Computed tomography scan.

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Radiol Bras  vol.50 número1

Radiol Bras vol.50 número1

Colonoscopy with biopsy of the intestinal mass led to a histo- logical diagnosis of moderately differentiated adenocarcinoma of the colon, and the patient was therefore submitted to segmental colectomy with colostomy. The anatomopathological study re- vealed a hard, annular tumor, which was ulcerative and vegeta- tive, infiltrating the intestinal wall and surrounding fat, thus con- firming the result of the microscopy study of the biopsy. Subse- quently, ultrasound of the urinary tract confirmed bladder nodula- tion (Figure 1D), with no perceptible flow on color Doppler. Com- plete transurethral resection of the nodulation was performed, and histopathological analysis of the resected specimen led to a diagnosis of superficial low-grade papillary urothelial carcinoma (World Health Organization grade I). A subsequent computed tomography scan of the abdomen and pelvis, for staging, showed no suspicious lesions. The final diagnosis was multiple, synchro- nous primary malignancies, probably secondary to smoking.
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Craniometaphyseal Dysplasia

Craniometaphyseal Dysplasia

A 4-year-old female was referred from the Depart- ment of Otorhinolaryngology to our department to examine her abnormal facial appearance and history of nasal obstruction and mild hearing loss. Her head circumference was in the 96th percentile, with notably wide-set eyes, a broad nasal root, a prominent fore- head, and mouth breathing due to narrow nasal passages (Fig. 1). She was born normally at term with a weight of 3.1 kg. The pregnancy and neonatal period were uneventful. She had no relevant family history of skeletal or craniofacial abnormalities. The craniofacial bones were noted to have salient sclerosis and hypero- stosis (Fig. 2). The distal femur was notable for a narrow diaphysis and widened metaphysis, resulting in an "Erlenmeyer flask"-shaped appearance (Fig. 3). A facial computed tomography scan exhibited reduced pneumatization of the bilateral mastoid air cells, diffuse cortical thickening of the craniofacial bones, obliteration of the paranasal sinuses, and nar- rowing of the cranial nerve foramina due to diffuse sclerosis of the cranial base (Fig. 4). Serum alkaline phosphatase was minimally elevated at 392 IU/L. Other characteristics were normal. The patient is cur- Clin Rheumatol 2011;17:35-6.
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Radiol Bras  vol.50 número1

Radiol Bras vol.50 número1

Colonoscopy with biopsy of the intestinal mass led to a histo- logical diagnosis of moderately differentiated adenocarcinoma of the colon, and the patient was therefore submitted to segmental colectomy with colostomy. The anatomopathological study re- vealed a hard, annular tumor, which was ulcerative and vegeta- tive, infiltrating the intestinal wall and surrounding fat, thus con- firming the result of the microscopy study of the biopsy. Subse- quently, ultrasound of the urinary tract confirmed bladder nodula- tion (Figure 1D), with no perceptible flow on color Doppler. Com- plete transurethral resection of the nodulation was performed, and histopathological analysis of the resected specimen led to a diagnosis of superficial low-grade papillary urothelial carcinoma (World Health Organization grade I). A subsequent computed tomography scan of the abdomen and pelvis, for staging, showed no suspicious lesions. The final diagnosis was multiple, synchro- nous primary malignancies, probably secondary to smoking.
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J. bras. pneumol.  vol.31 número6

J. bras. pneumol. vol.31 número6

A 66-year-old patient was referred to the thoracic surgery outpatient clinic for investigation of recurrent episodes of pneumonia for two years. Upon clinical and physical examination, the patient presented good general condition, mild dyspnea, normal skin color and normal blood gas analysis. In the thorax, the patient presented underlying fluid density and reduced breath sounds in the left lung base. A simple chest X- ray, taken upon admission, revealed left lower lobe opacity, with reduced lung volume and left mediastinal deviation, partial left lower lobe atelectasis and scoliosis of the thoracic vertebrae. A computed tomography scan of the chest revealed a low density image, characteristic of fat and obstructing the left main bronchus. The diagnostic hypothesis was recurrent pneumonia due to the bronchial obstruction caused by a lesion with fat density suggestive of lipoma.
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Int. braz j urol.  vol.29 número5

Int. braz j urol. vol.29 número5

Herein, we report a case of a cystadenoma in a 49-year-old asymptomatic man, detected in a routine ultrasonography for liver disease follow-up. The digital rectal examination detected a large mass anterior to rectum and posterior to bladder. Computed tomography scan and magnetic resonance imaging showed a normal prostate and a 9.0 cm cystic tumor, replacing the left seminal vesicle. The gross appearance and microscopic aspect was compatible with cystadenoma of seminal vesicle. Patient’s postoperative recovery was uneventful. He is currently alive, 3 years after the diagnosis, with no signs of recurrence.
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Hydrocarbon Pneumonitis; Clinical and Radiological Variability

