We report a case of mediastinal lymphangioma associated with Gorham's disease in a 38-year-old man who had suffered recurrent clavicular fractures during a seven-year period. Mediastinal widening associated with osteolysis of the clavicles and the sternal manubrium was revealed by chest radiography, while computed tomography demonstrated a cystic anterior mediastinal mass infiltrating mediastinal fat and associated with osseous destruction of the clavicles and manubrium. Chylothorax recurred during the course of the disease.
Adult ; Case Report ; Chylothorax/*complications ; Human ; Lymphangioma/*complications/radiography ; Male ; Mediastinal Neoplasms/*complications/radiography ; Osteolysis, Essential/*complications/pathology/radiography ; Thoracic Vertebrae/*pathology ; Tomography, X-Ray Computed

We reviewed serial computed tomographic (CT) scans of 58 patients with traumatic subdural hygroma (SDG) to investigate its natural history. All were re-evaluated with a special reference to the size and density of SDG. Thirty-four patients (58.6%) were managed conservatively and 24 patients (41.4%) underwent surgery. The lesion was described as remained, reduced, resolved, enlarged and changed. Means of interval from injury to diagnosis and any changes in CT were calculated. SDGs were resolved in 12 (20.7%), reduced in 15 (25.9%), remained in 10 (17.2%), enlarged in 2 (3.4%), and changed into chronic subdural hematoma (CSDH) in 19 patients (32.8%). SDG was diagnosed at 11.6 days after the injury. It was enlarged at 25.5 days, remained at 46.0 days, reduced at 59.3 days, resolved at 107.5 days, and changed into CSDH at 101.5 days in average. SDGs were developed as delayed lesions, and changed sequentially. They enlarged for a while, then reduced in size. The final path of a SDG was either resolution or CSDH formation. Nearly half of SDGs was resolved or reduced within three months, however, 61.3% of unresolved or unreduced SDG became iso- or hyperdense CSDH. These results suggest that the unresolved SDG is the precursor of CSDH.
Adolescence ; Adult ; Aged ; Aged, 80 and over ; Child ; Child, Preschool ; Craniocerebral Trauma/complications ; Disease Progression ; Hematoma, Subdural, Chronic/radiography* ; Hematoma, Subdural, Chronic/pathology* ; Hematoma, Subdural, Chronic/etiology ; Human ; Infant ; Longitudinal Studies ; Lymphangioma/radiography ; Lymphangioma/pathology ; Lymphangioma/etiology ; Middle Age ; Subdural Effusion/radiography* ; Subdural Effusion/pathology* ; Subdural Effusion/etiology ; Tomography, X-Ray Computed*

Mesenteric lymphangiomas are rare abdominal masses that are seldom associated with small bowel volvulus, and especially in adult patients. We report here on an unusual case of small bowel volvulus that was induced by a mesenteric lymphangioma in a 43-year-old man who suffered from repeated bouts of abdominal pain. At multidetector CT, we noticed whirling of the cystic mesenteric mass and the adjacent small bowel around the superior mesenteric artery. Small bowel volvulus induced by the rotation of the mesenteric lymphangioma was found on exploratory laparotomy. Lymphangioma should be considered as a rare cause of small bowel volvulus in adult patients.
Abdominal Pain/etiology ; Adult ; Contrast Media/diagnostic use ; Diagnosis, Differential ; Humans ; Intestinal Volvulus/*diagnosis/etiology/surgery ; Intestine, Small/*radiography/surgery ; Lymphangioma/*complications/surgery ; Male ; Mesenteric Artery, Superior/*radiography/surgery ; Radiographic Image Enhancement/methods ; Rare Diseases ; Tomography, X-Ray Computed