Unusual Locations (unusual + locations)

Distribution by Scientific Domains
Distribution within Medical Sciences

Selected Abstracts

Neonatal Congestive Heart Failure Due to a Subclavian Artery to Subclavian Vein Fistula Diagnosed by Noninvasive Procedures

Gregory H. Tatum MD
ABSTRACT Congestive heart failure in the neonate is usually due to intracardiac anomalies or cardiac dysfunction. Extracardiac causes are rare. Patient., We report a newborn infant who presented with respiratory distress and cardiomegaly. Result., Echocardiography identified a dilated right subclavian artery and vein and superior vena cava. Magnetic resonance imaging confirmed a subclavian artery to subclavian vein fistula that was treated with surgical ligation. The infant recovered fully. This case underscores the need for clinical suspicion of fistulous connection in unusual locations in the face of unexplained heart failure in the neonate. Conclusion., Echocardiographic and magnetic resonance imaging are effective noninvasive modalities to confirm the diagnosis prior to surgical intervention. [source]

De Novo Malignant Eccrine Spiradenoma with an Interesting and Unusual Location

Serkan Yildirim MD
Background. Reports in the literature reveal that malignant eccrine spiradenomas (MES) are exceedingly rare, and represent aggressive tumors arising in long-standing benign eccrine spiradenomas (ES). Objective. We present a de novo case of MES of the nose, in contrast to reports in the literature of progression from long-standing benign lesions. Methods. Case report and brief review of the literature. Results. Our case was accepted as de novo MES because there was no evidence of ES on pathologic examination. It was treated by surgical excision with 1 cm tumor-free margins. No recurrence or complications were observed for 2 months, but long-term follow-up could not be performed because the patient died of adenocarcinoma of the colon. Conclusion. Although previously reported lesions have arisen in long-standing benign ESs, usually on the trunk or extremities, this report shows that MES may occur as a primary malignant tumor and may occur in unusual locations such as the nose. [source]

Pericardial effusion as primary manifestation of metastatic cutaneous adenoid cystic carcinoma: Diagnostic cytopathology from an exfoliative sample

Maxime Benchetritt M.D.
Abstract Adenoid cystic carcinoma (ACC) occurs not only as a tumor of salivary glands, but also in very unusual locations, such as in the skin. Only very few cases of primary cutaneous of ACC have metastasized to the lymph nodes and lungs. We present a 53-year-old man with metastasis of the pericardium from a primary cutaneous ACC (PCACC) of the scalp, which had been surgically treated 14 years ago. Exfoliative cytologic findings from pericardial effusion included small clusters of basaloid cells with occasional cystlike spaces containing mucoid material. To our knowledge, this is the first case of pericardial metastasis from a PCACC. Diagn. Cytopathol. 2008;36:351,354. © 2008 Wiley-Liss, Inc. [source]

Cytologic features of meningiomas on crush preparations: A review

F.I.A.C., Momin T. Siddiqui M.D.
Abstract Meningiomas are rarely subjected to aspiration, however, since they may occur outside the central nervous system, it is important to recognize their cytologic features. The goal of this study was to examine the cytologic features of meningiomas in crush preparations and cytologic imprints prepared at the time of frozen section. A total of 97 cases of meningiomas evaluated intraoperatively by frozen section with concomitant crush preparation and cytologic imprint were reviewed to assess their cytologic features. The cytologic features of meningiomas identified in our study are cohesive syncitial clusters of cells with ill-defined boundaries. The nuclei are oval and may be eccentrically placed, along with small central nucleoli. The cytologic features may not reflect the histologic subtype. The psammomatous variant can however be easily recognized in touch preps/imprints. The presence of nuclear anaplasia, macronucleoli, mitotic activity, and sheet-like growth may suggest an atypical meningioma. In conclusion, the cytologic features identified would be helpful in diagnosis of meningiomas, especially in unusual locations. Diagn. Cytopathol. 2008;36:202,206. © 2008 Wiley-Liss, Inc. [source]

