Biomedical subjects
Publications and source records attributed to J Danziger.
Nodular amyloidosis is uncommon and is due to a local production of amyloid by aberrant plasma cells. Localized bosselated plantar amyloidosis has been reported before but we present the first case to our knowledge of bilateral plantar amyloidosis. The clinical presentation as well as therapeutic options for this uncommon entity are reviewed.
The authors report two cases of visual field defects which are postulated to be due to the distal end of an elongated basilar artery compressing the visual pathways in the posterior suprasellar region. The mechanism of production of these defects is discussed, relating the abnormal position of the distal end of the basilar artery to a normally situated or only slightly post-fixed optic chiasm and optic tract and to a markedly post-fixed optic chiasm.
Computerized tomography scanning has been proven useful in defining complex anatomical areas of the head and neck and in delineating soft-density foreign bodies. This was helpful in a child in whom all other modalities, including surgical exploration, had failed to localize a foreign body.
The radiographic appearances of intracranial metastases from primary osteogenic sarcomas in three patients are presented. In two patients, the diagnosis of metastatic disease could be made on conventional roentgenograms of the skull since mineralization of tumor osteoid could be seen within the brain parenchyma. This had a similar appearance to the primary bone tumor. Angiography in two of the three patients revealed the cerebral metastases to be hypervascular with tumor vessels, tumor stain and early draining veins.
Rhabdomyosarcoma of the head and neck may be treated with surgery, radiotherapy and chemotherapy or a combination thereof. Precise delineation of the full extent of the tumor in the head and neck is essential. Routine radiographs with hypocycloidal tomography and CT are complementary in defining the full extent of the lesion. Tomography is superior to CT scanning in demonstrating fine bone detail. Demonstration of the soft tissue tumor and its extensions is better seen on CT. The ability to discriminate differences more accurately in densities allows computerized tomography to appreciate better the integrity of the bone margins such as the thin walls of the sinuses.
Pituitary hyperplasia, or adenoma, may result from end or target organ failure as seen in primary hypothyroidism and hypogonadism. Associated enlargement of the sella turcica and contour alterations without significant increase in volume may be seen. A review was made of 12 patients with end organ failure demonstrating the spectrum of radiologic changes within the sella turcica. Recognition of pituitary enlargement resulting from end organ failure may eliminate unnecessary surgery.
Olfactory neuroblastomas are malignant, slowly growing neurogenic tumors originating from the olfactory mucosa of the nasal cavity. Fourteen patients with this tumor were evaluated and showed variable extension into adjacent structures such as the ethmoid and sphenoid sinuses, orbit, and anterior cranial cavity.
Ten unselected patients with gonadal dysgenesis, three with Klinefelter's and seven with Turner's syndromes, were studied. Two of the patients with Klinefelter's and two with Turner's syndromes had enlarged pituitary fossae. The other six patients had normal sized sella, but showed localized change in the sellar contour on polytomography, suggesting hyperplasia or microadenoma formation of the pituitary gland. All ten patients had abnormally high serum follicle-stimulating hormone levels both at basal and after luteinizing hormone-releasing hormone stimulation. These results suggest that hyperplasia or microadenoma of the pituitary gland may occur secondary to gonadal failure, producing enlarged volume or attenuation in the normal contour of the sella turcica. Lack of awareness of reactive pituitary changes secondary to gonadal failure may result in inappropriate surgical management of what may appear to be primary pituitary tumor.
The computed tomographic findings of four patients with neoplastic disease of the global rim are discussed. All four patients demonstrated eccentric thickening of the scleraluveal rim with extension into the globe. Possible ways of differentiating these lesions from other orbital conditions are discussed. Window widths below 100 EMI units are best to visualize neoplasms of the global rim. For evaluation of the orbits, multiple window widths with varying window levels should be used.
Computerized axial tomographic scans were performed on 7 patients, 3, 8 and 20 hours after lumbar myelography with Dimer-X. This contrast agent was seen in the subarachnoid cisterns 3 and 8 hours after injection, and 24 hours after injection it had completely disappeared.
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The technique and applicaton of computerised axial tomography of the head is briefly reviewed with regard to both normal and some pathological tomographic features.
The radiographic appearances of cranial and intracranial tuberculous lesions are reviewed. The manifestations of cranial and intracranial tuberculosis vary according to the location, severity of involvement and the chronicity of the disease.
The radiological features and some clinical aspects of lipomata of the central nervous system are discussed, with examples of the different sites of involvement.
The radiographic appearances of some of the many changes that occur within the arterial supply to the brain after trauma are discussed.
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