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

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*

Follicular dendritic cell sarcoma is a rare neoplasm that originates from follicular dendritic cells in lymphoid follicles. This disease usually involves the lymph nodes, and especially the head and neck area. Rarely, extranodal sites may be affected, including tonsil, the oral cavity, liver, spleen and the gastrointestinal tract. We report here on the imaging findings of follicular dendritic cell sarcoma of the abdomen that involved the retroperitoneal lymph nodes and colon. It shows as a well-defined, enhancing homogenous mass with internal necrosis and regional lymphadenopathy.
Abdomen/ultrasonography ; Abdominal Neoplasms/complications/*radiography/*ultrasonography ; Abdominal Pain/etiology ; Aged ; Colon/radiography/ultrasonography ; Colonic Neoplasms/complications/*radiography/*ultrasonography ; Dendritic Cell Sarcoma, Follicular/complications/*radiography/*ultrasonography ; Dendritic Cells, Follicular/radiography/ultrasonography ; Diagnosis, Differential ; Dyspepsia/etiology ; Female ; Gastrointestinal Hemorrhage/etiology ; Humans ; Lymph Nodes ; Male ; Middle Aged ; Radiography, Abdominal/methods ; Retroperitoneal Space/radiography/ultrasonography ; Tomography, X-Ray Computed/methods

Castleman's disease is a rare benign lymphoproliferative disorder of uncertain origin which most commonly involves the mediastinum but rarely affects the axilla. We report a case of localized Castleman's disease involving the axillary lymph node. Mammography revealed a well-defined, homogeneously dense ovoid mass, 3 cm in size, in the left axilla, while gray-scale ultrasonography (US) demonstrated a well-defined, uniformly hypoechoic ovoid mass with good through transmission. Peripheral hypervascularity was observed at power Dopper US, and early rapid homogeneous enhancement at contrast-enhanced dynamic CT.
Axilla ; Case Report ; Female ; Giant Lymph Node Hyperplasia/*diagnosis/radiography/ultrasonography ; Human ; Lymph Nodes/*pathology ; Middle Age ; *Tomography, X-Ray Computed ; *Ultrasonography, Doppler

BACKGROUND: Primary lymphoma of the gastrointestinal tract is an unusual disease for which the optimal management strategy has not been clearly defined. The role of surgery in the management of primary gastrointestinal lymphoma remains controversial. METHODS: We retrospectively reviewed the management and the outcome of 55 patients a diagnosis of gastrointestinal lymphoma who were treated at Kyung-Hee University Medical Center during the period 1986-1997. Thirty-seven of them underwent a resection for cure, and 23 patients of them underwent chemotherapy. 18 patients underwent chemotherapy only. Radiation therapy was excluded due to the small number of patients. Surgery consisted of wide local resection of the primary tumor (curative for stages I and II, and palliative for stages III and IV), and regional lymph nodes, with re-establishment of bowel continuity. Chemotherapy involved 6-10 courses of CHOP-B (cyclophosphamide, adriamicin, vincristine, prednisone, and bleomycin). Survival curves were calculated by using the Kaplan and Meier method. RESULTS: The mean age was 51 years (range: 3-82), the peak incidence of age was the fifth decades (34%), and the male-to-female ratio was 1.3:1. Common signs and symptoms at presentation were abdo minal pain (n=46), palpable mass (n=28), nausea/vomiting (n=26), and weight loss (n=18). The diagnostic sensitivities of ultrasound, contrast radiography, endoscopic biopsy, and computed tomography were 52%, 57%, 76%, and 78%, respectively. The primary tumor sites were the stomach (n=18), the terminal ileum & cecum (n=15), the small bowel (n=13), and the large bowel (n=9). The respective cumulative overall 5-year survival rates for stage I, II, III tumors were 89%, 74%, and 43% (p<0.05). The respective overall 5-year survival rate for resection only, resection with chemotherapy, and chemotherapy only were 100%, 78%, and 40% (p<0.05). By the Kaplan-Meier method, the prognostic factors of survival were stage and curative resection (p<0.05). CONCLUSION: A curative resection in a stage I, II lymphoma confined to the gastrointestinal tract and to regional involvement may improve patient survival.
Academic Medical Centers ; Biopsy ; Cecum ; Diagnosis ; Drug Therapy ; Gastrointestinal Tract* ; Humans ; Ileum ; Incidence ; Lymph Nodes ; Lymphoma* ; Prednisone ; Radiography ; Retrospective Studies ; Stomach ; Survival Rate ; Ultrasonography ; Vincristine ; Weight Loss

