Pediatric Cerebral Cavernous Malformations.

Cerebral cavernous malformations are the second most common vascular malformations in the central nervous system, and over one-third are found in children. Lesions may be solitary or multiple, be discovered incidentally, be sporadic, or be secondary to familial cavernomatosis or radiation therapy. Children may present with focal seizures, intracranial hemorrhage, or focal neurological deficits without radiological evidence of recent hemorrhage.

Splenogonadal fusion: a radiologic-pathologic correlation and review of the literature.

We present the case of a 29-year-old male who presented to his General Practitioner with a left testicular lump. Scrotal ultrasound examination revealed 4 well-defined, homogenous, mildly hypoechoic extratesticular mass lesions. He was referred for an urgent urological opinion and underwent local excision.

Renal vein leiomyosarcoma and renal cell carcinoma presenting together: A case report and discussion on the follow-up.

Leiomyosarcoma affecting the renal vein is rare, with about 30 documented cases in the English literature. The appearance on computed tomography can be difficult to interpret and is often confused with advanced renal cell carcinoma (RCC). This confusion can have implications on the perioperative care of patients presenting with this disease.

Testicular sarcoidosis masquerading as testicular carcinoma.

We present a case of a 27-year-old man with a history of weight loss. A chest x-ray demonstrated hilar lymphadenopathy and he was treated with anti tuberculosis treatment. He noticed a painless left scrotal swelling and a scrotal ultrasound scan raised the possibility of testicular cancer.

Can endoscopic ultrasound distinguish between mediastinal benign lymph nodes and those involved by sarcoidosis, lymphoma, or metastasis?

Background: Lymph nodes (LNs) echofeatures on endoscopic ultrasound (EUS) and concurrent fine needle aspiration (FNA) are alternatives to highly invasive approaches for etiologic diagnosis of mediastinal lymphadenopathy (MLAD).

Aims: To evaluate the efficacy of LNs echofeatures and FNA via EUS to distinguish benign LNs from LNs involved by sarcoidosis, lymphoma, and metastasis in non-lung cancer patients.

Methods: A retrospective review of patients who underwent EUS-FNA for MLAD was performed.

A case of mesenteric ischemia secondary to Fibromuscular Dysplasia (FMD) with a positive outcome after intervention.

Fibromuscular dysplasia (FMD) is a non-inflammatory, non-atherosclerotic angiopathy, which commonly affects the renal and internal carotid arteries. Although rare, FMD has the potential of involving the mesenteric vasculature. Due its low incidence and relatively little knowledge concerning its risk factors and etiology, actual diagnosis of FMD involving the mesenteric vessels requires a very high degree of suspicion.

Adult multilocular cystic nephroma: Report of six cases with clinical, radio-pathologic correlation and review of literature.

Background: Cystic renal neoplasms of the kidney can be benign or malignant. Multicystic nephroma (MCN) represents a rare benign cystic lesion of the kidney, which usually presents as a unilateral multicystic renal mass without solid elements. According to the World Health Organization (WHO) classification of the renal neoplasms, it is grouped along with mixed epithelial-stromal tumor of the kidney.

Changes in efficiency and resource utilization after increasing experience with double balloon enteroscopy.

Aim: To investigate changes in efficiency and resource utilization as a single endoscopist's experience increased with each subsequent 100 double balloon enteroscopy (DBE) procedures.

Methods: We reviewed consecutive DBE procedures performed by a single endoscopist at our center over 4 years. DBE was employed when the clinician deemed the procedure was needed for disease management.

Glycemic control after total pancreatectomy for intraductal papillary mucinous neoplasm: an exploratory study.

Background. Glycemic control following total pancreatectomy (TP) has been thought to be difficult to manage. Diffuse intraductal papillary mucinous neoplasm (IPMN) is a potentially curable precursor to pancreatic adenocarcinoma, best treated by TP.

Trainee participation is associated with increased small adenoma detection.

Background: Previous studies examining the effect of fellow participation on adenoma detection rate in colonoscopy have yielded conflicting results, and factors such as adenoma size and location have not been rigorously evaluated.

Objective: To examine whether fellow participation during screening, surveillance, or diagnostic colonoscopy affects overall, size-specific, or location-specific adenoma or polyp detection rate.

Methods: This was a retrospective study of 2430 colonoscopies performed in our ambulatory surgical center between September 2006 and December 2007, comparing adenoma and polyp detection rates of colonoscopies performed by fellows with supervising staff endoscopists (n = 318) with colonoscopies performed by staff endoscopists without fellow participation (n = 2112).

