Biomedical subjects
Publications and source records attributed to S A Deluca.
Ganglioneuroblastoma, although a rare neoplasm, is one of the most common causes of posterior mediastinal masses in children. This tumor occurs in children from one to 10 years of age. With intrathoracic involvement, the tumor may remain asymptomatic until it is large. The case reported illustrates a typical presentation of intrathoracic ganglioneuroblastoma.
Injuries that result in a sudden increase in intra-abdominal pressure may cause a diaphragmatic tear and visceral herniation. Right-sided tears are significantly less likely than left-sided tears because of the protective effect of the liver. When diaphragmatic elevation persists in a post-trauma patient, or if unexplained acidosis or hypoxemia develops, herniation of abdominal contents should be suspected. This is particularly true when other signs of severe trauma are present, such as multiple rib fractures, laceration of the liver or spleen, or a history of deceleration injury.
Hemochromatosis is a rare disorder in which about four times the normal amount of iron is absorbed in the intestine, resulting in the accumulation of iron in the skin, liver, pancreas and heart. Radiographic features may include a small liver on plain abdominal films, increased hepatic density on computed tomographic imaging, and loss of liver signal on magnetic resonance imaging as a result of the strong paramagnetic effect of iron. Management includes phlebotomy and supportive treatment of damaged organs.
Parathyroid hyperplasia is second only to adenoma as the most common cause of hyperparathyroidism. Symptoms are most likely to result from elevated serum calcium levels. Symptoms include nephrocalcinosis and nephrolithiasis. Studies that may help confirm a suspected diagnosis include ultrasonography, computed tomography, radionuclide scanning with thallium and/or technetium, and magnetic resonance imaging. Surgical treatment consists of excision of all but part of one parathyroid gland if all of the glands are enlarged.
Infectious disease is the most common etiology of a cavitary lung process, which can occur with necrotizing pneumonia, lung abscess and septic pulmonary embolism. Other infectious causes of pulmonary cavitation include cavitating fungal or mycobacterial granulomas and superinfection of preexisting spaces. Noninfectious causes of cavitation that should be considered in the differential diagnosis are infarction from thromboembolic disease or vasculitis, necrotic primary or metastatic tumor, rheumatoid nodules and air-filled congenital cysts. The clinical history combined with radiographic features can be helpful in diagnosing the underlying cause of cavitation.
Giant cell tumor is the second most common benign tumor of bone. Plain radiographs may demonstrate distinctive features but can also be misleading. The diagnosis may be aided by the use of other imaging modalities, such as bone scan, computed tomography and angiography. The recurrence rate is high, but some of the newer treatments seem to be associated with better outcomes.
Coarctation of the aorta is a common cardiovascular disorder with an unknown etiology. In the preductal type, blood flows from a patent ductus into the distal aorta. When the coarctation is juxtaductal or postductal, blood flows to the lower extremities by way of the subclavian arteries and collaterals. Plain films may show the reverse sign in postductal coarctation. Arteriography is the gold standard for making the diagnosis. However, magnetic resonance imaging will probably become an increasingly important diagnostic tool. The treatment of choice is surgery, with complete resection of the stenosed segment.
Diagnosis of thoracic spine fractures in patients with multiple trauma requires careful evaluation of the chest radiograph. Primary findings, consisting of a fracture line through the vertebral bodies, decreased height of the vertebral body, an increase in the interpediculate distance and misalignment of the vertebral bodies, may all be noted on the anteroposterior supine chest radiograph. Early diagnosis and intervention may prevent a catastrophic neurologic event, such as spinal cord or nerve root damage.
Castleman's disease is characterized by lymph node enlargement. There are two distinct histologic subtypes. Most patients are asymptomatic and under age 30, and a mediastinal or hilar mass is found incidentally on chest radiograph. The pathogenesis is unknown, but a chronic inflammatory process has been suggested by some investigators. Complete surgical excision is the treatment of choice and is generally curative.
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Conventional radiography reflects the underlying cause of pulmonary hypertension and may help to distinguish between precapillary and postcapillary etiologies. Adjunctive nuclear medicine studies may aid in identifying chronic pulmonary emboli as a cause of precapillary hypertension.
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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.