Axillary disorders originate from an axillary lymph node, subcutaneous fat layer, accessory breast, nerve, vessel and muscle. The most common causes of a palpable axillary mass are a lymph node pathology containing a benign axillary lymphadenopathy, and malignant lymph nodes such as a metastatic lymphadenopathy from breast cancer and a malignant lymphoma. For the detection of masses in the axilla, mammography and sonography are the imaging modalities of choice. We present a spectrum of various axillary masses with correlative radiological imaging and pathological findings in this pictorial essay. Knowledge of the radiological findings of various axillary disorders is useful for a differential diagnosis and for preventing unnecessary invasive procedures.
Animals ; Axilla ; Breast Neoplasms ; Breast* ; Diagnosis, Differential ; Lymph Nodes ; Lymphatic Diseases ; Lymphatic Metastasis ; Lymphatic System ; Lymphoma ; Mammary Neoplasms, Animal ; Mammography ; Neoplasm Metastasis* ; Pathology ; Radiography ; Subcutaneous Fat ; Ultrasonography

A 14-year-old Maltese dog presented with progressive exophthalmos and external deviation of the right eye. Ultrasonography revealed the presence of a retrobulbar mass and fine-needle aspiration cytology was performed, which detected a malignant mass. There was no evidence of metastasis on thoracic and abdominal radiography. Computed tomography showed no invasion into the bony orbit and no metastasis to the lung or lymph nodes. Exenteration was performed to remove the mass completely. Malignant peripheral nerve sheath tumor was confirmed by histopathological examination.
Adolescent ; Animals ; Biopsy, Fine-Needle ; Dogs ; Exophthalmos ; Humans ; Lung ; Lymph Nodes ; Neoplasm Metastasis ; Neurilemmoma* ; Orbit* ; Peripheral Nerves ; Radiography, Abdominal ; Recurrence* ; Ultrasonography

The identification of mediastinal lymph nodes (LNs) in lung cancer is an important step of treatment decision and prognosis prediction. The endobronchial ultrasound-guided transbronchial needle aspiration (EBUS-TBNA) is widely used to assess the mediastinal LNs and tissue confirmation in lung cancer. As use of bronchoscopy or EBUS-TBNA has been increased, bronchial anthracofibrosis (BAF) has been detected frequently. Moreover, BAF is often accompanied by mediastinal lymphadenopathy and showed false-positive positron emission tomography uptake, which mimics metastatic lymphadenopathy in lung cancer patients. However, clinical implication of BAF during bronchoscopy is not well understood in lung cancer. We retrospectively reviewed 536 lung cancer patients who performed EBUS-TBNA and observed BAF in 55 patients. A total of 790 LNs were analyzed and macroscopic tissue pigmentation was observed in 228 patients. The adjusted odds ratio for predicting malignant LN was 0.46 for BAF, and 0.22 for macroscopic tissue pigmentation. The specificity of BAF and macroscopic tissue pigmentation for predicting a malignant LN was 75.7% and 42.2%, respectively, which was higher than the specificity of using LN size or standard uptake value on PET. In conclusion, BAF and macroscopic tissue pigmentation during EBUS-TBNA are less commonly found in malignant LNs than reactive LNs in Korean lung cancer patients.
Adult ; Aged ; Aged, 80 and over ; Asian Continental Ancestry Group ; Biopsy, Fine-Needle ; Bronchi/*pathology ; Bronchoscopy ; Carcinoma, Non-Small-Cell Lung/*pathology/radiography ; Constriction, Pathologic ; Female ; Humans ; Logistic Models ; Lung Neoplasms/*pathology/radiography ; Lymph Nodes/pathology ; Lymphatic Diseases/*pathology ; Lymphatic Metastasis ; Male ; Middle Aged ; Odds Ratio ; Pigmentation ; Positron-Emission Tomography ; Predictive Value of Tests ; Republic of Korea ; Retrospective Studies ; Small Cell Lung Carcinoma/*pathology/radiography ; Ultrasonography, Interventional

An Australian cattle dog (case 1: 6-year-old castrated male) and a Shih-Tzu dog (case 2: 8-year-old castrated male) were referred to the Gyeongsang Animal Medical Center due to anorexia and depression. Physical examinations, complete blood counts, serum chemical analysis, radiography, ultrasonography, and bone marrow biopsy were performed. Upon physical examinations of cases 1 and 2, enlargement of superficial lymph nodes was not identified. Hematologic findings in these dogs included leukocytosis with severe lymphocytosis, anemia, and thrombocytopenia. Upon radiography, both dogs showed splenomegaly. Upon examination of a peripheral blood smear in case 1, immature lymphoid cells, featuring decreased nuclear chromatin condensation and nuclear pleomorphism, were present. Biopsy samples of the bone marrow in case 1 revealed hypercellularity as well as a large number of immature lymphoblastic cells similar in shape to cells in the peripheral blood. The characteristic morphological features of peripheral blood and bone marrow samples in case 2 were small lymphocytes. Thus, the dogs were tentatively diagnosed with acute lymphoblastic leukemia (ALL) and chronic lymphocytic leukemia (CLL), respectively. After diagnosis, the CLL patient was administered chlorambucil and prednisolone therapy. Due to its similarity to human leukemia, the canine leukemia model provides a valuable model for research into human leukemia.
Anemia ; Animals ; Anorexia ; Biopsy ; Blood Cell Count ; Bone Marrow ; Cattle ; Child ; Chlorambucil ; Chromatin ; Depression ; Diagnosis ; Dogs* ; Humans ; Leukemia ; Leukemia, Lymphocytic, Chronic, B-Cell* ; Leukocytosis ; Lymph Nodes ; Lymphocytes ; Lymphocytosis ; Lymphoma ; Physical Examination ; Precursor Cell Lymphoblastic Leukemia-Lymphoma* ; Prednisolone ; Radiography ; Splenomegaly ; Thrombocytopenia ; Ultrasonography

