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J N Bruneton

Publications and source records attributed to J N Bruneton.

At least 19 recordsLinked to original sources

Renal adenomas.

In presenting five new cases of renal adenomas the authors describe the general nature of these rare tumours. If the small adenoma corresponding to microscopic forms is frequent, the large adenoma is rare and always solitary. Haematuria and pain are the most common signs. The classic criterion of non-malignancy in a solid tumour measuring less than 3 cm has no diagnostic value. From a review of the lieterature on the subject, the authors demonstrate the angio-architecture corresponding to the different types of adenoma: the tubular adenoma which is hypervascularised and well circumscribed; the papillary adenoma, often cortical, hypovascular or avascular with bordering arcade; the alveolar adenoma; the mixed forms. They stress the difficulty of radiological diagnosis and the frequency of transitional forms with cancer. The place of angiography is in the pre-operative diagnostic assessment and in defining localised anomalies in angio-architecture which can guide histological examination in the search for neoplastic foci.

Adenoma

[The accuracy of angiography in the evaluation of benign renal tumours (author's transl)].

The authors review the literature regarding the angiography of three benign renal tumours: adenoma, angiomyolipoma and angioma. Renal adenomas area rare. Oncocytomas can be classified with papillary adenomas; they are fairly characteristic and can be diagnosed pre-operatively. The tubular, and particularly alveolar form cannot be distinguished angiographically from a carcinoma. Angiomyolipomas (hamartomas) occur in tuberous sclerosis or may be found alone. Angiography can first of all be an aid to topographic classification. Its isolated occurrence may cause difficulties in differentiation from a carcinoma. Certain angiographic signs may enable pre-operative diagnosis: the demonstration of aneurysmal arterial changes, linear course of tumour veins and the frequency of a peri-renal haematoma. Angiolipoma is the renal tumour which is most frequently complicated by pre-renal bleeding. Capillary, plexiform or cavernous angiomas are rare. If the first two are large enough (2 cm), their homogenous hypervascularisation may permit preoperative diagnosis. The diagnosis of cavernous angiomas is more difficult.

Adenoma

Normal variants of the sella turcica.

Complete study of the sella turcica requires multidirectional tomography. The authors have studied 200 radiographs of normal adults and noted the percentage of variants of each anatomical feature on both standard radiographs and tomograms. The greatest drawback of the standard radiograph is the difficulty in objectively evaluating the effect of pneumatization and/or a septum of the sphenoid sinus on the sellar floor. In this series the floor was concave in 58% of patients, flat in 32.5%, and convex in 9.5%. Lesions which simulate erosion of the posteromedial part of the lamina dura correspond to thinning of the central portion of the base of the dorsum sellae.

Adult

Lymphography in angio-immunoblastic lymphadenopathy.

Angio-immunoblastic lymphadenopathy (AIL) produces a characteristic lymphoproliferative syndrome, with characteristic lymphographic appearances. The authors studied the lymphographic manifestations of 18 cases of AIL. In 15 out of 18 cases, enlargement is observed in all the lymph nodes with a lacy or reticular storage pattern and sharp, well delimited margins. This lymphographic appearance reflects the histologic changes; only the peripheral sinuses, which are not involved, can be observed on lymphography.

Adult

[Radiological study of the chest involvement during angioimmunoblastic lymphadenitis (A.I.L.) Twenty observations (author's transl)].

From 20 observations, the authors worked out the frequency and the radiological picture of chest localizations of angio-immunoblastic lymphadenitis (A.I.L.). There are 2 kinds of pulmonary involvement: --a specific one by interstitial immunoblastic infiltration (20 to 45% of cases) and showing on X ray a reticulomicronodular interstitial syndrome; --a secondary infection (33% of cases) often the cause of death. Pleural involvement is unfrequent (11% to 25% of cases) and its onset late. Mediastinal lymph-node involvement is found in 37 to 50% of cases. It is usually discovered straight away.

Adult

[Arterial hypertension and horseshoe kidney during Von Recklinghausen's disease. Angiographic study and review of the literature (author's transl)].

Angiographic studies in a young girl aged 16 years who developed arterial hypertension during the course of Von Recklinghausen's disease, demonstrated the presence of an obliterated renal artery in a horseshoe kidney. The distal arterial segment was revascularized by two homolateral ureteral arteries. A full review of the literature revealed 30 cases of renal artery lesions for which angiography had been carried out in young people with neurofibromatosis. This demonstrates the low incidence of obliterative lesions (4 cases throughout the world) which are always associated with collateral vascularization. It was not possible to apply the usual surgical treatment in our case because of the associated horseshoe kidney.

Adolescent

[Angiomyolipomas (hamartomas) of the kidney. Radiological study apropos of 2 cases. Review of the literature].

Two patients with renal angiomyolipomas studied angiographically are reported:--A case of tuberous sclerosis with bilateral multiple lesions, renal, hepatic and adrenal;--An isolated lesion whose preoperative diagnosis allowed the excision of the tumor. A review of the literature from 1965 to 1977 identified 242 cases of which 177 were isolated angiomyolipomas. There were 54 cases associated with tuberous sclerosis and one with von Hippel-Lindau disease. The radiologic and especially the angiographic signs are illustrated, the hemorrhagic risks are stressed, and the diagnostic features of fetal renal hamartoma are described.

Adrenal Gland Neoplasms

[Voluminous hypernephroma of intermittent development. Diagnostic difficulties (author's transl)].

The authors report a case of cancer of the kidney of intermittent development for which nephro-urotomography was negative. They stress the interest of: --preliminary echotomography in patients with palpable masses in the left hypochondrium; --pharmaco-angiography for improved visualization of masses that are only weakly opaque; --a rapid infusion technique, proposed by various authors, which appears to be the most appropriate for the study of this type of mass which is mainly intermittent in its development.

Adenocarcinoma

[Congenital malformations of the inferior vena cava. Embryological, anatomical and radiological study (author's transl)].

Congenital malformations of the inferior vena cava are characterized by their diversity which is related to the complexity of the embryological development of this vessel. The authors review the embryogenesis and origin of the different segments of the inferior vena cava and describe the various types of malformation, including the causative embryological abnormality, ther frequency, possible clinical repercussions, and radiological aspects. Phlebocavography is essential for the identification of the various types of abnormality. Five different types of malformation are reported. Three of these are relatively rare (left inferior vena vaca, congenital membrane of the inferior vena cava, absence of the hepatic segment with continuation of the isolated azygos segment).

Adult

[Inferior mesenteric arteriovenous fistula of congenital origin. A report on one case and review of the published literature (author's transl)].

A fourth case of inferior mesenteric arteriovenous fistula of congenital origin is described by the authors, who also review the general characteristics of mesenteric (or portal) arteriovenous fistulae. Early clinical signs are hemorrhage from the digestive tract and chronic anemia. Endoscopy and barium X-rays are normal, and angiography is the only means of diagnosis. Surgical treatment is essential because of the risk of hemorrhages and portal hypertension.

Adult