L. Thanos - Academia.edu (original) (raw)

Papers by L. Thanos

Scandinavian Journal of Gastroenterology, 2005

Aneurysmal dilatation of the portal vein (ADPV) is a rare cause of portal hypertension. We descri... more Aneurysmal dilatation of the portal vein (ADPV) is a rare cause of portal hypertension. We described a case of ADPV in a female patient who presented with ascites. Imaging studies revealed tortuosity and dilatation of the main portal vein with turbulent flow. Endoscopy revealed oesophageal varices. A liver biopsy showed no abnormalities in liver histology. This is the first case of ascites as a complication of ADPV in the absence of liver cirrhosis, arteriovenous fistula or documented portal vein thrombosis. Hyperdynamic circulation and increased portal vein flow could be implicated in the pathogenesis of ascites in this setting.

Archives of Medical Science

Hepatocellular carcinoma (HCC) is a very common malignancy. Early diagnosis plays a significant r... more Hepatocellular carcinoma (HCC) is a very common malignancy. Early diagnosis plays a significant role in the management of patients, affecting survival and prognosis. Surgical resection is the treatment of choice; yet only a small number of patients are surgical candidates at the time of diagnosis. Furthermore, recurrences are very common even after a successful resection. These reasons urged the need to introduce a minimally invasive technique that can be repeated, without the fear of increasing mortality, morbidity, hospitalization and treatment-related cost. In the present article we present our long-standing experience regarding radiofrequency thermal ablation (RFA) treatment of HCC. Indications, clinical results from other investigators and complications are discussed. Additionally there is a description of the technique and the equipment used.

Acta Cytologica, 1997

BACKGROUND Malignant fibrous histiocytoma (MFH) arising primarily in the lungs is rare, and a pre... more BACKGROUND Malignant fibrous histiocytoma (MFH) arising primarily in the lungs is rare, and a preoperative diagnosis, as well as a surgical planning, is very important because of the tumor's propensity for vascular invasion and its low incidence of lymph node metastasis. The correct preoperative diagnosis of thoracic MFH is not easy to establish because the small fragments from needle and transbronchial biopsies are often inadequate for a conclusive histologic analysis. A preoperative bronchial brushing cytology suggestion of the diagnosis of primary MFH of the lungs may be helpful in such cases. CASE A 37-year-old male presented with a large, irregular mass in the inferior and middle lobes on chest roentgenography as well as on computed tomography. Two bronchoscopies were performed, with the diagnosis of undifferentiated large cell carcinoma. After surgical resection a more sophisticated pathologic analysis, including immunohistochemical and ultrastructural studies, revealed a primary MFH of the lungs. Revision of the bronchial brushing cytology disclosed many spindle-shaped cells with a "comet" configuration, strongly suggestive of MFH. CONCLUSION The bronchial brushing cytology features of spindle-shaped and bizarre, multinucleated giant cells with a comet appearance may be the key to the cytomorphologic diagnosis of MFH.

Minimally Invasive Therapy & Allied Technologies, 1998

ABSTRACT Vascular complications of laparoscopic cholecystectomy are encountered with increasing f... more ABSTRACT Vascular complications of laparoscopic cholecystectomy are encountered with increasing frequency. We report a patient with a pseudoaneurysm of the right hepatic artery who presented with haemobilia following laparoscopic cholecystectomy. The patient was managed successfully with transarterial selective embolisation and remains free of symptoms 11 months later.

European Radiology, 2000

A case of ruptured adrenal artery aneurysm is presented. The ultrasound, computed tomography and ... more A case of ruptured adrenal artery aneurysm is presented. The ultrasound, computed tomography and selective renal angiography findings are described in detail. Aneurysms of adrenal arteries are particularly rare. Early diagnosis is important because of their tendency towards rupture and subsequent high mortality rate.

Biomarkers, 2012

Scanty reports have focused on FDG-PET after radiofrequency ablation (RFA), for recurrence of hep... more Scanty reports have focused on FDG-PET after radiofrequency ablation (RFA), for recurrence of hepatic metastases. To assess FDG-PET diagnostic accuracy on detection of recurrent hepatic lesions. After a comprehensive search of PubMed and EMBASE, we performed a patient-based diagnostic meta-analysis of post-RFA FDG-PET. Across nine included articles, independent, random-effects sensitivity and specificity were 0.73(0.50-0.88) and 0.85(0.72-0.93), respectively. A symmetrical SROC curve was produced with no significant heterogeneity. Specificity was optimal for surgical RFA and colorectal origin of metastases. Synthesis of published evidence suggests PET/CT as an appropriate tool for optimizing post-ablation follow-up.

