PURPOSE: The purpose of this study is to describe the characteristic high-resolution(HR) Ct findings ofsolitary nodular bronchioloalveolar carcinoma(BAC) of the lung which are valuable for specific diagnosis of thedisease. MATERIALS AND METHODS: HRCT scans of 46 patients (31 with malignant and 15 with benign lesion) with asolitary pulmonary nodule seen on chest radiograph were distributed in random order and analyzed retrospectively.Two blinded observers jointly analyzed the marginal and internal characteristics of nodules as seen on HRCT, anddecisions on the findings were reached by consensus. Stepwise discriminant analysis for characteristic findings ofBAC was performed. RESULTS: The most frequent CT findings of BAC (n=15) were internal bubble lucency (14/15,93%)(p=0.001), area of ground-glass opacity (12/15, 80%;average 58% of tumor volume)(p=0.0001), pleural tag(12/15,80%;p=0/097), and lobulated and spiculated margin(8/15, 53%;p=0.459). Findings of ground-glass opacity(p=0.0001)and bubble lucency(p=0.0187) appeared to be discriminantin the diagnosis of BAC. CONCLUSION: Peripheral pulmonarynodules containing an area of ground-glass opacity associated with internal bubble-lucency are characteristic ofBAC. Specific histologic diagnosis of solitary nodular BAC can be suggested by careful analysis of HRCT findings.
Adenocarcinoma, Bronchiolo-Alveolar* ; Consensus ; Diagnosis ; Humans ; Lung* ; Radiography, Thoracic

A 39-year-old man presented with dizziness and melena for 2 months. Abdominal CT scan showed constrictive wall thickening with enhancement and proximal loop dilatation of the jejunum. On endoscopic examination, there was large amount of bile stained fluid in duodenum. Enteroscopy using pediatric colonoscope demonstrated an encircling mass with obstruction approximately 20 cm distal to the ligament of Treitz. Endoscopic jejunal biopsy showed moderately differentiated adenocarcinoma. Small intestinal adenocarcinoma is uncommonly encountered in clinical practice. Because small intestine is relatively inaccessible via routine endoscopy, diagnosis of small intestinal neoplasm is often delayed for several months after the onset of symptoms. Most of the patients are diagnosed in advanced stage. Therefore, when a small bowel neoplasm is suspected, enteroscopy is the most useful study. If enteroscope is not available, enteroscopy using pediatric colonoscope may permit earlier preoperative diagnosis. We report a case of primary jejunal adenocarcinoma diagnosed by endoscopic biopsy using pediatric colonoscope.
Adenocarcinoma/*pathology/radiography/surgery ; Adult ; Colonoscopes ; Endoscopy, Gastrointestinal ; Humans ; Jejunal Neoplasms/*pathology/radiography/surgery ; Male

OBJECTIVE: This study was designed to evaluate follow-up results in terms of patient prognosis for malignant pulmonary nodules depicted as pure ground-glass opacity (GGO) lesion observed at high-resolution CT (HRCT). MATERIALS AND METHODS: Surgical removal for malignant GGO nodules was accomplished in 58 patients (26 men, 32 women; mean age, 57 years; age range, 29-78 years). Patient prognoses were assessed by patient clinical status and the presence of changes in nodule size determined after a follow-up HRCT examination. Differences in patient prognoses were compared for nodule number, size, surgical method, change in size before surgical removal, and histopathological diagnosis by use of Fisher's exact test and Pearson's chi-squared test. RESULTS: Of the 58 patients, 40 patients (69%) were confirmed to have a bronchioloalveolar carcinoma (BAC) and 18 patients (31%) were confirmed to have an adenocarcinoma with a predominant BAC component. Irrespective of nodule size, number, treatment method, change in size before surgical removal and histopathological diagnosis, neither local recurrence nor a metastasis occurred in any of these patients as determined at a follow-up period of 24 months (range; 12-65 months). Of 14 patients with multiple GGO nodules, all of the nodules were resected without recurrence in six patients. In the remaining eight patients, the remaining nodules showed no change in size in seven cases and a decrease in size in one case as determined after a follow-up CT examination. CONCLUSION: Prognoses in patients with pure GGO malignant pulmonary nodules are excellent, and not significantly different in terms of nodule number, size, surgical method, presence of size change before surgical removal and histopathological diagnosis.
Adenocarcinoma/pathology/radiography/surgery ; Adenocarcinoma, Bronchiolo-Alveolar/pathology/radiography/surgery ; Adult ; Female ; Humans ; Lung Neoplasms/pathology/*radiography/surgery ; Male ; Middle Aged ; Multiple Pulmonary Nodules/pathology/*radiography/surgery ; Prognosis ; Solitary Pulmonary Nodule/pathology/*radiography/surgery ; *Tomography, X-Ray Computed ; Young Adult

