[Pump metastasis of the bone].
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Biomedical subjects
Publications and source records attributed to R Kadiri.
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We report six cases of meningioma, uncommon tumors which accounted for 2.7 of all meningiomas observed in our series. Computed tomography was performed in all patients and produced the diagnosis in only 40% of the cases. Surgical treatment was given. Histological examinations of the surgical specimens confirmed the diagnosis. CT and magnetic resonance imaging were sometimes misleading, suggestive of metastasis or glioblastoma. Selective carotid arteriography with opacification of the external carotid artery established the diagnosis. Prognosis was good after surgery.
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UNLABELLED: Transthoracic needle biopsy is a reliable method for the diagnosis of thoracic lesions, specially when they are peripleral. AIM: The main objective was to evaluate the results of US guidance for thoracic needle biopsy in 159 cases. RESULT: Overall sensitivity was 83% as tissue was obtained in 132/159 cases. In 24 cases, 2 or 3 biopsies were necessary. In 17 cases, analysis was made on cytology only with a 70.6% sensitivity. One pneumothorax and two cases of hemoptisies were encountered. COMMENTARY: US guidance is a useful method for the diagnosis of peripheral thoracic masses, yielding a high sensitivity and a very low complication rate.
The authors report a case of idiopathic renal arteriovenous fistula. The diagnosis was established angiographically in a 24 year old man presenting gross hematuria. Embolization of the fistula was performed. Efficiency of this treatment was appreciated clinically and by duplex renal ultrasonography. The characteristics of renal arteriovenous fistulas are reviewed.
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.
This retrospective work aims to analyse the incidence and the radiologic features of initial thoracic involvement of lymphomas, observed in 320 patients selected among 1,153 lymphomas (640 Hodgkin's diseases and 513 non-Hodgkin's lymphomas). Thoracic involvement was not observed in 833 (72%) patients with lymphoma. In Hodgkin's disease (HD) (n = 200) thoracic involvement was observed in 31% (200/640). The mediastinal lymph nodes were noted in 99.5% and predominated in the superior and mid mediastinum in 84.5%. Mediastino-thoracic ratio was superior to 0.33 in 33.5%. Unilateral paratracheal nodes were involved in 26% and the hilar groups in 39.5%. The lung involvement was present in 26.5%, such as nodules in 11% and alveolar infiltration in 6.5%. In the cases with lung involvement, there were concomitant mediastinal lymph nodes. Pleural and pericardial effusions were seen in 23.5% and 4%. Parietal involvement was noted in 1%. In non-Hodgkin's lymphomas (NHL) (n = 120) thoracic involvement was observed in 23% (120/513). The mediastinal lymph nodes were seen in 82.5%, located in superior and mid mediastinum in 60%. Mediastino-thoracic ratio was superior to 0.33 in 47%. Lymph nodes were unilateral paratracheal in 7.5% and hilar in 18%. The posterior mediastinal lymph nodes group was involved in 2%. Lung involvement was noted in 24%, pleural effusion in 48%, pericardial effusion in 4% and parietal involvement in 2.5%. In the cases of thoracic involvement in HD, mediastinal lymph nodes involvement is constant, affecting commonly the anterior mediastinal, paratracheal and hilar groups. Involvement of the posterior mediastinum and paracardiac groups is more common in NHL. Thoracic computed tomography is helpful in the detection of the abnormalities misdiagnosed on the chest X-ray. Computed tomography is valuable in the initial stages of HD because it can modify the treatment in 15%.
A new case of pancreatic cystic lymphangioma is reported in a young woman. The authors discuss its clinic and histologic features and emphasize the complementary findings of ultrasonography and CT scan which are similar to the other sites of cystic lymphangioma in adults.
Appendicular mucocele is a rare lesion presenting a combination of several histological lesions. It generally ruptures into the peritoneum and rarely into the retroperitoneum. The objective of this study was to examine the various radiological appearances of appendicular mucocele and to report three cases of mucocele which ruptured into the retroperitoneum. This retrospective series of 6 cases of histologically confirmed appendicular mucocele was collected by the Central Radiology Department of Ibn Rochd University Hospital in Casablanca. The mean age of the patients was 61.6 years (33 years-77 years) and the sex ratio was 4/2. A plain abdominal X-ray and ultrasonography were performed in all patients. Five patients were examined by CT scan and two underwent a barium enema. Five out of six mucoceles ruptured: into the peritoneal cavity in 2 cases with gelatinous ascites and into the retroperitoneum in 3 cases. The plain abdominal X-ray showed a mass in the right flank, which was calcified in 2 cases. Ultrasonography and CT scan were suggestive of the diagnosis of appendicular mucocele in only two cases. The case of non ruptured mucocele consisted of a clearly delimited, thin-walled collection. A loculated effusion with scalloping on the liver was observed in the two cases of gelatinous ascites. In the three cases of mucocele rupturing into the retroperitoneum, ultrasonography and CT scan showed a loculated retroperitoneal collection. This collection extended into the right psoas in 2 out of 3 cases. Gelatinous ascites is the usual complication of appendicular mucocele; but in rare cases of mucocele of a retrocaecal appendix, the mucus may enter the retroperitoneum.
