In 1961, Cornes first introduced the term multiple lymphomatous polyposis(MLP), and since then, this very raredisease has been considered as a malignant lymphoma originating in the mantle zone of gastrointestinal lymphoidtissue. MLP presents with a 0.5-2.0cm sized polypoid tumor, which affects long segments of the alimentary tractand frequently invades the mesenteric lymph nodes. It often consists of a dominant mass rather than polyps. Wedescribe three cases of endoscopically proven multiple lymphomatous polyposis, and include a review of theliterature. In differentiating multiple lymphomatous polyposis and other types of multiple polyposis in thegastrointestinal tract, the following features are helpful : the smooth surface of polyps, which is similar to agem seen during a barium examination ; the typical appearance of a gastric submucosal tumor and hypertrophiedgastric mucosal folds in UGI; the presence of enlarged lymph nodes, as seen on abdominal CT scanning.
Barium ; Gastrointestinal Tract* ; Lymph Nodes ; Lymphoma ; Polyps ; Tomography, X-Ray Computed ; Zea mays

9 Cases of femoral head fractures treated in Seoul National University Hospital were reviewed. They were classified according to Pipkin, and assessed according to Ebstein's criteria. The longest follow-up was 3 years and the shortest 6 months, the average being 1 year and 6 months. l. 8 cases were injured due to auto accident and there was no one who had worn seatbelt. 2. 1 case of intestine rupture and 2 cases of homothorax were accompanied. 3. There were 1 excellent, 1 good, and 1 poor results in 3 cases of Pipkin type 1, 1 fair result in 1 case of Pipkin type 2, 1 good and 1 fair results in 2 cases of Pipkin type 3, 1 good and 2 fair results in 3 cases of Pipkin type 4. 4. The following complications were encountered, 2 cases of sciatic nerve palsy, 1 case of avascular necrosis of femoral head, 1 case of traumatic arthritis.
Arthritis ; Follow-Up Studies ; Head ; Intestines ; Necrosis ; Rupture ; Sciatic Neuropathy ; Seoul

PURPOSE: To evaluate the enhancement patterns revealed by dual-phase CT, and other characteristic features of nodular hepatic involvement of malignant lymphoma, and to determine the usefulness of this imaging modality in the differentiatial diagnosis of hepatic masses. MATERIALS AND METHODS: Seven cases that pathologically confirmed as nodular hepatic involvements of malignant lymphoma among patients who underwent dual-phase CT for the staging or follow-up of malignant lymphoma, and two that confirmed as primary lymphoma among patients who underwent dual-phase CT for differential diagnosis of nodular hepatic masses were evaluated. There were eight cases of non-Hodgkin 's lymphoma (NHL) and one of Hodgkin 's disease(HD). The findings were analysed in terms of the number, size, and contour pattern of the masses, the enhancement pattern seen on dual-phase CT, and whether or not the vascular structure of the mass was normal. RESULTS: Primary lymphomas were present in two patients(single mass, n=1; multiple nodules, n=1) and secondary lymphomas in seven (single mass, n=6; multiple nodules, n=1). The maximum size of main masses was mean 5.1(range, 2-12) cm, and the contor was smooth in three cases, ill-defined in three and lobulated in three. During the early phase, five patients showed homogeneous low attenuation, and heterogeneous enhancement was observed in four. During the late phase, three of the five showed peripheral enhancement and the other two showed the same low attenuation, while two of the four showed central low attenuation, one showed iso attenuation, and one showed heterogeneous enhancement. In four of the patients whose main mass was larger than the mean, vascular shadow passed through the mass (left portal vein, n=2; branches of the right portal vein, n=1; and branches of the hepatic artery, n=1). CONCLUSION: Where dual-phase CT demonstrated nodular hepatic involvement of malignant lymphoma, contrast enhancement varied and so differentiation from other hepatic masses such as metastatic adenocarcinoma and hepatocellular carcinoma was therefore difficult. Homogeneity and a lack of necrosis, even though a mass is large and has a smooth well-defined contour, no capsulation and normal vasculature, may suggest the nodular hepatic involvement of malignant lymphoma.
Adenocarcinoma ; Carcinoma, Hepatocellular ; Diagnosis ; Diagnosis, Differential ; Follow-Up Studies ; Hepatic Artery ; Humans ; Lymphoma ; Necrosis ; Portal Vein

Intrabile duct tumor growth of hepatocellular carcinoma is an uncommon manifestation, but intraluminal bileduct hepatocellular carcinoma without primary hepatic parenchymal lesions is extremely rare. To our knowledge,only a few case reports have been published. We encountered two cases of primary hepatocellular carcinoma arisingin the bile duct; serum alpha-fetoprotein levels were within the normal limits. Both showed the followingcharacteristic radiologic features: 1) Cholangiography revealed filling defects within the dilated bile duct; 2)two-phase abdominal CT showed enhancement during the arterial-dominant phase and washout during the tissueequilibrium phase, as in typical HCC; and 3) hepatic arteriography revealed hypervascular tumor staining. Surgerywas performed and the resected specimen showed no detectable primary hepatic parenchymal mass; on the basis of thepathologic findings, intraluminal bile duct hepatocellular carcinoma was confirmed. We cautiously assume that thispeculiar type of HCC may arise primarily from bile duct mucosa.
alpha-Fetoproteins ; Angiography ; Bile Ducts* ; Bile* ; Carcinoma, Hepatocellular* ; Cholangiography ; Mucous Membrane ; Tomography, X-Ray Computed