The association of anisakiasis of the colon with colon cancer is rare and difficult to diagnose. Only one case of this type has been reported to date. In this study, we report a case of synchronous colon cancer and colonic anisakiasis. A 50-year-old woman was admitted for abdominal pain, and a volume-rendered surface-shaded image of CT colonography (CTC) revealed a concentric narrowing in the sigmoid colon and a segmental fold thickening in the ascending colon. A total colectomy was performed and the diagnosis of synchronous sigmoid colon cancer and anisakiasis of the ascending colon was confirmed. This case is the first reported visualization of synchronous colon cancer and colonic anisakiasis on a CTC.
Adenocarcinoma/*complications/*radiography/surgery ; Anisakiasis/*complications/*radiography/surgery ; Colectomy ; Colonic Diseases/*complications/*radiography/surgery ; *Colonography, Computed Tomographic ; Female ; Humans ; Middle Aged ; Sigmoid Neoplasms/*complications/*radiography/surgery

Synchronous primary lung cancers are relatively rare. The accurate diagnosis remains challenging, despite of the routine use of bronchoscopy and computed tomography (CT) of the chest. Herein we report a case of synchronous triple primary cancers of the right lung in a 72-year-old male patient in whom each tumor presented distinct CT imaging findings.
Adenocarcinoma/*diagnosis/pathology/radiography ; Adenocarcinoma, Mucinous/*diagnosis/pathology/radiography ; Aged ; Bronchoscopy ; Carcinoma, Squamous Cell/*diagnosis/pathology/radiography ; Diagnosis, Differential ; Humans ; Lung Neoplasms/*diagnosis/pathology/radiography ; Male ; Neoplasm Staging ; Neoplasms, Multiple Primary ; Positron-Emission Tomography ; Tomography, X-Ray Computed

OBJECTIVE: We wanted to evaluate the mammographic and sonographic differential features between pure (PT) and mixed tubular carcinoma (MT) of the breast. MATERIALS AND METHODS: Between January 1998 and May 2004, 17 PTs and 14 MTs were pathologically confirmed at our institution. The preoperative mammography (n = 26) and sonography (n = 28) were analyzed by three radiologists according to BI-RADS. RESULTS: On mammography, a mass was not detected in eight patients with PT and in one patient with MT (57% vs. 8%, respectively, p = 0.021), which was statistically different. The other findings on mammography and sonography showed no statistical differences between the PT and MT, although the numerical values were different. When the lesions were detected mammographically, an irregularly shaped mass with a spiculated margin was more frequently found in the MT than in the PT (100% vs. 83%, respectively, p = 0.353). On sonography, all 28 patients presented with a mass and most lesions showed as not being circumscribed, hypoechoic masses with an echogenic halo. Surrounding tissue changes and posterior shadowing were more frequently found in the MT than in the PT (75% vs. 50%, respectively, p = 0.253, 58% vs. 19%, respectively, p = 1.000). An oval shaped mass was more frequently found in the PT than in the MT (44% vs. 25%, respectively; p = 0.434). CONCLUSION: PT and MT cannot be precisely differentiated on mammography and sonography. However, the absence of a mass on mammography or the presence of an oval shaped mass would favor the diagnosis of PT. An irregularly shaped mass with surrounding tissue change and posterior shadowing on sonography would favor the diagnosis of MT and also a less favorable prognosis.
Adenocarcinoma/pathology/*radiography/*ultrasonography ; Adult ; Aged ; Breast Neoplasms/pathology/*radiography/*ultrasonography ; Diagnosis, Differential ; Female ; Humans ; Mammography ; Middle Aged ; Ultrasonography, Mammary

Malignant transformation of teratoma in the anterior mediastinum is rare; the mass usually has a long history and is seen in older patients. We report a case of teratoma with malignant transformation in the anterior mediastinum, complicated by rupture. CT revealed a lobulated, inhomogeneous cystic mass with a fat com-ponent and wall calcifications. The lateral wall was disrupted and consolidation in the adjacent left upper lobe was noted, suggesting rupture. A heterogeneously enhanced solid portion, obliterating the fat plane between the mass and the great vessels was present in the medial aspect of the mass, and pathologic examina-tion demonstrated the presence of adenocarcinoma.
Adenocarcinoma/pathology ; Human ; Male ; Mediastinal Neoplasms/pathology/*radiography ; Mediastinum/pathology ; Middle Age ; Rupture, Spontaneous ; Teratoma/pathology/*radiography

