Biomedical subjects
Publications and source records attributed to K Takayasu.
Explore the source record for details and available documents.
Explore the source record for details and available documents.
A 27-year-old woman was admitted to other hospital for acute pleuritis in May 1977. She suddenly had a focal epileptic seizure in the face with loss of consciousness on July 10, 1977. The same episodes of seizure occurred on Aug. 8, on Oct. 26, on Nov. 22, 1977. She was admitted to our hospital on Dec. 12, 1977. Neurological examinations showed no abnormality. Chest X-ray film showed bilateral severe thickening of the pleura. Plain skull films showed normal findings. Enhanced CT scanning showed a homogenous irregular contour of high density area surrounded by low density area in the right frontal region. The lateral ventricle was slightly shifted to the left side. 99mTc brain scan also detected a spherical abnormal uptake in this area. Right carotid angiography showed no abnormal vessels and increased vascularities. On Nov. 22, 1977, a craniotomy was made over the right fronto-temporal bone, and a walnut sized tumor in the frontal subcortex was totally removed successfully. Histologically, the tumor was diagnosed as brain tuberculoma. The antituberculous therapy (AB-PC, INAH, Rifampicin), high doses of gammabenin, and steroid were given. About four months later, she was in good health without neurologic deficits and returned to her work. The literature was reviewed, and the value of CT scan and RI scan in the diagnosis of cerebral tuberculoma was emphasized.
Incidence of intrahepatic arteriovenous fistula after needle biopsy of the liver, percutaneous transhepatic cholangiography, and transhepatic catheterization of an intrahepatic bile duct or portal vein, was determined by studying the hepatic arteriograms obtained within 1 month of the transhepatic procedure. An arteriovenous fistula, mostly arterioportal, occurred in 5 (5.4%) of the 93 patients after biopsy, in 3 (3.8%) of 79 after percutaneous transhepatic cholangiography, and in 7 (26.2%) of 26 after catheterization. None of the fistulae was so large and close to the porta hepatis as to cause portal hypertension. In 1 patient with an intrahepatic bile duct carcinoma, the long track of a 0.7-mm caliber needle became a fistula draining arterial blood into the parenchyma. In another, an aneurysm was found after biopsy and percutaneous transhepatic cholangiography. The possibility of spontaneous closure of small fistulae is discussed.
Explore the source record for details and available documents.
Explore the source record for details and available documents.
Explore the source record for details and available documents.
Explore the source record for details and available documents.
Explore the source record for details and available documents.
Explore the source record for details and available documents.
We reviewed computed tomography (CT) in eight patients with sclerosing hepatocellular carcinoma who underwent resection. Dynamic CT was performed 25-40 s (rapid phase) and 5-10 min (late phase) after injection of contrast medium. Most of the lesions were round and homogeneous. Tumors tended to show density equal to the liver. The relative density of the tumors in the rapid phase, however, tended to be higher than in other phases. A peripheral low-density area was absent. Dynamic CT was thus important in the diagnosis of sclerosing hepatocellular carcinoma.
A rapidly growing hepatic hemangioma was observed in a 40-year-old woman during the follow-up period of 1.5 years. Contrast enhanced CT and angiography performed 3.5 years prior to and at the time of operation were compatible with hemangioma, but the diameter of the mass changed from 4.6 to 7.2 cm during this period. The pathogenetic reason for this rapid growth was unclear at the time of resection.
We report a patient with a rare cystic hepatic tumor that was demonstrated as a high density mass by unenhanced CT and as a cystic mass with high echoic spots by ultrasonography. At surgery, the tumor was a unilocular cyst containing viscid tan fluid. Histopathologically, it was lined by ciliated epithelium and diagnosed as ciliated hepatic foregut cyst. We discuss the correlation between radiological imaging and content of the cyst.
During follow-up of non-Hodgkin lymphoma in a 60-year-old man, multiple hepatic small lesions were incidentally found by sonography. Dynamic CT disclosed enhancing masses in both the right and left lobes and faint arterioportal shunting in the left lobe of the liver. These findings were confirmed by angiography. Portal hypertension was, however, not present. Exploratory laparotomy revealed nodular regenerative hyperplasia of the liver. The nontumorous liver was normal.
Two asymptomatic patients with surgically proven solitary primary hepatic carcinoid tumors are reported. Ultrasonography showed hyperechoic masses containing multiple small cystic areas in both cases. On unenhanced CT, one tumor was of low density and one was isodense with multiple low density foci. One tumor showed marked retention of contrast medium on post-angiographic CT. Magnetic resonance imaging revealed low intensity masses on T1-weighted images and high intensity tumors with multiple areas of higher intensity on T2-weighted imaging. The small low density areas in these masses corresponded histopathologically to multiple vascular lakes. Late enhancement of the mass was presumed to correspond with proliferative fibrous tissue within the mass.
To differentiate focal nodular hyperplasia (FNH) from other hepatic tumors, especially hepatocellular carcinoma, we evaluated the hemodynamics of histologically proved FNH in three patients, two by arterial angio-CT and one by microangiography of the resected specimen. These studies demonstrated the centrifugal blood supply of FNH (early filling of central tumor vessels radiating to periphery, and lobulated tumor stains with central low density area in the late phase), which could not be demonstrated by dynamic CT or hepatic angiography. Arterial angio-CT is useful as a further study, when differential diagnosis of FNH is uncertain by other imaging techniques.
OBJECTIVE: To clarify imaging and clinicopathologic features of lymphoepithelial cysts (LEC), a benign lesion of the pancreas. MATERIALS AND METHODS: Two male patients with LECs that were found incidentally and proven surgically were reviewed. RESULTS: Sonography revealed a hypoechoic mass in both cases, one of which had septation and an intracystic isoechoic component within it. The mass was shown as low attenuation on unenhanced CT, and the intracystic solid component was not enhanced by dynamic CT or computed tomographic arteriography. One lesion had calcifications around the mass. Magnetic resonance imaging showed hyper- in hypointensity on T1-weighted imaging and hypo- in hyper- on T2-weighted imaging in one case. Both lesions were located on the surface of the head of the pancreas, and the main pancreatic ducts appeared normal on endoscopic retrograde pancreatography. Both patients were asymptomatic. CONCLUSION: These imaging and clinical findings suggest LEC, which should be considered when one encounters cystic lesions of the pancreas.
In three patients with colon cancer and liver metastases who had received intra-arterial chemo-infusion of fluorouracil (5FU) and mitomycin C and/or cis-diamminedichloroplatinum (CDDP), intrahepatic portal vein thrombosis (PVT) was incidentally demonstrated by computerized tomography (CT) 6, 1 and 7 months respectively after the cessation of administration of anti-cancer agents. One patient developed complete PVT in the whole liver as shown by follow-up CT 6 months after a diagnosis of pre-existing sclerosing cholangitis, and died from rupture of oesophageal varices. In the remaining two patients, PVT was found incidentally by follow-up CT in the right portal vein (Case 2) and the right anterior portal vein (Case 3) respectively; it spontaneously recanalized in Case 2 and was still present in Case 3 2 months later. PVT seems to be one of the complications of hepatic arterial chemo-infusion and its possibility must be borne in mind in such patients, even though the exact interval between the arterial chemo-infusion and occurrence of PVT could not be determined.