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Search Results: 1 - 10 of 32332 matches for " Peter Kalina "
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Enlarged cauda equina nerve roots in Cerebrotendinous Xanthomatosis  [PDF]
Peter Kalina
Open Journal of Clinical Diagnostics (OJCD) , 2011, DOI: 10.4236/ojcd.2011.13006
Abstract: CXT is a rare inherited autosomal recessive lipid storage disease due to the impaired metabolic pathway of cholesterol secondary to a deficiency in 27- sterol hydroxylase, an enzyme in the synthesis of chenodeoxycholic acid (CDCA), a primary bile acid. Abnormal bile acid synthesis leads to elevated plasma Cholestanol (a derivative of cholesterol) accumulation, especially in the lens, central nervous system (CNS) and tendons.
Spinal Cord Compression by Thoracic Vertebral Hemangioma—A Case Report  [PDF]
Peter Kalina
Open Journal of Medical Imaging (OJMI) , 2012, DOI: 10.4236/ojmi.2012.21005
Abstract: A 68 year old with lower extremity numbness, vibratory sensation loss, coldness and burning of his feet, unsteady gait, frequent falls and a sensory level had an MRI demonstrating aT7 and T8 vertebral body/posterior element lesion with epidural extension, cord compression and foraminal extension (Figures 1-5). Decompressive laminectomy/resection confirmed vertebral hemangioma, a common benign neoplasm that typically remains asymptomatic, found incidentally in 10% of the population. Progressive vertebral body hemangiomas may cause cord or nerve root compression due to epidural tumor extension, expanded bone, hematoma or fracture. Radiographs demonstrate course vertical striations caused by thick trabeculae. CT in indolent lesions demonstrates fat density while compressive lesions demonstrate soft tissue density. Indolent lesions follow fat signal on MRI; symptomatic lesions are T1 isointense/T2 hyperintense. Work-up for aggressive hemangiomas includes angiography to determine vascularity, identify feeding/draining vessels and identify blood supply to the cord. Biopsy helps differentiate hemangioma, lymphoma, myeloma or metastasis. Management of symptomatic hemangiomas includes vertebroplasty for pain, radiation for pain, compression or pre-op and decompressive laminectomy for epidural disease. Embolization of feeding vessels may be performed pre-op or may be curative. Hemangioma causing cord compression and neurologic symptoms by extraosseous extension is much less common than benign hemangioma. Imaging features may suggest potential for progression.
Cavernous Hemangioma of the Nasal Cavity  [PDF]
Peter Kalina, Jeffrey Rykken
Open Journal of Medical Imaging (OJMI) , 2011, DOI: 10.4236/ojmi.2011.12007
Abstract: A 22 year old six month pregnant female presented with right eye tearing, proptosis and nasal congestion. CT revealed a large right nasal cavity mass with involvement of the ethmoids, right maxillary sinus, lamina papyracea, cribriform plate and nasal septum. There was significant remodeling of the right cribriform plate with mild extra-axial intracranial and mild intraorbital extension. Transnasal endoscopic excision confirming the diagnosis of cavernous hemangioma of the nasal cavity. Hemangiomas are benign slow-growing vascular neoplasms classified as capillary, cavernous or mixed. Hemangiomas of the nasal cavity and paranasal sinuses are very rare with only a few reported cases. The occurrence and growth of these lesions during pregnancy may be related to increased blood volume or hormonal factors. The most common therapeutic option is complete surgical resection via transnasal endoscopic approach. Pre-operative embolization may be utilized in some cases to decrease the risk of intraoperative bleeding.
Early Initial Diagnosis of Gardner Syndrome in a 12-Year-Old Boy  [PDF]
Erich Bryan, Peter Kalina
Advances in Computed Tomography (ACT) , 2013, DOI: 10.4236/act.2013.21001
Abstract:

A 12-year-old boy presented to his primary care physician with a painful lump at the angle of the left mandible after being kicked in the jaw during a soccer game. Over the next 2 months the lesion became progressively firmer and fine needle aspiration was attempted. Results were non-diagnostic. Panorex examination revealed a calcified mass contiguous with the left angle of the mandible. Considerations were bony callus secondary to trauma versus a calcified hematoma. A maxillofacial CT showed multiple diffuse craniofacial osseous lesions including the clinically suspected region at the left angle of the mandible. Imaging findings were consistent with multiple craniofacial osteomas and workup for Gardner Syndrome was initiated. Genetic testing was subsequently positive for Familial Adenomatous Polyposis.

