Pleomorphic adenoma of the breast initially misdiagnosed as metaplastic carcinoma in preoperative stereotactic biopsy: a case report and review of the literature.

Pleomorphic adenoma (PA) is a benign mixed tumor found commonly in the salivary glands but rarely in the breast. PA might be misinterpreted clinically and pathologically as a malignant tumor. The differential diagnoses include fibroadenoma, phyllodes tumor and metaplastic carcinoma.

A dangerous liaison--pheochromocytoma in patients with malignant disease.

Background: Adrenal masses in patients with known malignancy may be interpreted as metastasized disease, although a significant proportion of these tumors are of adrenal origin. Despite improved imaging techniques, it remains difficult to distinguish an adrenal metastasis from a pheochromocytoma or a lipid-poor adrenocortical adenoma.

Patients And Methods: We report a case series of four patients with established or suspected malignant disease (melanoma, transitional cell carcinoma and prostate carcinoma, thyroid carcinoma, colorectal carcinoma) harboring an adrenal mass.

[Individualized dose requirement for spiral-CT analysis of the abdomen].

Purpose: To search for individualized scan protocols that provide adequate diagnostic information with minimal radiation exposure for abdominal CT in adults.

Material And Methods: Beginning with standard settings (120 kVp, 200 mA, 0.75 s, CTDI (w = 11.

A case of metastasizing invasive hydatidiform mole. Is less--less good? Review of the literature with regard to adequate treatment.

Background: Patients with invasive hydatidiform moles (IHM) have a good prognosis. Even if disease has spread, monocytostatic treatment might be sufficient if the diagnosis has been histologically confirmed. Established classifications divide gestational trophoblastic disease (GTD) including choriocarcinoma into cases with "high" and "low" risk.

Metallic stents and plastic endoprostheses in percutaneous treatment of biliary obstruction.

Background: In the light of the clinical controversy whether metallic stents or plastic endoprostheses should be used in the percutaneous treatment of biliary obstruction we retrospectively evaluated our experience with both drainage-systems.

Methods: 71 patients (mean age 68 +/- 12 years) underwent a total of 81 interventions and received either plastic endoprostheses (11.5 or 12 French diameter; N = 57/81) or metallic stents (N = 24/81).

Differential diagnosis of lymphadenopathy: power Doppler vs color Doppler sonography.

Our objective was to compare color and power Doppler sonography of superficial lymph nodes. One hundred ninety-three lymph nodes in 161 patients were assessed by color and power Doppler sonography using standardized settings. We tested which modality displayed more intranodal vessels and checked if these differences would have altered the diagnosis.

Single-bolus technique for spiral CT of laryngopharyngeal squamous cell carcinoma: comparison of different contrast material volumes, flow rates, and start delays.

Purpose: To evaluate different contrast material volumes, flow rates, and start delays for contrast material enhancement of neck structures and squamous cell carcinoma to determine the most effective examination protocol.

Materials And Methods: Seventy patients with squamous cell carcinoma were prospectively randomized into four groups for examination with different protocols (125 mL of contrast material administered at a flow rate of 2.5 mL/sec, 100 mL at 2.

Dose, volume, and tumor control prediction in primary radiotherapy of non-small-cell lung cancer.

Background: To evaluate the influence of total dose and tumor volume on local control and survival in primary radiotherapy of non-small-cell lung cancer (NSCLC).

Methods And Materials: We retrospectively analyzed the clinical course and CT-derived pre- and post-therapeutic tumor volume data of 135 patients with NSCLC undergoing primary radiotherapy at our department between 1989 and 1996. Among these, a total of 192 spatially separated tumor volumes (135 primary tumors, 1 additional intrapulmonary tumor, and 56 involved lymph nodes) were available for analysis.

Spiral CT of the neck: When do neck malignancies delineate best during contrast enhancement?

The aim of this study was to determine the time of best contrast of neck malignancies in contrast-enhanced CT. The CT was done in 20 patients with squamous cell carcinoma using a standard protocol (100 ml contrast agent at 2 ml/s). Dynamic series of the tumors were performed (scan interval 6 s).

Optimization of automatic bolus tracking for timing of the arterial phase of helical liver CT.

The aim of this study was to optimize bolus tracking for timing of the arterial phase of biphasic helical liver CT and to compare optimized bolus tracking to a standard delay. One hundred fifty patients were examined with six protocols: 5- or 10-s delay after triggering at a threshold of 50 or 75 or 100 HU enhancement in the aorta at the origin of the celiac arteries after injection of 120 ml contrast material at 3 ml/s. Optimal arterial enhancement was defined as 20-30% of hepatic enhancement in portal venous phase.

Compression repair of ruptured pseudoaneurysms guided by color Doppler ultrasonography: report of two cases.

Noninvasive treatment of ruptured postcatheterization pseudoaneurysms is rare. We report the use of ultrasonographically guided compression repair for the treatment of ruptured pseudoaneurysms in 2 cases. To ensure the immediate stop of bleeding, more compression was applied than for nonruptured pseudoaneurysms, regardless of flow in the femoral artery or vein, thus maximizing the effectiveness of this therapy.

Galactography and exfoliative cytology in women with abnormal nipple discharge.

