 (53%). Of 38 vertebral compression fractures (including 18 in nine additional patients), foci of abnormal SI consistent with tumor on either T1- or T2-weighted images were seen in 19 cases (50%). There was no correlation between MR imaging findings and laboratory or bone marrow findings. Foci of presumed tumor were better or exclusively shown on T2-weighted images in 11 of 17 patients (65%) with identifiable focal disease. Other suggestions of multiple myeloma on T1-weighted images may be the absence of fatty replacement or a generalized decrease in SI.

Female↗
PubMed1992

Multiple myeloma: spinal MR imaging in patients with untreated newly diagnosed disease.

Spinal magnetic resonance (MR) imaging was performed in 29 patients with newly diagnosed, untreated multiple myeloma. Nineteen (66%) patients were asymptomatic. Sagittal pre- and postcontrast T1-weighted spin-echo images and gradient-recalled-echo images of the thoracic and lumbosacral spine were obtained. Marrow involvement was identified in 20 (69%) patients. There were three MR patterns: focal lesions in nine patients (31%), diffuse involvement in seven (24%), and an inhomogeneous pattern of tiny lesions on a background of normal marrow in four (14%). A statistically significant correlation between MR imaging patterns of marrow involvement and serum hemoglobin values (one-way, P = .0899; Kruskal-Wallis, P = .0620) and between MR imaging patterns and percentage of marrow plasmacytosis (Kruskal-Wallis, P = .0314) was noted, with patterns of diffuse and focal marrow involvement associated with more abnormal values. Spinal MR imaging in patients with early myeloma may reveal marrow involvement in both symptomatic and asymptomatic patients. Some correlation was found between MR imaging patterns and laboratory indexes of disease.

Adult↗
PubMed1991

Edatrexate improves the antitumor effects of cyclophosphamide and cisplatin against non-small cell lung cancer.

The authors treated 32 patients with Stage IIIB or IV non-small cell lung cancer (NSCLC) with an outpatient regimen of edatrexate (10-ethyl-10-deaza-aminopterin) (10-EdAM) on days 1 and 8, cyclophosphamide on day 1, and cisplatin on day 1, repeated every 3 weeks with dose modification. The 22 men and 10 women (median age, 57 years of age) had no prior chemotherapy and a Zubrod performance status less than or equal to 2. A schedule with initial doses of 80 mg/m2, 800 mg/m2, and 80 mg/m2, respectively, yielded a 47% major response rate with two complete responses (95% confidence interval [CI], 25% to 70%), but it also yielded significant stomatitis and myelosuppression. A schedule with reduced starting doses (70 mg/m2, 700 mg/m2, and 70 mg/m2) was better tolerated, but dropped the major response rate to 27% with no complete responses (95% CI, 11% to 52%). Median survival time was 39 weeks for all 30 evaluable patients without a significant difference between the treatment groups (which were comparable in patient characteristics). Major response, however, was associated with longer survival time than minor response or no change (P = 0.024) or progressive disease (P = 0.001) (median survival times, 55, 39, and 27 weeks, respectively). When the doses delivered were compared, patients treated with the reduced dose schedule received less mean 10-EdAM per course (P = 0.01), although the doses of cyclophosphamide and cisplatin were comparable to the original dose schedule for the second course and thereafter. These results suggest that this three-drug regimen may have synergistic antitumor effects, with a steep dose-response relationship, particularly with 10-EdAM. With amelioration of the dose-limiting stomatitis of 10-EdAM, it seems possible to maximize the antitumor effects of this regimen.

Adult↗
PubMed1991

Mammographic and CT findings after breast reconstruction with a rectus abdominis musculocutaneous flap.

This essay illustrates the radiologic appearance of the reconstructed breast and the abdominal wall after breast reconstruction with a transverse rectus abdominis musculocutaneous (TRAM) flap. The findings are based on a retrospective study of 42 mammograms, 17 abdominal CT scans, and two CT scans each of the chest and pelvis of patients who underwent this procedure.

Abdominal Muscles↗
PubMed1990

Primary malignant tumors of the trachea. A radiologic and clinical study.

Fifty-four cases (55 foci) of primary tracheal malignancies were reviewed retrospectively. Radiologic material was available in 32 cases (33 tracheal foci). The most frequent primary malignant tumor of the trachea was squamous cell carcinoma (54.5%), followed by adenoid cystic carcinoma (18%) and adenocarcinoma (9%). The radiologic appearance of the tumors could be divided into intraluminal, wall-thickening, and exophytic forms. Wall-thickening and exophytic forms in this study accounted for 62% of the tumors. This indicates that malignant tumors of the trachea tend to extraluminal invasion. Tomography and computed tomography are the most helpful methods of radiologic examination for tracheal tumors. Bronchoscopy and radiologic examination are complementary procedures. The chief advantage of imaging is the demonstration of tracheal wall thickening and extraluminal changes. Hemoptysis, dyspnea, and cough were the most common symptoms. Four cases (7%) in our series presented as thyroid tumors due to direct extension into the thyroid gland. Fifteen of the 54 cases (28%) were associated with other carcinomas of the head and neck and the lung.

