Additional cases of pseudotumoral eosinophilic cystitis.
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Biomedical subjects
Publications and source records attributed to M A Galloy.
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Xanthogranulomatous pyelonephritis is a morphologic variant of pyelonephritis. Focal disease is very rare and can be misdiagnosed.
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Compensatory renal growth post-nephrectomy is well documented both clinically and experimentally. However, little is known about the capacity for compensatory growth in utero. We performed unilateral nephrectomy in fetal rabbits and studied the growth of the contralateral kidney. Thirty fetal rabbits underwent in utero uninephrectomies at day 25 of gestation. On gestational day 28, all the fetuses were delivered by cesarean section and the ratios kidney weight/body weight of the operated fetuses were compared to those of control littermates. The kidneys were then analysed by histology. A significant increase in renal weight was observed. The histological study of the remaining kidneys indicated a statistically significant increase of the glomerular area which confirmed the renal hypertrophy. This experiment demonstrates the capacity for the rabbit to develop in utero compensatory renal growth.
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The authors describe an infant with an aneurysm of the right iliac artery, associated with three sites involving the inferior mesenteric artery and its first two branches, most likely related to an episode of chicken pox. Helical angiography with computed tomography, performed with a continuous-rotation scanner, allowed precise assessment of the lesions, in particular those affecting the inferior mesenteric artery.
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Therapeutic management of osteoid osteomas may vary from conservative medical treatment to more aggressive, though effective, surgery. Based on observations in 4 cases in children, we demonstrate the importance of localizing the lesion on the CT-scan before percutaneous resection of the osteoid osteoma involving small bones since this method is the most conservative surgical procedure.
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On the basis of personal observation of four cases, the authors discuss the diagnostic aspects in this disease. Before birth, the diagnosis should be made by echography. After birth, magnetic resonance imaging scanning (IRM) is the method showing two types of cystic lymphangioma; a monomorphic and a polymorphic type. IRM is particularly valuable for the assessment of the extent of the disease all the more so as these tumours are often infiltrating. One should also recognise cervicomediastinal lymphangiomas which are more frequent in the very young and in whom the diagnosis is easy but one should not ignore the mediastinal component and those lymphangiomas which are purely mediastinal.
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Giant cell tumor of bone rarely affects children, in whom it is usually located in a metaphysis in contrast to the predominantly epiphyseal localization in adults. Five cases are reported, two at the femur, two at the fibula and one at the tibia. Plain film radiography and computed tomography are the most informative imaging studies. The differential diagnosis is with aneurysmal bone cyst and, in metaphyseal-epiphyseal forms, with chondroblastoma. Treatment usually consists in curettage of the tumor followed by filling of the cavity; however, more extensive resection is required in some cases.
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Eosinophilic granuloma of bone or Langerhans cell histiocytosis is mostly unifocal. It appears on plain X Ray as a solitary destructive lesion of long bones or flat bones. CT is useful to define the extension to the cortical bone and also to precisely localize the lesion when the anatomy is complex (hip, spine, base of the skull). MR is very useful in case of more aggressive lesions when there is extension to soft tissues. Differential diagnosis includes circumscribed osteitis and tumors in the case of extensive destruction. The natural course of solitary lesions is favorable, spontaneously or with therapy. The prognosis is more serious in the case of multiple lesions.
The authors report a retrospective series of 22 cases of bronchogenic cysts in children. The development of antenatal ultrasonography allowed the diagnosis in 3 cases. When the diagnosis is suggested for the time first postnatally, chest x-ray and oesophagography remain the essential initial investigations. Thoracic ultrasonography needs to be developed, as in some cases it can reveal the cystic nature of the tumour. In difficult cases, the work-up should be completed by CT scan, while keeping in mind that not all bronchogenic cysts present in the form of low-density images. A detailed review of the literature shows that mediastino-pulmonary opacities are more frequent than exclusively pulmonary images in the form of hyperlucent, fluid level or solid opacity images.