Cobb Syndrome: A Case Report with Review of Clinical and Imaging Findings  [PDF]
Alok Bhatt, Peter Kalina
Open Journal of Clinical Diagnostics (OJCD) , 2014, DOI: 10.4236/ojcd.2014.44033
Abstract: Cobb syndrome is a rare entity characterized by cutaneous vascular lesions and arteriovenous malformations in the spine, both in the same metamere. This syndrome is also known as cutaneous vertebral medullary angiomatosis, cutaneomeningospinal angiomatosis, and spinal arterial metameric disorder. We report the case of a male infant diagnosed with Cobb syndrome who was treated surgically. The presence of a cutaneous vascular lesion in this patient prompted subsequent imaging for spinal angioma or AVM in the same dermatome. Early recognition in this patient was shown to be life-changing, as patients with Cobb syndrome who have undergone early intervention have shown to be without neurologic deficit or have a halt in progression of symptoms.
Atypical Cystic Parotid Gland Acinic Cell Carcinoma in a Child  [PDF]
Noah N. Chasen, Peter Kalina
Advances in Computed Tomography (ACT) , 2013, DOI: 10.4236/act.2013.22010
Abstract: Purpose: To describe the extremely rare occurrence of acinic cell carcinoma of the parotid in a young child. Materials & Methods: A 14-year-old boy presented with a left sided facial mass. It was initially thought to be a bug bite or perhaps a wrestling injury. However, it progressed rapidly overall several weeks. CT revealed a well-circumscribed, cystic, 3.9 × 2.8 × 3.2 cmmass centered in the deep lobe of the left parotid gland, also involving the superficial lobe and extending medially through the stylomandibular tunnel with a component extending to the stylomastoid foramen. There was no solid enhancing portion. There were several enlarged level II lymph nodes suspicious for nodal metastases. Results: The mass was biopsied and pathology was consistent with acinic cell carcinoma. Complete left parotidectomy and left selective neck dissection was performed, confirming the diagnosis. Conclusions: Salivary gland neoplasms are rare in children. Less than 5% of salivary gland tumors occur in children. Salivary gland neoplasms account for less than 8% of pediatric head and neck tumors. Approximately 1/3 of salivary gland tumors arising in childhood are malignant; most being mucoepidermoid. Acinic cell carcinoma of the parotid gland in children is extremely rare, especially in those under age 16, with only a few available case reports. This case was also unusual in that the lesion was predominantly cystic.
Multiple Myeloma of the Thyroid Cartilage
Peter Kalina,Jeffrey B. Rykken
Case Reports in Hematology , 2012, DOI: 10.1155/2012/194797
Abstract: A 60-year-old male presented with hoarseness. His past medical history was remarkable for a plasmacytoma of the left maxillary sinus having been resected without systemic evidence of plasma cell myeloma (PCM), also known as multiple myeloma (MM), at the time. This maxillary sinus disease recurred and was treated with radiation. Workup for PCM was conducted. Treatment included melphalan and autologous stem cell transplant. Because of the therapeutic and prognostic implications, a Plasma cell neoplasm (PCN) in a neck mass must be carefully evaluated by clinical and pathological criteria in order to distinguish plasmacytoma from PCM. PCN involvement of the thyroid cartilage is very rare, with only 5 previously reported cases.
Multiple Myeloma of the Thyroid Cartilage
Peter Kalina,Jeffrey B. Rykken
Case Reports in Hematology , 2012, DOI: 10.1155/2012/194797
Abstract: A 60-year-old male presented with hoarseness. His past medical history was remarkable for a plasmacytoma of the left maxillary sinus having been resected without systemic evidence of plasma cell myeloma (PCM), also known as multiple myeloma (MM), at the time. This maxillary sinus disease recurred and was treated with radiation. Workup for PCM was conducted. Treatment included melphalan and autologous stem cell transplant. Because of the therapeutic and prognostic implications, a Plasma cell neoplasm (PCN) in a neck mass must be carefully evaluated by clinical and pathological criteria in order to distinguish plasmacytoma from PCM. PCN involvement of the thyroid cartilage is very rare, with only 5 previously reported cases. 