Friday, October 31, 2014

Cervicomedullary Exophytic Glioma

Focal lesion in lower medulla and upper cervical cord in region of formamen magnum and cervicomedullary junction posteriorly with evidence of sepatation and hypointense signal on T1 weighted images and hyperintense on T2 /FLAIR images.  There is cord thinning and altered signal intensity in the anteriorly placed cord tissue. These findings are consistent with diagnosis of exophytic cervicomedullary junction cystic glioma. Cervicomedullary glioma variants arise from upper cervical cord, with typical rostal extension into the cervicomedullary junction. The rostal extension is limited anteriorly by the pyramidal decussations; thus the mass expands posteriorly at the level of the obex and may rupture into the fourth ventricle. The caudal part is identical to an intramedullary tumor. 

Lacrimal Gland-Pleomorphic Adenoma

Case Report: Young patient with painless swelling in the left orbit of 4 years duration with FNAC suggesting pleomorphic adenoma  shows on Plain CT smoothly marginated lobulated well-defined soft tissue density SOL measuring approximately 2cm in the lacrimal gland location with no bony scalloping or fat or necrosis or calcification suggesting lacrimal gland origin.

Teaching points by Dr MGK Murthy

ü Pleomorphic adenoma is most common (50%) variety of lacrimal gland neoplasms. However pleomorphic adenomas most common in parotid salivary gland(84%)

ü It has epithelial and myoepithelial components. Three types histologically  are Myxoid(most common with high recurrence rate),Cellular, and classic varieties

ü CT shows encapsulated appearance (due to pseudocapsule),however microextensions seen on dissection

ü MR shows Low signal on T1 , Bright on T2 with peripheral low signal due to fibrous capsule and homogenous enhancement of small tumours and delayed enhancement  of large tumours  is typical. Necrosis and calcification  can also be seen.

ü Enucleation is the treatment of choice and recurrence is variable (1-50%)

ü Malignant Transformation is possible (1.5% in first 5 years and 9.5% when it is 15 years old)

Thursday, October 30, 2014

Complicated Mastoiditis-MRI

  • Fluid signal in the right mastoid suggesting right mastoiditis. Peripherally enhancing extra-axial area in the right temporal region suggesting epidural abscess with associated altered signal in the squamous temporal bone and extension into the massetric space. Focal ring enhancing lesion with extensive perilesional edema is noted in the right temporal lobe suggesting temporal lobe abscess (1.4 x 1.2cm).  Prominent leptomeningeal enhancement is noted in right temporal region.  There is resultant mass effect with uncus indenting the right cerebral peduncle. 

Findings are suggestive of right mastoiditis with intracranial extension-epidural and intraparenchymal abscess & meningitis. 

Wednesday, October 29, 2014

Google Pill For Detecting Diseases

Known as the “Nanoparticle Platform,” the project is part of a wider effort inside Google to develop new technologies capable of improving healthcare.

According to a report, Google is fashioning nanoparticles that combine a magnetic material with antibodies or proteins that can attach to and detect other molecules inside the body. The idea is that patients will swallow a pill that contains these particles, and after they enter the bloodstream—attempting to identify molecules that would indicate certain health problems—a wearable device could use their magnetic cores to gather them back together and read what they’ve found.
Reference and Further Reading:

The Test of “Time”

As a kid I used to wonder why organizations and stores across the world write on their boards, tag lines like “Since 1831” or “since 1920”.  But, with running my own organizations both DAMS and TeleRad Providers I have  realized that  we actually improved, and added processes every year. We are actually not the same organization anymore, we have changed with time and we have evolved with evolving technologies and consumer needs. Now I have understood the value of organizations which have survived more than 100 years with changing customer base and mindset, have actually stood the test of time.   This shows their patience and willingness to change according to times. It shows their adaptability or else their products would stop making sense. Time is most important test for any organization, because it does not forgive, if you don’t respect changing times you will perish.   Most people/ start ups give up in initial years.   There is chasm between starting something new and becoming mainstream. People who become successful are the ones who cross the chasm by surviving the test of time.  Organizations are like people, they age, with age some mature into adaptable system while some become senile, lose connect with the consumer base. True relationships and great organisations stand the test of time.

May we get the gift to come up with ideas that will last. Ideas that will stand the ”test of time”.

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