Adult↗
PubMed1990

Phase II study of 10-ethyl-10-deaza-aminopterin (10-EdAM; CGP 30 694) for stage IIIB or IV non-small cell lung cancer.

Thirty-one patients with stage IIIB or IV non-small cell lung cancer (NSCLC) were treated with intravenous 10-EdAM on a weekly basis. The starting dose was 80 mg/m2, with subsequent doses adjusted depending on evidence of toxicity. There were 20 men and 11 women with a median age of 58 years (range, 33-75). Response was evaluated in 30 patients, 5 with evaluable but not measurable tumors and 25 with measurable indicator lesions. There were no complete remissions; 3 patients achieved partial remission. Nine patients had a minor response, 6 showed no change, and 12 had progressive disease. Median survival for all 31 patients was 43 weeks (range, 12-65+). During the first 3-week period, the 10-EdAM dose was reduced or withheld in 19 patients (because of stomatitis in 12, SGPT elevation in 3, skin rash in 2, and granulocytopenia in 2), escalated in 11 patients, and unchanged in 1 patient. A mean of 34-88 mg/m2 of 10-EdAM (median, 50) was given per week during the first 5-week period. Myelotoxicity was infrequent and there was no significant nephrotoxicity. Considering the modest side effects of this treatment and the conservative dose-modification schedule which mandated substantial dose reductions, we conclude that 10-EdAM is a promising antitumor agent for NSCLC.

Adult↗
PubMed1990

Computed tomography in bronchogenic carcinoma.

As was indicated at the beginning of this review, a concensus does not exist regarding many aspects of the use of CT in evaluating bronchogenic carcinoma. When and how CT is used, therefore, becomes a function of the beliefs of the physician caring for the patient. The radiologist must be familiar with this philosophy to be able to advise when CT will be of value. Despite all of the variables considered on the preceding pages, there are some facts. (1) Normal mediastinal lymph nodes may be larger than 1 cm in maximal transverse diameter; the majority are not. (2) An enlarged node (independent of definition) need not harbor metastases. Histologic proof is necessary, especially if this information will preclude surgery. (3) CT less frequently offers usable information in small peripheral cancers. The use of CT in peripheral cancers is very much dependent on the surgeon's philosophy. (4) Important information for patient care is more frequently obtained in patients with central lesions or peripheral lesions associated with abnormal hili or mediastinums. This is also closely related to surgical philosophy. (5) Prediction of either chest wall or mediastinal invasion is treacherous and should only be diagnosed when the findings are certain.

Carcinoma, Bronchogenic↗
PubMed1990

Malignant pleural mesothelioma: CT manifestations in 50 cases.

Malignant pleural mesothelioma, a rare and usually fatal neoplasm that is associated with asbestos exposure, is being encountered with increasing frequency. Pretreatment CT findings from 50 patients with malignant pleural mesothelioma are illustrated. Pleural thickening was found in 46 (92%) of the 50 patients, thickening of the pleural surfaces of the interlobar fissures in 43 (86%), pleural calcifications in 10 (20%), and pleural effusions in 37 (74%). The volume of the involved hemithorax varied appreciably. Contractions of the involved hemithorax was noted in 21 (42%) of 50 patients and contralateral mediastinal shift in seven (14%). Disease beyond the parietal pleura was found in the chest wall (nine patients), mediastinum, lymph nodes, and diaphragm.

Adult↗
PubMed1990

Thoracic lymphoma.

Mediastinal adenopathy is a common manifestation of HD in a usually predictable pattern involving anterior and middle mediastinal nodes with or without disease in the hili. Hilar adenopathy is uncommon without detectable mediastinal disease and the lung is virtually never involved alone. In NHL the pattern of disease is more unpredictable. Lung manifestations include direct extension from involved nodes, nodules with or without cavitation, atelectasis secondary to endobronchial or nodal obstruction and rarely an interstitial pattern. Pleural effusions are not uncommon, but solid pleural masses are less frequent. Invasion of the pericardium is not often seen, although masses are commonly seen along the pericardium. Invasion of the chest wall occurs particularly with involvement of internal mammary nodes. Occasionally, posterior nodes will invade the adjacent vertebrae and spinal canal. The chest wall may be invaded by enlarged axillary nodes. Isolated chest wall soft-tissue masses are not common and are usually a manifestation of NHL, especially large cell lymphoma. Although the chest radiograph should detect most intrathoracic disease. CT has been found a necessary adjunct in patients with HD for accurate staging and therapy, especially if radiotherapy is planned. CT has been found helpful in NHL for staging, especially for the pleura and chest wall. MR imaging has not been found to contribute additional useful information except in selected cases.