Hydatid disease of the soft tissues is rare, with a frequency between 2.4 and 5.3% of all sites of hydatid disease. We report a retrospective study of 6 cases of hydatid cyst of soft tissues. The mean age of our patients was 36 years (range: 25 and 63 years) and the sex-ratio was 5 females to 1 male. The clinical symptoms consisted in a mass which had been present for a mean of 12 months. Plain X-rays showed a water density mass with no associated bone lesions. Ultrasonography and computed tomography defined the features of the hydatid cysts, which were situated in muscle in 5 cases and in the subcutaneous tissue in 1 case. Their dimensions varied between 1.5 and 25 cm. All types of Gharbi's classification were observed. Secondary hydatid cysts outside of the soft tissues were observed in 2 patients. Medical imaging, essentially ultrasonography, was suggestive of the diagnosis. Computed tomography provided more precise information concerning the number, site and morphology of the lesions and was able to eliminate neoplastic disease.
Thyroid disease is a very common disease, essentially affecting women, and raises diagnostic and therapeutic problems. The objective of this study was to specify the value of ultrasonography in the diagnosis and aetiological orientation of these lesions, based on a retrospective study of 100 patients. The results of ultrasonography were compared to the histological results. The aetiologies detected were dominated by benign lesions, particularly adenomas (56 cases), dystrophic goitres (32 cases) and cancers (7 cases). Ultrasonography allowed the detection of clinically impalpable nodules with no isotope scan signs in 11% of cases. The ultrasonographic appearance of benign nodules was variable. Solitary nodules were detected in 63 cases. They were hyperechoic in 15 cases, isoechoic in 8 cases, cystic in 9 cases, and mixed in 31 cases. A peripheral clear halo was revealed in 25 cases and macrocalcifications were present in 17 cases. Malignant lesions were visualized in 7 cases and were solitary in 5 cases. Solitary lesions had a hypoechoic echostructure in 1 case, an isoechoic echostructure in 2 cases and a mixed echostructure in 2 cases. The margins were poorly demarcated in 3 cases, and circumscribed without peripheral halo in 2 cases. Cervical lymphadenopathy was detected in 2 cases. Graves' disease, diagnosed in 2 patients, showed a diffuse hypoechoic appearance of the entire thyroid gland. Ultrasonography is a sensitive morphological method for the diagnosis of thyroid lesions. A detailed and precise analysis of the ultrasound signs of the lesion can suggest that benign or malignant nature of the lesion, which can be completed by Doppler-ultrasound and especially ultrasound-guided needle biopsies.
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Pseudoneoplastic hydatid cyst of the liver (type IV), still raises diagnostic difficulties on ultrasonography (US), and often leads us to perform computed tomography. We therefore, conducted a prospective study of 50 cases of hepatic hydatid cyst (HHC) type IV in order to define the US and Doppler features allowing easy diagnosis with the best cost-effectiveness ratio. HHC type IV represented 23.7% of all types. The average age was 43.5 years with a female predominance. Many signs were described and their frequency was established. The main signs were daughter cysts (82%), hypo or hyperechoic spirals (66%), and peripheral transonic collarette (54%). At least one of these signs was present in 90% of cases. The Doppler study showed the avascular nature of the lesion in 100% of cases. Hydatid serology using modern immunologic techniques confirmed the diagnosis in 74% of cases. The US-serology combination can establish the positive diagnosis of HHC type IV in 94% of cases. Computed tomography therefore has a small place in this setting.
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The authors report an unusual ultrasonographic aspect of hydatic cyst of kidney. They point out the importance of computed tomography in atypic hydatid cysts. Semiologic analysis of ultrasonographic and scanographic patterns, leads usually to the diagnosis of atypic hydatid cyst, in addition with serologic examination.
The authors report an exceptional case of spinal compression following an isolate rib hydatidosis. The CT scan has suspected the diagnosis. The authors recall the anatomoclinic features and specify the radiologic aspects of the osseous hydatidosis, especially the rib's localization which is very rare. MR imaging in addition of its diagnosis role showing a very evocative cyst images, is the exam of choice in order to appreciate the disease's extent and the degree of medular sufferance.
The authors report a retrospective study concerning 32 cases of non Hodgkin lymphoma of the small intestine, histologically confirmed. All patients underwent digestive opacification. Ultrasonography was performed in 15 cases and CT scan was performed in 6 cases. The average age was 36 years and the sex-ratio was 3.4. The classical radiological signs described in the literature were found in our patients. The diagnosis of lymphoma was easily suggested in the presence of polymorphic and multifocal lesions, and especially the aneurysmal appearance. Abdominal sonography and computed tomography contributed to the diagnosis and also helped to relate an abdominal mass to its digestive origin, by showing a classical "sandwich" appearance.