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Papers by Elisa Melo Abreu

O diagnostico da doenca inflamatoria pelvica e clinico, baseando-se numa combinacao de sintomas e... more O diagnostico da doenca inflamatoria pelvica e clinico, baseando-se numa combinacao de sintomas e sinais, que incluem dor pelvica e febre. A referenciacao ao medico radiologista ocorre na fase aguda da doenca, quando e necessario excluir diagnosticos diferenciais (ginecologicos, gastrointestinais ou urinarios) ou em doentes que tiveram um episodio agudo previo, por vezes assintomatico, que recorrem ao medico assistente por complicacoes, como dor pelvica cronica, gravidez ectopica e infertilidade. Neste contexto, e fundamental que o medico radiologista reconheca as manifestacoes radiologicas dos diferentes estadios da doenca inflamatoria pelvica, com especial enfase para o abcesso tubo-ovarico, cujas caracteristicas radiologicas colocam diagnostico diferencial com carcinoma do ovario.

BMJ Case Reports, 2017

A 45-year-old woman with a history of total hysterectomy with adnexal preservation for uterine le... more A 45-year-old woman with a history of total hysterectomy with adnexal preservation for uterine leiomyomas presented to our hospital with a right gluteal palpable mass, which she first noticed 6 months before and had progressively enlarged since then.Radiological studies revealed a 14 cm lesion with translevator growth that displaced rather than invaded adjacent structures, with a peculiar whorled pattern on T2-weighted MRI, which enhanced following gadolinium administration. CT-guided biopsy was performed, and in conjunction with imaging features the diagnosis of an aggressive angiomyxoma was assumed and confirmed following surgical excision.

BMJ case reports, Jan 5, 2016

Breast cancer in men is uncommon, accounting for <1% of all breast cancers. Even though lobula... more Breast cancer in men is uncommon, accounting for <1% of all breast cancers. Even though lobular structures are quite infrequent in the male breast, rare cases of invasive lobular breast carcinoma have been described, representing 1-2% of all breast cancers in men. Risk factors include undescended testes, congenital inguinal hernia, orchiectomy, orchitis, testicular injury, infertility and Klinefelter's syndrome, previous thoracic radiotherapy, alterations of the oestrogen-testosterone ratio and familial history (BRCA 2 and 1). The authors present a case of a 52-year-old man with no relevant predisposing factors to breast cancer, who presented with a painless, firm nodule, fixed to the nipple on the left breast, associated with nipple retraction and ulceration, and fully characterised by mammogram and ultrasound. Histopathological and immunohistochemical analysis revealed the diagnosis of invasive lobular breast carcinoma and the patient underwent left radical mastectomy, foll...

A 68-year-old woman was referred to our hospital to charaterize a pelvic mass, an incidental find... more A 68-year-old woman was referred to our hospital to charaterize a pelvic mass, an incidental finding on a routine ultrasound. A computed tomography (CT) and a magnetic resonance imaging (MRI) were performed. She was asymptomatic and laboratorial analysis was unremarkable.

A 57-year-old asymptomatic black man presented with palpable mass in his right breast. At physica... more A 57-year-old asymptomatic black man presented with palpable mass in his right breast. At physical examination, a painless, firm and fixed to the pectoral fascia nodule was found in the inner quadrant of his right breast. No axillary nodes were palpable.

A 54-year-old woman presented to the emergency room complaining of diffuse abdominal pain, diarrh... more A 54-year-old woman presented to the emergency room complaining of diffuse abdominal pain, diarrhoea and recent loss of weight. The physical examination showed a distended abdomen and a tubular painless mass, extending from the right hypochondrium to the pelvis. There was no fever and the laboratory parameters were unremarkable.

PURPOSE/AIM To illustrate the spectrum of appearances of solitary fibrous tumors, (localized or d... more PURPOSE/AIM To illustrate the spectrum of appearances of solitary fibrous tumors, (localized or disseminated, pleural or extrapleural, benign or malignant) using cross-sectional imaging techniques. To review the imaging features that aid in diagnosis. CONTENT ORGANIZATION A database review at our oncologic institution over the last seven-years retrieved 30 patients with the histological diagnosis of solitary fibrous tumors (SFTs). The authors evaluated the CT and/or MR imaging findings of SFTs in a variety of anatomic sites including lung, pleura, mediastinum, liver, mesentery, parotid, thyroid, orbit and several soft tissue regions (gluteus, shoulder, dorsal, face, axilla), including both benign and malignant SFTs. The content presentation will start with an introduction and description of the clinical and pathologic features. CT and MRI findings in SFTs will be discussed and Illustrative cases will be provided. It will end with a final conclusion. SUMMARY SFTs are rare mesenchymal...