The learning curve of in vivo probe-based confocal laser endomicroscopy for prediction of colorectal neoplasia.

Background: Probe-based confocal laser endomicroscopy (pCLE) is an emerging tool for in vivo imaging of the GI tract that requires the endoscopist to interpret microscopic images. The learning curve for interpretation of pCLE images is unknown.

Objective: To examine the learning curve of correctly identifying benign and neoplastic colorectal lesions by using pCLE and to evaluate the learning curve of obtaining high-quality images.

An evaluation of risk factors for inadequate cytology in EUS-guided FNA of pancreatic tumors and lymph nodes.

Background: The factors associated with maximizing the cytological adequacy of EUS-guided FNA (EUS-FNA) in pancreatic tumor evaluation are not well-known.

Objective: To examine associations of physician and procedural factors with the endpoint: the presence of an adequate cytological specimen found by using EUS-FNA in patients with pancreatic tumors and lymph nodes.

Design: Retrospective cohort study.

Endosonographic features predictive of malignancy in mediastinal lymph nodes in patients with lung cancer.

Background: EUS is useful in determining mediastinal lymph node (LN) metastases in patients undergoing staging for lung cancer. However, FNA of LNs is often performed only if suspicious features are present. The utility of individual LN features in predicting malignant cytology remains unclear.

Variation in Barrett's esophageal wall thickness: is it associated with histology or segment length?

Goals: To measure esophageal wall thickness (EWT) with endoscopic ultrasound (EUS) in patients with and without Barrett's esophagus (BE).

Background: Segment length and histology are used to evaluate BE. The development of varying depths of ablation therapy has renewed interest in using EUS for BE.

Endoscopic spray cryotherapy for esophageal cancer: safety and efficacy.

Background: Few options exist for patients with localized esophageal cancer ineligible for conventional therapies. Endoscopic spray cryotherapy with low-pressure liquid nitrogen has demonstrated efficacy in this setting in early studies.

Objective: To assess the safety and efficacy of cryotherapy in esophageal carcinoma.

High-definition colonoscopy detects colorectal polyps at a higher rate than standard white-light colonoscopy.

Background & Aims: Adenoma detection rates might be improved through use of high-definition colonoscopy, which can detect subtle mucosal changes. We investigated whether the use of high-definition white-light (HDWL) colonoscopy resulted in a higher rate of adenoma detection than standard-definition white-light (SDWL) colonoscopy in a clinical practice setting.

Methods: This retrospective study included 2430 patients who underwent colonoscopies from September 2006 to December 2007; 1226 received SDWL colonoscopy and 1204 received HDWL colonoscopy.

Patient outcomes after total pancreatectomy: a single centre contemporary experience.

Introduction: Total pancreatectomy (TP) is associated with significant metabolic abnormalities leading to considerable morbidity. With the availability of modern pancreatic enzyme formulations and improvements in control of diabetes mellitus, the metabolic drawbacks of TP have diminished. As indications for TP have expanded, we examine our results in patients undergoing TP.

Pancreatic neuroendocrine tumors among patients with intraductal papillary mucinous neoplasms: real association or just a coincidence?

Context: Intraductal papillary mucinous neoplasms (IPMNs) are being recognized with increased frequency and are the most common indication of pancreatic surgery at specialized centers. Many IPMN patients are found to have non-IPMN related pancreatic tumors like pancreatic neuroendocrine tumors (PNTs).

Objective: To study the prevalence of PNTs among patients with IPMN.

Lung cancer staging by combined endobronchial ultrasound (EBUS) and endoscopic ultrasound (EUS): The gastroenterologist's perspective.

This review deals with the combined approach of endoscopic ultrasound and endobronchial ultrasound for lung cancer staging. The review provides an overview for the gastroenterologist who performs endosonography with regard to the current evidence supporting the use of endoscopic ultrasound and endobronchial ultrasound in clinical practice.

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A 50-year-old woman presented with microscopic hematuria. Initial radiological investigations suggested the diagnosis of renal calculi in the left kidney. However, further assessment confirmed a renal artery aneurysm.

Economic analysis of combined endoscopic and endobronchial ultrasound in the evaluation of patients with suspected non-small cell lung cancer.

Lung cancer remains the most common cause of cancer-related death in the United States. This study evaluated the costs of alternative diagnostic evaluations for patients with suspected non-small cell lung cancer (NSCLC). Researchers used a cost-minimization model to compare various diagnostic approaches in the evaluation of patients with NSCLC.