Hungarian Radiology

[CALENDAR OF RADIOLOGICAL EVENTS, 2002]

APRIL 20, 2002

Hungarian Radiology - 2002;76(02)

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Hungarian Radiology

[Dilemma of screening for lung cancer]

MONOSTORI Zsuzsanna

[Lung cancer still represents one of the greatest and unsolved health problem of the world. The lung cancer mortality rate is the highest among all cancer cases in both genders. While the world is focusing on both primary and secondary prevention, the position of mass screening for lung cancer is complex and controversial, yet. This raises many issues that can only solved by a multidisciplinary approach. This summary is intending to help the radiologists to make the right decision in our modern computerised world. Nowadays one of the most important question is if screening of the high-risk group with low-dose spiral CT is efficient and cost-effective.]

Hungarian Radiology

[Conference of the Young Radiologists]

BÁGYI Péter

Hungarian Radiology

[The incidence of Hirschsprung disease with associated congenital anomalies]

WEISENBACH János, KONDOR Ariella, KHEZRI Seddiq, VAJDA Péter

[INTRODUCTION - Several publisactions described the association of Hirschsprung disease with other congenital anomalies. Most studies were in relation with the neurological, ophthalmological and ear-nose-throat disorders. The authors did not find any publication in the Hungarian literature presented other anomalies in patients with Hirschsprung disease. PATIENTS AND METHODS - The data of 43 patients treated for Hirschsprung disease at the Department of Paediatrics of Pécs University was analysed. The most frequent associated anomalies e. g. Down syndrome, omphalocele, anorectal malformation, annular pancreas, torticollis, syndactylia, Meckel diverticulum, upper urinary tract disorder and undescendent testis were studied. The patients who had several congenital anomalies were evaluated separately as well as those having congenital inguinal hernia. The authors compared the number of congenital anomalies occurred in patients with Hirschsprung disease with the incidence of these congenital disorders occurred in non-Hirschsprung patients in the literature. RESULTS - Among 43 patients, 6 children had associated congenital anomalies. 3 patients had only one of the following disorders: undescendent testis, urinary tract duplication and Down syndrome. 3 patients suffered from multiplex congenital anomalies: 1. Down syndrome with annular pancreas and torticollis. 2. Omphalocele, anal atresia, vesicoureteric reflux and syndactylia. 3. Anus atresia, Meckel diverticulum and limb (radius) hypoplasia. In addition 3 patients had other anomalies such as unilateral and bilateral inguinal hernia and umbilical hernia. CONCLUSION - On the basis of our results we can state that the incidence of other associated congenital anomalies are higher in patients with Hirschsprung disease. Single organ developmental anomaly is rare, it usually occurs in association with multiorgan disorders. Most likely this is the explanation why patients with Hirschsprung disease have more associated anomalies.]

Hungarian Radiology

[Serious lesion of the skull]

Hungarian Radiology

[Dr. László Csípő]

MONOKI Erzsébet

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Clinical Neuroscience

Life threatening rare lymphomas presenting as longitudinally extensive transverse myelitis: a diagnostic challenge

TOLVAJ Balázs, HAHN Katalin, NAGY Zsuzsanna, VADVÁRI Árpád, CSOMOR Judit, GELPI Ellen, ILLÉS Zsolt, GARZULY Ferenc

