Perforation of the Colon During Imatinib Mesylate (Gleevec) Treatment in a Patient with Chronic Myeloid Leukemia (CML).

Imatinib (Gleevec; STI-571) is a tyrosine-kinase inhibitor (TKI) used in the treatment of multiple cancers, most notably Philadelphia chromosome-positive (Ph+) chronic myelogenous leukemia (CML) as well as gastrointestinal stromal tumor (GIST). The most common adverse effects with imatinib include superficial edema, muscle cramps, musculoskeletal pain, rash, fatigue, headache, and gastrointestinal side effects. Less frequent side effects include pancytopenia, febrile neutropenia, flushing, and liver function test abnormalities.

High dose radiation therapy and chemotherapy as induction treatment for stage III nonsmall cell lung carcinoma.

Background: The current study was conducted to review the authors' experience in treating consecutive patients with American Joint Committee on Cancer (1997 revision) Stage III nonsmall cell lung carcinoma with aggressive preoperative chemoradiation followed by surgical resection.

Methods: The records of all patients who received preoperative chemoradiation were evaluated. Patients received 2 cycles of concurrent cisplatin and etoposide with 5940 centigrays of radiation therapy.

A case of giant cell myocarditis and malignant thymoma: a postmortem diagnosis by needle biopsy.

This paper reports a case of fulminant giant cell myocarditis arising in association with a malignant thymoma causing death in a 46-year-old woman. Although the diagnosis was suspected in life, postmortem examination was required for confirmation of giant cell myocarditis. Consent was obtained only for percutaneous needle biopsy of the heart.

Prevalence of pathologically proven intrapulmonary lymph nodes and their appearance on CT.

Objective: The objective of this study was to assess the prevalence of pathologically proven intrapulmonary lymph nodes and to evaluate their appearance on CT.

Materials And Methods: Over a 15-year period (1980-1994), 184 patients underwent minithoracotomies for evaluation of CT-detected peripheral pulmonary abnormalities. Of these 184 patients, 96 had well-circumscribed peripheral pulmonary nodules.

Chromic phosphate therapy in carcinoma of the ovary.

Background: Adjuvant therapy with intraperitoneal (IP) chromic phosphate (P-32) instillation in both early and advanced carcinoma of the ovary requires adequate intra-abdominal distribution for maximum therapeutic benefit. Abdominal-pelvic computed tomographic (CT) scanning with water-soluble IP contrast to establish the absence of intra-abdominal adhesions prior to P-32 instillation has not been previously reported.

Study Design: Sixteen patients with carcinoma of the ovary who were offered IP P-32 therapy between January 1988 and December 1992 were retrospectively reviewed.

Fine-needle aspiration biopsy of pancreatic ductal adenocarcinoma: loss of diagnostic accuracy with small tumors.

Eighty-three patients underwent CT-directed fine-needle aspiration biopsies (FNAB) for pancreatic ductal adenocarcinoma. Five factors that might have influenced the diagnostic sensitivity of FNAB were analyzed: clinical history, the number of passes for each FNAB, and three radiologic criteria including tumor size, tumor location, and the presence or absence of suspected tumor necrosis by CT scan. Sixty-three patients had a diagnosis of pancreatic carcinoma confirmed by FNAB (overall sensitivity = 76%).

N2 lung cancer: outcome in patients with false-negative computed tomographic scans of the chest.

Over the past 13 years 681 consecutive patients have undergone computed tomographic staging and surgical staging of the mediastinum. Five hundred one tested negative for mediastinal lymph node enlargement by computed tomographic staging, and 37 of these patients had cancerous mediastinal lymph nodes at thoracotomy (n = 36) or mediastinoscopy (n = 1). The survival in this group of patients was analyzed according to T status, central or peripheral location of tumor, cell type, areas of mediastinum that are involved, and extent of nodal involvement with tumor.

Long-term results after Russe bone-grafting: the effect of malunion of the scaphoid.

Twenty-five patients had Russe anterior corticocancellous bone-grafting between 1973 and 1984 for twenty-six symptomatic established non-unions of the scaphoid. The mean duration of follow-up was eleven years (range, seven to eighteen years). Twenty-one (81 per cent) of the twenty-six scaphoid bones united.

Lymphadenopathy in sclerosing cholangitis: pitfall in the diagnosis of malignant biliary obstruction.

We retrospectively reviewed abdominal computed tomographic (CT) studies from 20 patients with sclerosing cholangitis and found evidence of abdominal lymphadenopathy in 13 patients. Enlargement occurred primarily in areas draining the liver, such as the gastrohepatic ligament or celiac axis (N = 8), the porta hepatis (N = 7), and the pancreaticoduodenal region (N = 2). One patient had reactive adenopathy and retroperitoneal fibrosis.

Computed tomography-guided minithoracotomy for the resection of small peripheral pulmonary nodules.