Hepatocellular carcinoma is the most common malignant neoplasm arising from the liver. It is well known thatearly contrast enhancement and attenuation are revealed by flow dynamic imaging studies through the development ofabundant feeding vessels. In practice, however, various atypical findings may be noted. These many be due todiversity of various already known pathologic classification methods or the limitations of imaging techniqueswhich cannot exactly delineate all hemodynamic changes. In addition, a variety of degen-eration andhistopathologic and anatomic subtypes may be the cause of various radiologic findings. This illus-trated reportattempts to facilitate the radiologic interpretation of atypical hepatocellular carcinoma by classifi-cation andintroduction according to histologic and anatomic subtypes.
Carcinoma, Hepatocellular* ; Classification ; Hemodynamics ; Liver ; Liver Neoplasms

PURPOSE: To evaluate the dual-phase bolus CT findings and clinical significance of splenic S. O. L.(SpaceOccupying Lesion) basically included in abdominal CT but previously not considered important. MATERIALS AND METHODS: We retrospectively reviewed 64 splenic S.O.L.'s(0.94%) detected among 6842 patients who underwentdual-phase rapid sequence abdominal CT. Diffuse splenomegaly and heterogeneous enhancement during the arterialphase were excluded. Fifty-eight of 64 splenic S. O. L. cases were confirmed by surgery, biopsy, radiologic studyand follow up. RESULTS: In only eight patients(12.5%) were symptoms localized to the left upper quadrant. Therewere 21 cases of inflammatory and ischemic diseases(36.2%), 19 malignant tumors(32.8%), 12 benign cysts(20.7%),four benign tumors(6.9%), one metabolic disease and one hematoma(each 1.7%) ; six cases were not confirmed and inthese, S.O.L. was also found at other sites. Escept in the case of benign cysts and tumors, the early phase wasbetter than the late for the detection of S.O.L., though both were good for diagnosis. Among 21 inflammatory andischemic lesions there were eight cases of portal hypertensions, seven of pancreatitis, and one of tuberculosis ;five were due to other cauese. Among 19 patients with malignant tumors, metastases were most common(11 cases).Cases involving malignancy involved four lymphomas, two cases of leukemias and two angiosarcomas, which togetherrepresented only primary splenic malignancy. Two epidermoid and ten simple cysts were benign, while benign tumorsincluded three hemangiomas and one lymphangiomatosis ; these were difficult to differentiate from angiosarcoma.Gaucher's disease showed multiple low density lesions in the enlarged spleen and one hematoma was also present. CONCLUSION: Splenic S.O.L.'s are very rare and clinical symptoms directly related to splenic mass are uncommon.Benign and secondary lesions are more common than malignant and primary lesions, and cysts are also much rarerthan any other solid organs. Dual-phase CT especially during the early phase, is currently the modality of choicefor the evaluation of splenic S.O.L.
Biopsy ; Diagnosis ; Follow-Up Studies ; Hemangioma ; Hemangiosarcoma ; Hematoma ; Humans ; Hypertension, Portal ; Leukemia ; Lymphoma ; Metabolic Diseases ; Neoplasm Metastasis ; Pancreatitis ; Retrospective Studies ; Splenomegaly ; Tomography, X-Ray Computed ; Tuberculosis

In the treatment of an infected ununited fractures of a long bone, it often is difficult to achieve union and eradicate the infection. Over the past two decades, the electrical behaviour of bone has been studied with increasing interest and several reports reveal that electricity can stimulate osteogenesis. We have experienced 11 cases of infected non-union who were treated by immobilization plus direct current stimulation from January, 1980 to July, 1982. In all cases satisfactorv union occurred within averaging 8.1 months. The results obtained are as follows: 1. The direct current stimulation has revealed to be effective with antibiotics and some kinds of immobilization in treatment of infected non union. 2. If bone graft is combined with electrical stimulation, time from beginning of electrical treatment to union is shortened, as compared with cases of electrical stimulation alone. 3. The electrical stimulation is preferable to other surgeries in treatment of infected non-union due to its effectiveness and simplicity. 4. It is considered treatment of chronic osteomyelitis with silver anode is not due to electrically generated silver ion but its electricity per se. 5. To prevent refracture and assure complete healing, continued immobilization such as cast brace, walking cast, or conventional brace is necessary after electrical stimulation for the time being.
Anti-Bacterial Agents ; Braces ; Electric Stimulation ; Electricity ; Electrodes ; Fractures, Ununited ; Immobilization ; Osteogenesis ; Osteomyelitis ; Silver ; Transplants ; Walking

