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Biomedical subjects

H M Pollack

Publications and source records attributed to H M Pollack.

At least 127 records · Page 7Linked to original sources
PubMed1982

Transient ureteral obstruction after ureteral stenting.

Transient distal ureteral edema and obstruction have been recognized complications of retrograde ureteral catheterization for years. Similar changes in the proximal ureter may be induced by antegrade (percutaneous) ureteral intubation and are being more widely recognized as radiologists become more involved in upper urinary tract percutaneous manipulative procedures. Marked mucosal edema of the ureter was observed in four patients who had percutaneously placed, in-dwelling stent catheters. This was severe enough to produce transient ureteral obstruction after stent removal in two. Some degree of mucosal edema may be seen in most patients with in-dwelling stents. These ureteral changes may be secondary to the pressure effect of large diameter catheters on the proximal and midureter. Temporary proximal urinary diversion should be maintained until the edematous changes improve or subside, usually within 5-8 days.

Adult↗
PubMed1981

Splenic-gonadal fusion: identification by radionuclide scanning.

Splenic-gonadal fusion is an unusual congenital anomaly resulting from the fusion of the splenic and gonadal anlagen at approximately the sixth week of gestation. A 14-mo-old male presenting with signs and symptoms of testicular torsion underwent scrotal exploration, and ectopic splenic tissue was found adjacent to the left testis. The operative diagnosis of splenic-gonadal fusion prompted abdominal scanning with 99mTc-sulfur colloid. The radionuclide image demonstrated an unusual pattern of activity that was consistent with surgical description of the intraabdominal appearance of this disorder. It is suggested that 99mTc-sulfur colloid scanning may prove to be a useful adjunct in the evaluation of patients with this anomaly.

Abnormalities, Multiple↗
PubMed1981

Computed tomography of renal pelvic filling defects.

Thirteen patients with a variety of renal pelvic filling defects were evaluated using computed tomography (CT). Nonopaque calculi and some blood clots can be more accurately differentiated with this modality than has heretofore been possible. In transitional-cell carcinoma of the renal pelvis, the main value of CT appears to be in tumor staging. CT may also be helpful where urography cannot discriminate between extrinsic compression and true intraluminal renal pelvic defects.

Carcinoma, Transitional Cell↗
PubMed1981

Prospective analysis of the value of scrotal ultrasound.

Ultrasound was evaluated in 69 patients for its usefulness in distinguishing scrotal abnormalities requiring surgery from those that may have clinical follow-up only. Distinction was possible in the majority of cases. On imaging, tumor showed decreased echogenicity within the testicle, which was usually enlarged. Epididymal enlargement, marked increase in peritesticular fluid, and skin thickening suggest a non tumorous condition. The ultrasound characteristics of various scrotal abnormalities are described.

Dysgerminoma↗
PubMed1981

Multilocular renal cysts: radiologic-pathologic correlation.

Multilocular renal cyst, a well-encapsulated benign lesion consisting of multiple noncommunicating cysts, is an uncommon entity of uncertain nature. A spectrum of histologic findings and multiple theories of pathogenesis have resulted in numerous names for the lesion, including multilocular cyst, benign cystic nephroma, cystic hamartoma, cystic lymphangioma, cystic Wilms tumor, and Perlmann tumor. We believe these names, and others, refer to the same entity, namely multilocular cyst. Radiographically a multicystic renal mass which is often calcified and which may partially protrude into the renal pelvis is seen. Although angiography cannot definitively exclude a malignant tumor, a distinctive sonographic appearance-multiple cystic masses separated by highly echogenic septa-is highly suggestive of multilocular renal cyst. Inclusion of this lesion in the preoperative differential diagnosis of a solitary and presumed malignant renal mass may have significant therapeutic implications.

Adolescent↗
PubMed1981

Diagnostic considerations in urinary bladder wall calcification.

Though a relatively uncommon finding in general radiologic practice, urinary bladder wall calcification has relatively few etiologies. A series of 19 patients with radiographically visible bladder wall calcification encompassing most of the known causes is presented and other reported causes are discussed. Eight patients had schistosomiasis, six had primary carcinoma of the bladder, two had encrustation cystitis, and one each had amyloidosis, cyclophosphamide-induced cystitis, and tuberculosis. While a correct diagnosis is often not possible solely on the basis of the appearance of the calcification, such a diagnosis can usually be obtained expediently from a combination of history, clinical examination, appropriate laboratory studies, and radiographic evaluation of the bladder calcification and remaining urinary tract. Cystoscopy with biopsy of involved tissues is almost necessary, however, for confirmation and to rule out bladder neoplasia.

