Complex radiation diagnosis of nephroptosis in children

This paper analyzes a comprehensive study of 45 children treated at the Unit of Urology, Children's Republican Clinical Hospital One, Ministry of Health of the Russian Federation. Twenty children operated on for second- and third-degree nephroptosis made up an individual group. Clinical, laboratory, and radiation studies were performed 8-25 years after surgical treatment, by using radiation diagnostic techniques, such as excretory urography, ultrasonography, dynamic scintigraphy, aortography, Doppler color mapping ultrasonography. The authors have analyzed the capacities of complex radiation diagnosis of orthostatic renal dysfunctions in children with nephroptosis and the long-term results of nephropexy.     

Complex radiation diagnosis of post-operative recurrent hepatic tumors

The postoperative course of the disease was studied in 63 patients operated on for malignant hepatic lesion in 1990-1998. The pattern of surgical intervention-caused hepatic changes, which is observed at ultrasonography, CT, MRI, angiography, and oil-injected CT is described. Recurrences took place at the site of resection (9.5%) and outside (34.9%). Their largest number (71%) occurred in the first postresectional year. Diagnostic difficulties arose in the differential diagnosis of postoperative inflammatory changes and tumor recurrences at the site of resection (17% false positive results). Contrast MRI and intraarterial iodized oil CT proved to be the most effective radiation diagnostic techniques.     

Fine needle aspiration biopsy in the diagnosis of intrathoracic masses.

During a 3.5-year period (January 1, 1987, to June 30, 1990) 420 percutaneous fine needle aspiration (FNA) biopsies were performed on 390 patients (309 males, 81 females) suffering from one or more intrathoracic, radiologically visible lesions. Aspirations were carried out using 21- or 23-gauge Chiba needles under fluoroscopic or computed tomographic control. The aspirates were used to make minibiopsies and cytologic smears. Diagnosis was possible in 373 cases (95.64%): on the first pass in 344 cases, on the second in 28 cases and on the third in 1. In 17 cases (4.36%) the aspirate was inadequate for diagnosis. There were complications in 10 cases (2.56%) (9 pneumothorax and 1 hemophtysis) requiring intensive care. The 373 percutaneous FNA biopsy diagnoses included 256 malignant tumors (68.63%), of which 234 were primary and 22 were secondary, and 117 benign lesions (31.37%), 5 of them neoplastic and 112 nonneoplastic. Three hundred two of 373 percutaneous FNA biopsy diagnoses were followed (80.96%). One hundred twenty-three follow-ups were histologic (40.73%), including secondary tumors, which could be compared with the primary histotype. Twenty-eight follow-ups were cytologic (9.27%), and 151 were clinical (50.00%), using progression of the disease or the beginning of chemoradiotherapy as a criterion for malignancy and a stable condition or regression of the lesion with nononcologic medical treatment as a criterion for benignity. Percutaneous FNA biopsy diagnoses were confirmed in 288 cases (221 true positives and 67 true negatives) and unconfirmed in 14 (1 false positive and 13 false negatives). Specificity, sensitivity, negative predictive value, positive predictive value and total diagnostic accuracy were, respectively, 98.52, 94.44, 83.75, 99.54 and 95.36%. The histologic typing accuracy of percutaneous FNA biopsy on 70 specimens of surgically removed malignant epithelial neoplasias was 70.00%. These results confirm that percutaneous FNA biopsy is a reliable method of diagnosing intrathoracic masses and reduces the need for diagnostic thoracotomy.     

Fine needle aspiration cytology and immunocytochemistry in a case of intrathoracic thyroid goiter

Fine needle aspiration (FNA) was performed in the case of a patient with an anterior mediastinal mass. Examination of the smears revealed individual and groups of benign nondiagnostic cells. Surgical removal and histologic examination indicated that the mass was a true intrathoracic thyroid goiter. Subsequent immunocytochemical studies on the FNA smears showed thyroglobulin in the cytoplasm of the aspirated cells. The cytologic findings are presented; while not diagnostic of a thyroidal origin in this case, they serve as a reminder of the wide range of cytologic appearances of colloid nodules and goiters. This case will hopefully heighten the awareness of cytologists and other physicians to the consideration of the possibility of intrathoracic goiter in the differential diagnosis of mediastinal lesions seen in fine needle aspirates.     

Current radiation diagnosis of pyelonephritis

The paper deals with the current diagnosis of nonspecific and specific (tuberculosis) acute and chronic pyelonephritis. Having rather ample materials (308 patients with different forms of acute and chronic pyelonephritis), the authors compared different introscopic techniques (plain X-ray study, excretory urography, retrograde pyelography, ultrasonography, computed tomography and angiography) used in the diagnosis and monitoring of patients with pyelonephritis. Based on their own findings and on the data available in the literature, the authors described the symptomatology of pyelonephritis in detail by using a great variety of diagnostic techniques. The paper shows the place and potentialities of conventional X-ray in a variety of current diagnostic studies and the potentialities of imaging techniques in recognizing pyelonephritis, assessing their extent and the reserve potentialities of the diseased kidney. The authors show that the rational use of routine and current radiographic techniques is of great diagnostic and prognostic value, enhances the efficiency of therapy for pyelonephritis, shortens treatment periods, reduces the number of radical nephrectomies by using organ-sparing operations more widely, and decreases mortality rates.     

Hemangiosarcoma of the thyroid gland. Histological diagnosis problems

A bleeding tumor of the thyroid gland in a 69-year-old woman is presented. Histologically, it was a hemangiosarcoma with proliferation and vessel neoformation: vascular-like clefts or distinct capillaries with tumoral endo- and perithelial structures were present. With reference to the published data, problems of differential diagnosis in the undifferentiated and giant cell carcinomas of the thyroid gland are discussed.     

Complex radiological diagnosis of pulmonary thromboembolism

Three hundred and twelve patients (210 males and 102 females) aged 47 to 69 years who had suspected pulmonary thromboembolism (PTE) were examined. All the patients received hospital treatment in the clinics of I.M. Sechenov Moscow Medical Academy for different diseases, such as coronary heart disease, chronic venous insufficiency, hypertensive disease, and postoperative condition. PTE was ascertained in 209 patients. The examination used a "Hi Speed CT/i" spiral computer tomograph (General Electric) and an "Aquilion" computer tomograph (Toshiba), a "Millennium" gamma-chamber, and a "Sequoia" high-resolution ultrasound apparatus (Acuson). An algorithm of examination of patients with suspected PTE has been developed.