Oat cell carcinoma metastatic to ureter.
A rare and perhaps unique case of oat cell carcinoma metastatic to the ureter is presented.
Aged↗
Biomedical subjects
R K Zeman
Publications and source records attributed to R K Zeman.
The technetium-99m-sulfur colloid angiogram in suspected gastrointestinal bleeding.
Dynamic radionuclide angiography (5-sec. images) with technetium-99m-sulfur colloid proved to be helpful in 5 patients who presented with gastrointestinal bleeding. In 2, intermittently bleeding hypervascular lesions were seen on dynamic but not on static images; in 2 others, the dynamic images demonstrated hypervascular lesions better than the static scans; and in 1, the radionuclide angiogram localized colonic bleeding more accurately because of rapid peristalsis of extravasated tracer. The addition of the radionuclide angiogram to routine scintigraphy for gastrointestinal bleeding may be crucial for identification of hypervascular lesions and precise localization of bleeding sites.
Adult↗
Ureterosigmoidostomy: the development of tumors, diagnosis, and pitfalls.
The development of colon carcinoma after ureterosigmoidostomy has not received adequate attention in the radiologic literature. Two patients who had ureterosigmoidostomy and subsequently developed tumors are described. The third case is a patient with a ureterosigmoidostomy and a ureterocele that simulated the appearance of carcinoma in the sigmoid colon. This is the first report of this entity. Ureterosigmoidostomy patients need frequent follow-up studies since their incidence of carcinoma is significant. The use of barium to study the colon in this group of patients is controversial. Barium can potentially reflux into the kidney with fecal material, which can lead to fibrosis and impaired renal function. However, barium reflux up the ureter is usually of no significance except on those rare occasions when intrarenal reflux occurs and inflammatory changes may develop. The diagnosis of tumors in these patients, diagnostic pitfalls, and controversy regarding use of barium enemas in following these patients are discussed.
Adult↗
Correlation of computed tomography, sonography, and gross anatomy of the liver.
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Hepatic Veins↗
Intra-abdominal lymphangiectatic cysts: an uncommon abdominal lesion in children and young adults.
Three patients with intra-abdominal lymphangiectatic cysts, with details of their clinical radiologic, and pathologic findings, provide examples of the diverse and confusing clinical manifestations of this uncommon lesion. Their diversity is largely the result of their variable size and location within the mesentery, omentum, or mesocolon. Radiologic examination provides the greatest aid in preoperative diagnosis, and is useful in differentiation from ascites and other abdominal lesions. The characteristic histologic appearance of lymphangiectatic cysts provides their ultimate classification.
Adolescent↗
Comparison of computerized tomography, ultrasound and angiography in staging renal cell carcinoma.
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Adenocarcinoma↗
Ultrasonography and hepatobiliary scintigraphy in the assessment of biliary-enteric anastomoses.
Twenty-three patients with surgical diversion of the biliary tract were serially studied with ultrasonography and hepatobiliary scintigraphy using 99mTc-HIDA or 99mTc-disofenin. Refluxed biliary air resulted in nondiagnostic sonograms in 14% of cases. Persistent postoperative dilatation was present in five patients (22%). Scintigraphy allowed differentiation of biliary dilatation with obstruction from nonobstructed dilatation. By coordinating the noninvasive imaging results, those patients requiring study using direct injection of contrast material may be selected.
Adult↗
Current aspects of nuclear imaging in clinical oncology.
This presentation will focus on the recent developments in nuclear medicine that relate to diagnosis and staging in the cancer patient. The commercial availability of new Agar cameras as well as longitudinal tomographic scanning devices has improved gallium imaging significantly. This has enhanced tumor detection and resulted in better use of gallium scanning in the cancer patient. Areas of controversy have also developed. In particular, the question of whether or not the gallium scan can be used to avoid mediastinoscopy in some case of bronchogenic carcinoma will be detailed. Techniques in nuclear medicine must be carefully integrated with other noninvasive investigation such as CT and ultrasound. At Yale, the authors have gathered considerable data indicating the best way to interact nuclear medicine radionuclide scintigraphy of the liver with the ultrasound examination. Our approach to this problem for the detection of focal disease in the liver will be discussed. 99mTc-HIDA has been proven useful in a wide variety of biliary disorders. Use of scintigraphy in the evaluation of cholangio-enteric bypass procedures in the cancer patient will be reviewed.
Adenocarcinoma↗
Diagnostic utility of cholescintigraphy and ultrasonography in acute cholecystitis.
When faced with a patient with possible acute cholecystitis, technetium-99m-HIDA scintigraphy should be the primary diagnostic procedure performed. If scintigraphy reveals a normal gallbladder, acute cholecystitis is excluded. If the scintigram fails to visualize the gallbladder, ultrasonography is deemed advisable to exclude potential false-positive scintigrams and confirm the presence of cholelithiasis.