Archives of Disease in Childhood, 2008

Objective To detect the effectiveness and accuracy of fine-needle biopsy (FNB) as an accurate tec... more Objective To detect the effectiveness and accuracy of fine-needle biopsy (FNB) as an accurate technique for the diagnosis of lymphoma in children. Methods 23 patients underwent a FNB procedure. The patients ranged in age from 2 to 16 years, with a mean age of 9 years. For the whole series, two patients (8.7%) had tumours in the anterior mediastinum, 18 had tumours (78.26%) in the middle mediastinum and three in the posterior mediastinum (13%). All masses were punctured with a 18 gauge FNB needle. Results Lymphomas were the most common tumours and represented 73.9% of our patients (17/23). They generally presented in the teen years and were located in the middle mediastinum. Lymphomas were Hodgkins disease in 39% and non-Hodgkins lymphoma in the remaining 61%. Neurogenic tumours represented 13% of our total group and were the second most common mediastinal tumour. They were located in the posterior mediastinum. There were two cystic lesions of the mediastinum, representing 8.7% of th...

American Journal of Roentgenology, 2004

A 30-year-old female presented with aggravated dyspnea and cough. She had given birth to her firs... more A 30-year-old female presented with aggravated dyspnea and cough. She had given birth to her first baby three months ago. Physical examination showed reduced pulmonary sounds on the right side. Chest X-ray confirmed the diagnosis of right-sided pneumothorax. Computed tomography (CT) revealed reticular interstitial pattern and multiple bilateral cysts, pneumothorax of the right lung and small pleural effusion. The diagnosis was confirmed by pulmonary biopsy. Comment Lymphangioleiomyomatosis (LAM) is a rare, cystic lung disease that primarily affects young women. Exacerbations of LAM have been reported to occur during pregnancy and menstruation, as well as with exogenous estrogen use. The most common presentation of LAM is progressive dyspnea on exertion (difficulty breathing with physical activity), often in association with a history of pneumothorax or chylothorax. LAM occurs in two settings: In the disease tuberous sclerosis complex (TSC-LAM), an autosomal dominant disorder due to ...

A 50-year-old woman with history of asthma was admitted to our hospital because of fever (38 o C)... more A 50-year-old woman with history of asthma was admitted to our hospital because of fever (38 o C), cough, breathlessness and sweating at night of 10 days duration. Blood tests showed increased white blood tests with eosinophilia (14%), a high erythrocyte sedimentation rate and increased platelets. The blood cultures were negative and the blood gases were normal. The chest X-ray showed airspace infiltrates in the left upper pulmonary zone with peripheral distribution (fig.1). Chest CT scan showed peripheral airspace consolidation in the upper lobe of the left lung (fig. 2). Initially, the patient was diagnosed to have bacterial pneumonia and received antibiotics for almost a month which didn't improve her clinical condition. At that time, increased eosinophils (>60%, normally <1%) were found in fluid obtained by a bronchoscopy (bronchoalveolar lavage [BAL] fluid), while a new chest CT scan showed that the peripheral airspace consolidation disappeared and a new one in the ri...

A 45-year-old woman with a four year history of scleroderma under immunosuppressive treatment pre... more A 45-year-old woman with a four year history of scleroderma under immunosuppressive treatment presented to our department due to shortness of breath and feeling of heartburn. She denied any respiratory symptoms before this episode. Patient was known diabetic for 3 years, and hypertensive for 2 years. She mentioned no imaging workup in the last three years. Her vital signs upon admission were: heart rate 80 bpm, blood pressure 120/50 mm/Hg, respiratory rate 20/min. She was afebrile and oxygen saturation was 98% on room air. Physical examination revealed mild wheezing in basal lung, sclerodactyly, tightness and thickness of the skin on her hands and telangiectasia. Breast palpation revealed multiple, non painful hard lumps with no axillary lymphadenopathy. Her total blood count test showed WBC 4.800/μL, HCT 30%, platelets 148,000/μL, ESR 135 mm/hour. Chest X-ray showed few bilateral lower lobe interstitial infiltrates. Incidental and conspicuous finding though, were coarse diffuse cal...

