Various diseases can diffusely involve central airways, including the trachea and main stem bronchi. Central airway abnormalities are frequently not apparent or are overlooked on chest radiographs, even though the patient may have significant symptoms. Recent advances in spiral and multi-detector computed tomography (CT) with multi-planar reconstruction and three-dimensional demonstration, including virtual bronchoscopy, allow for excellent display of central airway anatomy and abnormalities with visualization of accurate locations of lesions. Early detection and proper diagnosis of airway diseases based on various radiographic findings will help determine appropriate treatment, including surgical planning and evaluation of treatment response. Herein we describe and illustrate the imaging findings of a wide spectra of diffuse central airway diseases.
Bronchi ; Bronchoscopy ; Humans ; Imaging, Three-Dimensional ; Thorax ; Tomography, X-Ray Computed ; Trachea

Various diseases can diffusely involve central airways, including the trachea and main stem bronchi. Central airway abnormalities are frequently not apparent or are overlooked on chest radiographs, even though the patient may have significant symptoms. Recent advances in spiral and multi-detector computed tomography (CT) with multi-planar reconstruction and three-dimensional demonstration, including virtual bronchoscopy, allow for excellent display of central airway anatomy and abnormalities with visualization of accurate locations of lesions. Early detection and proper diagnosis of airway diseases based on various radiographic findings will help determine appropriate treatment, including surgical planning and evaluation of treatment response. Herein we describe and illustrate the imaging findings of a wide spectra of diffuse central airway diseases.
Bronchi ; Bronchoscopy ; Humans ; Imaging, Three-Dimensional ; Thorax ; Tomography, X-Ray Computed ; Trachea

Ectopic thyroid is an uncommon congenital abnormality, but ectopic thyroid tissue can be present anywhere along the course of the thyroglossal duct and the embryologic descent from the base of the tongue. We report here on two cases with the ultrasonograpic findings of dual ectopy of the thyroid, and these findings were well correlated with the findings of nuclear scintigraphy.
Congenital Abnormalities ; Thyroid Dysgenesis ; Thyroid Gland ; Tongue

Acute phlegmonous infection of the gastrointestinal tract is characterized by purulent inflammation of the submucosa and muscular layer with sparing of the mucosa. The authors report a rare case of acute diffuse phlegmonous esophagogastritis, which was well diagnosed based on the typical chest computed tomographic (CT) findings and was successfully treated. A 48-yr-old man presented with left chest pain and dyspnea for three days. Chest radiograph on admission showed mediastinal widening and bilateral pleural effusion. The patient became febrile and the amount of left pleural effusion is increased on follow-up chest radiograph. Left closed thoracostomy was performed with pus drainage. A CT diagnosis of acute phlegmonous esophagogastritis was suggested and a surgery was decided due to worsening of clinical condition of the patient and radiologic findings. Esophageal myotomies were performed and the submucosal layer was filled with thick, cheesy materials. The patient was successfully discharged with no postoperative complication.
Acute Disease ; Cellulitis/complications/*diagnosis/radiography ; Drainage ; Esophagitis/complications/*diagnosis/surgery ; Gastritis/complications/*diagnosis/surgery ; Humans ; Klebsiella Infections/diagnosis ; Klebsiella pneumoniae/isolation & purification ; Male ; Middle Aged ; Pleural Effusion/etiology/radiography ; Thoracostomy ; Tomography, X-Ray Computed

Endoleak is an important complication following stent grafts for abdominal aortic aneurysms. Here we describe ultrasonography findings in an 86-year-old man including doppler ultrasonography and CT scan in an unusual and interesting case of the concurrent occurrence of a type II endoleak that originated from the left accessory renal artery and a type III endoleak due to shaft fracture of the stent.
Aged, 80 and over ; Angioplasty ; Aortic Aneurysm, Abdominal ; Endoleak ; Humans ; Renal Artery ; Stents ; Transplants ; Ultrasonography, Doppler

Concurrent occurrence of an adenocarcinoma and carcinoid tumor in the stomach has been observed infrequently; moreover, a gastric collision tumor of both tumor types has rarely been seen. We describe a case of a gastric collision tumor following the differential diagnosis from observing the morphological patterns more closely using CT gastrography. The patient presented with a gastric collision tumor that consisted of an adenocarcinoma and carcinoid tumor in the antrum of the stomach.
Adenocarcinoma* ; Carcinoid Tumor ; Carcinoma, Neuroendocrine ; Diagnosis, Differential ; Humans ; Neuroendocrine Tumors* ; Stomach ; Stomach Neoplasms ; Tomography, X-Ray Computed

PURPOSE: To analyze surgical specimens from patients with acute non-perforated and perforated appendicitis using high-resolution ultrasonography (US), and to correlate the US features with the pathologic findings. MATERIALS and METHODS: One hundred and six surgical appendix specimens obtained from patients with suspected acute appendicitis were evaluated. The following US features were evaluated for differentiating acute non-perforated appendicitis from perforated appendicitis: circumferential loss of the echogenic submucosal layer, disruption of the serosal layer, asymmetrical wall thickening, the sum of opposing walls > or = 9 mm and the presence of appendicoliths. The sensitivity and specificity of the US findings for diagnosing perforated appendicitis were determined. RESULTS: All US features were detected significantly more often in the perforated appendicitis group of specimens. The disruption of the serosal layer was the most significant independent predictor of perforation (p < .001). The sensitivity for circumferential loss of the echogenic submucosal layer, disruption of the serosal layer, asymmetrical wall thickening, wall thickness > or = 9 mm, and the presence of appendicoliths individually was 84.6%, 69.2%, 61.5%, 73.1% and 46.2%, respectively. The specificity for all of these findings was 86.3%, 98.7%, 95.0%, 85.0% and 85.0%, respectively. CONCLUSION: High-resolution US of appendiceal specimens was very useful for differentiating acute non-perforated from perforated appendicitis.
Appendicitis* ; Appendix ; Humans ; Sensitivity and Specificity ; Ultrasonography*

