CMR provides accurate, non-invasive assessment of regional myocardial fibrosis using LGE, while diffuse interstitial myocardial fibrosis is accurately assessed with post-contrast T1 mapping.

Two cases of peripheral T-cell lymphoma with primarily subcutaneous involvement and clinically presenting as panniculitis were reported in two children. One child developed florid hemophagocytic syndrome and was treated by combination chemotherapy but died 14 months later of disseminated fungal infection. The other child had mild systemic symptoms but no histological evidence of hemophagocytosis. Despite a more florid lymphomatous infiltrate, he attained a complete remission after a short course of prednisone and remains symptom-free at 3 years. Our report confirms that subcutaneous T-cell lymphoma is a distinct clinicopathological entity and highlights the two modes of clinical presentation. The development of florid hemophagocytic syndrome indicates a bad prognosis. This entity must be distinguished from other causes of panniculitis and immunophenotypic analysis of the atypical cells is essential in the diagnosis. Combination chemotherapy is the treatment of choice, but in patients who pursue an indolent course the administration of aggressive chemotherapy may be deferred.

Malignant lympho-epithelial lesion of the salivary gland is an undifferentiated squamous cell carcinoma which is associated with a prominent lymphocyte-rich stroma. This study reviews the current literature pertaining to this rare tumour with reference to the single recorded case of malignant lympho-epithelial lesion of the salivary gland presenting in Auckland, New Zealand. This 26 year old Caucasian male developed a rapidly growing lesion in the right parotid gland and multiple ipsilateral cervical lymph nodes. Treatment consisted of surgery and radiotherapy. The patients is currently disease free. One hundred and eight other cases have been reported in the literature, 82 of whom have Mongolian ancestry (Eskimos and southern Chinese) and 15 of whom are Caucasian. More than 50% of these patients (all Mongolian) have elevated titres of serum immunoglobulin A against Epstein-Barr virus capsid antigen. The age at presentation is variable, ranging from 10 to 86 years, with a slight female predominance. Forty-one per cent of patients present with regional lymph node metastases and 20% with distant metastases. Given the rarity of this disease, treatment is controversial. Current data suggest that early radical combined modality treatment using surgery and radiotherapy leads to prolonged survival and cure with 5 year survival rates greater than 50%.

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SUMMARY A tentative diagnosis of a fistula between the tendon sheaths of the right extensor carpi radialis and the intercarpal joint was confirmed by positive contrast radiography following injection of sodium diatrizoate into the joint. Surgical removal of a tag of synovial membrane and repair of the fistula was carried out. Post surgical treatment included mild exercise to prevent adhesions within the sheath. A month following discharge, contrast radiography revealed no communication between joint and tendon sheath. At this time mild distension of the sheath was relieved by aspiration and it did not recur when the horse returned to work following a further month of rest. RÉSUMÉ Le diagnostic présomptif d'une fistule reliant la gaine synoviale tendineuse de l'extérieur antérieur du métacarpe à la synoviale intra‐articulaire du carpe fut confirmé par radiographie. On utilisa comme agent de contraste, l'injection intra‐articulaire de diatrizoate de sodium. On procéda alors à l'ablation d'un fragment de membrane synoviale et à la réparation de la fistule. Le post opératoire comporta un exercice modéré afin de prévenir les adhérences à hauteur de la synoviale tendineuse. Une radiographie ultérieure révéla qu'il n'existait plus de communication entre l'articulation du carpe et la gaine tendineuse. A ce moment, une dilatation modérée de la gaine fut traitée par ponction et retrait du liquide en excés. Elle ne récidiva point quand le cheval fut remis au travail un mois plus tard. ZUSAMMENFASSUNG Die Verdachtsdiagnose einer Fistel zwischen der Sehnenscheide des rechten extensor carpi radialis und des intercarpalen Gelenks konnte durch Kontraströnt‐gendarstellung mit Natriumdiatrizoat bestätigt werden. Man entfernte einen Synovialis‐Lappen auf chirurgischem Weg und verschloss die Fistel. Die post operative Behandlung bestand in leichter Bewegung, um das Auftreten von Adhäsionen innerhalb der Sehnenscheide zu verhindern. Einen Monat nach der Entlassung konnte die Kontraströntgendarstellung keine Kommunikation zwischen Gelenk und Sehnenscheide mehr nachweisen. Zu dieser Zeit bestand noch eine leichte Ueberfüllung der Sehnenscheide, die durch Aspiration behandelt wurde. Es stellten sich keine Rückfälle ein, als das Pferd nach einem weiteren Monat Ruhe wieder in die Arbeit genommen wurde.