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Pope TL, Fechner RE, Wilhelm MC, Wanebo HJ, de Paredes ES. Lobular carcinoma in situ of the breast: mammographic features. Radiology 1988; 168:63-6. [PMID: 3380984 DOI: 10.1148/radiology.168.1.3380984] [Citation(s) in RCA: 43] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/05/2023]
Abstract
Lobular carcinoma in situ (lobular neoplasia; LCIS) of the breast is most commonly an incidental microscopic finding in breast tissue removed for some other reason. The authors reviewed the clinical and mammographic features and surgical findings in 26 cases of LCIS not associated with other breast abnormalities. In 16 instances, needle localization was performed before removal of the tissue, which yielded LCIS on histologic examination. Calcifications were the most common reason for biopsy, although there were no distinctive mammographic features of LCIS.
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52
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Paling MR, Pope TL. Computed tomography of isolated osteoblastic colon metastases in the bony pelvis. THE JOURNAL OF COMPUTED TOMOGRAPHY 1988; 12:203-7. [PMID: 3168541 DOI: 10.1016/0149-936x(88)90009-4] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/04/2023]
Abstract
Skeletal metastases from colorectal carcinoma are unusual and osteoblastic metastases are quite rare. Three cases are described in which an isolated recurrence of a previous colorectal carcinoma occurred within the pelvic bones, without evidence of skeletal metastases elsewhere so that local spread via portocaval anastomoses in the pelvis is postulated. In all three cases, proliferative calcification and new bone formation occurred within an expansile, destructive lesion, suggesting the occurrence of a synergistic effect between the underlying bone and a malignant neoplasm which has a propensity to calcify.
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Abstract
Acromioclavicular separation is a common traumatic injury. Diagnosis rests on clinical and radiographic findings. However, normal variation in the alignment of the acromioclavicular joint may make the roentgen diagnosis more difficult. We stress the variations of normal alignment at the acromioclavicular joint and offer suggestions for avoiding pitfalls in this clinical situation.
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54
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Kronthal AJ, Pope TL, Keats TE. Osteomyelitis of the sternum secondary to steroid injection: case report. VIRGINIA MEDICAL 1988; 115:128-9. [PMID: 3354259] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 01/05/2023]
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55
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Phillips CD, Pope TL, Jones JE, Keats TE, MacMillan RH. Nontraumatic avulsion of the lesser trochanter: a pathognomonic sign of metastatic disease? Skeletal Radiol 1988; 17:106-10. [PMID: 3363377 DOI: 10.1007/bf00365136] [Citation(s) in RCA: 41] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/02/2023]
Abstract
Isolated avulsion fractures of the lesser trochanter resulting from trauma are most commonly seen in adolescent athletes and are rare in adults. Standard therapy is nonsurgical with bedrest and immobilization of the leg. However, when this lesion is seen in the adult without significant trauma, it should be regarded as secondary to metastatic neoplasm until proven otherwise. Treatment should be surgical with prophylactic internal fixation of the hip to help prevent the commonly associated subtrochanteric pathologic fracture. In a patient without a known primary malignancy, biopsy should be carried out before therapy. We describe four patients with isolated avulsion fracture of the lesser trochanter due to metastatic carcinoma. Radiologists should be aware of this lesion because its presence has a decisive effect on therapy.
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56
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Pope TL. Vertebral body biopsies. AJR Am J Roentgenol 1987; 149:1078. [PMID: 3499781 DOI: 10.2214/ajr.149.5.1078] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/06/2023]
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57
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Nunley WC, Bateman BG, Kitchin JD, Pope TL. Intravasation during hysterosalpingography using oil-base contrast medium--a second look. Obstet Gynecol 1987; 70:309-12. [PMID: 3627577] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/06/2023]
Abstract
Hysterosalpingography is a study performed commonly to assess the upper reproductive tract in infertile women. A risk with hysterosalpingography is either lymphatic and/or venous intravasation with or without embolization. Of 593 consecutive hysterosalpingograms performed with a low-viscosity oil-base medium, intravasation occurred in 41 cases (6.9%). Embolization was documented in six patients. There were no recognized adverse sequelae from either intravasation or embolization. Intravasation was frequently associated with pathology of the upper genital tract, and suspected tubal occlusion was the most common abnormality detected. Proper timing of the procedure and avoidance of excessive instillation pressure will diminish the incidence of this complication. The use of both a low-viscosity oil-base medium and high-resolution fluoroscopic image intensification may increase the detection of intravasation.
