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Computed tomography of diffuse pulmonary haemorrhage with pathological correlation.

The utility of computed tomography (CT) is well established in patients with chronic interstitial lung disease. There are currently no descriptions of the CT appearances of diffuse pulmonary haemorrhage. The CT findings of six patients with diffuse pulmonary haemorrhage are presented. Pathological correlation from open lung biopsies in two of these patients provided a pathological basis for the CT appearances. All six patients had diffuse nodular opacities with no zonal predominance. The nodules were of uniform size in any single patient but varied (1-3 mm diam.) between patients. Patchy areas of 'ground-glass' opacification of the lung parenchyma due to recent haemorrhage was associated with apparent prominence of the segmental bronchi and obscured the background nodularity. The CT findings were similar in all six patients and, although not pathognomonic, awareness of the CT features described should raise the possibility of the diagnosis.

Adult↗

Major salivary gland tumours in a rural Kenyan hospital.

BACKGROUND: Salivary gland tumours are not well characterised in Africa. The Kijabe Hospital Pathology Laboratory operates a pathology service utilised by twenty one church/mission hospitals and thus has accumulated data from many parts of Kenya regarding major salivary gland neoplasms. OBJECTIVE: To review the specimens in order to help understand the spectrum of the salivary gland neoplasms in Kenya. DESIGN: Data on all major salivary gland tumours examined over the study period were obtained from the Pathology department computer database. Basic information on age, tribe, pathological diagnosis and site of the tumour were available for analysis. SETTING: A rural hospital in Kenya with a pathology service serving 21 church/mission hospitals throughout Kenya. SUBJECTS: All major salivary gland neoplasms examined in the pathology laboratory over the period January 1992 to December 1999. MAIN OUTCOME MEASURES: Age, tribe, pathological diagnosis, site of specimen. RESULTS: Over the period 1992 to 1999, 135 major primary salivary gland neoplasms were examined. Amongst 103 parotid tumours, 46% were pleomorphic adenomas and 19% were monomorphic adenomas. Consistent with other studies from sub-Saharan Africa, the Warthin's tumour was rare. The commonest malignant tumour was the mucoepidermoid carcinoma comprising 14% of specimens. Thirty two submandibularneoplasms are described. The commonest tumour was the pleomorphic adenoma (78%) and the commonest malignant tumour was the mucoepidermoid carcinoma (9%). CONCLUSIONS: Compared with other African studies, these figures are similar although in Kenya there is a predominance of monomorphic adenomas. Compared with Western studies there is an increased ratio of malignant to benign tumours and Warthin's tumours are much less common in Africa.

Adenocarcinoma↗

Comparison between computed tomography and magnetic resonance data and pathologic findings in substernal goiters.

Computed Tomography (CT) and Magnetic Resonance (MR) permit the acquirement of important diagnostic elements for the anatomo-topographic staging of substernal goiters, and for their characterization. The authors compared data obtained by CT and MR with intraoperative anatomo-topographic findings and definitive histology in 28 patients with substernal goiters. CT was performed in all these patients while MR only in 9. The results obtained showed an accuracy of 85.7% for CT and 100% for MR regarding the anatomo-topographic correspondence with intraoperative findings, without a significant statistical difference between these two diagnostic procedures. MR is more accurate than CT in showing the vascular dislocations. CT and MR have an accuracy of 82.1% and 77.7% respectively comparing their findings with histologic results obtained in operative specimens, without a significant statistical difference. In conclusion MR has to be considered the more accurate diagnostic procedure and therefore recommended in the study of patients with substernal goiters, while CT can be performed only in selected patients.

Adult↗

Pathology accessioning and retrieval system with encoding by computer (PARSEC). A microcomputer-based system for anatomic pathology featuring automated SNOP coding and multiple administrative functions.

A pathology accessioning and retrieval system with encoding by computer (PARSEC) has been developed, employing a relatively inexpensive microcomputer. PARSEC performs a variety of administrative functions for anatomic pathology, including accessioning of surgical specimens, storage of patient demographic information, editing, retrieval, and archiving of patient data, as well as CAP (college of American Pathologists) workload units, billing, and inventory functions for histopathology. In addition, appropriate gross and microscopic descriptions and pathologic diagnoses can be entered into the system by a text editor. Automatic assignment of SNOP (Systematized Nomenclature of Pathology) codes, is accomplished via an online SNOP lexicon, allowing the ultimate generation of completed surgical pathology reports. The data base management system employed makes optimum use of disk storage space, while permitting rapid data retrieval. Data file maintenance is automatically accomplished by the system, requiring no user intervention.

Computers↗

[Information provided by X-ray computed tomography in adrenal pathology].

After a brief review of the circumstances in which CT scan of the adrenal glands may be carried out, the following are discussed: the role of CT scan in the diagnosis of pheochromocytoma, in functional pathology of the cortex (hyperplasia or tumor) and the problem of incidentalomas. CT scan, a simple examination with immediate and reliable results, enables percutaneous biopsy to be carried out with complete safety.

Adrenal Gland Diseases↗

[Diagnostic contribution of computer tomography in muscular pathology].

CT analysis in 26 patients with well-identified muscle diseases, and 4 normal controls was performed to evaluate its diagnostic interest. Scans were obtained through pelvis, thigh and calves at comparable levels in all subjects. Results showed that elementary changes were devoid of specificity and density measurements did not significantly increase the diagnostic significance of images. A good correlation was found between the degrees of CT changes and clinical evaluation of the muscles. However, CT allowed a more precise study of abnormalities in muscles difficult to assess clinically and, in all pathological cases, led to a clear analysis of the topography and the selectivity of the pathological process. If safety criteria are fulfilled, CT would allow a precise follow-up study of muscle atrophies.