Small peripheral pulmonary nodules ranging in size from 1 mm to 20 mm were excised in 58 patients. Computed tomography was used to mark the skin overlying the nodules to minimize the surgical exposure needed for operative identification. The nodules were 1 cm or less in maximum diameter in 76% of the patients.

Fine needle aspiration biopsy in the diagnosis of renal angiomyolipoma.

Exclusive reliance on radiographic techniques for the diagnosis of renal angiomyolipoma can lead to misdiagnosis when the histological status is atypical, computerized tomographic findings are equivocal or renal cell carcinoma coexists. We report our experience and those of others in combining fine needle aspiration biopsy and radiological imaging to identify renal angiomyolipoma. Fine needle aspiration biopsy is safe and provides accurate histological diagnosis of renal angiomyolipoma.

Clinically significant adrenal hemorrhage secondary to metastases. Computed tomography observations.

Clinically significant adrenal hemorrhage due to adrenal metastases has rarely been reported. We describe three cases of this unusual entity, two from lung carcinoma and one from sarcoma. Adrenal hemorrhage was bilateral in two patients, and was the presenting manifestation of malignancy in two.

Lymphadenopathy in primary biliary cirrhosis: CT observations.

The authors retrospectively evaluated computed tomographic (CT) scans obtained in 21 patients with primary biliary cirrhosis, 13 of whom subsequently underwent liver transplantation. Evidence of enlarged lymph nodes, primarily in the gastrohepatic ligament and porta hepatis, was seen on CT scans in 17 patients (81%). Lymphadenopathy also occurred in unusual sites for benign adenopathy, including the paracardiac (24%) and mesenteric (19%) lymph nodes.

Parathyroid adenoma associated with neurofibromatosis: correlative scintigraphic and magnetic resonance imaging.

Correlative imaging by dual-isotope thallium/technetium subtraction scintigraphy, computed tomography, and magnetic resonance imaging demonstrated a pathologically proven parathyroid adenoma in a 62-year-old man with known neurofibromatosis, who presented with hypercalcemia and an elevated parathormone level. The association between neurofibromatosis and primary hyperparathyroidism is discussed.

Percutaneous fine needle aspiration biopsy using a modified coaxial technique.

A modified coaxial technique for the biopsy of small or deeply situated lesions using computed tomographic (CT) guidance is described. A 22-gauge needle was passed coaxially through an outer 18-gauge introducing needle and aspiration biopsy was performed. This modified coaxial technique allows for multiple biopsies to be obtained safely, expeditiously, and repeatedly.

A comparative study of magnetic resonance imaging versus computed tomography for the evaluation of maxillary and mandibular tumors.

The relative value of magnetic resonance imaging (MRI) versus computed tomography (CT) for imaging benign and malignant lesions of the maxilla and mandible was studied in a group of 16 patients. The imaging methods were evaluated for their ability to detect the lesion and define lesion margins, soft tissue extension, and bone involvement. The abnormality was identifiable with both imaging methods.

Computed tomography in evaluation of blunt renal trauma. Potential for misdiagnosis of renal infarction.

A case of global renal infarction resulting from blunt renal trauma is presented. The cortical 'rim sign' on computed tomographic (CT) scanning is suggestive of major renal arterial occlusion. Clinicians who use CT scanning as the initial imaging modality for the evaluation of blunt kidney trauma should be aware of this sign and its implications for management.

Mediastinal lymph node evaluation by computed tomography in lung cancer. An analysis of 345 patients grouped by TNM staging, tumor size, and tumor location.

To more clearly characterize the role of computed tomography in staging the mediastinal lymph nodes of patients with lung cancer, we analyzed computed tomographic and surgical findings in the chest in 345 consecutive patients with lung cancer who underwent operative staging. Patients were grouped according to the TNM staging system of the American Joint Commission, central or peripheral location of the primary tumor, lobar location of the tumor, and maximum tumor diameter as determined by computed tomography or gross pathology. One third of patients with abnormal findings on the computed tomographic scan did not have mediastinal lymph node metastases.

Computerized tomographic evaluation of tumors of the nasopharynx and maxillary sinus: potential impact on results of treatment.

A review of 23 consecutive patients with tumors of the nasopharynx and maxillary sinus seen over a two-year period was carried out. The purpose was to assess the value of computerized tomography (CT) in the definition of tumor extension to contiguous structures and its effect on treatment selection and management.CT was found to be very useful in detailing bone and soft-tissue invasion.

Use of computed tomography in the preoperative evaluation of patients with head and neck tumors.

Computed tomography (CT) is a sensitive, noninvasive radiographic technique which can produce detailed cross-sectional images of any anatomic region. The amount and accuracy of the information it provides far exceeds that produced by conventional radiographic techniques. The chemosurgeon can find CT scanning invaluable in his preoperative evaluation of patients with large, invasive head and neck tumors of cutaneous origin.