An asymptomatic 32-year-old woman presented to the pathologist for clinical evaluation in order t... more An asymptomatic 32-year-old woman presented to the pathologist for clinical evaluation in order to take a health certificate. Medical history and physical examination revealed none abnormality. Thus, she referred to our department for a chest x ray which revealed a solid mass at the lower lobe of the left lung. Chest computed tomography (CT) was then performed showing a large solid mass with great contrast medium enhancement. CT guided fine needle biopsy was decided in order to confirm the diagnosis (fig. 1). Comment Carcinoid tumors of the lung are a fascinating but uncommon group of pulmonary neoplasms. Typical carcinoid tumors of the lung represent the most well-differentiated and least biologically aggressive type of pulmonary NET. These tumors characteristically grow slowly and tend to metastasize infrequently. Atypical carcinoid tumors have a more aggressive histologic and clinical picture. They metastasize at a considerably higher rate than do typical carcinoid tumors and, th...

A 35-year-old woman presented to the Emergency Department due to fatigue, fever and cough for at ... more A 35-year-old woman presented to the Emergency Department due to fatigue, fever and cough for at least three days. She referred being immunocompetent with a medical history of treated pulmonary tuberculosis five years ago. She mentioned living in a house under renovation construction. Medical examination revealed mild respiratory distress (SpO2 96%) and wheezing. Laboratory investigation showed mild leukocytosis and increased C reactive protein of 50 mg/L. Chest x-ray revealed well-defined cystic lesion involving the right lower lung lobe. She immediately started antimicrobial therapy and underwent a computed tomography (CT) scan that revealed a cystic lesion surrounded by consolidation in the right lower lobe (fig. 1). Laboratory testing Figure 1. Computed tomography (CT) image revealing (a) cystic lesion of the lower right lobe with (b) pneumonic consolidation in the same area. to exclude tuberculosis and mycosis was taken. Due to lack of correspondence to the empirical antimicrob...

Tubercular cold abscesses secondary to neighbouring bone involvement are a well-known clinical ma... more Tubercular cold abscesses secondary to neighbouring bone involvement are a well-known clinical manifestation of extra-pulmonary tuberculosis. However, primary soft tissue tuberculous abscesses with no pulmonary involvement in immuno-competent patients are very uncommon. A rare case of multiple primary intrathoracic and extraperitoneal soft tissue tuberculous abscesses and mediastinal lymph node tuberculosis with no pulmonary involvement is reported. This case demonstrates the need for a high index of suspicion for such rare presentations of extra-pulmonary tuberculosis in patients from endemic areas.

Hepato- …, 1999

The evaluation of the clinical use of CT portography (CTp) and post-lipiodol CT (CT post-lip) in ... more The evaluation of the clinical use of CT portography (CTp) and post-lipiodol CT (CT post-lip) in terms of therapeutic implications in patients with liver malignancies, particularly hepatocellular carcinoma (HCC). We prospectively evaluated 130 patients with CTp and CT post-lip: 109 with HCC and underlying cirrhosis (group I) and 21 with liver metastases considered for surgical resection (group II). All patients also underwent hepatic angiography (hA). Mean lesion size was 4.6 cm and 2.2 cm for group I and II respectively. Previous contrast-enhanced CT studies were available for comparison. Diagnostic CTp examinations resulted in only 84.4% of group I due to enhancement in homogeneities and in all patients from group II. In comparison with the referral CT, additional lesions were seen in 83.6% of the HCC group and in 66.6% of the metastatic group that implicated treatment alterations in 15.21% and in 23.8% of them, respectively. Hepatic angiography revealed hypervascularity in 91.3% of HCC lesions and in 33.3% of metastatic ones. CT post-lip images suitable for evaluation resulted in 104/130 patients (80%). At CT post-lip false negative results were observed in 33.73% patients with HCC and in 30.95% patients with liver metastases. Selective lipiodol retention was seen in only 50% of the biopsy proved satellites. CTp reveals additional lesions that have therapeutic implications in at least 15% of HCC patients and in 20% of patients with metastatic disease, and should be routinely included in the preinterventional work-up particularly for cases in which intraarterial or percutaneous treatment is scheduled. By contrast, CT post-lip seems to be of limited value unless it is evaluated in combination with CTp and angiography.