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58
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de Lange EE, Pope TL, Fechner RE, Keats TE. Case report 428: Bizarre parosteal osteochondromatous proliferation (BPOP). Skeletal Radiol 1987; 16:481-3. [PMID: 3659995 DOI: 10.1007/bf00350544] [Citation(s) in RCA: 18] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/02/2023]
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59
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Paling MR, Pope TL. The variable nature of the mediastinal contour lines: CT/chest radiography correlation. THE JOURNAL OF COMPUTED TOMOGRAPHY 1987; 11:254-60. [PMID: 3608550 DOI: 10.1016/0149-936x(87)90091-9] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/06/2023]
Abstract
Interfacing of the lung with the mediastinum produces a number of mediastinal lines including those due to the innominate veins, left subclavian artery, paratracheal stripe, both anterior and posterior junction lines, the azygo-esophageal recess, descending aorta and paraspinal lines. Displacement or absence of one or more of these lines may be due to an abnormality of mediastinal contour or may indicate a mediastinal mass, but can occur in normal subjects. Correlative findings between chest radiography and chest computed tomography in 50 normal subjects illustrate the variable nature of these lines.
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60
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Pope TL, Keats TE, de Lange EE, Fechner RE. Case report 426: Unilateral, rapidly destructive arthropathy of the hip ("analgesic hip"). Skeletal Radiol 1987; 16:342-5. [PMID: 3616674 DOI: 10.1007/bf00361480] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/02/2023]
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61
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Pope TL, Keats TE, de Lange EE, Fechner RE, Harvey JW. Idiopathic synovial chondromatosis in two unusual sites: inferior radioulnar joint and ischial bursa. Skeletal Radiol 1987; 16:205-8. [PMID: 3589736 DOI: 10.1007/bf00356954] [Citation(s) in RCA: 23] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/02/2023]
Abstract
Synovial chondromatosis is a rare disorder of unknown cause characterized by multiple calcific bodies in the vicinity of the affected joint. It is most commonly seen in the knee, hip, elbow, and shoulder. We describe three cases of synovial chondromatosis in two extremely uncommon sites, the inferior radioulnar joint and the ischial bursa, and review the literature on the subject. The characteristic radiographic appearance, even if in an uncommon location, should prompt the radiologist to suggest the correct diagnosis preoperatively.
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Pope TL. Mucinous adenocarcinoma of the esophagus metastatic to a spinal fusion. Semin Roentgenol 1987; 22:137-8. [PMID: 3035722 DOI: 10.1016/0037-198x(87)90044-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/03/2023]
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63
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Pope TL, Fechner RE, Brenbridge AN. Carcinosarcoma of the breast: radiologic, ultrasonographic, and pathologic correlation. Can Assoc Radiol J 1987; 38:50-1. [PMID: 2953738] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/03/2023] Open
Abstract
Carcinosarcoma of the breast is a rare neoplasm which has been reported less than 20 times. Comprised of both malignant epithelial and malignant connective tissue components, it may radiographically exhibit features of either cellular element. We report the first film-screen mammographic description of such a lesion in a breast. Osteoid matrix calcification demonstrated mammographically should, in retrospect, have suggested osteogenic elements preoperatively.