Hydrocarbon Pneumonitis; Clinical and Radiological Variability

On laboratory examination, complete blood count revealed ele- vated white blood cells (14.110/μl) and an erythrocyte sedimen- tation rate of 56 mm/h. Serum electrolytes, hepatic and renal function tests were normal. Arterial blood gas measurements; pH = 7.38, pCO2 = 36.3 mmHg, pO2 = 55 mmHg and SaO2 = 85%. Spirometer revealed moderate restriction of lung function. On admission chest radiograph demonstrated a density in the right middle lobe. A Repeated chest radiography on the 3rd day of admission showed consolidation with volume loss and blur- ring of diaphragmatic contour in the right lower lobe (Fig 1A, 1B). A chest computed tomography scan showed a prominent consolidation with an air bronchogram in the right middle lobe, a minimal consolidation in the let lower lobe and atelectasis in
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Braz. j. .  vol.77 número3

Braz. j. . vol.77 número3

Fine needle aspiration cytology sho- wed loose arrangement of spindle cells in the myxoid matrix, suggestive of a soft tissue lesion. On computed tomography scan a 3.2x4.2 cm sized soft tissue density was seen in close proximity to the superficial lobe of the left parotid with tiny hypodensities of fat attenuation in the periphery. The lesion was extending anterior to the sternocleidomastoid muscle displacing the platysma. Post contrast showed a heterogenous enhancement.(Fig.1)

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Clinics  vol.71 número10

Clinics vol.71 número10

CONCLUSION: A computed tomography scan after minor head injury in pediatric patients did not show clinically relevant abnormalities that could lead to neurosurgical indications. Patients who fell more than 1.0 m were more likely to have changes in imaging tests, although these changes did not require neurosurgical inter- vention; therefore, the use of computed tomography scans may be questioned in this group. The results support the trend of more careful indications for cranial computed tomography scans for children with minor head trauma.

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Repositório Institucional UFC: Prenatal imaging findings in fetal Zika virus infection

Repositório Institucional UFC: Prenatal imaging findings in fetal Zika virus infection

Neuroimaging investigation contributes to the prenatal detection of microcephaly and other brain abnormalities in cases of intrauterine ZIKV infection. Neuroimaging is based antenatally on two- dimensional and three-dimensional ultrasound and fetal MRI, whereas computed tomography scan is performed postnatally. Although neuropathology associated with intrauterine ZIKV infection is characterized by nonspecific findings of brain disorder, reduced cortical gyration and white-matter hypomyelination or dysmyelination and cerebellar hypoplasia have been consistently observed in the majority of fetuses and newborns. Prenatal or postnatal genetic workup should be carried out to exclude cases of primary microcephaly. Follow-up should rely upon MRI and computed tomography scan as well as neuropediatrician to better define developmental outcome in survivors.
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Rev. Soc. Bras. Med. Trop.  vol.40 número1

Rev. Soc. Bras. Med. Trop. vol.40 número1

A 23-year-old man presented with a 3-day history of fever, headache and chills. He lived in Manaus, which is an endemic area for malaria in the Western Brazilian Amazon region. Physical examination revealed enlargement of the spleen and laboratory data showed moderate anemia and thrombocytopenia. The routine thick blood smear was positive for Plasmodium vivax and the patient started treatment with chloroquine and primaquine. At the follow-up visit two weeks later, the patient was afebrile but was complaining of abdominal pain in the left hypochondrium. Abdominal ultrasound revealed splenomegaly with a large fluid collection in the lateral subcapsular area (Figure A) and several other smaller cystic collections in the parenchyma. An axial computed tomography scan showed an enlarged spleen and the same fluid collections inside the splenic parenchyma (Figure B). Two other probable, smaller collections were also seen in the splenic parenchyma. Strict bed rest was recommended for the patient and he did not develop any clinical signs of rupture of the spleen. The main splenic complications of Plasmodium infection are splenic hematoma, splenic rupture, hypersplenism, ectopic spleen, splenic torsion, splenic cysts and hyperreactive malarial spleen. Splenic rupture is generally the most common finding in Plasmodium vivax infections and is secondary to subcapsular hematomas. Nonsurgical management consists of observation for 7-14 days in the hospital, strict bed rest, and administration of fluids and blood derivatives as needed. Delayed rupture rarely occurs. When last seen one month later, the patient had recovered from the abdominal pain. Ultrasound showed a normal-sized spleen with some scattered small cystic lesions.
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J. Pediatr. (Rio J.)  vol.81 número3 en v81n3a15

