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PubMed1995

Iliopsoas compartment: normal anatomy and pathologic processes.

The iliopsoas compartment is an extraperitoneal space that contains the greater psoas, smaller psoas, and iliac muscles. Many pathologic processes may involve the iliopsoas compartment, including inflammatory, hemorrhagic, and neoplastic conditions. Psoas muscle infection is usually due to direct extension from contiguous structures. With the decreasing incidence of tuberculosis, the majority of psoas abscesses now encountered have a pyogenic origin. Hemorrhage into the psoas muscle can be spontaneous or secondary to various conditions. Neoplastic involvement of the psoas muscle is usually due to contiguous spread and is rarely primary. With the refinement of imaging modalities, there has been increased recognition of diseases that involve the iliopsoas compartment. Although these conditions may look similar radiologically, they can be correctly diagnosed by combining the radiologic findings with the clinical history. Biopsy is effective in diagnosis of such conditions; aspiration and drainage are effective in both diagnosis and therapy.

Abscess↗
PubMed2006

P2Y1 receptors mediate inhibitory purinergic neuromuscular transmission in the human colon.

Indirect evidence suggests that ATP is a neurotransmitter involved in inhibitory pathways in the neuromuscular junction in the gastrointestinal tract. The aim of this study was to characterize purinergic inhibitory neuromuscular transmission in the human colon. Tissue was obtained from colon resections for neoplasm. Muscle bath, microelectrode experiments, and immunohistochemical techniques were performed. 2'-deoxy-N(6)-methyl adenosine 3',5'-diphosphate tetraammonium salt (MRS 2179) was used as a selective inhibitor of P2Y(1) receptors. We found that 1) ATP (1 mM) and adenosine 5'-beta-2-thiodiphosphate (ADPbetaS) (10 microM), a preferential P2Y agonist, inhibited spontaneous motility and caused smooth muscle hyperpolarization (about -12 mV); 2) MRS 2179 (10 microM) and apamin (1 microM) significantly reduced these effects; 3) both the fast component of the inhibitory junction potential (IJP) and the nonnitrergic relaxation induced by electrical field stimulation were dose dependently inhibited (IC(50) approximately 1 microM) by MRS 2179; 4) ADPbetaS reduced the IJP probably by a desensitization mechanism; 5) apamin (1 microM) reduced the fast component of the IJP (by 30-40%) and the inhibitory effect induced by electrical field stimulation; and 6) P2Y(1) receptors were localized in smooth muscle cells as well as in enteric neurons. These results show that ATP or a related purine is released by enteric inhibitory motoneurons, causing a fast hyperpolarization and smooth muscle relaxation. The high sensitivity of MRS 2179 has revealed, for the first time in the human gastrointestinal tract, that a P2Y(1) receptor present in smooth muscle probably mediates this mechanism through a pathway that partially involves apamin-sensitive calcium-activated potassium channels. P2Y(1) receptors can be an important pharmacological target to modulate smooth muscle excitability.

Adenosine Diphosphate↗
PubMedDate not supplied

Fine needle aspiration cytology in the diagnosis of non-Hodgkin's lymphomas of the muscle: a report of 2 cases.

BACKGROUND: Primary skeletal muscle lymphoma has been reported in very few cases. Although such imaging techniques as computed tomography and magnetic resonance imaging can supply diagnostic indications, the most reliable data are obtained by means of muscle biopsy investigations. Fine needle aspiration cytology (FNAC) has not been considered before for the diagnosis of muscle lymphoma. CASES: In case 1, 60-year-old man presented with 2 masses in the pectoral muscle and neck. FNAC of the neck mass was performed. The diagnosis was non-Hodgkin's diffuse B-cell lymphoma of the muscle; the diagnosis was confirmed by surgical biopsy of the pectoral muscle. In case 2, a 70-year-old man presented with a mass in the quadriceps muscle. The results of FNAC aroused suspicion of lymphoma, and a muscle biopsy confirmed the presence of a non-Hodgkin's B-cell lymphoma. Immunohistochemistry identified it as non-Hodgkin's marginal zone B-cell lymphoma of MALT type. CONCLUSION: FNAC can be a valuable starting point in muscle involvement by lymphoma because of the possibility of obtaining material by means of multiple aspirations without causing patients any discomfort.