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64
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deLange EE, Pope TL, Fechner RE, Keats TE. Bizarre parosteal osteochondromatous proliferation vs. benign florid reactive periostitis. AJR Am J Roentgenol 1987; 148:650. [PMID: 3492900 DOI: 10.2214/ajr.148.3.650-a] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/06/2023]
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65
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Holmes WS, Pope TL, de Lange E, Fechner RE, McDowel CL, Keats TE. Case report 413: Florid reactive periostitis of the proximal phalanx of the fourth finger (parosteal fasciitis, pseudosarcomatous fibromatosis, fasciitis ossificans). Skeletal Radiol 1987; 16:163-5. [PMID: 3576253 DOI: 10.1007/bf00367767] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/02/2023]
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66
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Hurst RW, Cail WS, Pope TL, Keats TE, Cimmino C. Pseudoforamina of the skull base: a normal variant. AJNR Am J Neuroradiol 1987; 8:737. [PMID: 3113218 PMCID: PMC8333676] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/04/2023]
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67
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Kerns S, Pope TL, de Lange EE, Fechner RE, Keats TE, Cimmino C. Annulus fibrosus calcification in the cervical spine: radiologic-pathologic correlation. Skeletal Radiol 1986; 15:605-9. [PMID: 3810180 DOI: 10.1007/bf00349852] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/02/2023]
Abstract
Intervertebral disc calcification can be secondary to a variety of pathologic processes including some of the arthritides, metabolic diseases, and trauma. The annulus fibrosus is the most commonly calcified component and may mimic vertebral body fracture, limbus vertebra, or a persistent ring apophysis. We describe two young patients who developed calcification in the anterior annulus fibrosus and present radiologic-pathologic correlation in this condition in another case. This calcification may actually be secondary to subclinical or chronic stress on the involved intervertebral disc.
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Abstract
Dedifferentiated chondrosarcomas, unlike ordinary chondrosarcomas, are highly aggressive tumors that frequently metastasize. The lesion is characterized by a lytic intraosseous or extraosseous soft-tissue mass that is devoid of the calcifications that are usually associated with a chondroid tumor. We describe the radiographic and pathologic features of five cases involving dedifferentiated chondrosarcoma.
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69
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70
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Calhoun P, Feldman PS, Armstrong P, Black WC, Pope TL, Minor GR, Daniel TM. The clinical outcome of needle aspirations of the lung when cancer is not diagnosed. Ann Thorac Surg 1986; 41:592-6. [PMID: 3718033 DOI: 10.1016/s0003-4975(10)63066-4] [Citation(s) in RCA: 69] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/07/2023]
Abstract
One hundred thirty-two of 397 consecutive percutaneous fine needle aspirations done at the University of Virginia between January, 1979, and December, 1984, for pulmonary lesions showed no evidence of cancer on cytological examination. We reviewed the presenting symptoms, radiographic findings on the day of needle aspiration, and the descriptive cytological terms to determine if it was possible to distinguish benign from malignant disease in these 132 patients. We found a specific benign diagnosis in only 16 (12%) of the 132 patients, and 1 of them ultimately was found to have cancer. In the remaining 116 patients, analysis of age, sex, smoking history, presenting symptoms, radiographic findings at the time of needle aspiration, and cytological terms other than malignancy did not enable distinction of benign from malignant disease as the cause of the radiographic finding. In the group of 132 patients without suggestion of cancer on initial cytological study, 38 (29%) were subsequently found to have a malignant process.
