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K Kakuma

Publications and source records attributed to K Kakuma.

11 recordsLinked to original sources
PubMed2001

Primary leptomeningeal lymphoma.

Primary leptomeningeal lymphoma is a rare disorder, and the neuroradiological characteristics or the complication of this rare disorder have not been well reported. We reported herein a patient with a primary leptomeningeal lymphoma who has complication with subdural hematoma. The patient complained of headache and vomiting. Neurological examination revealed progressive cranial nerve palsy. Cerebrospinal fluid examination disclosed monoclonal proliferation of atypical B-lymphocytes. Cranial computed tomographic scans showed a left frontal mass with convex form to the brain parenchyma. T1-weighted magnetic resonance (MR) images disclosed subacute subdural hematoma. However, proton-weighted MR images showed high signal intensity in subarachnoid space, which suggested leptomeningeal lymphoma. He underwent craniotomy, and the diagnosis of leptomeningeal lymphoma complicated with subdural hematoma was confirmed. Systemic examinations disclosed no lymphomatous lesions except for leptomeningus, and the diagnosis of primary leptomeningeal lymphoma was established. We suggested that subdural hematoma was associated with primary leptomeningeal lymphoma in this patient. Cerebrospinal fluid examination and proton-weighted MR imaging should be performed when progressive neurological abnormalities are found in patients with subdural hematoma.

Aged↗
PubMed1999

201Tl SPET in the differential diagnosis of brain tumours.

The aims of this study were to assess the utility of 201Tl single photon emission tomography (SPET) in the differential diagnosis of brain tumours and to elucidate the relationship between 201Tl tumour uptake and degree of contrast-enhancement on magnetic resonance imaging (MRI). Early (15 min) and delayed (3 h) 201Tl SPET imaging and T1-weighted MRI were performed before and after Gd-DTPA enhancement in 101 (41 malignant and 60 benign) untreated brain tumours. The 201Tl uptake ratio (tumour-to-normal brain count ratio) for both the early and delayed SPET studies and the retention index (the ratio of delayed to early 201Tl uptake) were calculated. Malignant tumours were separated from benign tumours with 87% accuracy based on the assumption that tumours with a 201Tl retention index < 0.7 or no abnormal uptake are benign. Meningiomas and pituitary adenomas were differentiated from other benign tumours by their characteristic pattern on SPET. The degree of contrast-enhancement of the tumour on MRI was concordant with the early 201Tl uptake ratio for most histological types. However, schwannomas and cavernous haemangiomas showed a low 201Tl uptake ratio in spite of a high degree of contrast-enhancement on MRI. In conclusion, 201Tl SPET provides additional information that helps in the differential diagnosis of brain tumours.

Adenoma↗
PubMed1997

Thyroid nodules: evaluation with US-guided core biopsy with an automated biopsy gun.

To evaluate the efficacy of ultrasound (US)-guided automated core biopsy of thyroid nodules, 74 biopsies were performed in 61 consecutive patients with an 18-gauge short-throw (1.1-cm excursion) biopsy gun. Results were correlated with diagnoses made at surgery (n = 38) or at sonographic follow-up of at least 6 months (n = 36). Sensitivity, specificity, and accuracy of diagnoses made with automated core biopsy were 84%, 95%, and 91%, respectively. US-guided biopsy with an automated biopsy gun allowed accurate assessment of thyroid nodules.

Adult↗
PubMed1997

[US-guided core biopsy of the breast with an automated biopsy gun: comparison with an aspiration core needle device].

To evaluate the efficacy of an automated Tru-cut type of biopsy gun in US-guided breast biopsy, we performed 162 breast biopsies in 148 patients using an 18 gauge short-throw (1.1cm excursion) Tru-cut-type biopsy gun (Ace-cut needle). The results of the series were compared with another series of aspiration core biopsies, which were performed on 113 breast lesions in 112 patients using an 18 gauge Sure-cut needle. The results of the two series were correlated with the diagnoses made at surgery or clinical follow-up. Sensitivity, specificity, and accuracy for the automated biopsy gun were 89.2%, 94.9%, and 92.7%, and for the Sure-cut needle, 75.0%, 78.6%, and 77.5%, respectively (p < 0.01 for specificity and accuracy, by chi 2 test). There were no serious complications. The diagnostic surgical biopsy to operated cancer ratios in 1991 (without core biopsy), 1993 (with aspiration core biopsy), and 1995 (with automated core biopsy) were 2.9 (46/10), 2.0 (30/17), and 0.5 (12/24), respectively. We concluded that US-guided breast biopsy with an automated biopsy gun is a safe and highly accurate method, and could replace the diagnostic surgical biopsy.

