RESUMEN
A case of osteitis fibrosa cystica or brown tumor of bone in a patient presenting with acute spinal cord compression that was suggested initially by needle aspiration biopsy of the spine is described. Following the aspiration biopsy, excision of vertebral lesions, cord decompression, and spinal fusion were successfully performed. A parathyroid adenoma was subsequently identified and also resected. Along with the diagnosis of malignancy, the presence of hyperparathyroidism with osteitis fibrosa cystica should be considered in a patient presenting with lytic lesions in bone, especially if they are associated with hypercalcemia. Serum parathormone level determination is usually diagnostic of hyperparathyroidism, but this test has a 7-10-day turnaround time. Preoperative needle aspiration biopsy is a safe and rapid method of diagnosing osteitis fibrosa cystica and may be of critical importance in a patient with acute and progressive symptoms such as cord compression.
Asunto(s)
Biopsia con Aguja , Osteítis Fibrosa Quística/diagnóstico , Compresión de la Médula Espinal/etiología , Enfermedades de la Columna Vertebral/diagnóstico , Adenoma/complicaciones , Adenoma/cirugía , Citodiagnóstico , Femenino , Humanos , Hiperparatiroidismo/complicaciones , Persona de Mediana Edad , Osteítis Fibrosa Quística/etiología , Osteítis Fibrosa Quística/patología , Neoplasias de las Paratiroides/complicaciones , Neoplasias de las Paratiroides/cirugía , Enfermedades de la Columna Vertebral/etiología , Enfermedades de la Columna Vertebral/patologíaAsunto(s)
Enfermedades de la Columna Vertebral/diagnóstico por imagen , Sinovitis Pigmentada Vellonodular/diagnóstico por imagen , Sinovitis/diagnóstico por imagen , Tomografía Computarizada por Rayos X , Anciano , Anciano de 80 o más Años , Femenino , Humanos , Mielografía , Enfermedades de la Columna Vertebral/cirugía , Sinovitis Pigmentada Vellonodular/patologíaRESUMEN
PIP: With the advent of whole body computed tomography (CT), an early diagnosis of hepatic tumors may be posible and laparotomy for diagnosis unnecessary. The CT scanner used was the whole body Delta unit. Patients were examined after an iv dose of 100 cc of Renograffin 60. Solid and cystic components of lesions can thus be determined. Case reports are given of 2 patients. The 1st patient had been taking Ovulen-21 for 21 months. Her liver scan revealed a large filling defect in the right lobe of the liver. Abdominal angiography showed an avasuclar mass displacing the right kidney. A CT scan depicted a large mass replacing the right lobe of the liver. The density of the mass indicated a fluid-filled cyst. At laparotomy a cyst involving the entire right lobe of the liver was found. Several nodules were present in the cyst wall. The diagnosis was cyst-adenoma of the liver. The other patient had taken Ovulen-21 for 7 years. An enlarged liver and symptoms of cholecystitis were present. The CT scan revealed a bolbous mass in the right lobe of the liver. The tumor was of the same density as the liver. At laparotomy a large hepatic adenoma was found. A 2nd mass was present in the left lobe. The tumors were not resected; cholecystectomy was done. Because of bleeding, a hepatic artery was ligated. Postoperatively, a repeat CT scan showed a large area of decreased density. At reoperation a large hematoma with necrosis of the hepatic adenoma was found and drained. The CT is an accurate method of performing percutaneous biopsies and aspiration procedures. An exact position of the needle tip can be obtained. CT-guided biopsies have also been done on masses in other areas.^ieng
Asunto(s)
Adenoma/diagnóstico por imagen , Cistoadenoma/diagnóstico por imagen , Neoplasias Hepáticas/diagnóstico por imagen , Tomografía Computarizada por Rayos X , Adenoma/inducido químicamente , Adulto , Biopsia con Aguja , Anticonceptivos Orales/efectos adversos , Cistoadenoma/inducido químicamente , Femenino , Humanos , Neoplasias Hepáticas/inducido químicamente , Neoplasias Hepáticas/patología , Neoplasias Hepáticas/cirugíaRESUMEN
The usefulness and accuracy of CT scanning in the determination of bone mineral content is studied. The radius in 31 patients of both sexes and varying ages was examined using both the Norland-Cameron bone mineral analyzer and the CT scanner. There was reasonably good correlation (r=.72). Ten cadaver bones were then examined with CT scanning and were sent to the laboratory for calcium determination. These results indicate excellent correlation (r=.97). It is concluded that CT scanning represents the only practical and accurate in vivo method of bone mineral content determination.
Asunto(s)
Huesos/metabolismo , Minerales/metabolismo , Adulto , Anciano , Huesos/diagnóstico por imagen , Femenino , Humanos , Masculino , Persona de Mediana Edad , Radiografía , Radio (Anatomía)/diagnóstico por imagen , Radio (Anatomía)/metabolismoRESUMEN
This work examines the scope and accuracy of CT in the detection of tumors, abscesses, cysts, and parenchymal disorders of the liver. While CT remains an emerging modality, it is shown to be equal to nuclear medicine in detecting mass lesions. It has also been possible to distinguish obstructive from nonobstructive jaundice. Presently, CT is not well suited to the study of cirrhosis. Technological advances in CT design and contrast agents offer promise of significantly improved resolution.