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71
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72
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Choplin RH, Kawamoto EH, Dyer RB, Geisinger KR, Mills SE, Pope TL. Atypical carcinoid of the lung: radiographic features. AJR Am J Roentgenol 1986; 146:665-8. [PMID: 3485338 DOI: 10.2214/ajr.146.4.665] [Citation(s) in RCA: 37] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/06/2023]
Abstract
Atypical carcinoid of the lung is a neuroendocrine neoplasm with cellular and clinical features intermediate between those of typical carcinoid and small cell undifferentiated carcinoma of the lung. These neoplasms exhibit a wide range of histologic appearances and are misdiagnosed in up to 50% of cases. The clinical records and radiographs of 32 patients with this diagnosis from the University of Virginia Medical Center and Wake Forest University Medical Center were reviewed. Sixteen of these cases had been misdiagnosed pathologically. While the most frequent radiographic finding was a round or avoid lobulated peripheral mass, other appearances included thin-walled cavities, poorly defined nonsegmental infiltrates, and mediastinal masses. Fifty percent of the patients in this study have died from their tumor, with a mean survival of 15.5 months. This contrasts with both typical carcinoid and small cell undifferentiated carcinoma, in which patients develop fatal metastatic disease in 5% and nearly 100%, respectively. Proper categorization of typical carcinoid, atypical carcinoid, and small cell undifferentiated carcinoma is necessary to determine appropriate therapy, prognosis, and reporting of end results.
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73
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Senofsky GM, Wanebo HJ, Wilhelm MC, Pope TL, Fechner RE, Broaddus W, Kaiser DL. Has monitoring of the contralateral breast improved the prognosis in patients treated for primary breast cancer? Cancer 1986; 57:597-602. [PMID: 3942996 DOI: 10.1002/1097-0142(19860201)57:3<597::aid-cncr2820570334>3.0.co;2-5] [Citation(s) in RCA: 48] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/08/2023]
Abstract
Bilateral breast cancer has a cumulative incidence of about 7% in patients with primary operable breast cancer, and most of these lesions are metachronous. Most retrospective studies have shown that a majority of these patients have invasive cancer in the second breast, and varying percentages have nodal metastases, which may be of a higher stage than the first cancer. Physicians are now more aware of the importance of careful monitoring of the second breast after ipsilateral mastectomy, and improvements have been made in mammographic surveillance. A retrospective, comparative analysis of two separate breast cancer populations at risk for bilateral breast cancer was done on patients who entered into the system before effective mammographic monitoring (BEM) and after effective mammographic monitoring (AEM). The first group of patients consisted of 500 consecutive patients with primary breast cancer diagnosed during the years 1969 through 1975, of whom 37 (7.4%) had bilateral breast cancer. The second group consisted of 557 consecutive patients diagnosed during the years 1977 through 1984, of whom 36 (6.5%) had bilateral breast cancer. The staging percentages of the second breast cancer in the BEM group were Stage 0, 5.4%; Stage I, 48.6%; Stage II, 10.8%; Stage III, 21.6%; and Stage IV, 13.5%. The second group had an improvement in stage, with 33.3% being Stage 0, 22.2% Stage I, 29.6% Stage II, 3.7% Stage III, and 3.7% Stage IV (P less than 0.05). The median interval between primary lesions was 39 months in the first group and 19 months in the second group (in part, this difference may represent increased identification of synchronous cancers). The second breast cancer was undetected by mammography in 9 of 34 (26%) patients. Six were detected by contralateral biopsy (all were lobular carcinomas in situ), and three were found by clinical examination (all were invasive cancers). It was concluded that more aggressive monitoring of the second breast by frequent clinical examination, mammography, and selected contralateral biopsy appears to have increased the early detection rate of second breast cancers in patients under observation.
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Tatu WF, Pope TL, Daniel TM, Senofsky GM. Computed tomography of mediastinal cystic hygroma in an adult: case report and review of the literature. THE JOURNAL OF COMPUTED TOMOGRAPHY 1985; 9:233-6. [PMID: 4017613 DOI: 10.1016/0149-936x(85)90067-0] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/08/2023]
Abstract
Conventional and computed tomography findings in a cystic hygroma (lymphangioma) of the middle mediastinum in an adult are reported and compared with previously reported cases. The pertinent literature is reviewed.
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75
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Pope TL, Shaffer H. Small bowel xanthomatosis: radiologic-pathologic correlation. AJR Am J Roentgenol 1985; 144:1215-6. [PMID: 3873804 DOI: 10.2214/ajr.144.6.1215] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/07/2023]
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