Hodgkin Disease↗
PubMed1990

Radiation-induced malignant pleural mesothelioma.

Malignant pleural mesothelioma is a rare and usually fatal disease. Its association with asbestosis is well recognized. The authors report a case of malignant pleural mesothelioma that developed 30 years after the patient underwent radiotherapy for breast cancer. This appears to be the first such case reported in the radiology literature.

Breast Neoplasms↗
PubMed1989

Angiosarcoma arising in an irradiated breast. A case report and review of the literature.

The authors discuss an angiosarcoma that developed in a 50-year-old woman's breast 10 years after she underwent conventional postoperative irradiation with cobalt 60 teletherapy. Although angiosarcoma developing in a lymphedematous arm after radical mastectomy is a well-known phenomenon, and several cases of angiosarcoma are known to have occurred in the chest wall after mastectomy with or without irradiation, only one other case of angiosarcoma in an irradiated breast has been reported. The possible role of therapeutic irradiation in inducing this malignancy is discussed.

Breast Neoplasms↗
PubMed1989

Ductal carcinoma-in-situ of the breast: fine-needle aspiration cytology of 12 cases.

Aspiration specimens from 12 patients with histologically documented ductal carcinoma-in-situ (DCIS) of the breast (seven patients) or DCIS with minute foci of stromal invasion (five) were evaluated. Five patients presented with palpable masses, 1.5-4.0 cm, and four patients presented with localized thickening, associated with nipple erosion and discharge in two of them. One patient had nipple inversion, and one patient had bilateral nipple discharge. In one patient, no apparent abnormality of the breast was present. Mammography was either suspicious for or strongly suggestive of carcinoma in 10 patients and negative in two. Aspirates from all patients were composed of fragments of atypical ductal epithelium and numerous single epithelial cells. In nine cases, the smears were hypercellular and similar to aspirates of typical invasive ductal carcinoma. Calcifications were present in six cases. In four of these, associated tumor necrosis was evident. Cytologic features separating DCIS patients from those showing minimal stromal invasion or common types of invasive ductal carcinoma (IDC) were not identified. We conclude that fine-needle aspiration cytology of DCIS is identical to that of IDC. If preoperative radiotherapy or chemotherapy is considered in the management of invasive breast carcinoma, cutting-needle biopsy for confirmation of tumor invasion is necessary.

Adult↗
PubMed1989

Computed tomography of hepatic oil embolism following lymphangiography.

Computed tomographic (CT) findings in two cases of hepatic oil embolism following lymphangiography are described. Both patients had lymphatic obstruction and opacification of the liver due to collateral flow of lymphangiographic contrast. Computed tomography of the liver showed a distinctive branching pattern due to the intrahepatic ethiodol.

Adult↗
PubMed1989

The chest radiograph after resection of pulmonary nodules with a neodymium-YAG laser.

We studied the chest radiographs of 30 patients (39 thoracotomies) after resection of pulmonary nodules with a neodymium-YAG laser. New "nodules" were often visible in the resected areas. These gradually evolved into linear scars with or without a small, nodular component or disappeared. In 11 of 39 thoracotomies, postresection cavities developed at the site of the lesion. Familiarity with the typical radiographic findings after laser resection and their normal evolution is necessary to avoid confusing these expected findings with residual or recurrent disease or with infection following surgery.

Adult↗
PubMed1989

Radiation-induced sarcoma of bone: CT findings in 19 cases.

We reviewed the CT findings in 19 cases of radiation-induced sarcoma of bone. The latent period before development of the sarcoma ranged from 5 to 50 years (mean, 17 years). In all 19 lesions, a soft-tissue extraosseous component was seen on CT, and 18 of them had associated bone destruction. Expansion of the affected bone and tumor-matrix mineralization each were present in 10 patients, but occurred together in only five patients. Periosteal reaction was seen in five patients, one of whom had an associated fracture. Radiation osteitis could not be identified on CT scans in the affected bone of any of the patients when tumor was present, but it was present in contiguous bone in two patients and had been shown 6 years before tumor became apparent in the affected bone in one other patient. Radiation-induced sarcoma of bone should be considered when bone destruction and an associated soft-tissue mass are shown on CT, or when changes occur in the appearance of previously stable irradiated bone.

Adolescent↗