Infection versus neoplasm in the spine: differentiation by MRI and diagnostic pitfalls

MRI images of 135 patients with spine infection and 81 patients with spine neoplasm were retrospectively analysed in order to identify criteria that will help in distinguishing infection from neoplasm and in differentiating the forms of spine infection. Disc involvement occurred in 93% of infections and only 1% of neoplasms. Features of tuberculous spondylitis included paraspinal soft tissue abscesses (95%), vertebral collapse (91%), pathognomonic intraosseous abscess seen on Gd-enhanced images (84%), epidural extension (68%), gibbus (26%), skip lesions (16%) and posterior element involvement (11%). Pyogenic and brucellar infections had comparable features, i. e. predilection for the lower lumbar spine, preservation of vertebral morphology, minimal granulation tissue production and epidural extension. Primary neoplasms affected solitary vertebrate while secondary neoplasms demonstrated skip lesions and frequent extraosseous soft tissue masses. Posterior elements were frequently affected in both. MRI is a useful method for distinguishing infection from neoplasm in the spine and for differentiating tuberculous spondylitis from other infections in the majority of cases. Correspondence to: M. C. Haddad     

Comparison of counterelectrophoresis and hemagglutination inhibition tests for hepatitis-associated antigen

Comparison of testing for hepatitis-associated antigen (HAA) by a commercial counter-electrophoresis system and a semiautomated hemagglutination inhibition technique shows the latter to be a practical and sensitive procedure for screening voluntary blood donors.     

Mucoepidermoid thymic carcinoma: A challenging mediastinal aspirate

Primary thymic carcinoma—mucoepidermoid cell (MEC) type is rare and only one report describing the cytologic features of this neoplasm in the metastatic site is described. We describe the cytological features of poorly differentiated carcinoma possibly MEC in a 54‐year‐old man who presented with cough, weight loss, and puffiness of face for 3 months. The significance of this infrequently encountered neoplasm lies in its potential confusion of origin of the tumor—thymus or metastases from a primary bronchial MEC. Immunocytochemical profile was suggestive of a thymic carcinoma of the MEC type. Diagn. Cytopathol. 2009. © 2009 Wiley‐Liss, Inc.     

Brachytherapy-based partial breast irradiation is associated with low rates of complications and excellent cosmesis

BackgroundRecent retrospective, claims-based analyses have suggested a potential increased rate of toxicities associated with brachytherapy-based accelerated partial breast irradiation (APBI). The purpose of this analysis was to examine cosmesis and toxicity data from the prospective American Society of Breast Surgeons (ASBS) breast brachytherapy registry trial to compare to the findings from the claims analyses.MethodsThe ASBS breast brachytherapy registry is a prospective nonblinded multi-institutional registry trial. Patients with Stage 0–II breast cancer undergoing breast conserving therapy were eligible. A total of 1665 patients were enrolled and 1449 treated between 2002 and 2004 with a median followup of 63 months. All patients were treated with the MammoSite (Hologic, Inc.) single-lumen device to deliver adjuvant APBI (34 Gy in 3.4 Gy fractions).ResultsThe rate of excellent/good cosmesis was 90.6% at 84 months. The rate of a complication (symptomatic seroma, infection, fat necrosis, telangiectasias) at 1 year/any time point was 24.2%/38.5%, whereas the rate of noninfectious complications at 1 year/any time point was 14.8%/28.9%. The rate of symptomatic seroma, fat necrosis, infection, and telangiectasia at any time was 13.4%, 2.5%, 9.6%, and 13.0%, respectively.ConclusionsThe final toxicity analysis from ASBS breast brachytherapy registry trial confirms the previously noted excellent cosmesis and toxicity profiles and fails to confirm retrospective claims analyses that have suggested higher rates of toxicity for brachytherapy-based APBI.     

NRG brain tumor specialists consensus guidelines for glioblastoma contouring

Journal of Neuro-Oncology - NRG protocols for glioblastoma allow for clinical target volume (CTV) reductions at natural barriers; however, literature examining CTV contouring and the relevant white...     

Gastrointestinal parasite infestation

Twenty-five percent of the world's population could be suffering parasitic infestation. Highest prevalence is in underdeveloped agricultural and rural areas in the tropical and subtropical regions. In some areas incidence may reach 90% of the population. In contrast, some major economic projects intended to promote local development have, paradoxically, caused parasitic proliferation, e.g. bilharziasis in Egypt and Sudan and Chagas disease in Brazil. The commonest cosmopolitan gastrointestinal parasite is Entamoeba histolytica. Some intestinal parasite are endemic in temperate climates, e.g. Entrobius vermicularis. The AIDS epidemic has increased the prevalence and severity of parasitic disease, particularly Strongyloides stercolaris. Tropical parasites are seen in Western people who travel to tropical countries. Radiology has acquired a major role in diagnosis and management of gastrointestinal parasite infestations and their complications.