Mature teratoma of the retroperitoneum: radiologic, pathologic, and clinical correlation

Article Abstract:

The development of cross-sectional imaging techniques has greatly improved the detection of tumors in the retroperitoneal cavity, the sac that contains the large organs of the gut. The new technique is a highly efficient and sensitive means by which the exact location and characteristics of a tumor can be determined with little clinical risk to the patient. Prior to improved imaging techniques, teratoma, a type of congenital tumor of the retroperitoneum has been a rarely diagnosed disease. Researchers have not perfected diagnostic imaging techniques for the evaluation of this disease. The findings presented are consistent with previous reports and are based on improvements in the diagnostic technique. The structural characteristics of benign teratomas fall along a spectrum ranging from fluid filled to completely solid. In one half of the cases studied, fat in the form of adipose tissue and in large enough quantities to be detected with computed tomography (CT) was present. CT scans revealed either congealed or linear strands of calcium deposits. The combination of radiologically detectable fat and calcium was noted in eight of the eighteen cases that were studied. This observation should be considered highly suggestive of mature teratoma, although it is not known to what extent this finding may overlap with those for other tumors of the retroperitoneum, containing fat and calcium. The superiority of CT over ultrasound (US) in the localization and characterization of retroperitoneal teratomas is discussed. There are limitations that qualify the universal reliability of the findings. The data was based on a retrospective analysis of images from randomly obtained cases from multiple institutions without the advantage of a uniform protocol. Researchers caution that because of this selection factor their observations are limited to mature teratomas and should not be extended to other retroperitoneal primary or cancerous tumors of germ cell origin.

Research, Tumors, Teratoma, Medical imaging equipment, Peritoneum

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Pancreatic transplants: CT-guided biopsy

Article Abstract:

It is necessary to perform a biopsy on pancreatic tissue from a transplanted pancreas when the transplant does not function properly. These biopsies are needed to find the cause of the disfunction so that it can be treated. Present procedure for removing pancreatic tissue requires the use of a general anesthetic and a large-bore needle. This procedure is also only able to obtain tissue samples from the head but not the tail of the pancreas. This is a problem since the findings from the samples taken must be assumed representative of the pancreas as a whole. This study examined the use of computed tomographic (CT) guidance to enable samples to be taken from both the head and the tail of pancreatic transplants. Ten biopsies were obtained from pancreatic transplants using CT guidance. Four of these involved taking samples from both the head and the tail of the transplanted pancreas. Results of the 10 biopsies showed three to be normal, three showed signs of immunological rejection, and three showed problems in blood supply that were damaging surrounding tissue. Two of the four biopsies involving both sections of the pancreas showed different results between samples taken from the head and those taken from the tail. In one of these, the biopsy from the head was normal, but the biopsy from the tail showed damaged tissue from a diminished blood supply. This tissue was removed, and the patient is doing well with the remainder of the pancreatic transplant. These results indicate that CT-guided biopsy of pancreatic transplant tissue can be done easily and accurately and can result in important information for the early detection of problems with transplants. Early detection is important in order to treat and prevent transplant rejections. (Consumer Summary produced by Reliance Medical Information, Inc.)

Care and treatment, CT imaging, CAT scans, Transplantation of organs, tissues, etc., Organ transplantation, Tissue transplantation, Transplantation, Pancreatic diseases

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Pancreatic transplants: CT with clinical and pathologic correlation

Article Abstract:

Pancreatic transplants from cadavers to patients suffering from insulin-dependent (type I) diabetes is an option for a select group of patients to prevent problems with blood vessel (microvascular) disease. The advantage of using an advanced radiologic technique, computed tomography (CT), to evaluate graft viability in these patients is evaluated. In a six-year period from 1981, 68 different CT scans of 15 patients with pancreatic transplants (two received two grafts) were taken. CT proved unhelpful in detecting graft rejection problems and in assessing the physiologic status of the pancreatic graft. Most CT scans, however, were ordered to assess the possibility of collection of intraabdominal fluid, and the method was extremely helpful in detecting fluid accumulations within the abdomen.

Case studies, Evaluation, Diabetes, Diabetes mellitus, PET imaging, Positron emission tomography

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