The signal intensity of pulmonary nodules may be useful for malignant and benign differentiation on DWI. However, the interpretation of small metastatic nodules, nonsolid adenocarcinoma, some granulomas, and active inflammatory nodules should be approached with caution.
Summary Squamous cell carcinoma (SeC) of the foot is a rare sequelae of chronic ulceration secondary to leprosy neuropathy. Most of the tumours are relatively slow growing and tend to metastasize late. Survival after local excision is generally good. In this series of 17 patients so far there have been 3 deaths attributable to see, all of whom presented with locally advanced tumours and lymph node metastasis.Leprosy is a chronic infectious disease caused by My cobacterium leprae which pre dominantly affects skin and peripheral nerves. Damage to peripheral nerves occurs as a result of host immunity (reversal reaction, i.e. delayed-type hypersensitivity) to the presence of bacteria in nerves or as a result of fibrosis due to chronic inflammation in peripheral nerves.This results in sensory, motor and autonomic loss in the affected limbs. As a result of paralysis of the dorsiflexors (damage to the common peroneal nerve) of the fo ot the forefoot is subjected to more pressure than usual with each step. Damage to the posterior tibial nerve results in anaesthesia of the plantar surface and some loss of cushioning in the fo ot due to wasting of the fo ot intrinsic muscles. Patients with insensitive fe et are prone to recurrent wounds which often become secondarily infected. Secondary infec tion can lead to the absorption of digits. A proportion of patients with chronic ulcers (usually those present for more than 10 years 3 -5 ) develop see ' which is usually of low grade malignancy.
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