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Biomedical subjects

P Costello

Publications and source records attributed to P Costello.

At least 91 records · Page 5Linked to original sources
PubMed1985

Lymphangiography, ultrasonography, and computed tomography in Hodgkin's disease and non-Hodgkin's lymphoma.

Findings from histologic analysis, lymphangiography, ultrasonography, and computed tomography were reviewed for 54 cases of Hodgkin's disease and 18 cases of non-Hodgkin's lymphoma. All patients were classified as clinical stage 1 or 2 disease at the time of the imaging studies. The ultrasound and computed tomography studies identified only 30 to 40% of the truly positive patients. This low sensitivity contrasts with lymphangiography, which identified 95% of the truly positive Hodgkin's disease patients and 70% of the patients with abdominal spread of non-Hodgkin's lymphoma. Many errors in interpretation were attributable to location and distribution of disease in these patients and the differing patterns of spread in Hodgkin's disease and non-Hodgkin's lymphoma. The evidence indicates that when findings are positive on computed tomography or ultrasound, no other study is necessary. In stage 1 or 2 lymphoma, non-Hodgkin's patients with negative noninvasive findings and all Hodgkin's patients, regardless of their noninvasive findings, should undergo lymphangiography.

Abdomen↗
PubMed1985

Solitary nodular sarcoidosis.

Three patients, each with a solitary lung nodule consisting of sarcoid tissue, are described. With the exception of one case where a submandibular lymph node was palpable, clinical and pathological involvement was limited to the thorax and the prognosis was highly favourable. In spite of atypical features, the absence of other causes of granulomatous inflammation suggests that these patients had sarcoidosis. What factors account for limited granulomatous reaction in this form of sarcoidosis are unknown. Previous use of corticosteroids and an age of over 40 years are two possible causes suggested by these cases.

Adult↗
PubMed1985

CT body stereotaxic instrument for percutaneous biopsy and other interventive procedures: phantom studies.

This article describes a new body stereotaxic system that defines a fiducial point by means of a skin localization device placed directly on the patient. The system uses a rectilinear stereotaxic frame to guide the needles along the calculated path. A method for calculating paths that require angulations from one scan slice to another is described, as well. The system was tested in a foam phantom and shown to be intrinsically accurate in vitro to within 2 mm in both the x and y axis.

Biopsy, Needle↗
PubMed1985

Focal splenic disease demonstrated by ultrasound and computed tomography.

Twenty-five patients with focal splenic disease were analyzed retrospectively to determine the relative strengths and weaknesses of ultrasound and computed tomography (CT) in the detection and analysis of focal splenic lesions. Lesions were detected in all 25 patients by ultrasonography and in 22 of 25 patients by CT. Ultrasonography appears to be more sensitive in the detection of focal lymphoma within the spleen and may be slightly more sensitive in the detection of microabscesses. CT may offer more specific information regarding the nature of certain lesions, including the detection of cyst wall calcification, gas within an abscess, and the specific site of origin of tumor invading the spleen. Ultrasonography may at times be more specific in the diagnosis of cystic lesions. We recommend ultrasonography as the first method for splenic imaging with CT used when necessary for further characterization of focal lesions.

Abscess↗
PubMed1984

Peripancreatic lymph node enlargement in Hodgkin's disease, non-Hodgkin's lymphoma, and pancreatic carcinoma.

The distribution of enlarged lymph nodes in the upper abdomen and retroperitoneum were classified according to their relationship to the pancreas in 47 patients with non-Hodgkin's lymphoma; in nine patients with Hodgkin's disease; and in 40 patients with pancreatic carcinoma. Four patterns of lymph node enlargement were evident: (1) preaortic retropancreatic lymphadenopathy; (2) pancreaticosplenic lymphadenopathy; (3) isolated celiac and/or portal lymphadenopathy; and (4) diffuse extensive lymphadenopathy. Features differentiating lymphoma from primary pancreatic neoplasm are discussed.

Adult↗
PubMed1984

Liposarcoma involving the scapula.

An unusual case of a soft tissue liposarcoma arising in the upper limb was studied by computed tomography. Computed tomography suggested the diagnosis of myxoid liposarcoma using the criteria of textural inhomogeneity and bony erosion and scalloping of the scapula.

Aged↗
PubMed1984

Porcelain gallbladder: ultrasound and CT appearance.

Nine patients with calcification of the gallbladder wall (porcelain gallbladder) were analyzed by ultrasound and the appearance correlated with the CT, radiographic, clinical, and surgical findings. Three distinct patterns were identified: (a) a hyperechoic semilunar structure with acoustic shadowing posteriorly, simulating a stone-filled gallbladder devoid of bile, which was seen in 5 patients; (b) a biconvex , curvilinear echogenic structure with variable acoustic shadowing, seen in all 3 patients with carcinoma of the gallbladder; and (c) an irregular clump of echoes with posterior acoustic shadowing, seen in 1 patient. Potential pitfalls in the diagnosis of gallbladder calcification are presented, and the association between calcification and cancer is emphasized.

