Postpartum thrombotic complication in a patient with paroxysmal nocturnal hemoglobinuria.

Paroxysmal nocturnal hemoglobinuria (PNH) is a clonal nonneoplastic hematopoietic stem cell disease characterized by an acquired mutation of the PIG-A gene with reduction or absence of CD55 and CD59. The absence of these proteins renders PNH erythrocytes susceptible to complement-mediated hemolysis. We report the case of a PNH patient before and during pregnancy until delivery.

Contrast-enhanced ultrasound for characterizing lymph nodes with focal cortical thickening in patients with cutaneous melanoma.

Objective: The aim of this study was to ascertain the utility of contrast-enhanced ultrasound in assessing the significance of focal cortical thickening in the lymph nodes of patients followed up after surgery for cutaneous melanoma.

Materials And Methods: Ultrasound was used to examine 460 consecutive patients to identify nodes with focal hypoechoic cortical thickening. Patients whose nodes revealed these features underwent contrast-enhanced ultrasound and ultrasound-guided fine-needle aspiration cytology (FNAC) focusing on the area of cortical thickening.

Fine-needle aspiration cytology and (99m)Tc-pertechnetate scintigraphy together in patients with differentiated thyroid carcinoma.

The aim of this study was to evaluate the usefulness of fine-needle aspiration cytology (FNAC) and (99m)Tc-pertechnetate scintigraphy (TS) together in patients with differentiated thyroid carcinoma. Data from a series of 357 patients (284 women and 73 men, median age 43 years, range 19-73) with solitary thyroid nodule and no signs of hyperfunction, who had undergone both FNAC and TS prior to surgery, were retrospectively reviewed. FNAC distinguished 3 groups of TN (benign, follicular neoplasm, cancer), while patients with 'cold' TN were considered at risk of having a thyroid tumor.

Early (sentinel lymph node biopsy-guided) versus delayed lymphadenectomy in melanoma patients with lymph node metastases : personal experience and literature meta-analysis.

Background: It is debated whether patients with melanoma who undergo lymphadenectomy after a positive sentinel lymph node (SN) biopsy (SNB) have a better prognosis compared with patients who are treated for clinically evident disease.

Methods: The records of 190 patients with cutaneous melanoma who underwent radical lymph node dissection after a positive SNB (completion lymph node dissection [CLND]; n = 100) or who had clinically evident lymph node metastasis (therapeutic lymph node dissection [TLND]; n = 90) were analyzed. Moreover, the MEDLINE, EMBASE, and Cochrane databases were searched for studies that investigated the survival impact of SNB-guided CLND compared with TLND for clinically evident disease.

FNA cytology and frozen section examination in patients with follicular lesions of the thyroid gland.

Patients with solitary thyroid nodules should have fine-needle aspiration (FNA) cytology as the initial screening test, but the most of those referred to a surgeon usually undergo frozen section examination (FS). The aim of this retrospective study was to assess the usefulness of FNA cytology and FS together in patients with a solitary thyroid nodule (TN). Two-hundred and ten patients with a TN and FNA cytology suggesting follicular neoplasm underwent intraoperative FS and subsequent hemithyroidectomy or total thyroidectomy.

Intraoperative modification of a supracricoid laryngectomy to a subtotal laryngectomy with tracheohyoidoepiglottopexy.

In recent decades, with the widespread diffusion of the supracricoid laryngectomy in the treatment of selected advanced laryngeal neoplasm, the indications to non-conservative surgery are less frequent than in past. We report the case of a patient in whom a planned supracricoid laryngectomy was intraoperatively converted in an extended partial laryngectomy with tracheohyoidoepiglottopexy for a tumor involving the cricoid cartilage.

Meconium periorchitis: a rare cause of fetal scrotal cyst--MRI and pathologic appearance.

A case of meconium periorchitis detected by fetal MRI and misdiagnosed during pregnancy as inguinoscrotal hernia is reported for the first time. A full-term black boy presented at birth with an asymptomatic, 'stony-hard', scrotal mass suggestive of an in utero testicular torsion or testicular/paratesticular tumor. Early surgical treatment resulted in the removal of paratesticular yellowish amorphous material.

Usefulness of combined sestamibi scintimammography, axillary ultrasonography and FNA cytology in reducing the number of sentinel node procedures in patients with early-stage breast cancer.

Background: Intraoperative analysis of the sentinel lymph node (SLN) status is currently performed in patients with breast cancer (BC) undergoing surgery. Axillary node (AN) metastases are present in up to 60% of cases, but the risk is only 30% in patients with early stage (T1) BC. The aim of this study was to evaluate the usefulness of 99mTc-sestamibi scintimammography (SSM), axillary ultrasonography (US) and US-guided fine-needle aspiration (FNA) cytology together in detecting axillary metastases preoperatively and their potential role in reducing the number of SLN procedures.

Bisphosphonate-associated jawbone osteonecrosis: a correlation between imaging techniques and histopathology.

Objectives: Recently, jawbone osteonecrosis has been reported as a potential adverse effect of bisphosphonates administration. This paper considers and highlights histopathologic and radiologic features of this condition.

Study Design: Eleven patients, owing to unresponsiveness to conservative treatment and uncontrollable pain, underwent surgical resection of diseased jawbone after extensive hyperbaric oxygen therapy.

High risk of malignancy in patients with incidentally discovered adrenal masses: accuracy of adrenal imaging and image-guided fine-needle aspiration cytology.

Aims And Background: The incidental finding of nonfunctioning adrenal masses (incidentalomas) is common, but no reliable criteria in differentiating between benign and malignant adrenal masses have been defined. The aim of this preliminary study was to assess the usefulness of adrenal imaging and image-guided fine-needle aspiration cytology in patients with nonfunctioning adrenal incidentalomas with the aim of excluding or confirming malignancy before surgery.