Charcot-Marie-Tooth Disease↗

[X-ray computed tomography in venous pathology].

After presenting the tomodensitometric semiology of venous thromboses in various territories, the authors define its indications. It is essentially in deep territories, head, chest and abdomen that the CT-Scan is used to study and diagnose unrecognized thromboses as well as determine the venous repercussion of various neighboring ailments. The respective place of the CT-Scan, ultrasonography and various phlebographies is analyzed.

Humans↗

[The posterior interparieto-peritoneal or retroperitoneal spaces. 2: Pathological x-ray computed tomographic image].

The old reports about the interparieto-peritoneal spaces described particularly the renal space and its environment. The CT scan has modified the in vivo study of the extraperitoneal spaces (E.P.S.) and brought the question of the acquired knowledge up again. An anatomical research was performed in the first part of this study which describes the structures limited between the parietalis fascia and visceral peritoneal fascias. These are the true EPS which the main element is the propria fascia of Sappey (lateroconal fascia) and its anterior and posterior renal double layers. All these lamellar structures limits spaces variably infiltrated with fat tissue: the anterior pararenal space almost virtual, the posterior pararenal space which continues till the Bogros space and the anterior and posterior renal spaces of the renal compartment which the fat continues till the bladder and accompanies the ureter. The second part of this study precises some notions of general topography which are necessary for reading abnormal CT scan images. This part reminds the aortic and arterial general organization of the vertebrates as described by Mackay. It underlines the architectural importance of the three areas so defined: parietal or peripheral, intermediate or mesoblastic genitourinary and deep lateral or digestive endoblastic. These three areas corresponds to the three vascular aortic circles. It emphasized the importance to accept in practice the notion of visceral joining fascia which has been proved in adult people. The longitudinal architecture of the compartments is precise with respect to their appartenance to one among the three arterial arches of Mackay. What the anatomy suggest, the pathology can prove. Several pathological processes are studied on CT scan: large hemorrhagic or necrotic collections in acute pancreatitis, abnormalities or diseases of renal or adrenal compartments, extraperitoneal mesenchymomas, diseases of the psoas compartment. All these observations are analysed in order to explain anatomical and CT scan findings. This study refers not only to the oldest researches which are still valuable but also to the most recent controversies. All the questions are not solved using the clearest schemes.

Abdomen↗

[Sialographic and computed tomographic studies in pathology of the major salivary glands].

A retrospective study is reported which took place over 3 years (1986-1989) and included 99 patients (57 men and 33 women, age range 8-90 years) with lesions attributable to salivary gland diseases. Patients were examined using CAT and sialographic tests. From an analysis of the results it is clear that sialography retains its importance as a means of diagnosis in inflammatory diseases, calculosis and autoimmune disorders, whereas CAT should be used as the preferential diagnostic test for neoplastic lesions.

Adult↗

Pleomorphic carcinoma of the pancreas: computed-tomographic, sonographic, and pathologic findings.

We present a series of eight cases of pleomorphic carcinoma of the pancreas, an uncommon lesion that contains bizarre giant cells and resembles sarcoma histologically. To our knowledge, this entity has not been described in the radiological literature. Clinical symptoms are similar to those of the usual pancreatic ductal cell carcinoma, but at presentation the primary tumor mass is usually large, and widespread metastatic disease is present. The most striking finding is massive lymphadenopathy, which may mimic lymphoma. A combination of clinical history, imaging findings, and results of percutaneous biopsy should lead to the proper diagnosis and may help to differentiate this entity from others that may affect lymph nodes.

Adult↗

Computer data processing of medical diagnoses in pathology.

Modes of insertion of pathology diagnoses into a computer data storage and retrieval system are reviewed. The conversion of free-flowing diagnostic sentences into internal code is considered, and the advantages of coding are discussed from two aspects: (a) to minimize storage, and (b) to help alleviate difficulties in retrieval of synonymous terminology. Methods of manually pre-coding diagnoses into Systemized Nomenclature of Pathology (SNOP) code are discussed. Data encoding produces a fixed format record which provides significant economy in data handling. The potential use of a real-time visual display unit in data gathering and automatic coding is presented.

Diagnosis, Computer-Assisted↗

[Value of x-ray computed tomography in muscular pathology. Personal cases and review of the literature].

The authors have studied the advantage of CT scans in muscular pathology. The scan, in addition to the diagnosis of tumors and muscular abscesses, permits to differentiate primary myopathies from neurogenic atrophies: in the course of myopathies, the muscle volume is preserved and they appear as a hypodensity; in neurogenic atrophies, the muscle volume is reduced with preserved density. The CT scan permits to determine the extension of these lesions. In the course of polymyositis, certain forms of rheumatoid arthritis, the scan discloses a trabecular and "worm-eaten" aspect of the muscles. This is also observed after long-term steroid therapy and other endocrine diseases (hyperthyroidism, osteomalacia) indicating an infra-clinical myopathy. In vertebral osteoporosis with fractures and patients with chronic lumbalgia, very often, an atrophy of the spinal muscle is observed. Finally, in the course of acquired kyphosis of the adult patient (camptocormia), the CT scan suggest an isolated myopathy, with late manifestations, of the paravertebral muscles.

Adult↗