Background and aims – Description of two cases of rare intravascular large B-cell lymphoma and secondary T-cell lymphoma diagnosed postmortem, that manifested clinically as longitudinally extensive transverse myelitis (LETM). We discuss causes of diagnostic difficulties, deceptive radiological and histological investigations, and outline diagnostic procedures based on our and previously reported cases. Case reports – Our first case, a 48-year-old female was admitted to the neurological department due to paraparesis. MRI suggested LETM, but the treatments were ineffective. She died after four weeks because of pneumonia and untreatable polyserositis. Pathological examination revealed intravascular large B-cell lymphoma (IVL). Our second case, a 61-year-old man presented with headache and paraparesis. MRI showed small bitemporal lesions and lesions suggesting LETM. Diagnostic investigations were unsuccessful, including tests for possible lymphoma (CSF flow cytometry and muscle biopsy for suspected IVL). Chest CT showed focal inflammation in a small area of the lung, and adrenal adenoma. Brain biopsy sample from the affected temporal area suggested T-cell mediated lymphocytic (paraneoplastic or viral) meningoencephalitis and excluded diffuse large B-cell lymphoma. The symptoms worsened, and the patient died in the sixth week of disease. The pathological examination of the presumed adenoma in the adrenal gland, the pancreatic tail and the lung lesions revealed peripheral T-cell lymphoma, as did the brain and spinal cord lesions. Even at histological examination, the T-cell lymphoma had the misleading appearance of inflammatory condition as did the MRI. Conclusion – Lymphoma can manifest as LETM. In cases of etiologically unclear atypical LETM in patients older than 40 years, a random skin biopsy (with subcutaneous adipose tissue) from the thigh and from the abdomen is strongly recommended as soon as possible. This may detect IVL and provide the possibility of prompt chemotherapy. In case of suspicion of lymphoma, parallel examination of the CSF by flow cytometry is also recommended. If skin biopsy is negative but lymphoma suspicion remains high, biopsy from other sites (bone marrow, lymph nodes or adrenal gland lesion) or from a simultaneously existing cerebral lesion is suggested, to exclude or prove diffuse large B-cell lymphoma, IVL, or a rare T-cell lymphoma.

Clinical Neuroscience

Association of anterior thoracic meningocele and azygos lobe of the lung

DENIZ Ersay Fatih, SENAYLI Atilla, BICAKCI Ünal

Here we report an anterior thoracic meningocele case. Twoyears- old female patient was presented with kyphosis. Azygos lobe of the lung was also demonstrated during radiological studies. Posterolateral thoracotomy incision and extralpeural approach was performed for excision of the anterior meningocele to untether the cord. Although both anomalies are related to faulty embryogenesis and it is well known that faulty embryogenesis may also reveal coexisting abnormalities, we could not speculate a common mechanism for anterior thoracic meningocele and azygos lobe of the lung association.

Hungarian Radiology

[The quality control of radiological equipments in Hungary]

PELLET Sándor, PORUBSZKY Tamás, BALLAY László, GICZI Ferenc, MOTOC Anna Mária, VÁRADI Csaba, TURÁK Olivér, GÁSPÁRDY Géza

Clinical Neuroscience

[PSYCHOPHYSIOLOGICAL AND CLINICAL ASPECTS OF THE EEG SYNCHRONIZATION RELATED TO COGNITIVE PROCESSES]

MOLNÁR Márk, CSUHAJ Roland, CSIKÓS Dóra, HAMVAI Csaba, CZIGLER Balázs, BÁLINT Andrea, GAÁL Zsófia Anna

[The authors review the various forms of EEG-synchronization with special emphasis on the characteristics of the induced and enhanced rhythms. The suggested role of the various EEG frequency bands in the cognitive processes is demonstrated by examples from the literature. The relationship between linear and nonlinear electrophysiological complexity and EEG synchronization is analyzed, with a touch on the use of Omega-complexity and synchronization likelihood methods. In the present study the EEG recorded during adding and subtracting tasks was analyzed with the above methods. It was found that during the adding task the theta band increased in the frontal area, which may be related to activation of working memory processes. Mapping the scalp-distribution of synchronization likelihood also confirmed increased synchronization in the frontal area in addition to which increased values were found in the left temporo-parietal area. The analysis of linear and nonlinear EEG synchronization associated with cognitive processing is suitable to explore the task-related and region specific features of these events.]

Clinical Neuroscience

[The role of sleep dynamics and delta homeostasis in cognitive functions]

HALÁSZ Péter

[The paper is aimed to introduce the neuronal network basis of dynamic sleep processes, including the micro-structure of sleep and the relationship of sleep dynamics with homeostatic regulation and plastic changes during sleep. Newer studies tend to show that beyond the wellknown long-term homeostatic and circadian regulation of NREM sleep, sleep is regulated by a stimulus and arousal dependent flexible defense system, the elements of which participate in sleep delta homeostasis. Within the EEG elements of sleep a more larger amount represents reactible type as it was thought previously.. Both the events of wake state and sensory input during sleep are shaping the sleep EEG in a function- and localisation specific way and the next day cognitive functios are determined by these changes.]