The International Journal of Artificial Organs, 2014

Cardiovascular morbidity in hemodialysis (HD) patients may be influenced by the activation of cir... more Cardiovascular morbidity in hemodialysis (HD) patients may be influenced by the activation of circulating mononuclear cells (MCs) with subsequently increased endothelium interaction. The use of more biocompatible membranes would reduce this monocyte activation. We compare monocyte activation after using two different high-flux polymers, polysulphone and polyethersulphone. The first part of the study was done with 10 patients who successively received dialysis for 2 weeks with polysulphone and polyethersulphone. The second part with 30 patients dialyzed for 3 months with polysulphone or polyethersulphone. Blood samples were taken before (pre-HD) and after (post-HD) the first HD session with each membrane to evaluate the effect of a single HD session. To assess acute and chronic effects of membranes, blood samples were taken pre-HD, after 2 weeks (first part of study) and after 3 months (second part of study). MCs were isolated from blood and then incubated with cultured human endothelial cells to evaluate MC adhesion, MC-dependent endothelial toxicity, and endothelial protein expressions of nitric oxide synthase and endothelin-converting enzyme-1 (ECE-1). One single HD session did not induce any changes. Dialysis for 2 weeks (first part of study) with polyethersulphone reduced MC adhesion to endothelium, cellular toxicity, and ECE-1 protein expression compared to polysulphone or basal conditions. Dialysis for 3 months (second part of study) increased MC adhesion to endothelium, whereas cellular toxicity was decreased with both dialyzers compared to the basal situation. Although polyethersulphone HD decreased the interaction of MC with the endothelium in short-term experiments, both membranes were comparable in the long-term.

Breast tissue superposition or parenchymal density have been known as Digital Mammography's (DM) ... more Breast tissue superposition or parenchymal density have been known as Digital Mammography's (DM) main limitations. More expensive and case-specific tools such as MRI and ultrasound imaging may be used to address this problem, but 2D DM remains the most practical and cost-effective approach. Digital Breast Tomo-synthesis (DBT) has the ability to overcome both problems. However, the images produced by this technique are affected by the limited resolution between slices, which combined with a lack of a viewing mode make it difficult to visualize the true 3D structure of the breast. This is unfortunate since stereo static 3D representations can improve real lesion detection. In this paper, we propose a new interactive visualization approach to DBT that explores all three dimensions of the volume data. Our approach allows combining DBT slices to generate a 3D representation of the breast in order to improve the radiologist's depth perception. Preliminary results suggest that this alternative has the potential to achieve similar visual enhancement of lesions, as well as to reduce the time required to locate and classify these.

O diagnostico da doenca inflamatoria pelvica e clinico, baseando-se numa combinacao de sintomas e... more O diagnostico da doenca inflamatoria pelvica e clinico, baseando-se numa combinacao de sintomas e sinais, que incluem dor pelvica e febre. A referenciacao ao medico radiologista ocorre na fase aguda da doenca, quando e necessario excluir diagnosticos diferenciais (ginecologicos, gastrointestinais ou urinarios) ou em doentes que tiveram um episodio agudo previo, por vezes assintomatico, que recorrem ao medico assistente por complicacoes, como dor pelvica cronica, gravidez ectopica e infertilidade. Neste contexto, e fundamental que o medico radiologista reconheca as manifestacoes radiologicas dos diferentes estadios da doenca inflamatoria pelvica, com especial enfase para o abcesso tubo-ovarico, cujas caracteristicas radiologicas colocam diagnostico diferencial com carcinoma do ovario.

BMJ Case Reports, 2017

A 45-year-old woman with a history of total hysterectomy with adnexal preservation for uterine le... more A 45-year-old woman with a history of total hysterectomy with adnexal preservation for uterine leiomyomas presented to our hospital with a right gluteal palpable mass, which she first noticed 6 months before and had progressively enlarged since then.Radiological studies revealed a 14 cm lesion with translevator growth that displaced rather than invaded adjacent structures, with a peculiar whorled pattern on T2-weighted MRI, which enhanced following gadolinium administration. CT-guided biopsy was performed, and in conjunction with imaging features the diagnosis of an aggressive angiomyxoma was assumed and confirmed following surgical excision.

BMJ case reports, Jan 5, 2016

Breast cancer in men is uncommon, accounting for <1% of all breast cancers. Even though lobula... more Breast cancer in men is uncommon, accounting for <1% of all breast cancers. Even though lobular structures are quite infrequent in the male breast, rare cases of invasive lobular breast carcinoma have been described, representing 1-2% of all breast cancers in men. Risk factors include undescended testes, congenital inguinal hernia, orchiectomy, orchitis, testicular injury, infertility and Klinefelter's syndrome, previous thoracic radiotherapy, alterations of the oestrogen-testosterone ratio and familial history (BRCA 2 and 1). The authors present a case of a 52-year-old man with no relevant predisposing factors to breast cancer, who presented with a painless, firm nodule, fixed to the nipple on the left breast, associated with nipple retraction and ulceration, and fully characterised by mammogram and ultrasound. Histopathological and immunohistochemical analysis revealed the diagnosis of invasive lobular breast carcinoma and the patient underwent left radical mastectomy, foll...