Levodopa-induced ocular dyskinesia in Parkinson's disease

H. Grötzsch
Levodopa (LD)-induced dyskinesia (LID), one of the most common motor complications in advanced Parkinson's disease (PD), involve mostly the limbs, trunk and head, but unusual locations have been reported including respiratory muscles, the face and the eyes. The aim of this study was to further investigate the frequency and characteristics of LD-related abnormal involuntary eye movements (AIEMs) in PD. Thirty-two patients with advanced PD and various motor complications were evaluated and videotaped in an ON and OFF state. We found AIEMs in five patients (16%) which were present exclusively during the ON state and which completely disappeared when OFF. They consisted of repeated, stereotyped upward and/or sideways gaze deviation movements, sometimes phasic, brief and jerky, sometimes tonic and sustained for several seconds. The main direction of gaze deviation was toward the side more affected by parkinsonism. AIEMs typically paralleled limb and trunk LID and were modulated by the same facilitation and inhibitory maneuvers. We concluded that AIEMs are not uncommon in advanced PD and represent a particular topography of LID, hence the term ,ocular dyskinesia' to designate these AIEMs that seem to have a specific pattern in PD as compared with other forms of parkinsonism. [source]

Sentinel lymph node biopsy in patients with melanoma and breast cancer

R. F. Uren
Abstract Sentinel lymph node biopsy (SNLB) is a new method for staging regional node fields in patients with cancers that have a propensity to metastasise to lymph nodes. The majority of early experience has been obtained in patients with melanoma and breast cancer. The technique requires the close cooperation of nuclear medicine physicians, surgical oncologists and histopathologists to achieve the desired accuracy. It involves: (i) identification of all lymph nodes that directly drain a primary tumour site (the sentinel nodes) by the use of pre-operative lymphoscintigraphy, (ii) selective excision of these nodes by the surgeon, guided by pre-operative blue dye injection and a gamma detecting probe intra-operatively and (iii) careful histological examination of the sentinel nodes by the histopathologist using serial sections and immunohistochemical stains. If the nodes are normal it can be inferred with a high degree of accuracy that all nodes in the node field are normal. This means that radical dissections of draining node fields can be avoided in patients with normal lymph nodes. A further advantage of lyamphatic mapping is that drainage to sentinel nodes in unusual locations is identified, leading to more accurate nodal staging than could be achieved with routine dissection of the closest node field. (Intern Med J 2001; 31: 547,553) [source]

The risk of ipsilateral versus contralateral recurrent deep vein thrombosis in the leg

P. Lindmarker
Abstract. Lindmarker P, Schulman S, the DURAC Trial Study Group (Karolinska Hospital, Karolinska Institute, Stockholm, Sweden) The risk of ipsilateral versus contralateral recurrent deep vein thrombosis in the leg. J Intern Med 2000; 247: 601,606. Objectives. To investigate the risk of ipsilateral versus contralateral recurrent deep vein thrombosis in the leg. Design. An open prospective long term follow-up multicentre trial. Patients were followed by frequent outpatient visits at each centre during the first 12 months after inclusion and thereafter annually. Setting. Sixteen hospitals in central Sweden. Subjects. A total of 790 consecutive patients with objectively verified first episode of acute deep vein thrombosis and without diagnosed malignant disease were recruited from a randomized study comparing 6 weeks with 6 months of oral antivitamin K therapy as secondary thromboprophylaxis. Main outcome measures. Deep vein thrombosis in the contralateral leg was confirmed by venography or ultrasound. With regard to the ipsilateral leg, venography was required. Results. A recurrent episode of venous thromboembolism was documented in 192 patients after a mean (±SD) period of 31(±29) months. In 26 additional patients with ipsilateral symptoms the diagnostic critera were not fulfilled. One hundred and eleven patients have deceased and 69 patients withdrew from the study. The 392 patients without recurrent episodes were followed for a median of 96 months with 90% for at least 48 months. An objectively verified recurrent contralateral and ipsilateral deep vein thrombosis occurred in 95 and 54 cases, respectively, and in 41 patients pulmonary embolism was documented. In two patients thromboses with unusual locations were registered. The risk of contralateral versus ipsilateral recurrence was significantly increased with a risk ratio of 1.6 (95% confidence interval 1.4,1.9) in a time to event model. In a multivariate analysis none of the investigated variables were significantly associated with the side of recurrent thrombosis. Conclusions. The risk of a recurrent deep vein thrombosis is increased in the contralateral leg. This brings into question the importance of an impaired venous flow for recurrent episodes of thrombosis. [source]

CT appearances of hydatid disease at various locations

K Taori
Summary Hydatid disease has characteristic imaging features on CT, which allow accurate preoperative diagnosis in most cases. However, when it occurs at unusual locations the diagnosis is often difficult, especially as the imaging appearance varies at different sites. In this article we have presented a pictorial review of the CT features of disease due to Echinococcus granulosus at various sites in the human body. [source]