Cholangiolocellular carcinoma is a rare lesion, intermediate in type between hepatocellular and cholangio-cellular carcinoma. The radiologic findings of cholangiolocellular carcinomas have not been reported. We describe the ultrasound, CT, MR, and angiographic findings of a case of cholangiolocellular carcinoma not associated with liver cirrhosis.
Liver Cirrhosis ; Ultrasonography

PURPOSE: To determine which morphologic and radiologic characteristics and common features of HCC in patients with a survival time of more than five years are useful for prognosis and appropriate therapeutic modality. MATERIALS AND METHODS: Among 178 patients in whom HCC was diagnosed at our hospital and who underwent dynamic CT and angiography, we retrospectively reviewed the cases of 12 who survived more than five years. Initially, the gross finding, size, number, vascularity of HCC, and extent of portal vein invasion were analyzed. The presence of lymph node enlargement was investigated during follow-up study and in cases confirmed surgically, the results were compared with the histopathologic findings. The therapeutic modalities of the 12 patients were as follows; only surgical resection, 3 cases(1 case: re-operation); surgical resection with transarterial chemoembolization(TAE), 5 cases(1 case: re-operation); only TAE, 4 cases (1 case: combined with hollium in-jection); and at present, expiry after survival for more than five years, 3 cases; survival with disease, 3 cases and survival without disease, 6 cases(2 cases: re-operation after recurrence). RESULTS: In 12 patients who survived more than five years, initial gross classification was single nodular type in 11 cases and massive type in one case; all showed typical ypervascularity on dynamic CT and hepatic angiography. With regard to extent of portal vein invasion, two cases showed involvement of the lobar branch and in one case invasion of the segmental branch was noted. In the other nine cases there was either invasion of the distal small branch or no definite portal vein invasion. HCC size ranged from 2 to 10 (mean, 5)cm. In eight cases involving surgical resection (reoperation : two cases), the histopathologic findings indicated, pre-dominantly, the trabecular type and Edmondson grade II -III. The exception was one case of grade III -IV. In eight cases of single HCC at the time of diagnosis, multiple recurrent HCCs were present. In four cases tumors did not recur, and follow-up study revealed no lymph node enlargement. CONCLUSION: Initial radiologic findings [number of tumors (one only), gross classification (nodular type), vascu-larity(hypervascularity), portal vein invasion(lesser extent), histopathologic findings(predominantly trabecular type)] and the absence of lymph node enlargement are thought to be more important factors than tumor size in the prognosis of HCC. If initial examination of HCC reveals the above mentioned radiologic features, a more aggressive and active therapeutic management approach should be carefully considered.
Angiography ; Carcinoma, Hepatocellular* ; Classification ; Diagnosis ; Follow-Up Studies ; Humans ; Lymph Nodes ; Portal Vein ; Prognosis ; Retrospective Studies

PURPOSE: To compare the differential radiologic findings of renal cell carcinoma presenting as a homogeneous solid mass (HS-RCC) and muscle-predominant angiomyolipoma (MP-AML). MATERIALS AND METHODS: Nine of 76 surgically and pathologically proven RCCs presenting at CT or magnetic resonance (MR) imaging as a homogeneous solid mass, and four cases of MP-AML were included in this study. Echogenicity at sonography, attenuation at non-enhanced CT (NECT), the contour of the mass, signal intensities at T1- and T2-weighted MR imaging, the existence of a capsule, and the pattern and degree of enhancement at CT and MR imaging were retrospectively analyzed. RESULTS: Two of five HS-RCCs were isoechoic and three were hyperechoic. Two of three MP-AMLs, however, were isoechoic, and one was mixed echoic. All nine HS-RCCs were round or oval in shape, but three MPAMLs were lobulated and one was round. At NECT, seven of eight HS-RCCs were isodense and one was hypodense compared to surrounding normal renal parenchyme, but three MP-AMLs were hyperdense masses and one was isodense. At enhanced CT, HS-RCCs showed various degrees of homogeneous enhancement, but all MP-AMLs showed moderate homogeneous enhancement. All three MP-AMLs demonstrated heterogeneous hypointensity at T2-weighted MRI and homogeneous hypointensity at T1-weighted MRI. HS-RCCs showed various signal intensities at both T1- and T2-weighted MRI, and in five cases, heterogeneous high signal intensity at T2-weighted MRI. Capsules were observed in seven of nine HS-RCCs but not in any of the three MP-AMLs. At enhanced T1-weighted MRI, MP-AMLs showed mild to moderate enhancement, but HSRCCs showed mild, moderate, and strong enhancement in two, two, and five cases, respectively. CONCLUSION: Echogenicity, density at NECT, signal intensity at MR T2-WI, the contour of the mass, and the existence of a capsule are features which are useful in the differential diagnosis of HS-RCC and MP-AML.
Angiomyolipoma* ; Capsules ; Carcinoma, Renal Cell* ; Diagnosis, Differential ; Magnetic Resonance Imaging ; Retrospective Studies