1/12. Secondary polycythemia associated with idiopathic membranous nephropathy.A 58-year-old male patient had secondary polycythemia associated with idiopathic nephrotic syndrome. The renal biopsy revealed membranous nephropathy, and the bone marrow biopsy disclosed hypercellular marrow with mild panhyperplasia. The concentration of serum erythropoietin was 8.5 mU/ml. The erythrocytosis was characterized by an increased red cell volume (40.2 ml/kg) and normal arterial oxygen saturation. There were no associated lesions that could induce secondary polycythemia, except the biopsy-proven membranous nephropathy. He was treated with prednisolone and cyclophosphamide, and the nephrotic syndrome was partially remitted after 6 weeks. With partial remission of nephrotic syndrome, the erythrocytosis was resolved. This case illustrates the rarely reported association of the nephrotic syndrome and erythrocytosis, and the resolution of erythrocytosis with improvement of nephrotic syndrome.- - - - - - - - - - ranking = 1keywords = volume (Clic here for more details about this article) |
2/12. Idiopathic noncondylar hemimandibular hyperplasia.A female patient with 'idiopathic non-condylar hemimandibular hyperplasia' was followed from the age of 7.5-11.5 years. This rare disorder was characterised by an increase in volume of the right inferior ramus and mandibular body. It also included accelerated development and eruption of the teeth on the affected side, but no indication of enlargement of the condyle or the condylar neck. To date, review of the literature revealed several cases of hemimandibular hyperplasia and unilateral condylar hyperplasia, both of which present with enlargement of the condyle. However, the patient differed significantly from any previously reported cases, since she had no enlargement of the condyle. The above mentioned patient also differed from patients with hemihypertrophy, since the teeth were accelerated in development, but not hyperplastic. In addition, from histopathologic and radiographic examinations, as well as an angiogram, benign fibro-osseous and vascular lesions of the mandible were excluded. Although this is a single case report and neither the aetiology nor the pathogenesis is yet understood, it may suggest a new disorder of the mandible. Therefore, future reporting of similar cases should be encouraged.- - - - - - - - - - ranking = 1keywords = volume (Clic here for more details about this article) |
3/12. Diffuse pulmonary neuroendocrine cell hyperplasia: radiologic and clinical features.PURPOSE: The purpose of this study was to define the radiologic features of pulmonary neuroendocrine cell hyperplasia and correlate them with clinical findings. METHOD: Five women, ranging in age from 45 to 63 years, were diagnosed with pulmonary neuroendocrine cell hyperplasia. Two radiologists assessed the presence and extent of airway wall thickening, mosaic pattern, air trapping, ground-glass opacity, nodular opacity, and centrilobular opacity on high resolution CT. The CT findings were compared with physiologic data and histologic features. RESULTS: On CT scans, mosaic pattern was the predominant finding in all patients. The extent of mosaic pattern was correlated with the forced expiratory volume in 1 s/forced vital capacity ratio (r = 0.8508, p = 0.0317). Nodular lesions were noted in three patients. Airway walls were thickened in four patients. In one patient, ground-glass opacity and centrilobular opacity were also noted on high resolution CT. CONCLUSION: Pulmonary neuroendocrine cell hyperplasia is characterized by mosaic perfusion due to air trapping, airway wall thickening, and occasional small nodules on high resolution CT scans. The extent of mosaic perfusion correlates with physiologic evidence of airway obstruction.- - - - - - - - - - ranking = 1keywords = volume (Clic here for more details about this article) |
4/12. Diffuse idiopathic neuroendocrine cell hyperplasia causing severe airway obstruction in a patient with a carcinoid tumor.We report a 57-year-old female with severe airway obstruction who underwent resection of a tumor of unknown dignity during lung volume reduction surgery. The nodule consisted of a well-differentiated neuroendocrine tumor (carcinoid), and severe chronic obstructive lung disease was due to diffuse idiopathic pulmonary neuroendocrine cell hyperplasia, a very rare cause of obliterative bronchiolitis. Radionuclide ablative therapy of the neuroendocrine tissue was considered but not found to be feasible due to a low lung/background ratio of the radiotracer.- - - - - - - - - - ranking = 1keywords = volume (Clic here for more details about this article) |
5/12. Scintigraphic findings mimicking focal nodular hyperplasia in a case of hepatoblastoma.hepatoblastoma is a primary liver neoplasm in which prompt diagnosis and resection are critical to long-term survival. liver scintigraphy using Tc-99m sulfur colloid and Tc-99m iminodiacetic acid (IDA) derivatives has been used in the evaluation of hepatic masses. Most space-occupying lesions of the liver appear as photopenic regions following either Tc-99m SC or IDA agents. Two exceptions have been reported. focal nodular hyperplasia (FNH) has been shown to have variable colloid uptake, which is dependent upon the number of kupffer cells per given volume. Many patients with FNH will demonstrate activity within the FNH to be greater or equal to the normal liver. In addition, two cases of hepatoblastoma have been reported to show colloid activity within the tumor, and in one patient slight uptake of Tc-99m IDA was noted in the tumor 15 minutes postinjection. The current case demonstrates a hepatoblastoma in which the scintigraphic findings with Tc-99m SC and Tc-99m IDA were similar to those reported, with retention of IDA far greater than the previously reported case.- - - - - - - - - - ranking = 1keywords = volume (Clic here for more details about this article) |