Methods: Forty-two consecutive patients (18 men and 24 women; median age, 54 years; range, 25-75 years) with incidentally discovered adrenal masses of 3 cm or more in the greatest diameter were prospectively enrolled in the study.

Automated quantitative evaluation of lymph node perfusion on contrast-enhanced sonography.

Objective: The aim of this study was to assess the performance of experimental software (Qontraxt) intended to provide automated quantification of sonographic signal intensity, which is related to the contrast enhancement of lymph node tissue, to differentiate benign from malignant lymph nodes.

Subjects And Methods: In 31 patients (age range, 24-86 years; mean age +/- SD, 53.6 +/- 14.

Is there a role for arthroscopic synovectomy in oligoarticular juvenile idiopathic arthritis?

Objective: To evaluate the longterm efficacy and safety of arthroscopic synovectomy (AS) in children with oligoarticular juvenile idiopathic arthritis (JIA).

Methods: Patients with oligoarticular JIA and persistent monoarticular involvement, refractory to nonsteroidal antiinflammatory drugs (NSAID) and/or intraarticular corticosteroid (IAC) treatment underwent AS followed, one month later, by IAC. The efficacy of AS was prospectively evaluated, and a good response was defined as absence of synovitis or > or = 60% decrease in articular score from baseline.

Sensitivity and positive predictive value of CT, MRI and 123I-MIBG scintigraphy in localizing pheochromocytomas: a prospective study.

Aim: To establish a standardized non-invasive imaging protocol for patients with pheochromocytoma undergoing surgery.

Methods: A series of 32 consecutive patients (16 men, 16 women; median age 43 years, range 15-71 years) with biochemically confirmed pheochromocytoma underwent computed tomography (CT) scanning, magnetic resonance imaging (MRI) and meta-[I]iodobenzylguanidine (MIBG) whole-body scintigraphy prior to adrenalectomy or excision of extra-adrenal tumour (paraganglioma).

Results: At final pathology no malignant pheochromocytomas were found.

Usefulness and limits of ultrasound-guided hook-wire positioning for localisation of soft tissue lesions prior to surgery.

Purpose: The aim of our study was to assess the usefulness of positioning metal wires under ultrasound guidance for localising soft tissue lesions in the preoperative phase.

Materials And Methods: We studied superficial soft-tissue lesions in 12 patients, using hooked mammographic wires of different lengths. One patient had a multifocal growth of disease which required a double localisation procedure.

Role and cost-effectiveness of adrenal imaging and image-guided FNA cytology in the management of incidentally discovered adrenal tumours.

Incidentally discovered adrenal masses (incidentalomas) are relatively frequent and unsuspected incidentalomas (AI) of more than 1 cm in size may be found in 1-5% of patients who have undergone abdominal or chest computed tomography (CT)-scan for unrelated reasons. Once an AI is detected, the two major questions are whether the patient has biochemical evidence of adrenal hyperfunction, and whether the mass is an adrenal metastasis or a malignant adrenal tumour. In most cases (>90%) AI are non-functioning, with a low (<10%) risk of being malignant, and an estimated cumulative risk of malignant transformation of less than 1:1000.

Usefulness of 99mTc-pertechnetate scintigraphy and fine-needle aspiration cytology in patients with solitary thyroid nodules and thyroid cancer.

The aim of this study was to evaluate the accuracy of fine-needle aspiration (FNA) cytology and thyroid scintigraphy (TS) in patients with solitary thyroid nodules. We retrospectively reviewed a series of 657 consecutive patients (531 (80.8%) women and 126 (19.

Progressive bilateral sensorineural hearing loss probably induced by chronic cyclosporin A treatment after renal transplantation for focal glomerulosclerosis.

Objective: The immunosuppressive agent cyclosporin A (CsA) has contributed to the success of organ and bone marrow transplantation. CsA-related neurotoxicity is a well-known occurrence. Sensorineural hearing loss (SNHL) due to initiation of CsA treatment is an extremely rare finding.

Evaluation of lymph node perfusion using continuous mode harmonic ultrasonography with a second-generation contrast agent.

Objective: To evaluate the contribution of continuous mode contrast-enhanced harmonic ultrasonography (CE-HUS) with a second-generation contrast agent to the characterization of superficial lymphadenopathies with respect to conventional ultrasonographic techniques (B-mode and power Doppler).

Methods: Fifty-six lymph nodes from 45 patients were studied both by conventional techniques and by CE-HUS. The dimensions, intranodal architecture, margins, and location of vessels were evaluated.

High-sensitivity power Doppler imaging of normal superficial lymph nodes.

Purpose: This study was conducted to describe the various patterns of vascularity of the normal superficial lymph nodes detected using high-sensitivity power Doppler imaging according to the dimension and anatomic location of the nodes.

Subjects And Methods: A total of 712 lymph nodes (416 in the neck, 205 in the groin, and 91 in the axilla) were studied in 118 patients with high-sensitivity Power doppler. Three categories of vascularity were defined: absence of vascularity (type 1), hilar and perihilar vascularity (type 2), and vascularity in the entire node (type 3).

Craniocervical necrotizing fasciitis secondary to parotid gland abscess.

Necrotizing fasciitis is a potentially fatal soft-tissue infection that predominantly affects the abdominal wall, perineum and extremities. It is an uncommon clinical entity in the head and neck region and an exhaustive review of the English language literature disclosed reports on approximately 160 cases. Dental pathology, post-traumatic or iatrogenic skin or mucosa injuries and parapharyngeal or peritonsillar infections were the most frequently described origins.