A lateral chest radiograph is frequently useful and sometimes decisive in detecting chest pathology. Certainparts, such as the posterior wall of the bronchus intermedius (PWBI) and subcarinal regions, can be evaluated onlyon lateral chest radiograph. The authors present and emphasize the findings of PWBI and subcarinal abnormalities. Abnormal PWBI, more than 3 mm thick, is seen in cases of minor degree of oblique position, pulmonary edema, inflammation, neoplasm and enlarged lymph nodes. It can also be seen in patients with subcarinal mass. The findings of subcarinal mass on lateral view are ill-defined increased opacity, fullness of the inferior hilarregion, doughnut sign, extra-density and thickening of the PWBI. Detection of changes in the PWBI and subcarinalregion may be the only diagnostic evidence of hilar and subcarinal disease and helps in its early detection priorto computed tomography.
Bronchi* ; Humans ; Lymph Nodes ; Pathology ; Radiography, Thoracic* ; Thorax*

Sarcoidosis is a systemic disorder of unknown cause that is characterized by the presence of noncaseating granulomas. The radiological findings associated with sarcoidosis have been well described. The findings include symmetric, bilateral hilar and paratracheal lymphadenopathy, with or without concomitant parenchymal abnormalities (multiple small nodules in a peribronchovascular distribution along with irregular thickening of the interstitium). However, in 25% to 30% of cases, the radiological findings are atypical and unfamiliar to most radiologists, which cause difficulty for making a correct diagnosis. Many atypical forms of intrathoracic sarcoidosis have been described sporadically. We have collected cases with unusual radiological findings associated with pulmonary sarcoidosis (unilateral or asymmetric lymphadenopathy, necrosis or cavitation, large opacity, ground glass opacity, an airway abnormality and pleural involvement) and describe the typical forms of the disorder as well. The understanding of a wide range of the radiological manifestations of sarcoidosis will be very helpful for making a proper diagnosis.
Diagnosis, Differential ; Humans ; Lymph Nodes/pathology ; Radiography, Thoracic ; Sarcoidosis, Pulmonary/pathology/*radiography ; Thoracic Diseases/pathology/*radiography ; *Tomography, X-Ray Computed

In addition to imaging the lymphatics and detecting various types of lymphatic leakage, lymphangiography is a therapeutic option for patients with chylothorax, chylous ascites, and lymphatic fistula. Percutaneous thoracic duct embolization, transabdominal catheterization of the cisterna chyli or thoracic duct, and subsequent embolization of the thoracic duct is an alternative to surgical ligation of the thoracic duct. In this pictorial review, we present the detailed technique, clinical applications, and complications of lymphangiography and thoracic duct embolization.
Catheterization ; Chylothorax/*radiography/therapy ; Chylous Ascites/*radiography/therapy ; Embolization, Therapeutic ; Humans ; Lymph Nodes/radiography/surgery ; Lymphography ; Thoracic Duct/radiography ; Tomography, X-Ray Computed

Forty-four cases of abdominal and pelvic computerized tomography (CT) for urological evaluation were reviewed and analyzed as follows: Computerized tomography is a very convenient and non-invasive method to evaluate stages of renal tumor and is more superior in diagnosing hypoplastic kidney and hamartoma than ordinary renal angiography and ultrasonography. Computerized tomography is more informative in evaluation of retroperitoneal space than conventional radiography. It is almost impossible or very difficult to differentiate stage of the bladder tumor A, B1 and B2. Stages beyond C and mass in the pelvic cavity can be detected with relative accuracy. Lymph node metastasis into the retroperitoneal space in testis tumor is diagnosed by computerized tomography.
Angiography ; Hamartoma ; Kidney ; Lymph Nodes ; Neoplasm Metastasis ; Radiography ; Retroperitoneal Space ; Testis ; Ultrasonography ; Urinary Bladder Neoplasms ; Urology*

OBJECTIVES: To  present  an  uncommon  cause  for  a  submandibular  mass  and  review  of  the literature.
METHODS:
Design: Case Report
Setting: Tertiary Government Hospital
Patient: One
RESULTS: A  25-year-old  lady  presented  with  a  painless  chronic  submandibular  swelling. Ultrasound identified a solid mass following which an uncomplicated core biopsy was performed obtaining    an    accurate    pre-operative    histopathological    diagnosis.    Pre-operative    arterial embolization of this vascular mass led to a relatively bloodless wide local excision. Radiological imaging for distant metastases was negative.
CONCLUSION: Epitheloid  Hemangioendothelioma  is  an  uncommon  cause  for  a  submandibular mass.   A malignant   vascular   soft   tissue   tumor   with   morphologic   characteristics   similar   to carcinomas, melanomas and epitheloid sarcomas, it has a high rate of metastasis and morbidity when it affects the soft tissues and viscera. Immunohistochemistry provides clues to differentiation and recommended treatment consists of a surgical wide local excision with regional lymph node resection. As there are no established standard therapeutic protocols for this disease due to its rarity, an individual case-by-case approach and follow-up needs to be undertaken.

