Arthur C. Allen

LYMPHOSARCOMA AND PERIURETERAL FIBROSIS.

Numerous terms have been applied to the condition resulting from fibrotic tissue surrounding, compressing, and occasionally occluding one or both ureters (3, 11, 14, 16, 20, 22). While the process usually involves the mid or upper portions of the ureters, involvement of the lower ureters, retroperitoneal vessels, kidneys, bladder, lungs, and mediastinum has been reported (1, 3, 5, 6, 18, 19). Multiple nonneoplastic etiologies have been surmised (3, 4, 6–8, 10, 11, 13, 15, 17, 22). Reticulum-cell sarcoma and Hodgkins disease, however, have been implicated (9, 21). We wish to report 4 cases in which periureteric fibrosis was found in association with lymphosarcoma, 3 of which were without antecedent irradiation to the retroperi-toneum. Case I: In this 68-year-old white woman generalized adenopathy developed in 1960. Biopsy of a left axillary node disclosed lymphosarcoma (Fig. 1). Intravenous pyelography in November 1960 and again in January 1961 revealed bilateral hydronephrosis and proximal hydroureter (F...

SOME ASPECTS OF VASCULAR DISEASE OF THE SMALL INTESTINE.

VASCULAR compromise of the intestine may produce a broad spectrum of pathologic change; corresponding roentgen patterns are not specific for a given disease but reflect the stage of compromise. These patterns have been the subject of a previous paper (30). Recognition of an increasing number of cases of noncatastrophic vascular involvement of the small bowel has focused attention on their importance. Our experience would indicate that such minor insults are far more frequent than superior mesenteric occlusion. Some clinical, pathologic, and experimental aspects of this problem are presented in this paper. Arterial or arteriolar insufficiency and venous obstruction, congestion, and resultant oxygen deprivation may vary in degree. Similarly, the segment of small bowel involved may vary in length. The end-result depends upon an interplay between these factors and the collateral blood supply. Of all the intestinal layers, the mucosa is most sensitive to ischemia; therefore the earliest and mildest changes res...

The Crescent Sign

In 1962, Dunbar et al. (1) reported a “crescent” sign in hydronephrosis. This sign was attributed to the contrast material in collecting tubules that had changed their orientation by approximately 90 degrees so as to lie parallel to the renal convexity and close to its surface. This change in orientation is caused by increased pressure in the renal collecting system and is seen only in severe hydronephrosis. It is detectable during the early phases of intravenous pyelography and then disappears as calyces and pelvis are opacified. It is our purpose to present a case of hydronephrosis secondary to ureteropelvic stricture that appears to document Dunbars explanation for the crescent sign. Case Report J. H. B., a 4-month-old white male, was hospitalized Jan. 4, 1963, because of an upper respiratory infection of ten days duration. The mother reported the presence of a protuberant abdomen since birth and an abdominal mass observed for the first time on the day of admittance. Physical examination revealed a we...