PURPOSE: To classify the ultrasonographic findings of cystic lesions of the breast and correlated them with the pathology, to evaluate the characteristic features of cystic masses in benign and malignant tumors, and to determine the appropriate level of patient management according to the ultrasonographic findings. MATERIALS AND METHODS: From June 2002 through to June 2004, the ultrasonographic findings of 113 pathological proven cystic breast lesions were reviewed retrospectively. The cystic lesions were classified as simple acysts, clustered cysts, cysts with thin septa, complicated cysts, cystic masses with a thick wall/ septa or nodules, and complex solid and cystic masses. The ultrasonographic findings of each type of cystic lesion of the breast were compared with the pathology and evaluated according to whether they were benign or malignant. RESULTS: Of the 113 lesions, there were 17 simple cysts, 10 clustered cysts and 19 cysts with thin septa. Twenty four cases of complicated cysts were found to be benign. Five (31.3%) of the 16 cases of cystic masses with a thick wall / septa or nodules and 17 (63%) of the 27 cases of complex solid and cystic masses were found to be malignant. The shape and margin of the 43 cases of cystic masses with a solid component were analyzed. Seventeen out of 36 sonographical round or oval shaped masses and 10 out of 27 sonographical circumscribed margins were found to be malignant. CONCLUSION: The simple cysts, clustered cysts, cyst with thin septa and non-symptomatic complicated cysts detected by sonography were all benign. Symptomatic complicated cysts should be aspirated and treated appropriately. Cystic masses with a solid component should be examined by a biopsy with a pathological confirmation.
Biopsy ; Breast* ; Humans ; Pathology ; Retrospective Studies ; Ultrasonography*

Overexpression of cyclooxygenase-2 (COX-2) has been associated with hepatocarcinogenesis. Inhibitors of COX-2 have proapoptotic and antiproliferative effects on malignant tumors and inhibit tumor invasion to the surrounding tissues. We report here a case of complete regression of advanced hepatocellular carcinoma (HCC) during COX-2 inhibitor administration. An eighty-year-old female was diagnosed as an advanced HCC, which was associated with HCV infection. She received COX-2 inhibitor for 3 months due to degenerative arthritis of both knees. Tumor enhancement on arterial phase CT completely disappeared without specific treatment for the HCC, and the tumor size decreased on the follow-up CT scan.
Aged, 80 and over ; Antineoplastic Combined Chemotherapy Protocols/*therapeutic use ; Carcinoma, Hepatocellular/*drug therapy ; Cyclooxygenase 2 Inhibitors/administration & dosage/*therapeutic use ; Diclofenac/administration & dosage/analogs & derivatives/therapeutic use ; Female ; Humans ; Lactones/administration & dosage/therapeutic use ; Liver Neoplasms/*drug therapy ; Pyrazoles/administration & dosage/therapeutic use ; Sulfonamides/administration & dosage/therapeutic use ; Sulfones/administration & dosage/therapeutic use

OBJECTIVE: We wanted to describe the retrospective CT features of subtle pleural metastasis without large effusion that would suggest inoperable lung cancer. MATERIALS AND METHODS: We enrolled 14 patients who had open thoracotomy attempted for lung cancer, but they were proven to be inoperable due to pleural metastasis. Our study also included 20 control patients who were proven as having no pleural metastasis. We retrospectively evaluated the nodularity and thickening of the pleura and the associated pleural effusion on the preoperative chest CT scans. We reviewed the histologic cancer types, the size, shape and location of the lung cancer and the associated mediastinal lymphadenopathy. RESULTS: Subtle pleural nodularity or focal thickening was noted in seven patients (50%) having pleural metastasis and also in three patients (15%) of control group who were without pleural metastasis. More than one of the pleural changes such as subtle pleural nodularity, focal thickening or effusion was identified in eight (57%) patients having pleural metastasis and also in three patients (15%) of the control group, and these findings were significantly less frequent in the control group patients than for the patients with pleural metastasis (p = 0.02). The histologic types of primary lung cancer in patients with pleural metastasis revealed as adenocarcinoma in 10 patients (71%) and squamous cell carcinoma in four patients (29%). The location, size and shape of the primary lung cancer and the associated mediastinal lymphadenopathy showed no significant correlation with pleural metastasis. CONCLUSION: If any subtle pleural nodularity or thickening is found on preoperative chest CT scans of patients with lung cancer, the possibility of pleural metastasis should be considered.
Adenocarcinoma/radiography/secondary ; Adult ; Aged ; Carcinoma, Squamous Cell/radiography/secondary ; Female ; Humans ; Lung Neoplasms/*pathology ; Male ; Middle Aged ; Pleural Effusion, Malignant/pathology ; Pleural Neoplasms/*radiography/*secondary ; Preoperative Care ; Retrospective Studies ; *Tomography, X-Ray Computed