1/14. Mediastinal irradiation: A risk factor for atherosclerosis of the internal thoracic arteries.Previous radiotherapy to the thorax is a risk factor for coronary artery disease. patients with radiation-induced atherosclerosis tend to be young and frequently have lesions involving the coronary ostia and left anterior descending artery. Bypass is often the most suitable method of revascularization, and given the young age of the patient, arterial conduits would be considered superior to vein grafts. However, the internal thoracic arteries can lie within the radiation field and may not be free of atherosclerosis. A 40-year-old man who required coronary artery bypass grafting for multivessel coronary artery disease 11 years following radiotherapy for Hodgkin's lymphoma is reported. Preoperative angiography showed that the right internal thoracic artery had significant atherosclerosis and was unsuitable as a conduit.- - - - - - - - - - ranking = 1keywords = vessel (Clic here for more details about this article) |
2/14. Delayed cerebrovascular consequences of therapeutic radiation. A clinicopathologic study of a stroke associated with radiation-related carotid arteriopathy.A young woman, successfully treated for Hodgkin's disease with radiation and MOPP chemotherapy, incurred a devastating stroke months after radiation therapy to the neck and other areas. There was no premonitory clinical history of cerebrovascular attacks. autopsy showed unilateral thrombotic occlusion of the internal carotid artery unassociated with neoplastic or fibrotic annular constriction of the vessel. There was medial thickening and fibroblastic proliferation within the carotid artery. Areas of focal elastic membrane degeneration involved the cervical portions of the carotid. Thrombus was organized to the damaged vessel wall and was propagated into the intracranial vessels. aneurysm formation and arterial hemorrhages were absent. These vascular changes occurred in an area of extensive radiation (7200 rads). Pathoanatomical studies in this patient indicate that radiation-induced vascular changes were associated with a "delayed" stroke.- - - - - - - - - - ranking = 3keywords = vessel (Clic here for more details about this article) |
3/14. Perivascular Ki-1 lesions.We describe three male patients diagnosed by histologic and immunophenotypic criteria to have a Ki-1 lymphoproliferative disorder. All three cases shared a unique morphologic finding, not previously described: prominent perivascular cuffing of anaplastic/pleomorphic tumor cells around small and medium sized vessels. One case was a Ki-1 anaplastic large cell lymphoma (ALCL) which developed in the setting of a low grade follicular B-cell lymphoma. A pseudoglandular pattern caused referral for consultation as a possible adenocarcinoma. One case was a cutaneous Ki-1 lymphoproliferative disorder consistent with lymphomatoid papulosis (LyP). The third case was a cutaneous Ki-1 ALCL. This study provides evidence that although perivascular cuffing of tumor cells is not frequently seen in Ki-1 lymphoproliferative disorders (3 of 116 cases in our consultation file), it may be a prominent architectural feature causing confusion with epithelial or mesenchymal tumors. For this reason we recommend inclusion of this feature in the list of architectural features already described for Ki-1 lymphoproliferative disorders.- - - - - - - - - - ranking = 1keywords = vessel (Clic here for more details about this article) |
4/14. Late bleeding from right internal mammary artery after HeartMate left ventricular assist device implantation.Postoperative bleeding is one of the major complications after implantation of left ventricular assist devices. We experienced 5 unusual cases, which had bleeding from the right internal mammary artery between 5 and 69 days after implantation of a HeartMate (Thoratec Corporation, Pleasanton, CA) device. It was evident that the outflow graft had eroded through the vessel. Sudden decreases in device flow, hypotension, bleeding from the driveline or chest tube sites, and a drop in hematocrit were the initial manifestations. Chest roentgenogram and transthoracic echocardiography were effective in identifying hemothorax and cardiac tamponade. Four out of 5 patients survived to heart transplantation and were discharged from the hospital. When identified and treated appropriately, this complication does not impair patient outcome.- - - - - - - - - - ranking = 1keywords = vessel (Clic here for more details about this article) |