Aged↗
PubMed2002

Intramuscular hemangioma of the posterior belly of the digastric muscle failing to highlight on magnetic resonance imaging.

Intramuscular hemangiomas of the digastric muscle are rare. We present the fifth case reported and the second to be imaged in vivo with magnetic resonance imaging. Accurate preoperative diagnosis of these lesions is difficult, but may be facilitated by a high degree of clinical suspicion and imaging. Magnetic resonance imaging using T2-weighted sequencing has been reported to effectively highlight these lesions. We present a case in which magnetic resonance imaging failed to highlight an intramuscular hemangioma of the posterior belly of the digastric muscle. Possible reasons for this failure are discussed.

Adolescent↗
PubMed1988

A test for muscle lesions and their regeneration following intramuscular drug application.

A standard infiltration of the rat tibialis anterior muscle with 0.1 ml of local anesthetics was used as a model to help choose criteria for testing the intramuscular toxicity of drugs. Anesthetics used were 0.2% carbisocaine, 1% and 2% Lidocaine, 0.5% Marcaine, 1% and 2% Mesocaine, 1% and 2% Procaine. Increases in the serum levels of creatine kinase were monitored for 24 hours, and the weight, as well as macro- and microscopic changes in the muscle for a period of 1 month. Exposure of the muscle to local anesthetics resulted in 2 types of lesions. One was characterized by selective muscle fiber damage in the injected area. The other type of lesion was a generalized one that involved a number of cell types. To assess the intramuscular toxicity of drugs we defined the type of lesion, its size, and the rate of subsequent muscle regeneration. We recommend the following criteria for the assay of myotoxicity of new drugs being developed as pharmaceutical agents: 1) serum creatine kinase level 1 hour after intramuscular injection of the drug; 2) microscopic findings at 3, 7, and 21 days; 3) the cross-sectional area of the lesion at 3 days; and 4) the weight of the muscle at 7 and 21 days.

Anesthetics, Local↗
PubMed2000

Cavernous hemangioma behaving like peroneal tenosynovitis.

Hemangioma of the tendon sheath is rarely reported. In this case report, a 22-year-old man, who had been seen for peroneal tenosynovitis before (although symptoms remained) was reevaluated. A cavernous hemangioma was located in the peroneal muscle and the tendon. Complete excision was performed.

Adult↗
PubMed1980

Angiography of duodenal leiomyomas and leiomyosarcomas.

Five duodenal smooth muscle neoplasms (two leiomyomas and three leiomyosarcomas) are reported. All occurred in the lower second part of the duodenum, and the angiographic findings were similar to those of myomatous tumors occurring elsewhere in the gastrointestinal tract. The leiomyomas were hypervascular with sharply demarcated margins. The leiomyosarcomas were hypervascular with sharply demarcated margins. The leiomyosarcomas were larger and less vascular than the leiomyomas and had indistinct margins. However, local invasion and metastases were definite signs of malignancy. One of the patients with a leiomyoma was examined because of active bleeding, and the hemorrhage was controlled by selective embolization.

Angiography↗
PubMed1997

MR imaging of skeletal muscle metastases.

OBJECTIVE: The purpose of this article is to describe the MR imaging appearance of skeletal muscle metastases. CONCLUSION: Skeletal muscle metastasis must be considered in patients with a known primary carcinoma who present with a painful muscle mass. Muscle metastasis may be the initial presentation of carcinoma. The MR imaging appearance, although not specific, may provide clues to the diagnosis.

Female↗
PubMed2002

Intramuscular myxoma: characteristic MR imaging features.

