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Biomedical subjects

T L Pope

Publications and source records attributed to T L Pope.

At least 73 records · Page 4Linked to original sources

Idiopathic synovial chondromatosis in two unusual sites: inferior radioulnar joint and ischial bursa.

Synovial chondromatosis is a rare disorder of unknown cause characterized by multiple calcific bodies in the vicinity of the affected joint. It is most commonly seen in the knee, hip, elbow, and shoulder. We describe three cases of synovial chondromatosis in two extremely uncommon sites, the inferior radioulnar joint and the ischial bursa, and review the literature on the subject. The characteristic radiographic appearance, even if in an uncommon location, should prompt the radiologist to suggest the correct diagnosis preoperatively.

Adult↗

The variable nature of the mediastinal contour lines: CT/chest radiography correlation.

Interfacing of the lung with the mediastinum produces a number of mediastinal lines including those due to the innominate veins, left subclavian artery, paratracheal stripe, both anterior and posterior junction lines, the azygo-esophageal recess, descending aorta and paraspinal lines. Displacement or absence of one or more of these lines may be due to an abnormality of mediastinal contour or may indicate a mediastinal mass, but can occur in normal subjects. Correlative findings between chest radiography and chest computed tomography in 50 normal subjects illustrate the variable nature of these lines.

Diagnosis, Differential↗

Carcinosarcoma of the breast: radiologic, ultrasonographic, and pathologic correlation.

Carcinosarcoma of the breast is a rare neoplasm which has been reported less than 20 times. Comprised of both malignant epithelial and malignant connective tissue components, it may radiographically exhibit features of either cellular element. We report the first film-screen mammographic description of such a lesion in a breast. Osteoid matrix calcification demonstrated mammographically should, in retrospect, have suggested osteogenic elements preoperatively.

Aged↗

Intravasation during hysterosalpingography using oil-base contrast medium--a second look.

Hysterosalpingography is a study performed commonly to assess the upper reproductive tract in infertile women. A risk with hysterosalpingography is either lymphatic and/or venous intravasation with or without embolization. Of 593 consecutive hysterosalpingograms performed with a low-viscosity oil-base medium, intravasation occurred in 41 cases (6.9%). Embolization was documented in six patients. There were no recognized adverse sequelae from either intravasation or embolization. Intravasation was frequently associated with pathology of the upper genital tract, and suspected tubal occlusion was the most common abnormality detected. Proper timing of the procedure and avoidance of excessive instillation pressure will diminish the incidence of this complication. The use of both a low-viscosity oil-base medium and high-resolution fluoroscopic image intensification may increase the detection of intravasation.

Contrast Media↗

Has monitoring of the contralateral breast improved the prognosis in patients treated for primary breast cancer?

Bilateral breast cancer has a cumulative incidence of about 7% in patients with primary operable breast cancer, and most of these lesions are metachronous. Most retrospective studies have shown that a majority of these patients have invasive cancer in the second breast, and varying percentages have nodal metastases, which may be of a higher stage than the first cancer. Physicians are now more aware of the importance of careful monitoring of the second breast after ipsilateral mastectomy, and improvements have been made in mammographic surveillance. A retrospective, comparative analysis of two separate breast cancer populations at risk for bilateral breast cancer was done on patients who entered into the system before effective mammographic monitoring (BEM) and after effective mammographic monitoring (AEM). The first group of patients consisted of 500 consecutive patients with primary breast cancer diagnosed during the years 1969 through 1975, of whom 37 (7.4%) had bilateral breast cancer. The second group consisted of 557 consecutive patients diagnosed during the years 1977 through 1984, of whom 36 (6.5%) had bilateral breast cancer. The staging percentages of the second breast cancer in the BEM group were Stage 0, 5.4%; Stage I, 48.6%; Stage II, 10.8%; Stage III, 21.6%; and Stage IV, 13.5%. The second group had an improvement in stage, with 33.3% being Stage 0, 22.2% Stage I, 29.6% Stage II, 3.7% Stage III, and 3.7% Stage IV (P less than 0.05). The median interval between primary lesions was 39 months in the first group and 19 months in the second group (in part, this difference may represent increased identification of synchronous cancers). The second breast cancer was undetected by mammography in 9 of 34 (26%) patients. Six were detected by contralateral biopsy (all were lobular carcinomas in situ), and three were found by clinical examination (all were invasive cancers). It was concluded that more aggressive monitoring of the second breast by frequent clinical examination, mammography, and selected contralateral biopsy appears to have increased the early detection rate of second breast cancers in patients under observation.

Breast Neoplasms↗

Annulus fibrosus calcification in the cervical spine: radiologic-pathologic correlation.

Intervertebral disc calcification can be secondary to a variety of pathologic processes including some of the arthritides, metabolic diseases, and trauma. The annulus fibrosus is the most commonly calcified component and may mimic vertebral body fracture, limbus vertebra, or a persistent ring apophysis. We describe two young patients who developed calcification in the anterior annulus fibrosus and present radiologic-pathologic correlation in this condition in another case. This calcification may actually be secondary to subclinical or chronic stress on the involved intervertebral disc.

Adult↗

The clinical outcome of needle aspirations of the lung when cancer is not diagnosed.

One hundred thirty-two of 397 consecutive percutaneous fine needle aspirations done at the University of Virginia between January, 1979, and December, 1984, for pulmonary lesions showed no evidence of cancer on cytological examination. We reviewed the presenting symptoms, radiographic findings on the day of needle aspiration, and the descriptive cytological terms to determine if it was possible to distinguish benign from malignant disease in these 132 patients. We found a specific benign diagnosis in only 16 (12%) of the 132 patients, and 1 of them ultimately was found to have cancer. In the remaining 116 patients, analysis of age, sex, smoking history, presenting symptoms, radiographic findings at the time of needle aspiration, and cytological terms other than malignancy did not enable distinction of benign from malignant disease as the cause of the radiographic finding. In the group of 132 patients without suggestion of cancer on initial cytological study, 38 (29%) were subsequently found to have a malignant process.

Adolescent↗

Dedifferentiated chondrosarcoma: radiographic features.

Dedifferentiated chondrosarcomas, unlike ordinary chondrosarcomas, are highly aggressive tumors that frequently metastasize. The lesion is characterized by a lytic intraosseous or extraosseous soft-tissue mass that is devoid of the calcifications that are usually associated with a chondroid tumor. We describe the radiographic and pathologic features of five cases involving dedifferentiated chondrosarcoma.

Acetabulum↗

Atypical carcinoid of the lung: radiographic features.

Atypical carcinoid of the lung is a neuroendocrine neoplasm with cellular and clinical features intermediate between those of typical carcinoid and small cell undifferentiated carcinoma of the lung. These neoplasms exhibit a wide range of histologic appearances and are misdiagnosed in up to 50% of cases. The clinical records and radiographs of 32 patients with this diagnosis from the University of Virginia Medical Center and Wake Forest University Medical Center were reviewed. Sixteen of these cases had been misdiagnosed pathologically. While the most frequent radiographic finding was a round or avoid lobulated peripheral mass, other appearances included thin-walled cavities, poorly defined nonsegmental infiltrates, and mediastinal masses. Fifty percent of the patients in this study have died from their tumor, with a mean survival of 15.5 months. This contrasts with both typical carcinoid and small cell undifferentiated carcinoma, in which patients develop fatal metastatic disease in 5% and nearly 100%, respectively. Proper categorization of typical carcinoid, atypical carcinoid, and small cell undifferentiated carcinoma is necessary to determine appropriate therapy, prognosis, and reporting of end results.

Adult↗