Acute Disease↗
Disparate dilatation of the intrahepatic and extrahepatic bile ducts in surgical jaundice.
Intrahepatic biliary dilatation on ultrasound has been reported as an early sign of biliary obstruction. This paper reports 12 patients with extrahepatic biliary obstruction in whome the extrahepatic biliary system was increased in caliber despite a normal appearance of the intrahepatic ducts. The bile ducts in all of these patients were evaluated with ultrasound and percutaneous transhepatic cholangiography. Computed tomography was performed in one case. The causes of obstructive jaundice included stricture, choledocholithiasis, and neoplasm. The common bile duct provides a sensitive indicator of biliary obstruction, and its demonstration by noninvasive or invasive means is mandatory even when the intrahepatic ducts appear to be normal.
Adult↗
Acute experimental biliary obstruction in the dog: sonographic findings and clinical implications.
Three dogs were serially studied with sonography after cholecystectomy and total acute biliary obstruction. Peripheral biliary dilatation could be diagnosed as early as 4 hr after biliary obstruction and before significant elevation of serum bilirubin. These experimental results support the thesis that total biliary obstruction may be diagnosed before the onset of icterus.
Alkaline Phosphatase↗
Coordinated imaging in the detection and characterization of renal masses.
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Adenocarcinoma↗
Tc-99m HIDA scintigraphy in segmental biliary obstruction.
Segmental biliary obstruction as a result of primary or secondary hepatic malignancy has been reported with increasing frequency. For two representative patients, the clinical and Tc-99m HIDA scintigraphic findings in segmental biliary obstruction are described. The presence of photon-deficient dilated bile ducts in one segment of the biliary tree is highly suggestive of localized biliary obstruction and should be considered in the patient with suspected or proven hepatic malignancy despite the absence of jaundice.
Adenocarcinoma↗
Tc-99m HIDA cholescintigraphy: the distended photon-deficient gallbladder.
Four patients with distended, photon-deficient gallbladders are presented. Markedly delayed apearance of Tc-99m HIDA in a distended gallbladder may represent chronic cholecystitis, partial obstruction of the common bile duct, or physiologic gallbladder distention. Obtaining delayed images is important in this group of patients to avoid premature diagnosis of cystic-duct obstruction. If the distended gallbladder fails to visualize within 24 hr, hydrops with cystic-duct obstruction is suggested.
Adult↗
Percutaneous antegrade bilateral dilation and stent placement for internal drainage.
The authors describe a percutaneous method of establishing a channel betweeen the ureter and bladder across an obstruction. This technique, which involves a balloon catheter and placement of pelvivesical stents to provide internal drainage, is useful when the underlying disease contraindicates surgery and when retrograde catheterization from the bladder has failed. Palliation is achieved with little discomfort or risk to the patient.
Humans↗
Ultrasound in experimental and clinical renal vein thrombosis.
Static ultrasound was used to study five dogs with surgically produced unilateral renal vein thrombosis and eight patients with unilaterally occluded renal veins. In both clinical and experimental situations, renal vein thrombosis acutely led to decreased cortical echogenicity and nephromegaly. Between 10 days and three weeks, there was an increase in cortical echogenicity with preservation of corticomedullary definition; the late changes were decreased renal size, increased cortical echogenicity, and loss of corticomedullary definition. Histologic examination showed a significant deposition of collagen within the cortex and medulla of the dogs' kidneys during the late stage of the disease. Real time ultrasonography in two dogs and in one patient during acute renal vein thrombosis demonstrated absence of transmitted pulsations to the affected renal vein. Doppler ultrasound in one patient with proved renal vein thrombosis demonstrated absence of flow. The differential diagnosis and significance of the ultrasound findings are discussed.
Animals↗
Ultrasound in the evaluation of renal masses.
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Abscess↗
A quantitative clinical comparison of three 99mTechnetium labeled brain imaging radiopharmaceuticals.
In a comparison study of three commonly employed 99mTc brain imaging pharmaceuticals, 16 patients with proven brain lesions had imaging performed with DTPA, glucoheptonate, and pertechnetate over a short interval of time. Lesion detectability was assessed by a data processing system which evaluated average lesion-to-background activity ratios for each patient examination. Statistical analysis of the resultant data demonstrated a significant improvement (20%) in lesion-to-background ratio in favor of one hour delayed DTPA images versus two hour delayed pertechnetate images. Comparison of one hour delayed DTPA images with one hour delayed glucoheptonate images did not reveal a significant difference in lesion-to-background ratio. The authors conclude that both Tc-DTPA and Tc-glucoheptonate are superior alternatives to pertechnetate when employed in the manner described.
Brain↗