Objective: To evaluate galactography and cytology in women with nipple discharge without clinical or mammographic evidence of cancer.

Methods: During a 12.5-year period, 384 women (15-85 years, mean age 47.

Predictive value of galactographic patterns for benign and malignant neoplasms of the breast in patients with nipple discharge.

The purpose was to identify features of malignant and non-malignant neoplastic breast disease on galactography and to estimate their predictive value. This is the largest reported study correlating galactographic morphological patterns with histopathology and the only blinded study. The study included 351 consecutive galactograms and 161 breast biopsies performed in patients with nipple discharge over a 10-year period.

Is the appearance of microcalcifications on mammography useful in predicting histological grade of malignancy in ductal cancer in situ?

It has been proposed that the grade of malignancy of ductal carcinoma in situ (DCIS) of the breast can be estimated by the morphology of microcalcifications found on mammography. We correlated microcalcifications and histopathology in a retrospective blinded review. We reviewed all patients who underwent excisional breast biopsy over a 5 1/2-year period.

Pathological angioarchitecture in lymph nodes: underlying histopathologic findings.

Pathologic changes of the intranodal angioarchitecture, as displayed by colour Doppler sonography, were used in recent studies to predict malignant infiltration of superficial lymph nodes. We searched for the underlying histopathologic findings in a prospective study including 100 lymph nodes in 86 patients. In the histopathologic specimens, we evaluated tumour infiltration, distribution of intranodal vessels, hilar structures, thickness of the capsule and tissue alterations (necrosis, sclerosis, lipo-/fibromatosis).

Current value of double-contrast pharyngography and of computed tomography for the detection and for staging of hypopharyngeal, oropharyngeal and supraglottic tumors.

In light of recent endoscopic techniques the current value of double-contrast pharyngography (DCP) and of CT for detection and staging of hypo-, oropharyngeal, and supraglottic tumors is evaluated. The DCP of 151 patients and CT obtained from 99 of these patients were retrospectively analyzed in a double-blinded manner. We used a standard protocol which comprised all relevant anatomical subregions.

Multivariate analysis of the adjustment of the colour duplex unit for the differential diagnosis of lymph node alterations.

Intranodal angioarchitecture was used as criterion for the differential diagnosis of lymph node alterations by colour duplex sonography. The influence of the adjustment of the duplex unit on the diagnostic accuracy and on the rate of lymph nodes with detectable intranodal flow signals was tested. A total of 243 superficial lymph nodes in 127 patients were included in a retrospective study.

Spiral CT angiography of renal arteries: comparison with angiography.

A prospective study was carried out to determine the accuracy of spiral CT angiography (CTA) in the detection of renal artery stenosis (RAS). Eighty-two patients with arterial hypertension underwent CTA and digital subtraction angiography (DSA) to exclude RAS. For CTA a contrast medium bolus of 100-150 ml (flow rate 3 ml/s) was injected.

Lymphadenopathy: differentiation of benign from malignant disease--color Doppler US assessment of intranodal angioarchitecture.

Purpose: To differentiate reactive from malignant lymphadenopathy by using color Doppler ultrasonographic (US) findings of intranodal blood vessels.

Materials And Methods: Color Doppler US was performed in 117 lymph nodes in 100 consecutive patients before performance of surgical biopsy (47 nodes), neck dissection (62 nodes), or high-speed core biopsy (eight nodes). The presence of malignant changes in intranodal angioarchitecture (focal perfusion defects, aberrant course of central vessels, displacement of intranodal vessels, subcapsular vessels) was evaluated in each node.

Long-term results of vena cava filters: experiences with the LGM and the Titanium Greenfield devices.

Purpose: Vena cava filter (VCF) application is the method of choice to prevent recurrent pulmonary embolism in patients with deep venous thrombosis. Because of the reported complications after VCF placement we summarize our long-term follow-up results with the LGM and Titanium Greenfield (TG) devices.

Methods: Eighty-seven LGM VCF and 17 TG VCF were placed in 104 patients (average age 64 years).

[Value of color-coded duplex ultrasound in evaluating arm blood vessels--arteries and hemodialysis shunts].

Aim: Comparison of colour coded duplex sonography (CCDS) to angiography in visualizing arteries and haemodialysis fistulas of the upper extremity.

Method: 1145 arterial and vein segments were visualised using CCDS and angiography in 219 patients by different examiners with different degrees of experience. Sensitivity, specificity and accuracy were calculated.

Chronic recurrent osteomyelitis with clavicular involvement in children: diagnostic value of different imaging techniques and therapy with non-steroidal anti-inflammatory drugs.

Unlabelled: Chronic recurrent, uni- or multifocal osteomyelitis (CRMO), an inflammatory disorder of unknown origin, involves mk:/night/arul/4310946m.3dultiple osseous sites and may affect the clavicle. We report on 6 children with clavicular involvement out of 11 children suffering from CRMO.

[Value of high speed punch biopsy after mammographic stereotactic localization in diagnosis of non-palpable breast changes].

To investigate the accuracy of a single high-speed core biopsy, in 159 stereotactically localised nonpalpable breast lesions a single high-speed core biopsy was performed prior to open surgery. All pathological findings of the specimen, core biopsies and open biopsies, were compared. Two biopsies were technically insufficient.