STUDY OF MRI MORPHOLOGY OF SPINAL TUBERCULOSIS

OBJECTIVE: To study the morphology of tuberculosis of spine on MRI. METHODS AND MATERIALS: A retrospective study was done in the department of Radiodiagnosis, PESIMSR, Kuppam.This study includes 37 patients with suspected Spinal Tuberculosis, who were referred to the department of Radiodiagnosis between 2019 Jan to 2021 July. Informed consent was taken from all the patients. This study was done on GE Signa Explorer 1.5 Tesla. RESULTS: A total of 37 cases were included in the study. Of these 37 cases, 31 were males and 6 were females. The most common age group involved was between 20-40 years, seen in 15 cases followed by 41-60 yrs seen in 14 cases and 61-90 yrs seen in 8 cases. Lumbar vertebrae were commonly affected accounting for 86% of total cases (32cases) followed by dorsal and cervical vertebrae accounting for 8% and 5 % respectively (3 and 2 cases respectively). Intervertebral disc involvement (Discitis) was most commonly seen in 32 cases followed by vertebral endplate involvement (27 cases) in our study. Prevertebral & paravertebral involvement were found in 20 and 23 cases respectively . In our study,19 cases had shown the involvement of posterior elements .Epidural soft tissue component was seen in 22 cases. Psoas abscess and paraspinal involvement were seen in 9 and 8 cases respectively. CONCLUSION: MRI helps in the early assessment of the extent and severity of disease compared to X-ray and CT scan. It is valuable in detecting early marrow changes, intervertebral disc involvement, extradural abscess and cord compression.

A bilayered tissue engineered in vitro model simulating the tooth periodontium

Due to the complexity of the structure of the tooth periodontium, regeneration of the full tooth attachment is not a trivial task. There is also a gap in models that can represent human tooth attachment in vitro and in vivo. The aim of this study was to develop a bilayered in vitro construct that simulated the tooth periodontal ligament and attached alveolar bone, for the purpose of tissue regeneration and investigation of physiological and orthodontic loading. Two types of materials were used to develop this construct: sol-gel 60S10Mg derived scaffold, representing the hard tissue component of the periodontium, and commercially available Geistlich Bio-Gide® collagen membrane, representing the soft tissue component of the tooth attachment. Each scaffold was dynamically seeded with human periodontal ligament cells (HPDLCs). Scaffolds were either cultured separately, or combined in a bilayered construct, for 2 weeks. Characterisation of the individual scaffolds and the bilayered constructs included biological characterisation (cell viability, scanning electron microscopy to confirm cell attachment, gene expression of periodontium regeneration markers), and mechanical characterisation of scaffolds and constructs. HPDLCs enjoyed a biocompatible 3-dimensional environment within the bilayered construct components. There was no drop in cellular gene expression in the bilayered construct, compared to the separate scaffolds.

Intraosseous schwannoma of inferior pubic ramus – A rare benign osseous neoplasm

Intraosseous schwannomas are a very rare subgroup of schwannomas. They account for <1% of all primary bone neoplasms. The mandible is the most commonly involved bone followed by the sacrum. We herein report a case of intraosseous schwannoma involving the inferior ramus and body of the pubic bone in a 43-year-old male who presented with a swelling in the right groin. On radiographs and computed tomography, it appeared as a mildly expansile, lytic, multiloculated lesion in the right pubic bone with a narrow zone of transition, sclerotic margins with areas of cortical breach, and a significant intra and extrapelvic soft-tissue component which did not show any areas of calcification. On magnetic resonance imaging, it appeared isointense to skeletal muscle on T1-weighted images, mildly hyperintense on T2-weighted images, and markedly hyperintense on short-tau inversion recovery images. The differentials considered on imaging were chondroid neoplasms such as chondromyxoid fibroma or low-grade chondrosarcoma, giant cell tumor, and plasmacytoma. However, biopsy and histopathology revealed an intraosseous schwannoma. The patient was operated and the lesion was excised in toto. Intraoperatively, the origin of the lesion was identified as the right obturator nerve. Post-operative, the patient recovery was uneventful and he was discharged.

Retroperitoneal Sclerosing Angiomyolipoma with Long-Term Follow up: A Case Report with Unique Clinicopathologic and Genomic Profile

Sclerosing angiomyolipoma (sAML) is a rare variant of the perivascular epithelioid tumors exhibiting distinct morphology with extensive stromal hyalinization, which makes it challenging to recognize. It often lacks an adipose tissue component and melanocytic markers may be expressed only focally, further posing a diagnostic challenge. Here, we report a case of sAML of the left pararenal retroperitoneum in a 52-year-old woman with 92 months of clinical follow up and discuss the histologic features, immunoprofile, molecular alterations, and differential diagnoses that can aid in the diagnosis of this unique and rare entity.

The role of puncture biopsy in the treatment of pathological fractures of the cervical vertebrae

The aim is to analyze the data obtained during biopsy of primary and secondary lesions and pathological fractures of the cervical vertebrae and their influence on the tactics of treatment of patients. Evaluation of the effectiveness of biopsy of pathological processes in the cervical vertebrae. Materials. The results of biopsies of 20 patients with lesions of the cervical vertebrae of unknown etiology or with the presence of pathological fractures with compression of the spinal cord and roots by a vertebra or a soft tissue component were analyzed. The following results were obtained: the presence of a secondary lesion of the cervical vertebrae was revealed: metastatic nature – 10, primary tumors – 1, lymphoproliferative tumors – 3, no tumor lesion was detected – 3, not enough material for the study – 3. Conclusion. The results obtained indicate the high efficiency and sufficient safety of puncture biopsy in diagnosing lesions of the cervical vertebrae, even in complex localizations (C2). Revealing the nature of vertebral lesions in the absence of absolute indications for decompression and stabilization interventions significantly affects the tactics and order of treatment of the patient.

Ghost cell odontogenic carcinoma of the left maxilla

We report the case of a 25-year-old man with a maxillary ghost cell odontogenic carcinoma (GCOC). The patient presented to the maxillofacial and head and neck surgery clinic with a growing lump in the left maxilla. Initial workup with CT revealed a cystic lesion in the left upper jaw with associated bone erosion and an enhancing soft-tissue component. Enucleation showed a GCOC associated with a calcifying odontogenic cyst. After the diagnosis was obtained, the patient underwent widening of the first surgical resection. GCOCs are rare odontogenic neoplasms with unspecific clinical and imaging presentation, whose definitive characterisation is based on pathology. Current treatment approaches mainly involve surgical excision, but the prognosis is highly unpredictable due to intertumoral heterogeneity. As tumour recurrences occur in 73% of cases, radical surgery with negative margins is highly recommended. Therefore, it is essential to recognise this entity to offer patients adequate management.