Calcinosis↗
PubMed1981

Cholesteatoma of the upper urinary tract.

Cholesteatoma of the urinary tract is a rare condition which can be diagnosed radiographically. The radiographic findings of stringy intraluminal defects or nodules that may lightly calcify or coalesce to form a discrete mass in association with calculi and/or obstruction are characteristic. A history of chronic urinary tract infection, renal colic, and desquamated epithelial cells in the urine further support the diagnosis.

Adult↗
PubMed1981

Detecting lymphatic metastases from prostatic carcinoma: superiority of CT.

CT scanning was performed on 29 consecutive patients with clinically localized prostatic carcinoma (stage A or B). Bipedal lymphangiography was performed in 12 cases. Histologic confirmation was obtained in 15 cases (pelvic lymphadenectomy in 12 and positive percutaneous needle biopsy in three). In these 15 proven cases, the overall accuracy of CT was 93% with one false positive and no false negatives. Lymphangiography was far less accurate (55%) with two false positives and three false negatives in 11 proven cases. The greater accuracy of CT resulted primarily from its ability to detect abnormal nodes in the pelvis, particularly hypogastric nodes, which are rarely opacified by lymphangiography. Preliminary experience suggests that CT is superior to lymphangiography in detecting early lymphatic spread from prostatic carcinoma in the pelvis. In the future, CT-guided percutaneous needle biopsy should be useful for documenting metastases in these patients.

Biopsy, Needle↗
PubMed1981

CT staging of bladder carcinoma.

CT staging was performed in 49 consecutive patients with known carcinoma of the bladder. The overall accuracy of CT staging in 25 patients with surgically confirmed disease stage was 64%. Most diagnostic errors in this series were related to the determination of perivesical fat involvement by tumor. The overall accuracy of CT in predicting lymph node metastasis was 92%. The sensitivity was 60% and the specificity ws 100%. Because of the current management of bladder carcinoma, the major role of CT is in the evaluation of lymph nodes for metastatic disease. Since CT cannot detect metastasis to nonenlarged lymph nodes, it has only a limited role in the staging of bladder carcinoma at this time.

Carcinoma, Transitional Cell↗
PubMed1981

Percutaneous nephrostomy: comparison of sonographic and fluoroscopic guidance.

Both sonography and fluoroscopy have been recommended for renal localization and needle guidance for percutaneous nephrostomy. The respective efficacies of both methods have been compared in a prospective study of 88 patients undergoing percutaneous nephrostomy by the catheter over guide wire technique. Fifty-five patients had initial puncture using either an A-mode (42 patients) or real time (13 patients) sonographic aspiration transducer, while 33 patients had a single plane vertical beam fluoroscopy for puncture guidance. The use of either sonographic method for the initial needle puncture significantly reduced the number of puncture attempts (p = 0.000004) and potential iatrogenic risk, eliminated the need for intravenous administration of contrast material, allowed initial safe introduction of a large caliber needle, and decreased the length of time needed to perform the procedure.

Drainage↗
PubMed1980

Clinicopathological conference: incidentally found renal mass.

Doctor Petersen confirmed our preoperative suspicion that this lesion might represent a benign proximal tubular adenoma. Tessler and associates found 5 such cases from July 1974 to January 1975 and reviewed all cases of renal carcinoma in their institution from 1952 through 1975. An additional 9 cases were discovered with none before 1964. One must ask if there is an increased incidence now occurring or are we just beginning to recognize this entity with increasing sophistication? The question also must arise whether with a high degree of suspicion a less radical operation is indicated. Certainly, the angiogram is the only possible preoperative tool that can arouse suspicion but this still is far from diagnostic. The spoke-wheel configuration of vessels, a homogeneous nephrogram similar to the normal parenchyma and sharp margination in the absence of marked increased vascular puddling may all be suggestive. In this older patient with a normal contralateral kidney total nephrectomy still is indicated because angiographic patterns are not pathognomonic. Conversely, in the rare younger individual with concomitant unrelated bilateral renal disease or in the solitary kidney with a polar lesion partial nephrectomy should be considered. Although some differential recognition may be possible by gross examination, such as the tan color, sharp demarcation, absence of hemorrhage or necrosis and so forth, it always has been our policy not to violate Gerota's fascia or to biopsy in the treatment of suspected renal carcinoma. Thus, until a specific preoperative diagnosis is possible nephrectomy continues to be the treatment of choice in the proximal tubular adenoma with so-called oncocytic features. Debate will continue in urologic, pathologic and radiologic circles on whether such an entity is universally benign and with increasing recognition only time will tell.

Adenoma↗