6/12. Increasing infertility in myotonia dystrophica Curschmann-Steinert. A case report.A 26-year-old male came to our andrologic out-patient clinic because of his desire to have children. Preliminary examinations revealed a varicocele left and a subclinical varicocele right. Testicular volume was smaller than normal, and spermiogram values were already poor (vitality, motility and morphology). Basic hormones were normal. The anamnesis gave no information on hereditary disorders. Surgical treatment of the varicocele did not bring the desired outcome. A testicular biopsy showed Leydig cell hyperplasia with strongly reduced spermiohistogenesis. In a renewed and extensive anamnesis, the patient revealed that he suffers from myotonia dystrophica Curschmann-Steinert. This disorder causes sclerosis of the tubuli seminiferi contorti, which can ultimately lead to azoospermia.- - - - - - - - - - ranking = 1keywords = volume (Clic here for more details about this article) |
7/12. Sporadic unilateral adrenomedullary hyperplasia with hypertension cured by adrenalectomy.Adrenomedullary hyperplasia (AMH) with increased urinary excretion of epinephrine is regarded as the earliest adrenal manifestation in familial pheochromocytoma; however, pathogenetic mechanisms and morphogenesis involved in the development of sporadic adrenomedullary diseases are unknown as yet. We present 4 patients with clinical, biochemical, imaging, and morphological findings of sporadic unilateral adrenomedullary hyperplasia cured by unilateral adrenalectomy. All patients were hypertensive with intermittent hypertensive crises, and with increased catecholamine concentrations in urine and serum. Correct unilateral localization was achieved by 123-I-BG-scan (planar and SPECT) (n = 2) or cavovenous blood sampling with selective catheterization of both suprarenal veins (n = 2). Histomorphometric analyses revealed diffuse adrenomedullary hyperplasia in all 4 specimens with significant increase of relative volume to 17.6% (controls, 8.7%), and of estimated medullary weight to 0.95 g (controls, 0.45 g); corticomedullary ratio (C:M) was decreased to 5.4 (controls, 11.2). dna histograms showed euploidy in all cases. In 3 patients, dna analysis revealed evidence of cell proliferation, but without increase to grade of malignancy indices (0.101-0.523). adrenalectomy was performed preferentially by a translumbar approach; the operative and postoperative course was uneventful in all 4 patients. blood pressure without antihypertensive drugs returned to normal in 3 patients, in 1 patient to the upper normal limit.- - - - - - - - - - ranking = 1keywords = volume (Clic here for more details about this article) |
8/12. Increased acinar complexity with polyhydramnios.We report 4 cases that presented a contradiction in terms of intrauterine lung growth. In all cases there was increased acinar complexity despite an array of influences known to be associated with pulmonary hypoplasia. In 2 of the 4 cases the lungs were severely hypoplastic by weight. Following an analysis of the factors operative in each case regarding lung growth, we conclude that diffuse increased acinar complexity occurs in selected cases with massive polyhydramnios. The observation is of importance because it is consonant with an intimate and dynamic relationship between amniotic fluid volume, lung fluid production, and fetal breathing movements in normal intrauterine lung growth and maturation. Although lung hypoplasia is known to occur in association with polyhydramnios, the reported alterations in lung structure were not previously observed.- - - - - - - - - - ranking = 1keywords = volume (Clic here for more details about this article) |
9/12. Massive edema of the ovary associated with hydrothorax and ascites.A 29-year-old woman with massive edema of the ovary which was grossly mistaken for neoplasia because it was associated with large volumes of both pleural effusion and ascites is described. The ovarian mass measured 10 X 10 X 8 cm and weighed 850 g. Total hysterectomy and bilateral salpingo-oophorectomy were performed. Microscopically, the ovary consisted of diffusely edematous stroma enveloping nests of hyperplastic theca cells or showing a loose myxomatous contexture. However, no endocrine activity of the ovary was demonstrated on the basis of laboratory endocrine values obtained by radioimmunoassay techniques.- - - - - - - - - - ranking = 1keywords = volume (Clic here for more details about this article) |
10/12. diagnosis of pancreatic islet hyperplasia causing hypoglycemia in a patient with portacaval anastomosis.A patient with biopsy-proved biliary cirrhosis and previous gastrojejunostomy and portacaval anastomosis experienced episodes of severe hypoglycemia. She was found to have hyperinsulinemia and hyperglucagonemia. An oral glucose tolerance test showed postgastrectomy hypoglycemia. Results of the intravenous tolbutamide test were diagnostic for insulinoma, but results of the intravenous glucagon test and prolonged fast (96 hours) were not. Failure, on two occasions, to suppress c-peptide normally during insulin-induced hypoglycemia led to a diagnosis of pancreatogenous hyperinsulinemia. The pancreas showed a 10-fold increase in islet volume, with intensely positive staining with anti-insulin and anti-glucagon antiserums in addition to anti-somatostatin and anti-pancreatic polypeptide antiserums. incidental findings at pancreatic exploration were a mesothelioma, which did not stain with anti-insulin antiserum, and, at autopsy one year later, a hepatoma.- - - - - - - - - - ranking = 1keywords = volume (Clic here for more details about this article) |
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