Human ; Female ; Adult ; Neoplasms ; Immunohistochemistry ; Viscera ; Melanoma ; Hemangioendothelioma ; Radiography ; Sarcoma ; Biopsy ; Lymph Nodes

OBJECTIVE: To compare sonography and mammography in terms of their diagnostic value in breast cancer cases which initially presented as an axillary mass without a palpable mass or other clinical symptoms. MATERIALS AND METHODS: Seven patients with enlarged axillary lymph nodes who first presented with no evidence of palpable breast lesions and who underwent both mammography and sonography were enrolled in this study. In six of the seven, the presence of metastatic adenocarcinoma was confirmed preoperatively by axillary needle aspiration biopsy; in four, subsequent sonographicallyguided breast core biopsy performed after careful examination of the primary site indicated that primary breast cancer was present. In each case, the radiologic findings were evaluated by both breast sonography and mammography. RESULTS: Breast lesions were detected mammographically in four of seven cases (57%); in three of the four, the lesion presented as a mass, and in one as microcalcification. In three of these four detected cases, fatty or scattered fibroglandular breast parenchyma was present; in one, the parenchyma was dense. In the three cases in which lesions were not detected, mammography revealed the presence of heterogeneously dense parenchyma. Breast sonography showed that lesions were present in six of seven cases (86%); in the remaining patient, malignant microcalcification was detected at mammography. Final pathologic examination indicated that all breast lesions except one, which was a ductal carcinoma in situ, with microinvasion, were infiltrating ductal carcinomas whose size ranged from microscopic to greater than 3 cm. At the time of this study, all seven patients were alive and well, having been disease free for up to 61 months after surgery. CONCLUSION: In women with a palpable axillary mass confirmed as metastatic adenocarcinoma, breast sonography may be a valuable adjunct to mammography.
Adenocarcinoma/radiography/secondary/*ultrasonography ; Adult ; Axilla/*pathology ; Biopsy, Needle ; Breast/*pathology ; Breast Neoplasms/pathology/radiography/*ultrasonography ; Carcinoma, Infiltrating Duct/pathology/radiography/*ultrasonography ; Carcinoma, Intraductal, Noninfiltrating/pathology/radiography/*ultrasonography ; Female ; Human ; Lymph Nodes/radiography/*ultrasonography ; Mammography ; Middle Age ; Ultrasonography, Mammary

PURPOSE: To describe the CT and clinical features of tuberculosis involving the right middle lobe of the lung. MATERIALS AND METHODS: Among patients diagnosed with pulmonary tuberculosis at our hospital during the past three years, 16 cases (mean age of patients: 72 years) were reviewed for radiological and clinical presentation of patients that underwent CT and chest radiography and showed mainly right middle lobe involvement. RESULTS: Middle lobe collapse or consolidation (n=16) and bronchial stenosis or obstruction without the presence of soft tissue masses (n=15) were the main findings. Enlarged mediastinal or hilar lymph nodes (n=15), cavities within consolidated tissue (n=2), ill-defined centrilobular nodules (n=12), a tree-in-bud appearance (n=10), focal consolidations (n=7) and small nodules (n=4) were found. All patients were older than 64 years and most complained of non-specific symptoms. A sputum smear for AFB was positive in four cases. CONCLUSION: A diagnosis of tuberculosis in the right middle lobe is suggested in older patients with following CT findings: 1) middle lobe collapse or consolidation; 2) middle lobe bronchus stenosis or obstruction without the presence of soft tissue masses; 3) mediastinal or hilar lymphadenopathy; 4) cavities within consolidation, and centrilobular nodules with branching linear structure in the adjacent lungs. Further evaluation such as bronchoscopy is recommended for confirmation even when the sputum smear for AFB is negative.
Bronchi ; Bronchoscopy ; Constriction, Pathologic ; Diagnosis ; Humans ; Lung* ; Lymph Nodes ; Lymphatic Diseases ; Radiography ; Sputum ; Thorax ; Tuberculosis ; Tuberculosis, Pulmonary*

PURPOSE: To evaluate the radiologic findings and clinical feasibility of thymic enlargement in patients with hyperthyroidism. MATERIALS AND METHODS: Seven patients with hyperthyroidism and anterior mediastinal bulging revealed by chest radiogaphy were evaluated. The CT findings were analyzed with regard to the shape of the anterior mediastinal mass, surrounding infiltration, and enlargement of mediastinal lymph nodes. Whether or not tumor markers (alpha-fetoprotein, beta-human chorionic gonadotrophin, and chorionic embryonic antigen) showed increased levels was determined, and the size and thickness of the anterior mediastinal mass were measured and compared with previously described age-matched thymus data. In addition, changes in the thyroid gland were evaluated. RESULTS: In all seven patients, anterior mediastinal masses were bi-lobed, with no surrounding infiltration or enlarged mediastinal lymph node, and tumor marker levels showed no increase. The masses were therefore considered to be thymus. In six patients, the size of the thymus exceeded two upper standard deviations of mean value and in one patient, it was smaller than this. In three patients, PCNB (percutaneous needle biopsy) revealed normal thymic tissue and in two, follow-up chest PA demonstrated no interval change. CT showed that in three patients, the thyroid glands were diffusely enlarged. CONCLUSION: In patients with hyperthyroidism, an anterior mediastinal mass seen on chest radiographs was due to thymic enlargement. The recognition of CT findings of thymic enlargement in such patients may avoid unnecessary biopsy.
Biopsy ; Chorion ; Follow-Up Studies ; Humans ; Hyperthyroidism* ; Lymph Nodes ; Needles ; Radiography, Thoracic ; Thorax ; Thymus Gland ; Thyroid Gland ; Biomarkers, Tumor

The classic presentation of small cell carcinoma is hilar or mediastinal lymph node metastases while the primary tumor remains an occult tumor. Grossly enlarged hilar and mediastinal lymph nodes can be frequently seen on the chest radiographs and CT scans. We report here on a case of small cell carcinoma that manifested as a unilateral bulky thoracic mass in a pregnant woman.
Carcinoma, Small Cell* ; Female ; Humans ; Lymph Nodes ; Mediastinum ; Neoplasm Metastasis ; Pregnant Women* ; Radiography, Thoracic ; Tomography, X-Ray Computed

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