5/14. Normal anatomy and limitations in CT interpretation of lymph node disease.The CT appearance of normal retroperitoneal lymph nodes has been described. In many instances the structures are too small to be identified. other retroperitoneal structures, such as collapsed bowel loops, vessels, and other perirenal structures, may simulate the presence of nodes. CT is of great benefit in disease with bulky tumors, such as non-Hodgkin's lymphoma, testicular tumors, etc. Its usefulness is much more limited in disease that may have extensive nodal involvement but no significant enlargement of the nodes. The accuracy of CT scanning in Hodgkin's disease and in many instances of genitourinary tumors is questioned, and we submit that further studies are needed to establish the reliability of this mode of examination.- - - - - - - - - - ranking = 1keywords = vessel (Clic here for more details about this article) |
6/14. cerebral infarction due to radiation accelerated arteriosclerosis.radiation therapy may cause accelerated arteriosclerosis of carotid and vertebral vessels which can cause cerebral infarction. This is a late complication which usually occurs several years after therapy and often affects vessels in locations where severe arteriosclerotic change is uncommon.- - - - - - - - - - ranking = 2keywords = vessel (Clic here for more details about this article) |
7/14. Coronary heart disease--a possible risk in megavoltage therapy?A 21-year old man died of an extensive anteroseptal myocardial infarction 16 months after receiving megavoltage radiotherapy to a mantle field for Hodgkin's disease stage PS IA confined to the midcervical lymph nodes on the left side of the neck. Post mortem findings revealed severe atherosclerotic changes in the coronary arteries. This case and a review of the literature suggest that irradiation to the heart may induce or accelerate atherosclerosis of the epicardial vessels. This should be taken into consideration when starting prophylactic irradiation to the mantle field in patients with Hodgkin's disease stage IA without obvious involvement of the mediastinun. Histologic examination of the heart and coronary vessels should be performed in any fatal case after megavoltage therapy involving the heart.- - - - - - - - - - ranking = 2keywords = vessel (Clic here for more details about this article) |
8/14. Computerized tomography of retroperitoneal lymphadenopathy: benign or malignant.A distinguishing feature has been noted to help differentiate between malignant retroperitoneal nodes and nodes which contain reactive hyperplasia. This sign is the presence of a cleavage plane between the mass of nodes and the great vessels which are easily visible in benign disease. This distinction is in reference to malignant nodal disease where the contours of the vessels are obscured. The ability to make a diagnosis of benign disease on CAT scan has enabled us to choose the appropriate course of therapy and, in some patients, allowed us to avoid exploratory laparotomy for diagnosis.- - - - - - - - - - ranking = 2keywords = vessel (Clic here for more details about this article) |
9/14. Necrotizing myelopathy complicating Hodgkin's disease.A case of necrotizing myelopathy is presented as a complication of Hodgkin's disease. The distinctive pathologic feature of this case was severe acute vasculitis involving only the vessels of the spinal cord that was considered to have been the cause of the segmental necrosis.- - - - - - - - - - ranking = 1keywords = vessel (Clic here for more details about this article) |
10/14. Granulomatous angiitis of the brain: a successfully treated case.A patient with clinical and radiographic findings initially suggesting a neoplasm was diagnosed as having hodgkin disease. Computerized axial tomography demonstrated profound diffuse decreased density similar to that seen in cases of cerebral edema or leukomalacia. cerebral angiography showed blood vessels with a beaded appearance. A diagnosis of granulomatous angitis was made on the basis of brain biopsy specimens. Viral cultures were negative. skin testing revealed poor response to antigens. The patient improved dramatically following a combination of radiotherapy and steroid therapy. Resolution of the low-density abnormally seen on serial EMI scanning and resolution of the vasculitis demonstrated in the post-therapy brain biopsy specimen was dramatic. This is the first case of granulomatous angitis of the brain diagnosed during life, and it points out the value of radiation and steroid therapy for relief of neurologic symptoms.- - - - - - - - - - ranking = 1keywords = vessel (Clic here for more details about this article) |
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