Rachna Arora

Detection of vascularity in wrist tenosynovitis: power doppler ultrasound compared with contrast-enhanced grey-scale ultrasound

IntroductionWe sought to assess vascularity in wrist tenosynovitis by using power Doppler ultrasound (PDUS) and to compare detection of intra- and peritendinous vascularity with that of contrast-enhanced grey-scale ultrasound (CEUS).MethodsTwenty-six tendons of 24 patients (nine men, 15 women; mean age ± SD, 54.4 ± 11.8 years) with a clinical diagnosis of tenosynovitis were examined with B-mode ultrasonography, PDUS, and CEUS by using a second-generation contrast agent, SonoVue (Bracco Diagnostics, Milan, Italy) and a low-mechanical-index ultrasound technique. Thickness of synovitis, extent of vascularized pannus, intensity of peritendinous vascularisation, and detection of intratendinous vessels was incorporated in a 3-score grading system (grade 0 to 2). Interobserver variability was calculated.ResultsWith CEUS, a significantly greater extent of vascularity could be detected than by using PDUS (P < 0.001). In terms of peri- and intratendinous vessels, CEUS was significantly more sensitive in the detection of vascularization compared with PDUS (P < 0.001). No significant correlation between synovial thickening and extent of vascularity could be found (P = 0.089 to 0.097). Interobserver reliability was calculated to be excellent when evaluating the grading score (κ = 0.811 to 1.00).ConclusionsCEUS is a promising tool to detect tendon vascularity with higher sensitivity than PDUS by improved detection of intra- and peritendinous vascularity.

Ameloblastic carcinoma: A case report and literature review

Ameloblastic carcinoma (AC) is a rare epithelial odontogenic tumor of the jaws, which exhibits cytological features of ameloblastoma and carcinoma. It has a distinct predilection for mandible. These lesions may initially show histologic features of ameloblastoma that dedifferentiate over time. Others may present with features of epithelial dedifferentiation in ameloblastoma. A case of ameloblastomic carcinoma in a 64-year-old male is reported, who presented with swelling in the left mandible 3 months after the extraction of the left upper molar.

Fine needle aspiration cytology of anaplastic meningioma.

Dear Editor, Meningiomas of the head and neck region are rare but well described on fine needle aspiration cytology (FNAC). Anaplastic meningioma is a rare WHO grade III intracranial tumour that has not been reported from extracranial sites or on FNAC. We describe here the cytological features of a case of anaplastic meningioma in a 15-year-old boy who underwent a subtotal resection with recurrence of multiple soft tissue swellings over the scalp, 2 months after surgery. FNAC performed from a scalp swelling showed a highly cellular aspirate composed of tumour cells arranged in loose clusters with prominent perivascular arrangement (Figure 1). The capillary-sized vessels were long and arborising with frequent branching. The tumour cells were loosely adhering to these vessels and extended out with long cytoplasmic processes. In well-spread areas the tumour cells were polygonal in shape with a moderate amount of cytoplasm and round to oval nuclei with prominent nucleoli (Figure 2). Occasional foci of whorling were found, composed of tight morulae of cells arranged in concentric circles [Figure 1 (arrow) and Figure 2 (inset)]. Frequent mitotic figures were seen [Figure 2 (arrow)]. There were no nuclear grooves, pseudoinclusions or psammoma bodies. Immunocytochemistry (ICC) was carried out on extra smears prepared during aspiration, fixed in ethanol. Immunocytochemistry (ICC) for vimentin and epithelial membrane antigen (EMA) were positive while cytokeratin was negative. A review of the histological sections of the previous resection (published earlier) showed a haemangiopericytoma-like pattern with few cellular whorls and high MIB-1 labelling index. Diagnosis of typical meningioma (WHO grade I) on FNAC is easily accomplished, when characteristic

A Microprocessor-Based System for Monitoring Gas Turbines

The development and testing of hardware and software for a microprocessor-based monitoring system for gas turbines is described in this paper. The operators of gas turbines can be trained to monitor running hours, slip between high and low pressure compressor spools and torque on the reduction gear-box under various conditions ofoperation. The system will replace the traditional method of monitoring these parameters which are more time consuming and error prone.