The variable manifestations of extraarticular synovial chondromatosis

Clinically, patients with extraarticular synovial chondromatosis are seen with a juxtaarticular mass due to metaplasia of synovial cells and subsequent formation of cartilaginous nodules. Three patients are described to illustrate the varied clinical and radiographic features of this disease. One patient had involvement of the knee and wrist while another had involvement of the knee along with presumed intraarticular synovial chondromatosis of the elbow. The third patient had a solitary finger lesion. Routine radiographs in extraarticular synovial chondromatosis demonstrate either solitary or multiple calcified juxtaarticular masses with chondroid matrix. Bone scintigraphy reveals intense radionuclide uptake within the calcified masses. Computed tomography clearly defines the extent of the lesion. Arthrography can evaluate for intraarticular extension.

Cytologic diagnosis of gliomatosis cerebri

Malignant cells were found in the cerebrospinal fluid of an elderly woman with a clinically confusing neurologic disease that was recognized as gliomatosis cerebri at autopsy. The usefulness of cerebrospinal fluid cytology in the antemortem diagnosis of this unusual brain tumor is discussed.

Computed tomographic mammography. Diagnosis of mammographically and clinically occult carcinoma of the breast

If breast cancer can be detected early, while it is still localized and before it can be palpated, the prognosis for cure is excellent. Heretofore, conventional mammography has been the only means available to detect cancer at such an early stage. Two cases of minimal breast carcinoma measuring less than 5 mm in diameter have been detected and correctly diagnosed using computed tomographic mammography (CT/M). Both cases occurred in fatty breasts and were clinically and mammographically occult. These cases demonstrate the value of CT/M in the diagnosis of minimal breast carcinoma that would have been missed otherwise.

Computed tomography in detection and diagnosis of breast cancer

From October 1, 1976 through July 31, 1979, at the University of Kansas Medical Center, CT/M examinations were performed on 1625 patients. Seventy-eight cancers were histologically diagnosed. A CT/M study using our contrast medium enhancement technique yields both static anatomical changes and dynamic measurements of abnormal iodide concentrations in the breast cancers. This unique ability of CT/M provides many advantages as compared with conventional mammography in the diagnosis of breast cancer. The detection rate in 78 cancers by CT/M was 94% and 77% for the mammography. The CT/M appears to be specially superior to the mammography for detecting cancers in dense, premenopausal dysplastic breasts. The CT/M can detect totally unsuspected very small breast cancers that were unable to be identified by conventional mammography or physical examinations. The CT/M scan also seems to be a better test for recognizing precancerous high risk lesions. CT/M evaluation affords definitive diagnostic help in instances where the mammographic and/or physical examinations are inconclusive. Although CT/M will not replace conventional mammography in routine breast examinations, it overcomes the limitation of mammography.

Preoperative diagnosis of potentially precancerous breast lesions by computed tomography breast scanner: preliminary study

Eighteen cases of severe atypical epithelial hyperplasia of the breast were detected preoperatively by computed tomography breast scanner (CT/M) with contrast enhancement. The CT number before enhancement ranged from -17 to +31 and increased to 26 to 42 after enhancement (5.2-8.4% increase in attentuation). These data suggest that CT/M can differentiate these potentially precancerous lesions from benign fibrocystic disease.

Treatment of cervical intraepithelial neoplasia with the carbon dioxide laser beam. A preliminary report

Forty-five patients with histologically proved cervical dysplasia or carcinoma in situ were treated by the carbon dioxide-laser method. The carbon dioxide laser induces cell vaporization by causing intracellular steam combustion stimulated by the emission of a mixture of carbon dioxide, nitrogen, and helium. This method of treatment is easily performed in the outpatient clinic without anesthesia, is inexpensive, and is effective in the treatment of cervical intraepithelial neoplasia. The treatment allows preservation of the transformation zone, thus permitting future colposcopic visualization.

Isoantigens A, B, and H in morphologically normal mucosa and in carcinoma of the larynx

A modified Coombs' mixed cell agglutination reaction was performed on biopsy specimens of 24 patients with squamous cell carcinoma of the larynx. Isoantigens A, B, and H(O) were absent in 15 cases, partially lost in eight, and completely retained in one case. In four cases the initial biopsy specimens were histologically benign yet negative for isoantigens. In subsequent biopsies these showed the presence of carcinoma. The morphologically normal-appearing squamous mucosa adjacent to a carcinoma was found to be devoid of isoantigens in ten cases. The investigation suggested that isoantigenic alteration as detected by mixed cell agglutination reaction was a sensitive sign, since it occurred in squamous mucosa prior to recognizable morphologic change for malignancy. The reaction may represent a functional dedifferentiation in cancerous tissue, analogous to but sometimes preceding morphologic dedifferentiation. The results were comparable to those in previous studies of neoplasms of various other anatomic sites.

The Radiology Corner. Gastrointestinal histoplasmosis, roentgenographic, clinical and pathological correlation

Five cases with gastrointestinal histoplasmosis are presented. Gastrointestinal involvement is moderately frequent during the hematogenous dissemination of histoplasmosis. Depending on the underlying pathological changes, six roentgenographic patterns can be identified: 1. malabsorptive; 2. ulcerative; 3. polypoid; 4. granulomatous; 5. tumefactive and 6. compressive. Perforation, hemorrhage, obstruction and erroneous diagnosis for ulcerative colitis, Crohn's disease or carcinoma are the major complications. Histoplasmosis should be included in the differential diagnosis of diseases presenting with a malabsorption pattern, gastrointestinal polyposis, ulcerative and granulomatous gastrointestinal diseases and carcinoma, particularly if pulmonary lesions co-exist.

Ultrasonic diagnosis of seminal vesicle cyst

Seminal vesicle cysts are uncommon, particularly when associated with ipsilateral agenesis of the kidney, ureter, and/or trigone. This entity should be considered when a cystic pelvic mass is seen in a young male. B-scan ultrasound can be of considerable aid in making the diagnosis.

Acinic cell carcinoma: collective review, including bilateral cases

Bilateral acinic cell carcinoma of the parotid gland is rare. On the basis of one case and a review of 486 parotid acinic carcinomas, unilateral as well as bilateral, total parotidectomy seems to be the treatment of choice for this low-grade malignant neoplasm that recurs commonly following inadequate excision. If involved by tumor, the facial nerve must be taken. Metastases are more likely to lung and bone than to regional nodes. For this reason, radical neck dissection is not routinely indicated.

Hailey-Hailey disease in a black family

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