Aged↗
PubMed1984

Cardiopulmonary function following post-cardiac surgical mediastinitis.

Eleven survivors of bacterial mediastinitis, which followed cardiac surgery through a median sternotomy approach, underwent noninvasive cardiopulmonary evaluation to determine whether clinically apparent mediastinal fibrosis had developed. Compared to preoperative values, forced vital capacity was reduced by 9.75 percent of predicted; the greatest reduction occurred in those patients with Gram-negative mediastinitis. In one patient, an abnormal jugular venous wave form and apex cardiogram were consistent with constrictive cardiac physiology, but this was not associated with an abnormal echocardiogram or impaired functional status. In this small series, no serious abnormalities in cardiopulmonary function were detected which could be attributed to prior mediastinal infection.

Adult↗
PubMed1983

Management of malignant ascites with peritoneovenous shunting.

The onset of intractable ascites secondary to malignant disease is a harbinger of a short life span (less than 8 weeks) in most patients. Repeated paracentesis is a preferable form of management unless a longer life span is anticipated. In patients with ovarian or breast carcinoma, peritoneovenous shunting is an effective means of controlling malignant ascites. In addition, long-term symptomatic relief can be achieved for the balance of the patient's life. Postoperative coagulation defects are minimal if most of the ascites is removed at the time of shunt placement. Circulating fibrin split products universally appear postoperatively in the peripheral circulation of patients with patent shunts. Pulmonary metastasis is not a clinically significant problem secondary to placement of the peritoneovenous shunt for malignant ascites.

Ascites↗
PubMed1983

Assessment of tumor response by computed tomography liver volumetry.

The volumes of hepatic tumors were calculated before and after therapy in 12 patients. The results were compared with clinical response, radionuclide scans, and initial qualitative computed tomography (CT) reports. A strong correlation was found between tumor volume determination and clinical response (9 of 12 patients). In only 4 of 10 patients did radionuclide scans agree with clinical response; the initial qualitative CT report disagreed with clinical response and quantitative CT response in four patients. Quantitative CT measurement was more accurate than qualitative CT evaluation and thus should be refined to offer a clinically useful addition to CT evaluation.

Follow-Up Studies↗
PubMed1983

Renal cyst wall thickening following percutaneous aspiration.

Computed tomography (CT) is an accurate and efficient means for evaluating and characterizing renal masses. Using established criteria, benign cortical cysts may be accurately differentiated from complex cysts or solid renal lesions. We report a case of cyst wall thickening simulating a cystic tumor that occurred after percutaneous aspiration of a simple renal cyst.

Aged↗
PubMed1983

CT findings in angioimmunoblastic lymphadenopathy.

Two cases of angioimmunoblastic lymphadenopathy with intraabdominal involvement are presented. Lymphadenopathy indistinguishable from lymphoma and leukemia was evident on computed tomography. The pathological features are discussed.

Aged↗
PubMed1983

Peripheral hepatic artery embolization for primary and secondary hepatic neoplasms.

Eighteen patients underwent peripheral arterial embolization with Gelfoam powder for treatment of primary or metastatic hepatic neoplasms. Except for two cases in which the patients could not undergo long-term arterial infusion, all cases were treatment failures from intravenous chemotherapy, intra-arterial chemotherapy, or, in some cases, intra-arterial chemotherapy plus radiation therapy. Fourteen patients had good symptomatic relief from the procedure. Four of these patients are alive at 3, 5, 6, and 18 months following the procedure. Four patients died within 2 weeks following embolization, three of progression of disease and one of aspiration pneumonia. Of the patients showing symptomatic relief, 10 died of progression of cancer 2 to 14 months following embolization, with a median survival of 5 months. Based on the results in this small group of patients, it would seem that transcatheter hepatic dearterialization is often successful palliative therapy in patients who are not responsive to traditional therapies. Because of the low procedural morbidity, transcatheter embolization is superior to surgical dearterialization.

Carcinoma, Hepatocellular↗
PubMed1983

Computed tomography in acute cholecystitis: new observations.

The computed tomographic CT findings in five patients with acute cholecystitis were analyzed. Common findings included thickening and nodularity of the gallbladder wall, cholelithiasis, and dilatation of the gallbladder lumen. Other more specific findings included poor definition of the gallbladder wall, pericholecystic fluid collections, and gas collections within the gallbladder wall. Most of the CT findings are suggestive but not pathognomonic, and correlation with the clinical, scintigraphic, and sonographic findings is necessary.

Acute Disease↗