The present study was intended to define the relationship of radiological findings and pathological types ofprimary lung cancer. The 85 cases were selected after confirmation of the cell types by bronchoscopic biopsy,cervical lymph node or thoracotomy biopsy and lung resection. Results of the study were presented below. 1.Primary lung cancer is frequently developed after 4th decade and males were affected more frequently than femaleswith ratio of 2 to 1. 2. The frequencies of pathologic cell types of lung cancer were presented as follows.Squamous cell carcinoma 40% Adenocarcinoma 25% Undifferentiated cell carcinoma 30% Alveolar cell carcinoma 5% 3.The findings of plain chest radiograph were presented as follows. In squamous cell carcinoma, hilar enlargement orhilar mass is the most frequent finding (53%) with atelectasis(26%) or obstructive pneumonitis(26%). Inadenocarcinoma, pleural effusion is accompained about half of cases (53%). In undifferentiated cell carcinoma,hilar mass with mediastinal widening and pleural effusion is frequent finding.
Adenocarcinoma ; Adenocarcinoma, Bronchiolo-Alveolar ; Biopsy ; Carcinoma, Squamous Cell ; Humans ; Lung Neoplasms ; Lung ; Lymph Nodes ; Male ; Pleural Effusion ; Radiography, Thoracic ; Thoracotomy

OBJECTIVE: To evaluate the inter-group differences in growth and the pathological results of nodular ground-glass opacities (GGOs) according to their size and focal solid portions. MATERIALS AND METHODS: Ninety-six nodular GGOs in 55 individuals followed by CT for at least one month from an initial chest CT were included. Forty nodular GGOs in 30 individuals were pathologically confirmed to be: adenocarcinoma (n = 15), bronchioloalveolar carcinoma (BAC) (n = 11), atypical adenomatous hyperplasia (AAH) (n = 8), focal interstitial fibrosis (n = 5) and aspergillosis (n = 1). Lesions were categorized based on high-resolution CT findings: pure nodular GGO (PNGGO) < or = 10 mm, PNGGO > 10 mm, mixed nodular GGO (MNGGO) < or = 10 mm, and MNGGO > 10 mm. In each group, the change in size during the follow-up period, the pathological results and the rate of malignancy were evaluated. RESULTS: Three MNGGO lesions, and none of the PNGGO, grew during the follow-up period. Resected PNGGOs < or = 10 mm were AAH (n = 6), BAC (n = 5), and focal interstitial fibrosis (n = 1). Resected PNGGOs > 10 mm were focal interstitial fibrosis (n = 4), AAH (n = 2), BAC (n = 2), and adenocarcinoma (n = 2). Resected MNGGOs < or = 10 mm were adenocarcinoma (n = 2), and BAC (n = 1). Resected MNGGOs > 10 mm were adenocarcinoma (n = 11), BAC (n = 3), and aspergillosis (n = 1). CONCLUSION: Mixed nodular GGOs (MNGGOs) had the potential for growth; most were pathologically adenocarcinoma or BAC. By contrast, PNGGOs were stable for several months to years; most were AAH, BAC, or focal interstitial fibrosis.
Tomography, X-Ray Computed/*methods ; Middle Aged ; Male ; Lung Neoplasms/pathology/radiography ; Lung Diseases/pathology/*radiography ; Humans ; Female ; Aged, 80 and over ; Aged ; Adult ; Adenocarcinoma/pathology/radiography

Intestinal duplications are rare developmental abnormalities that may occur anywhere in the gastrointestinal tract. The possibility of a malignant change occurring in these duplications is very low. We present a case of adenocarcinoma arising in a duplication of the cecum. A 41-year-old male patient was admitted because of a palpable abdominal mass. Abdominal computed tomography revealed a 6-cm, peripheral wall-enhanced, round, cystic mass in the cecal area. Excision of the mesenteric mass and a right hemicolectomy was performed. Upon histologic examination, the patient was diagnosed with adenocarcinoma arising in a duplication of the cecum.
Adenocarcinoma/*pathology/radiography/surgery ; Adult ; Biopsy ; Cecal Neoplasms/*pathology/radiography/surgery ; Cecum/*abnormalities/radiography/surgery ; Colectomy ; Humans ; Male ; Tomography, X-Ray Computed ; Treatment Outcome