Aneurysms of the renal artery

The detection of renal artery aneurysms has greatly increased in the last years with the use of angiographic procedures and nowadays thanks to digital subtraction angiography routinely adopted in the diagnostic evaluation of patients affected by lesions at the renal artery level. This study reports the data of 31 renal artery aneurysms observed in 30 patients admitted to our Institute from 1970 to 1986. All the aneurysms were demonstrated by means of selective renal angiographies. Twenty-two patients out of 30 presented hypertension. In order to establish the possible role of the aneurysm in the genesis of hypertension, in all these cases the PRA was determined. In 27 patients a surgical procedure was adopted. This paper reviews our series of patients, analyzing the diagnostic procedures, the symptomatology presented with particular regard to the presence and the type of the associated hypertensive condition, the adopted therapeutic procedures and the results.     

Unique pineal gland metastasis of clear cell renal carcinoma: case report and review of the literature

The metastatic involvement of the pineal gland is an extremely unusual event; it has a 4% incidence in patients with disseminated neoplasias. Most metastatic pineal lesions are asymptomatic. Only in a small number of cases the symptoms produced by metastatic involvement of this organ precede those of the primary tumor or those of another metastatic site. To our knowledge the herein reported case is the first in which the pineal gland was apparently the unique metastatic site of a primitive kidney carcinoma and where the symptoms produced by metastasis in the pineal region were the first sign of the disease.     

Characterization of tumoral lesions of the breast: preliminary experience with multislice spiral CT

The aim of the present study was to validate low dose Multislice Spiral Computed Tomography (MSCT) in the diagnosis of breast lesions. Fourteen patients with mammographic and ultrasound findings suspect of malignant neoplasm underwent dynamic MSCT of the breast under basal conditions and 1, 3, and 6 minutes after intravenous injection of iodinated contrast medium. Both enhancement of the lesion >100% without further increase after 6 minutes, and irregular margins of the lesion were considered signs of malignancy. All lesions were examined cytologically and/or histologically. A correct diagnosis was achieved by MSCT in 7/8 malignant lesions, and in 6/6 benign lesions. The only malignant lesion missed by MSCT was histologically a ductal carcinoma in situ (false negative). In one case the MSCT showed the multifocality of an infiltrating ductal carcinoma, and in another it defined the bilaterality of the malignant lesions. Sensitivity and specificity of MSCT in the diagnosis of malignancy of a lesion were 88% and 100%, respectively. Our results suggest that MSCT is an effective diagnostic method to define suspicious breast lesions, and a valid alternative to Magnetic Resonance Imaging, especially when the latter is not feasible.     

Bronchioloalveolar carcinoma: clinical, radiographic, and pathological findings. Surgical results

BACKGROUND: Bronchioloalveolar carcinoma (BAC) remains one of the most controversial of lung cancer subtypes. METHODS: From 1980 to 1998, 374 resected patients for NSCLC were followed up in our department. Of the 147 cases histologically defined as adenocarcinoma, 34 were pure BAC. The records of these 34 patients were retrospectively reviewed in order to evaluate patient and tumor characteristics and to identify which variables had a prognostic impact on survival and recurrence rate. RESULTS: Patient age, sex, smoking habits and symptoms were not differentiating characteristics when related to radiographic presentation or to natural history. Mucinous cell-type (23.6% of cases) was more frequent with non-smokers, presence of a single nodule or mass and stage I. Favorable characteristics were: a) the prevalence of stage I and N0 cases (59% and 76.7% of cases, respectively) with a mean survival time of 66 and 77 months, respectively; and b) the radiographic presentation of a solitary pulmonary nodule or mass (76.4% of cases), that, independently of nodal involvement, showed a higher mean survival time (62 months). Independently significant adverse prognostic factors were: stage II-IV, lymph node involvement, and patient age over sixty years. The radiographic presence of multiple or satellite nodules was related to a significantly adverse prognosis (mean survival time: 18 months) by univariate analysis; this was not confirmed by multivariate analysis. CONCLUSIONS: In our experience BAC was the NSCLC subtype more frequently associated with a good outcome after resection; surgery should not to be denied also in patients with multiple nodules, when under sixty years of age and no lymph node involvement.     

聚丙交酯复合乙交酯微球经肝动脉化疗栓塞术治疗肝癌的动物实验

目的：在肝细胞癌动物模型上观察聚丙交酯复合乙交酯（PLcG)微球经肝动脉化疗栓塞术（TACE）治疗肝癌的疗效。方法：在雄性ACI大鼠（15例）肝包膜下植入Morris Hepatoma 3924A肝癌小瘤块（1mm3),移植术中13天时行磁共振检查,再经正中腹切开术和经胃十二指肠动脉逆行插管进行以下介入治疗：治疗组A（40mg PLcG 0.05mg丝裂霉素,4例）,对照组B（0．05mg丝裂霉素＋0．04mg碘化油＋肝动脉结扎,4例）和对照组C（1．5ml生理盐水,7例）,插管术后13天再次行磁共振术观察肝肿瘤体积变化。结果：在C组,肿瘤体积在实验期间增长27．12倍,在B组,肿瘤体积增长3．76倍,而在A组,肿瘤体积仅增长2．87倍。A组与C组肿瘤体积增长率在t检验时均有显著性差异（P＜0．05）,结论：在动物实验中将PLcG微球运用于TACE可明显抑制肝肿瘤生长。