Pitfalls in paediatric oncology imaging

Imaging a new mass lesion in a child requires careful consideration of a variety of issues. The age of the child is an important factor in determining the appropriate test to start with and the age also helps provide an appropriate differential diagnosis, which can then be used to guide further imaging. The long-term outcome for most children with cancer is very good, with over 70% achieving 5-year survival and presumed cure. Consequently their imaging requirements should be regarded as equal to all other children. Minimizing exposure to ionizing radiation, particularly where follow-up imaging is required is an important consideration. This article focuses specifically on general paediatric radiology and neuro-oncology imaging is not addressed. The pitfalls to be aware of in plain radiography, ultrasonography, computed tomography, magnetic resonance imaging and nuclear medicine (positron emission tomography-computed tomography and single photon emission computed tomography) in children with a proven or suspected malignancy are discussed.

Mediastinal tumor and Klinefelter's syndrome

Klinefelter's syndrome with karyotype 47,XXY in patients with primary extragonadal germ cell tumors rarely occurs. The endocrinology of Klinefelter's syndrome is changed; elevated beta-human choriomic gonadotropin levels are present. Chemotherapy and thoracic surgery brought complete remission in a patient with lung metastases.

[1st case of AIDS in Salzburg. Important diagnostic hint by determination of neopterin]

This case report describes the first case of AIDS in Salzburg. The patient belonged to the male homosexual risk group. He presented with opportunistic infections: oral candidiasis, bilateral Pneumocystis carinii pneumonia and cerebral toxoplasmosis. The diagnosis of AIDS was corroborated by highly elevated urinary neopterin levels. Despite treatment with antibiotics the patient died within 5 weeks due to cardiorespiratory insufficiency.