Showing papers by "Sue C. Kaste published in 2002"

Epithelioid sarcoma: clinical, MR imaging and pathologic findings.

Abstract: Objective. To report and describe the MR imaging features of eight new cases of this rare soft tissue sarcoma and correlate them with the clinical and histologic findings. Design and patients. Retrospective analysis was carried out for the MR imaging characteristics and histologic findings of eight patients with pathologically proven epithelioid sarcoma and the literature was reviewed. Findings were correlated in each case with the patient's clinical presentation and eventual outcome. Results. The patients, whose primary tumors ranged from 2.5 cm to 19 cm in maximum dimension, were 1 to 90 years of age. Tumors involved the extremities (n=5), the scalp (n=2) and the paraspinal muscles (n=1). Five tumors presented as well-defined, frequently painful, deeply situated masses and three as subcutaneous nodules or cutaneous ulcers with no palpable mass. Four patients had associated regional lymphadenopathy and one had distant metastases at diagnosis. MR imaging showed tumor infiltration of adjacent tissues in seven patients. Signal characteristics reflected varying degrees of cellularity, and the presence of necrosis, hemorrhage, fibrosis, hyalinization and inflammation. Bone marrow involvement was demonstrated in one patient. Clinical outcomes were generally poor. Conclusions. Epithelioid sarcoma is an aggressive soft tissue sarcoma with a varied clinical presentation, growth pattern, MR signal characteristics and histologic picture. The tumor favors the distal extremities and is commonly infiltrative and accompanied by enlarged regional lymph nodes. This neoplasm may present as an intramuscular mass but should also be suspected in patients with ulcerating cutaneous nodules with or without regional lymphadenopathy.

Effect of collagen and mineral content on the high-frequency ultrasonic properties of human cancellous bone.

Abstract: The technology surrounding ultrasonic bone assessment is evolving rapidly as investigators explore the utility of new ultrasonic parameters and different ultrasonic frequencies. This study had three main goals. The first was to perform in vitro measurements of the speed of sound (SOS) and normalized broadband ultrasonic attenuation (nBUA) in specimens of normal human cancellous bone using a 2.25 MHz broadband measurement system. The second was to explore the utility of a backscatter-based parameter called apparent integrated backscatter (AIB). The third goal was to investigate the roles that collagen and mineral content play in affecting each of these three ultrasonic parameters. This was accomplished by chemically treating the specimens to remove one or the other of these two important constituents of bone. Our results showed that in most cases SOS and nBUA correlated well (p < 0.05) with bone mineral density (BMD) as measured by quantitative computed tomography (QCT). In contrast, AIB did not correlate strongly with BMD. When the specimens were demineralized, decreases were produced in SOS (19-39%) and nBUA (44-58%). Changes produced in AIB were not significant except along the superoinferior direction, in which a 12% decrease was measured. When the specimens were decollagenized, decreases were produced in SOS (10-12%). In contrast, increases were produced in both nBUA (35-77%) and AIB (14-15%). From this study we conclude that high-frequency ultrasonic measurements may yield useful information about the content and organization of both collagen and mineral in cancellous bone.

Magnetic resonance imaging after incomplete resection of soft tissue sarcoma.

Abstract: Review of magnetic resonance imaging was compared with the pathologic review of reexcision specimens from 24 pediatric patients who had initial incomplete resection for soft tissue sarcoma to determine the accuracy of magnetic resonance imaging in detecting residual tumor The median age of patients was 128 years The most common diagnosis was synovial sarcoma (eight of 24 patients; 30%) Magnetic resonance imaging detected residual tumor in eight patients and no tumor in eight patients; the images of eight patients were indeterminate Pathologic examination showed residual tumor in 14 of 24 (58%) specimens obtained in reexcision For two of the eight patients (25%) for whom imaging had detected no tumor, microscopic examination detected residual tumor; for one of the eight patients for whom imaging had detected tumor, microscopic examination detected no tumor Five of the eight patients (63%) for whom the results of imaging studies were indeterminate had residual tumor on microscopic evaluation The sensitivity of magnetic resonance imaging for detecting residual tumor was 78%, the specificity was 86%, the positive predictive value was 078, and the negative predictive value was 086 Decisions regarding the need for additional resection should not be based on magnetic resonance imaging alone

Treatment of refractory osteosarcoma with fractionated cyclophosphamide and etoposide

Abstract: PurposeStandard multiagent chemotherapy for osteosarcoma may include platinum compounds, doxorubicin, and high-dose methotrexate. By identifying new chemotherapeutic strategies, the outcome of these patients can be improved and the toxicity of treatment regimens decreased.Patients and MethodsThe aut

Skeletal manifestations of pediatric acute megakaryoblastic leukemia.

Abstract: Once considered rare, acute megakaryoblastic leukemia (AMKL) now accounts for about 12% of all cases of de novo acute myeloid leukemia in children. Most cases of AMKL are difficult to diagnose because of their complex clinical presentation and unusual bone marrow morphologic features. In children, AMKL is often confused with metastatic solid tumors or myelodysplastic syndrome. Between January 1984 and December 1999, 43 patients were diagnosed with childhood AMKL at the authors' institution. Five of these presented with unusual skeletal lesions. These abnormalities (bilaterally symmetrical periostitis and osteolytic lesions) differed markedly from those commonly reported in association with pediatric acute leukemias. The authors present their experience and review the literature to define the spectrum of bony involvement associated with AMKL. This report will contribute to the evolving clinical characterization of this entity and increase clinicians' and radiologists' awareness of the manifestations of AMKL.

Radiologic appearance of primary jaw lesions in children

Abstract: Background: The jaw (an unusual site of primary tumors in children and adolescents) has lesions often found incidentally by dentists on routine panoramic radiographs or during examination of a child who has swelling or tooth pain. Objective: This pictorial seeks to familiarize pediatric radiologists with the radiographic appearance of a variety of primary jaw lesions. Materials and methods: We retrospectively searched institutional records for cases of primary jaw lesions in children and adolescents. Jaw lesions were characterized as: I, well-circumscribed radiolucent lesions; II, lesions with mixed or variable appearance; III, poorly circumscribed radiolucent lesions; and IV, radiopaque lesions. Results: Although most oral and maxillofacial lesions in children are benign, a broad spectrum of tumors was identified; lesions may occur in patients with unrelated prior malignancy. Conclusion: Because radiologic studies may identify jaw lesions and direct further care, familiarity with the appearance of these entities is prudent.