J. Pediatr. (Rio J.) vol.81 número3 en v81n3a15

Description: A 16-year-old girl was brought to our hospital with fever and blood-tinged sputum 2 weeks prior to her admission. She suffered from neurologic sequelae of herpetic encephalitis and had been bed-ridden since 5 years of age. A longitudinal paraspinal soft mass had been noted in the previous week by her mother. She had been given oral feeding despite frequent choking for the past few years. On palpation, the mass can be squeezed to follow the least resistance of subcutaneous space longitudinally extending to the lower thoracic region. Chest computed tomography scan revealed right lower lobe necrotizing pneumonitis and a pleuro-cutaneous fistula leading to the subcutaneous air locules. A protracted course of antibiotics was prescribed and subcutaneous air trapping decreased in size over 8 weeks.
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J. bras. pneumol.  vol.34 número4 en v34n4a10

J. bras. pneumol. vol.34 número4 en v34n4a10

vated in the supine position, asthenia, anorexia, and weight loss (5 kg). One week after the onset of symp- toms, the patient presented progressively worsening chest pain (on the left side) with pleuritic character- istics, frequent fits of dry cough upon exertion, and an isolated peak of fever had appeared. The electro- cardiogram results were normal, and endoscopy of the upper digestive tract revealed a compliant cardia and antral gastritis. A chest X-ray showed a hetero- geneous hypotransparency, with loss of substance in its center, in the middle third of the left lung field. A computed tomography scan of the chest revealed a 4-cm mass with heterogeneous content and pleural extension to the level of the lingula, as well as two micronodules in the posterior region of the right lung field (Figure 1). An etiological study was carried out based on the working diagnosis of pulmonary neoplasia. From the analytical study, we highlight the following results: an erythrocyte sedimentation rate of 98 mm in the first hour; a cancer antigen 125 level of 63.3 U.mL –1 (<35.0);
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Arq. NeuroPsiquiatr.  vol.71 número6

Arq. NeuroPsiquiatr. vol.71 número6

Figure. Meningioma associated with non-traumatic subdural hematoma. Axial computed tomography scan (A) showed heterogeneous subdural hemorrhage (arrowheads) associated with a dural attached tumor on right parietal convexity (asterisk). Axial T1 weighted image (B) and T2 gradient echo sequence* (C) distinguished both extra-axial contents, clot (arrowheads) and tumor (*). Comparative axial T1 weighted image post-gadolinium administration (D) depicted intense tumor enhancement (*). No enhancement was noticed on subdural hemorrhage (arrowheads). Surgical pathology (hematoxylin and eosine staining) confirmed a meningioma (grade I) with prevalent features of the meningothelial subtype associated with hemorrhage (E).
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Arq Bras Endocrinol Metab  vol.58 número6

Arq Bras Endocrinol Metab vol.58 número6

The uncommon aggressive pituitary tumors are named carcinomas when metastases are de- tected, either in the central nervous system and/or systemically. Some cases are associated with hormonal overproduction, but most are diagnosed because of local symptoms. These ne- oplasias are generally refractory to current treatments. A 51 year-old woman presented sudden onset of headache, left arm paresis and left facial hypoesthesia. Computed tomography scan and magnetic resonance imaging revealed a pituitary tumor invading the left sphenoidal and cavernous sinuses. Laboratory data excluded hormonal hypersecretion. The patient underwent transsphenoidal surgery and histological indings showed a neoplasia with Ki-67 estimated at 75%. Medical imaging excluded both a primary occult tumor and central nervous system or systemic dissemination. Three weeks postoperatively, neurological condition worsened, with new onset of ataxia, bilateral ptosis, ophthalmoplegia and an increase in the size of the lesion, leading to surgical intervention by craniotomy, followed by only a few sessions of radiotherapy, because of severe disease progression. Patient died nearly 2 months after the initial manifesta- tions. This case illustrates the aggressiveness of some pituitary lesions, the limited eficacy of current treatment modalities such as surgery or radiotherapy and the pitfalls of the current pitui- tary tumors classiication. To our knowledge, this case corresponds to one of the most aggres- sive pituitary neoplasms reported so far, with a very high Ki-67 index (75%) and short survival (2 months). Ki-67 index could be of prognostic value in pituitary tumors. Pituitary tumors World Health Organization (WHO) classiication could be revisited. Arq Bras Endocrinol Metab. 2014;58(6):656-60
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PDF EN Jornal Brasileiro de Pneumologia 4 10 english

