The incidence of pancreatic trauma is increasing and still remains a major source of morbidity and mortality. We have graded the pancreatic trauma on CT according to its pattern into four grades. We also determine the accuracy of CT in the evaluation of pancreatic trauma and the role of CT for delineation of pancretic ductal injury which is critical factor in outcome of pancreatic trauma. CT correctly diagnosed the pancreatic trauma and its traumatic pattern and severity in 22 of 25 cases. Pancreatic enlargement was the most common findings observed in 19 cases. Other findings were 15 cases of intrapancreatic low density hematoma, 12 cases of parenchymal fracture which were predilected in pancreatic neck area. CT grade III and IV could predict the pancreatic ductal injury, and was well correlated with severity of posttraumatic pancreatitis, duration of admission days and incidence of complications. So we concluded that CT can play a definite role for diagnosing and determining the prognosis of pancreatic trauma.
Diagnosis* ; Hematoma ; Incidence ; Mortality ; Neck ; Pancreatic Ducts ; Pancreatitis ; Prognosis

Pulmonary Langerhans' cell histiocytosis is an uncommon granulomatous disorder of unknown cause. The authors retrospectively evaluated radiographs and computed tomographic findings of five patients with biopsy-proven pulmonary Langerhans' cell histiocytosis. The main structural abnormalities consisted of small nodules and cystic air spaces, but one case showed only pneumothorax due to bullae rupture. Its distribution has been known predominently in the upper lung fields, but in our cases, the lung lesions were distributed in the entire lung fields or predominently in the lower lung fields. We propose that pulmonary Langerhans' cell histiocytosis is extremely variable of its structural abnormalities and distribution.
Histiocytosis* ; Humans ; Lung ; Pneumothorax ; Retrospective Studies ; Rupture

A total of 47 preoperative CT scans in patients with renal cell carcinoma were retrospectively reviewed and compared with surgical findings to assess the accuracy of CT for determining the perinephric tumor extension. CT criteria for perinephric extension were hazy ill-defined tumor margin, perirenal nodule and fascial thickening. Regardless of the tumor stage, the accuracy of CT in detecting perinephric extension was 76.6%(36/47), with a sensitivity of 88.9% (16/18) and specificity of 68.9% (20/29). The cause of understaging (n=2) was microscopic infiltration of the perinephric space. The causes of overstaging were tumor infiltration to the renal capsule (n=5), partial adhesion with the perinephric fat (n=3) and renal vein thrombosis (n=1). A smooth clear tumor margin is highly reliable sign for stage I but infiltrative findings onto renal capsule and perirenal fat could be considered stage I.
Carcinoma, Renal Cell ; Humans ; Renal Veins ; Retrospective Studies ; Sensitivity and Specificity ; Thrombosis ; Tomography, X-Ray Computed

A total of 47 preoperative CT scans in patients with renal cell carcinoma were retrospectively reviewed and compared with surgical findings to assess the accuracy of CT for determining the perinephric tumor extension. CT criteria for perinephric extension were hazy ill-defined tumor margin, perirenal nodule and fascial thickening. Regardless of the tumor stage, the accuracy of CT in detecting perinephric extension was 76.6%(36/47), with a sensitivity of 88.9% (16/18) and specificity of 68.9% (20/29). The cause of understaging (n=2) was microscopic infiltration of the perinephric space. The causes of overstaging were tumor infiltration to the renal capsule (n=5), partial adhesion with the perinephric fat (n=3) and renal vein thrombosis (n=1). A smooth clear tumor margin is highly reliable sign for stage I but infiltrative findings onto renal capsule and perirenal fat could be considered stage I.
Carcinoma, Renal Cell ; Humans ; Renal Veins ; Retrospective Studies ; Sensitivity and Specificity ; Thrombosis ; Tomography, X-Ray Computed

To determine the distinction of primary ovarian carcinoma from metastatic ovariancarcinoma, the author studied total 40 cases of malignant tumors(13 primary ovarian carcinomas:7 serous, 4 mucinous, and 2 endometrioid, 7 metastatic ovarian adenocarcinomas,10 gastric adenocarcinomas and 10 colonic adenocarcinomas) using primary antibody to CEA,CK7, CK20 and CK18. The results were summerised as follows: The expression of CK7was demonstrated in all(7) serous and 3 out of 4 mucinous adenocarcinoma, and 1 out of10 each gastric and colonic adenocarcinoma. The CK20 positivity was seen in 4 out of 10cases of colonic adenocarcinoma and 3 out of 7 cases of metastatic adenocarcinoma. Allprimary ovarian carcinoma and gastric adenocarcinoma were negative for CK20 except forfocal positivity in only 1 ovarian mucinous adenocarcinoma. All types of serous andendometrioid adenocarcinoma were negative for CEA. But, the vast majority of mucinousadenocarcinoma, metastatic adenocarcinoma, gastric and colonic adenocarcinoma were positivefor CEA. The CK18 may not be helpful to differentiate the primay or metastatic carcinomabecause all cases examined were positive for CK18 except for 1 ovarian mucinous carcinoma.Immunostainning for CK7 may be helpful on differential diagnosis of primary andmetastatic ovarian carcinoma, especially mucinous adenocarcinoma and metastatic gastric andcolonic adenocarcinoma. The CK20 may be a useful marker for differential diagosis inprimary and metastatic ovarian carcinomas. The CEA may be of value on differential diagnosisof mucinous and nonmucinous(serous and endomerioid) ovarian carcinomas, and metastaticcolonic adenocarcinoma and endometrioid carcinoma.In conclusion, immunohistochemical study for CEA, CK7, and CK20 may be helpful indifferential diagnosis between primary and metastatic ovarian carcinoma.
Adenocarcinoma ; Adenocarcinoma, Mucinous ; Colon ; Diagnosis ; Diagnosis, Differential* ; Female ; Immunohistochemistry ; Mucins ; Neoplasm Metastasis ; Ovary