To develop criteria for prostatic cancer patient care related to early diagnosis, treatment according to accurate staging and follow up in Korea, a clinical study was made on 49 patients with prostatic malignancy who were admitted to the Departrnent of Urology, Korea University College of Medicine between January 1981 and December 1985. The results were as follows 1. The incidence of prostatic malignancy was 1.6% of all inpatients, 2.2% of male inpatients and 10.1% of all male G-U tract tumors. 2. The age distribution ranged from 17 to 85 years with the highest incidence of 60 to 80 years (65%) and 3 of these 49 patients (6.1%) were men less than 40 years old. 3. The incidence of prostatic cancer has increased over the years with B.P.H. and the numbers of patients was comparable to the numbers of patients with B.P.H. during this period representing 49 and 214. 4. Prostatism (59%) and acute urinary retention (41%) were two common presenting symptoms, with symptom caused by metastasis such as persistent bone pain (14%) and pulmonary symptoms (4%). 5. On digital rectal examination at admission, 12 patients had a hard nodule in the prostate with 8 patients of multiple nodules, and 7 patients had soft, smooth prostate presumed B.P.H. 6. Of 9 tumors that extended over the prostate by Intraoperative palpation, 7 (78%) were identified by transrectal ultrasonography but only 2(22%) were identified correctly by digital rectal examination. Transrectal ultrasonography was especially useful in detecting and staging the prostatic cancer. 7. Perineal or transrectal prostatic needle biopsy was done in 29 patients. Adenocarcinoma was found in 26 patients and rhabdomyosarcoma in 3 patients. The histopathologic classification of 3 rhabdomyosarcomas was embryonal, alveolar and pleomorphic. 8. Distant metastasis was found in 28 patients (57%): The sites involved were bone in 24 patients, lymph node in 5 patients, lung in 3 patients and liver and skin in each 1 patient. The sites most frequently involved were pelvis (65%) and spine (50%) in the bony skeleton, and obturator lymph nodes (60%) in lymph node metastasis. 9. In 54% of the patients in which bone scans were positive for metastasis conventional radiographic surveys were negative. The nuclear bone scan was a highly sensitive means for detecting skeletal metastasis 50% more than the conventional bone radiography. 10. The patients were grouped according to American Urological system. 30(6l.2%) patients had stage D, 7(l4.3%) had stage C, 6(12.2%) had stage B and 6 had stage A. Of 6 patients with stage A 4 had histologically proved stage A1, 2 had stage A2. Grade III lesions made up to the largest group accounting for approximately half (47%) of the total patients. This study showed significant correlation between tumor grades and clinical stage of the disease, demonstrating a shift from lower to higher clinical stage with increasing tumor grades. 11. Patients with clinical stage B lesions were preferentially and best treated with prostatectomy, stage C with external beam radiation therapy, stage D with endocrine therapy. 3 patients with prostatic rhabdomyosarcoma were treated with radiation and systemic chemotherapy and one of these 3 patients was also treated with total cystoprostatectomy and urinary diversion. 12. Follow up study with serial measurements of acid phosphatase level and assessment of clinical status was made on 24 patients. (2l patients of adenocarcinoma, 3 patients of rhabdomyosarcoma, Of the 4 patients who had a response as determined by acid phosphates level 3 patients (75%) improved in clinical status and mean survival was more than 24 months. Of the 3 patients who had no change in acid phosphatase level 2 patients (67 %) deteriorated in clinical status and had a mean survival of 7 months. Of the 9 patients who had a progression in acid phosphatase level 7 patients (78 %) deteriorated in clinical status and had a mean survival of 10 months.
Acid Phosphatase ; Adenocarcinoma ; Adult ; Age Distribution ; Biopsy ; Biopsy, Needle ; Classification ; Digital Rectal Examination ; Drug Therapy ; Early Diagnosis ; Follow-Up Studies ; Humans ; Incidence ; Inpatients ; Korea ; Liver ; Lung ; Lymph Nodes ; Male ; Neoplasm Metastasis ; Palpation ; Patient Care ; Pelvis ; Phosphates ; Prostate ; Prostatectomy ; Prostatic Neoplasms ; Prostatism ; Radiography ; Rhabdomyosarcoma ; Skeleton ; Skin ; Spine ; Ultrasonography ; Urinary Diversion ; Urinary Retention ; Urology