PDF EN Jornal Brasileiro de Pneumologia 4 10 english

vated in the supine position, asthenia, anorexia, and weight loss (5 kg). One week after the onset of symp- toms, the patient presented progressively worsening chest pain (on the left side) with pleuritic character- istics, frequent fits of dry cough upon exertion, and an isolated peak of fever had appeared. The electro- cardiogram results were normal, and endoscopy of the upper digestive tract revealed a compliant cardia and antral gastritis. A chest X-ray showed a hetero- geneous hypotransparency, with loss of substance in its center, in the middle third of the left lung field. A computed tomography scan of the chest revealed a 4-cm mass with heterogeneous content and pleural extension to the level of the lingula, as well as two micronodules in the posterior region of the right lung field (Figure 1). An etiological study was carried out based on the working diagnosis of pulmonary neoplasia. From the analytical study, we highlight the following results: an erythrocyte sedimentation rate of 98 mm in the first hour; a cancer antigen 125 level of 63.3 U.mL –1 (<35.0);
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Int. braz j urol.  vol.43 número1

Int. braz j urol. vol.43 número1

Patient and method: A 30 year-old asymptomatic man presented with left testicular swelling for 2 months. Physical examination revealed an enlarged and hard left testis. Alpha-fetoprotein (>1000ng/mL) and beta-HCG (>24.000U/L) were increased. Beta-HCG increased to >112.000U/L in less than one month. The patient underwent a left orchiectomy. Pathological examination showed a mixed NSGCT (50% embryonal carcinoma; 30% teratoma; 10% yolk sac; 10% cho- riocarcinoma). Computed tomography scan revealed a large tumor mass close to the left renal hilum (10x4x4cm) and others enlarged paracaval and paraortic lymph nodes (T2N3M1S3-stage III). Patient was submitted to 4 cycles of BEP with satisfactory response. Residual mass was suggestive of teratoma. Based on these findings, he was submitted to a robot-assisted RPLND.
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Radiol Bras  vol.48 número5

Radiol Bras vol.48 número5

Besides the reduction of radiation exposure, the optimi- zation of the protocols brought additional benefits such as reduction in the time required to perform the scans. Previ- ously to the protocols review, 71.2% (364/511 scans) of the patients remained for at least 7 minutes inside the CT scan- ner. After implementation of the new protocols, only 15.5% of the patients (122/768 scans) were submitted to the equi- librium phase. Considering the number of abdominal scans in the hospital environment, and that both the patient and the apparatus have to wait for approximately three minutes for the start of the equilibrium phase, the elimination of such a phase saved time enough to allow for the performance of more scans per day, besides a shorter patient stay inside the scanner.
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J. Bras. Nefrol.  vol.32 número4 en v32n4a11

J. Bras. Nefrol. vol.32 número4 en v32n4a11

Horseshoe kidney is the most common of all renal fusion anomalies, occurring in approximately 0.25% of the general population. Horseshoe kidney with only a single ureter is a rare anomaly. A 60-ye- ar-old man was admitted to hospital for routine health screening. His family his- tory was negative for kidney diseases, and there was no abnormality in his physical examination. A computed tomography (CT) scan revealed an atypical horseshoe kidney with cysts and three-dimensional spiral CT reconstruction showed the pre- sence of a single ureter. The patient has since been followed up for two years wi- thout any signs of clinical disease. We report a rare case of a patient with a hor- seshoe kidney with cysts and a single ure- ter that was diagnosed incidentally. Keywords: genito urinary abnormalities, polycystic kidney diseases, cysts.
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Int. braz j urol.  vol.36 número1

Int. braz j urol. vol.36 número1

Perinephric abscess is a serious entity ne - glected in the urological literature. Morbidity and mortality have fallen in the last decades thanks to the progress in diagnosis with ultrasonography and overall computed tomography (CT) scan and due to improvement in medical and surgical therapies. Nevertheless, the best way of surgical management of such collections has been a subject of debate. In this article, the authors compared retrospectively the outcome of 43 perinephric abscess drained percutane- ously with 43 cases drained by open surgery. Renal stones and diabetes mellitus were the most important predisposing factors. Abscesses drained by open surgery were signiicantly greater and multiloculated when compared to percutaneously drained abscesses. The cure rate was signiicantly higher in the group treated by the open access. There were no difference in the complication rate but hospital stay was longer among patients treated percutaneously.
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Pulmonary lymphomas: evaluation by computed tomography.

Pulmonary lymphomas: evaluation by computed tomography.

This paper describes the tomographic appearance of pulmonary lymphomas. We studied the thoracic computed tomographies of ten patients with biopsy-proven diagnoses non-Hodgkin’s and Hodgkin’s disease. The most common radiologic findings in this series are the alveolar opacities with air bronchograms (n=8). Other manifestations include multiple pulmonary nodules (n=4), thickening of broncho-vascular bundles (n=3) and foci of ground- glass attenuation (n=2). The present series confirms the results published in available literature about the radiographic appearance of the disease.

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