Hungarian Radiology

[A Travel from the Present to the Future A Radiology Assistant in Denmark Viborg, 18 March to 13 May 2002]

GERGELY Márta

OCTOBER 20, 2003

Hungarian Radiology - 2003;77(05)

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Hungarian Radiology

[Peritoneal encapsulation associated with lipophage and foreign body granulomas]

SZÁNTÓ Dezső, SZŰCS Gabriella, DITRÓI Edit

[INTRODUCTION - Peritoneal encapsulation is a rare developmental anomaly in which the ileal loops are encased in an accessory peritoneal compartment between the omentum and mesocolon. CASE REPORT - A 44 year old foreign female patient presented a history of recurrent abdominal pain, distension, constipation and suppurative inflammation of abdominal anterior wall. She had a 2nd type diabetes and three similar episodes in the last nine months from her abdominomural war-injury, only. Extension revealed an independent of peristaltic rushes protrusion in the left anterior abdominal wall. On the abdominal plain films we saw a metaloid foreign body in the left subcostal plane and a globular calcareous deposit in the intertubercular one. The family physician of the patient informed us about the further follow up. At the laparatomy peritoneal encapsulation furthermore foreign body and lipophage granulomas were found. Histology of these granulomas proved the diagnosis. CONCLUSION - The speciality of case is the association of an uncommon developmental anomaly with lipophage and foreign body granulomas with pyogenous inflammation of the abdominal wall.]

Hungarian Radiology

[Ultrasound is not a stetoscope]

HARKÁNYI Zoltán

[Introduction of the small size, portable ultrasound machines opened new opportunities in ultrasound imaging. The optimal application of these equipments and the new problems related to the use are widely discussed in the literature. This brief review summarizes the advantages, main indication and limitations of the method. The single most important aspect for the patient is that emergency ultrasound examination should be available regardless of the profession of the doctors. The most difficult question is how to provide and control an optimal education and training for the doctors. Possible solutions are also discussed. It is predictable that the availablity of the portable ultrasound studies will significantly increase the number of examinations, therefore economical consequences must also be considered. The author disagree with the conception, which states that ultrasound machine can be used as a stetoscop in the doctor's pocket.]

Hungarian Radiology

[György Csákány MD has Passed Away 1920-2003]

Hungarian Radiology

[Márton Lányi: Brustkrankheiten im Mammogramm Springer, 2003.]

GÖBLYÖS Péter

Hungarian Radiology

[The 13th Symposium of Pediatric Radiology Balatonszéplak, 28-30 August 2003]

VÁRKONYI Ildikó

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Late simultaneous carcinomatous meningitis, temporal bone infiltrating macro-metastasis and disseminated multi-organ micro-metastases presenting with mono-symptomatic vertigo – a clinico-pathological case reporT

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Although vertigo is one of the most common complaints, intracranial malignant tumors rarely cause sudden asymmetry between the tone of the vestibular peripheries masquerading as a peripheral-like disorder. Here we report a case of simultaneous temporal bone infiltrating macro-metastasis and disseminated multi-organ micro-metastases presenting as acute unilateral vestibular syndrome, due to the reawakening of a primary gastric signet ring cell carcinoma. Purpose – Our objective was to identify those pathophysiological steps that may explain the complex process of tumor reawakening, dissemination. The possible causes of vestibular asymmetry were also traced. A 56-year-old male patient’s interdisciplinary medical data had been retrospectively analyzed. Original clinical and pathological results have been collected and thoroughly reevaluated, then new histological staining and immunohistochemistry methods have been added to the diagnostic pool. During the autopsy the cerebrum and cerebellum was edematous. The apex of the left petrous bone was infiltrated and destructed by a tumor mass of 2x2 cm in size. Histological reexamination of the original gastric resection specimen slides revealed focal submucosal tumorous infiltration with a vascular invasion. By immunohistochemistry mainly single infiltrating tumor cells were observed with Cytokeratin 7 and Vimentin positivity and partial loss of E-cadherin staining. The subsequent histological examination of necropsy tissue specimens confirmed the disseminated, multi-organ microscopic tumorous invasion. Discussion – It has been recently reported that the expression of Vimentin and the loss of E-cadherin is significantly associated with advanced stage, lymph node metastasis, vascular and neural invasion and undifferentiated type with p<0.05 significance. As our patient was middle aged and had no immune-deficiency, the promoting factor of the reawakening of the primary GC malignant disease after a 9-year-long period of dormancy remained undiscovered. The organ-specific tropism explained by the “seed and soil” theory was unexpected, due to rare occurrence of gastric cancer to metastasize in the meninges given that only a minority of these cells would be capable of crossing the blood brain barrier. Patients with past malignancies and new onset of neurological symptoms should alert the physician to central nervous system involvement, and the appropriate, targeted diagnostic and therapeutic work-up should be established immediately. Targeted staining with specific antibodies is recommended. Recent studies on cell lines indicate that metformin strongly inhibits epithelial-mesenchymal transition of gastric cancer cells. Therefore, further studies need to be performed on cases positive for epithelial-mesenchymal transition.

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Creutzfeldt-Jakob Disease: A single center experience and systemic analysis of cases in Turkey

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We aimed to analyze the clinical, laboratory and neuroimaging findings in patients with sporadic Creutzfeldt-Jakob disease (CJD) in a single center as well as to review other published cases in Turkey. Between January 1st, 2014 and June 31st, 2017, all CJD cases were evaluated based on clinical findings, differential diagnosis, the previous misdiagnosis, electroencephalography (EEG), cerebrospinal fluid and cranial magnetic resonance imaging (MRI) findings in our center. All published cases in Turkey between 2005-2018 were also reviewed. In a total of 13 patients, progressive cognitive decline was the most common presenting symptom. Two patients had a diagnosis of Heidenhain variant, 1 patient had a diagnosis of Oppenheimer-Brownell variant. Seven patients (53.3%) had been misdiagnosed with depression, vascular dementia, normal pressure hydrocephalus or encephalitis. Eleven patients (87%) had typical MRI findings but only 5 of these were present at baseline. Asymmetrical high signal abnormalities on MRI were observed in 4 patients. Five patients (45.4%) had periodic spike wave complexes on EEG, all appeared during the follow-up. There were 74 published cases in Turkey bet­ween 2005 and 2018, with various clinical presentations. CJD has a variety of clinical features in our patient series as well as in cases reported in Turkey. Although progressive cognitive decline is the most common presenting symptom, unusual manifestations in early stages of the disease might cause misdiagnosis. Variant forms should be kept in mind in patients with isolated visual or cerebellar symptoms. MRI and EEG should be repeated during follow-up period if the clinical suspicion still exists.

Clinical Neuroscience

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Clinical Neuroscience

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