A 68-year-old woman was referred to our hospital to charaterize a pelvic mass, an incidental find... more A 68-year-old woman was referred to our hospital to charaterize a pelvic mass, an incidental finding on a routine ultrasound. A computed tomography (CT) and a magnetic resonance imaging (MRI) were performed. She was asymptomatic and laboratorial analysis was unremarkable.

A 57-year-old asymptomatic black man presented with palpable mass in his right breast. At physica... more A 57-year-old asymptomatic black man presented with palpable mass in his right breast. At physical examination, a painless, firm and fixed to the pectoral fascia nodule was found in the inner quadrant of his right breast. No axillary nodes were palpable.

A 54-year-old woman presented to the emergency room complaining of diffuse abdominal pain, diarrh... more A 54-year-old woman presented to the emergency room complaining of diffuse abdominal pain, diarrhoea and recent loss of weight. The physical examination showed a distended abdomen and a tubular painless mass, extending from the right hypochondrium to the pelvis. There was no fever and the laboratory parameters were unremarkable.

PURPOSE/AIM To illustrate the spectrum of appearances of solitary fibrous tumors, (localized or d... more PURPOSE/AIM To illustrate the spectrum of appearances of solitary fibrous tumors, (localized or disseminated, pleural or extrapleural, benign or malignant) using cross-sectional imaging techniques. To review the imaging features that aid in diagnosis. CONTENT ORGANIZATION A database review at our oncologic institution over the last seven-years retrieved 30 patients with the histological diagnosis of solitary fibrous tumors (SFTs). The authors evaluated the CT and/or MR imaging findings of SFTs in a variety of anatomic sites including lung, pleura, mediastinum, liver, mesentery, parotid, thyroid, orbit and several soft tissue regions (gluteus, shoulder, dorsal, face, axilla), including both benign and malignant SFTs. The content presentation will start with an introduction and description of the clinical and pathologic features. CT and MRI findings in SFTs will be discussed and Illustrative cases will be provided. It will end with a final conclusion. SUMMARY SFTs are rare mesenchymal...

The International Journal of Artificial Organs, 2014

Cardiovascular morbidity in hemodialysis (HD) patients may be influenced by the activation of cir... more Cardiovascular morbidity in hemodialysis (HD) patients may be influenced by the activation of circulating mononuclear cells (MCs) with subsequently increased endothelium interaction. The use of more biocompatible membranes would reduce this monocyte activation. We compare monocyte activation after using two different high-flux polymers, polysulphone and polyethersulphone. The first part of the study was done with 10 patients who successively received dialysis for 2 weeks with polysulphone and polyethersulphone. The second part with 30 patients dialyzed for 3 months with polysulphone or polyethersulphone. Blood samples were taken before (pre-HD) and after (post-HD) the first HD session with each membrane to evaluate the effect of a single HD session. To assess acute and chronic effects of membranes, blood samples were taken pre-HD, after 2 weeks (first part of study) and after 3 months (second part of study). MCs were isolated from blood and then incubated with cultured human endothelial cells to evaluate MC adhesion, MC-dependent endothelial toxicity, and endothelial protein expressions of nitric oxide synthase and endothelin-converting enzyme-1 (ECE-1). One single HD session did not induce any changes. Dialysis for 2 weeks (first part of study) with polyethersulphone reduced MC adhesion to endothelium, cellular toxicity, and ECE-1 protein expression compared to polysulphone or basal conditions. Dialysis for 3 months (second part of study) increased MC adhesion to endothelium, whereas cellular toxicity was decreased with both dialyzers compared to the basal situation. Although polyethersulphone HD decreased the interaction of MC with the endothelium in short-term experiments, both membranes were comparable in the long-term.

Breast tissue superposition or parenchymal density have been known as Digital Mammography's (DM) ... more Breast tissue superposition or parenchymal density have been known as Digital Mammography's (DM) main limitations. More expensive and case-specific tools such as MRI and ultrasound imaging may be used to address this problem, but 2D DM remains the most practical and cost-effective approach. Digital Breast Tomo-synthesis (DBT) has the ability to overcome both problems. However, the images produced by this technique are affected by the limited resolution between slices, which combined with a lack of a viewing mode make it difficult to visualize the true 3D structure of the breast. This is unfortunate since stereo static 3D representations can improve real lesion detection. In this paper, we propose a new interactive visualization approach to DBT that explores all three dimensions of the volume data. Our approach allows combining DBT slices to generate a 3D representation of the breast in order to improve the radiologist's depth perception. Preliminary results suggest that this alternative has the potential to achieve similar visual enhancement of lesions, as well as to reduce the time required to locate and classify these.