Nine cases with histologically proven renal oncocytoma are presented. In all cases, ultrasonography gave the first indication of a tumour and intravenous urography was tumour-specific in only six, whilst angiography was so in only four of the cases with peripheral extension beyond the normal organ limits. Examination by computed tomography showed retrospectively, in the three cases with smaller oncocytomas up to 3 cm in diameter, findings that seemed promisingly characteristic: without contrast medium, the tumour appeared homogeneously hyperdense in comparison with normal renal parenchyma, but homogeneously hypodense after injection of contrast medium. One of the smaller oncocytomas, however, showed regions of heterogeneity both with and without contrast medium. Only one oncocytoma of 4 cm diameter presented the central stellate, low-attenuation "scar" described by Quinn et al. The angiographic criteria cited by Ambos were fulfilled in only three of the larger oncocytomas. In four of the cases, the tumour was enucleated and the organ left in situ on the basis of frozen section diagnosis. Those patients with tumours extending outside the organ or those of questionable diagnosis on frozen section were treated by nephrectomy. In one patient, the pathologist suspected metastasis from the thyroid; hemithyroidectomy confirmed on oncocytic adenoma of the left thyroid lobe.
Residual contrast medium in the renal parenchyma was demonstrated by computerized tomography in 11 patients with renal trauma, inflammatory renal disease, infarction and a large renal cyst. The contrast medium (10 to 100 ml.) was administered intravascularly 30 minutes to 48 hours before the computerized tomography scan. In each patient the scan demonstrated residual contrast medium (either initially or after a second scan with additional contrast enhancement) in a variety of parenchymal zones that frequently appear to be normal with other imaging techniques. After a suitable interval for accumulation of residual contrast medium, computerized tomography appears to provide better visualization of the renal parenchyma than conventional modes of examination. Persistent retention of contrast medium in the renal parenchyma is believed to represent cortical damage.
The myelograms of 7 patients with traction injury of the brachial plexus are compared with the operation findings. It appears that not only the roentgenological sign of the "traumatic meningocele" but also other myelographic abnormalities are to be considered as indications of a nerve root lesion. These changes are demonstrated. The myelogram of a 6-months-old child showing a nerve root avulsion due to birth trauma is represented. Myelographic examination of each patient with posttraumatic brachial palsy should be performed as soon as possible. A sufficient myelographic diagnosis of the nerve root lesion can be achieved only in considering also the less impressive radiological signs.
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