OBJECTIVE: The purpose of our study was to identify the characteristic MR imaging features of intramuscular myxoma. MATERIALS AND MATERIALS: We retrospectively reviewed the MR imaging features of 20 patients with intramuscular myxoma. Clinical assessment included the age and sex of the patient and location of the tumor. Radiologic evaluation included the lesion size and shape, border definition, signal on T1- and T2-weighted or fluid-sensitive MR sequences, enhancement pattern, presence or absence of a fat rind, and presence or absence of increased signal in the adjacent muscle on T2-weighted or fluid-sensitive MR sequences. RESULTS: The mean age of patients presenting with intramuscular myxoma was 61 years (range, 15-85 years; median, 64 years). The mean lesion size was 6.9 cm (range, 3-17 cm; median, 6.3 cm). A peritumoral fat rind was present in 13 of the patients (65%) with myxoma, and an increased signal in the adjacent muscle on fluid-sensitive sequences was present in 11 patients (55%). Intramuscular myxomas were homogeneously low in signal intensity on T1-weighted MR sequences in 19 patients (95%), with all lesions showing a high signal intensity on T2-weighted or fluid-sensitive MR sequences. Twelve of the myxomas had well-defined borders, and eight had borders that were partially ill defined. Of the 11 lesions imaged after gadolinium administration, six (55%) showed intense heterogeneous enhancement. CONCLUSION: Findings of a mass that on MR images shows a perilesional fat rind, the signal intensity of fluid, and an increased signal in the adjacent muscle on T2-weighted or fluid-sensitive MR sequences are strongly suggestive of intramuscular myxoma. The degree of lesion enhancement varies but is most frequently intense and heterogeneous. Although the recognition of these features likely will not obviate biopsy of any individual lesion, it will allow more accurate prebiopsy diagnosis and preoperative planning.

Adolescent↗
PubMed1997

Evolution of AIDS and AIDS related malignancies in pediatric patients in the United States.

The pediatric AIDS epidemic began in the U.S.A. between 1983 and 1985. Hemophilia patients were among the first victims of this disease with the majority of these patients infected prior to 1984. At the South Texas Hemophilia Center 69 of 108 patients less than 21 years of age demonstrated serologic evidence of infection. Of these patients, 6 subsequently developed malignancies between 1987 and 1994. Between 1992 and 1996 data was subsequently accumulated on the development of malignancy in HIV positive patients through the Pediatric Oncology Group, which to date has enrolled 24 HIV positive children with malignancy. In these studies the majority of patients had B cell, non-Hodgkin's lymphomas, however approximately 20% of the patients were identified with leiomyosarcomas. Histologic studies of tumors of 6 children with AIDS and leiomyosarcomas or leiomyoma identified the EBV receptor or CD 21 in the tumor using immunoperoxidase techniques, whereas similar staining was not seen in smooth muscle tumors from HIV negative children. In situ hybridization techniques identified EBV-EBER probe in the tumors from HIV positive patients. In 2 patients with adequate tumor tissue EBV genome was present in high concentration using PCR techniques and Southern blot studies showed a monoclonal and biclonal proliferation. Other laboratories have reported similar EBV findings in lymphomas from AIDS patients. Thus EBV appears to be an important cofactor in development of malignancy in pediatric AIDS patients.

AIDS-Related Opportunistic Infections↗
PubMed2005

Skeletal muscle metastasis secondary to cancer--a report of seven cases.

Cancer metastasis to the skeletal muscle is very rare. In this report, we describe 7 cases (6 males, 1 female, age 55-76, mean 66 y.o.) with unusual presentation of cancer metastasis to the skeletal muscle, illustrating the principal clinical, radiographic and histologic features. The primary tumors were lung cancer in 4 cases (3 adenocarcinomas, 1 squamous cell carcinoma) and renal cell carcinoma, esophageal carcinoma, hepatocellular carcinoma in each one. The metastatic sites were the adductors, iliopsoas, rectus femoris, biceps bracii, triceps bracii, deltoid, and paravertebral muscle in each one. The unusual sites of metastases were visualized by CT and/or MRI and confirmed by needle or trocar biopsy. Five patients died in 2 to 24 months with the average of 8 months after initial examination.

Aged↗