1. Introduction Plasma cell neoplasms (PCNs) include extramedullary plasmacytoma (EMP), solitary bone plasmacytoma (SBP), and manifestation of plasma cell myeloma (PCM). EMP and SBP are benign and local. PCM is a systemic process and the most common PCN with the worst prognosis. Workup for PCM generally includes serum electrophoresis with evaluation for the presence of a monoclonal peak, consisting of IgG with kappa light chain. This case demonstrates the possibility of an indolent course of PCM with destructive laryngeal plasmacytoma without systemic findings. PCN accounts for less than 1% of head/neck tumors. Furthermore, PCN of the thyroid cartilage is very rare. 2. Case Report A 60-year-old male presented with a three-month history of increasing hoarseness. Imaging was obtained consisting of a soft tissue neck MRI with noncontrast axial sequences (Figure 1), postcontrast coronal MRI and CT (Figure 2), postcontrast axial CT (Figure 3) and a nuclear medicine bone scan (Figure 4). His past medical history was remarkable for a plasmacytoma of the left maxillary sinus having been resected, although there was no systemic evidence of PCM at the time. This maxillary sinus disease recurred and was treated with radiation. Workup for PCM included serum electrophoresis demonstrating a monoclonal peak consisting of IgG with kappa light chain. Figure 1: Axial T1 (a) and T2 (b), noncontrast: homogeneous, well-defined mass of the right thyroid cartilage laminae. Figure 2: Coronal MRI (a) and coronal CT (b); postcontrast homogeneous enhancement of the mass. Figure 3: CT, postcontrast, soft tissue (a) and bone windows (b) Uniformly expanded right thyroid cartilage laminae. Figure 4: Nuclear Medicine Bone Scan: Confirms increased uptake of the lesion. Initial bone marrow analysis demonstrated a slight increase in erythroid precursors and a slight
Brooke-Spiegler Syndrome with Multiple Scalp Cylindromas and Bilateral Parotid Gland Adenomas
Peter Kalina,Rokea el-Azhary
Case Reports in Radiology , 2012, DOI: 10.1155/2012/249583
Abstract: A 62-year-old female presented with numerous soft tissue lesions of her scalp and bilateral preauricular region. Several of these have been biopsied or removed with a diagnosis of cylindromas. Cylindromas are benign tumors with a differentiation towards apocrine sweat glands that increase in number and size throughout life. Multiple scalp cylindromas may coalesce and cover the entire scalp, resulting in the “turban tumor.” These are often associated with the autosomal dominant Brooke-Spiegler syndrome with coexistent facial trichoepitheliomas and spiradenomas. There is a very rare association between cylindromas and basal cell adenoma and adenocarcinoma of the parotid gland, with only 17 reported cases. Ours is the first CT demonstration of both the scalp and parotid gland findings in this uncommon situation.
Brooke-Spiegler Syndrome with Multiple Scalp Cylindromas and Bilateral Parotid Gland Adenomas
Peter Kalina,Rokea el-Azhary
Case Reports in Radiology , 2012, DOI: 10.1155/2012/249583
Abstract: A 62-year-old female presented with numerous soft tissue lesions of her scalp and bilateral preauricular region. Several of these have been biopsied or removed with a diagnosis of cylindromas. Cylindromas are benign tumors with a differentiation towards apocrine sweat glands that increase in number and size throughout life. Multiple scalp cylindromas may coalesce and cover the entire scalp, resulting in the “turban tumor.” These are often associated with the autosomal dominant Brooke-Spiegler syndrome with coexistent facial trichoepitheliomas and spiradenomas. There is a very rare association between cylindromas and basal cell adenoma and adenocarcinoma of the parotid gland, with only 17 reported cases. Ours is the first CT demonstration of both the scalp and parotid gland findings in this uncommon situation. 1. Introduction Cylindromas are benign tumors histologically similar to sweat glands. Multiple scalp cylindromas may coalesce to cover the entire scalp, resulting in the so-called “turban tumor.” Multiple scalp cylindromas are often associated with Brooke-Spiegler syndrome. There is a rare association between cylindromas and basal cell adenoma as well as adenocarcinoma of the parotid gland. This is the first case to demonstrate the CT appearance of both the scalp and parotid gland findings in this uncommon syndrome. 2. Case Report A 62-year-old female presented with a long history of numerous soft tissue lesions bulging from her scalp as well as her preauricular (parotid) region. These were noted to range in size from 2?mm to 2?cm diameter (Figures 1–6). Multiple similar appearing facial lesions were also noted. Several of these lesions have been biopsied or removed in the past. Unfortunately, many have continued to grow and many have recurred. Figure 1: Skull radiograph, lateral view: multiple nodular densities overlie the calvarium. Figure 2: Noncontrast head CT: multiple nodular smooth surfaced well-demarcated soft tissue lesions arising from the scalp. Figure 3: Noncontrast head CT: multiple nodular smooth surfaced well-demarcated soft tissue lesions arising from the scalp. Figure 4: Head CT, noncontrast: multiple nodular masses of varying sizes in both parotid glands. Figure 5: Clinical photographs of the multiple scalp lesions. Figure 6: Clinical photographs of the multiple scalp lesions. 3. Discussion Cylindromas are benign tumors that histologically demonstrate a differentiation towards apocrine sweat glands. They usually begin to appear in the second or third decades and tend to gradually increase in number and size throughout life [1, 2].
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