Biopsy, Needle↗
PubMed1992

[Unilateral persistent hyperhidrosis after ischemic stroke].

A 64-year-old right hemiplegic woman, who had been treated for hypertension for 15 years, was admitted to our hospital. Neurologic examination on admission disclosed right hemiplegia and motor aphasia; however, ophthalmoparesis, pupillary abnormality, and blepharoptosis were not evident. Excessive sweating on the right side of the body, which was most marked on the face, was observed. Amount of sweating on the left side of the body was normal. Unilateral hyperhidrosis persisted for more than 2 months. MRI revealed hemorrhagic infarctions in the left basal ganglia, internal capsule, thalamus, hypothalamus, and medial part of the cerebral peduncle. 123I-IMP SPECT disclosed hypoperfusion in the left striatum, thalamus, occipital cortex, and right cerebellar hemisphere. Cerebral angiography revealed arteriosclerotic changes in the basilar artery, but that the left posterior cerebral artery and its branches were not occluded. Unilateral persistent hyperhidrosis is rare after ischemic stroke. Hypothalamic lesion was thought to be responsible for the hyperhidrosis in this patient. As the hypothalamus receives its blood supply from the posterior cerebral artery, unilateral persistent hyperhidrosis may be an important sign of cerebral infarction in the posterior cerebral artery region.

Cerebral Infarction↗
PubMed1988

Discordant hepatic uptake of Tc-99m HIDA and Tc-99m colloid in a patient with segmental biliary obstruction.

Discordant hepatic uptake between Tc-99m HIDA and Tc-99m colloid occurred in a 63-year-old female with segmental biliary obstruction due to cholangioma. Radiographic CT and a percutaneous transhepatic cholangiogram revealed the obstructed right hepatic duct as well as the dilated intrahepatic duct in the right lobe. At surgery this was confirmed, and a 2 cm mass encasing the right hepatic duct was identified. It should be included in the gamut of discordant hepatic uptake of Tc-99m IDA and Tc-99m colloid.

Adenoma, Bile Duct↗
PubMed1988

The role of Ga-67 citrate imaging in pancreatitis.

Two patients with pancreatitis in whom an area of predominant uptake of Ga-67 citrate was demonstrated involving the entire pancreas are presented. Ultrasound and x-ray CT did not reveal any morphologic abnormalities in the pancreas, whereas Ga-67 citrate imaging indicated the presence of active inflammatory change. Ga-67 citrate imaging may be useful in confirming the diagnosis of acute pancreatitis or acute exacerbation of chronic pancreatitis based on clinical and laboratory data, especially when ultrasound and/or x-ray CT cannot reveal any morphologic abnormalities in the pancreas.

Aged↗
PubMed1986

[Bilateral ureteral obstruction by periarterial fibrotic reactions in aortoiliac arteriosclerosis: report of a case].

A 60-year-old man visited our hospital with the chief complaint of right flank pain. A right ureteral stone was suspected by the findings of KUB and DIP, and conservative treatment was carried out. Repeat KUB and DIP a month after treatment showed that the stone shadow was not visible and right hydronephrosis had increased. Closer examinations by RP and CT scan revealed right ureteral obstruction caused by periarterial fibrosis accompanied with arteriosclerotic changes of the aortoiliac region. The arteriosclerotic changes were confirmed by pelvic arteriography, and then right ureterolysis and lateral displacement were performed. DIP four months after the operation showed improvement of right hydronephrosis, but left hydronephrosis was observed. As the same cause as the right side was suspected, left ureterolysis and intraperitoneal transposition were also performed. Histological findings of each periureteral tissue resembled idiopathic retroperitoneal fibrosis. DIP three months after the second operation showed no hydronephrosis. Case reports of ureteral obstruction due to perianeurysmal fibrosis have not been infrequent recently, but our case showed severe arteriosclerotic changes instead of conspicuous aneurysm. The possibility of occurrence of periarterial fibrosis caused by severe arteriosclerotic changes is discussed.

Aorta, Abdominal↗