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

From Oct. 1, 1983 to May 31, 1988, 6198 mammograms were taken and 443 mastectomies were performed at the Yonsei University Hospital, Seoul, Korea. Of these, 191 cases had preoperative mammography performed prior to surgery (study group) and 252 cases underwent mastectomies without preoperative mammography (control group). There were no significant differences between the two groups in pathological stages, axillary lymph node metastasis and size of the tumor, suggesting that little benefit is derived from the preoperative mammography in the hospital setting. However, there were a number of other findings, including a 14% incidence of multiple foci and localization of non-palpable cancer in 3% of cases, that could help us to make therapeutic plans and strategies for these patients.
Breast Neoplasms/pathology/*radiography/surgery ; Female ; Hospitalization ; Human ; Lymphatic Metastasis ; *Mammography ; Preoperative Care ; Prospective Studies

Colonic Neoplasms ; pathology ; Colonic Polyps ; pathology ; Fluorodeoxyglucose F18 ; Humans ; Lymphatic Metastasis ; diagnostic imaging ; Male ; Middle Aged ; Positron-Emission Tomography ; Radiography

We report herein a case of hepatoid adenocarcinoma of the stomach with liver metastasis. Gastric carcinoma generally presents as adenocarcinoma and rarely shows a hepatoid pattern, which can produce alpha-fetoprotein (AFP). The stomach is one of the common sites at which hepatoid adenocarcinoma has been detected. A 75-year-old female patient was admitted to the hospital with a symptom of epigastric discomfort. Gastrofibroscopy revealed a large tumor occupying the greater curvature of the stomach body. The level of serum AFP was markedly increased. Abdominal computed tomography revealed multiple liver masses. Biopsy samples of the gastric lesion and liver masses finally confirmed her case as hepatoid adenocarcinoma in the stomach with liver metastasis. The AFP-producing gastric carcinoma needs special attention because it often presents with early liver metastasis and has a poor prognosis.
Adenocarcinoma/*diagnosis/pathology/radiography ; Aged ; Female ; Gastroscopy ; Humans ; Liver Neoplasms/*diagnosis/secondary/ultrasonography ; Lymphatic Metastasis ; Stomach Neoplasms/*diagnosis/pathology/radiography ; Tomography, X-Ray Computed ; alpha-Fetoproteins/metabolism

OBJECTIVE: To assess the feasibility of computed tomography (CT) lymphography using ethiodized oil for sentinel node mapping in experimentally induced VX2 carcinoma in the rabbit thigh. MATERIALS AND METHODS: This experiment received approval from the institutional animal use and care administrative advisory committee. Twenty-three rabbits with VX2 carcinoma in the thigh underwent CT before and after (1 hour, 2 hour) peritumoral injection of 2 mL ethiodized oil. After the CT examination, sentinel nodes were identified by peritumoral injection of methylene blue and subsequently removed. The retrieved sentinel and non-sentinel lymph nodes were investigated with radiographic and pathologic examinations. Based on the comparison of CT findings with those of radiographic and pathologic examinations, the diagnostic performance of CT for sentinel node identification was assessed. RESULTS: All 23 rabbits showed 53 ethiodized oil retention nodes on post-injection CT and specimen radiography, and 52 methylene blue-stained nodes at the right femoroiliac area. Of the 52 blue-stained sentinel nodes, 50 nodes demonstrated ethiodized oil retention. Thus, the sentinel node detection rate of CT was 96% (50 of 52). On pathologic examination, 28 sentinel nodes in 17 rabbits (nodes/rabbit, mean +/- standard deviation, 1.7 +/- 0.6) harbored metastasis. Twenty seven of the 28 metastatic sentinel nodes were found to have ethiodized oil retention. CONCLUSION: Computed tomography lymphography using ethiodized oil may be feasible for sentinel node mapping in experimentally induced VX2 carcinoma in the rabbit thigh.
Animals ; Carcinoma/pathology/*radiography/secondary ; Contrast Media/*diagnostic use ; Ethiodized Oil/*diagnostic use ; Feasibility Studies ; Female ; Injections ; Lymph Node Excision/methods ; Lymph Nodes/pathology/*radiography ; Lymphatic Metastasis/radiography ; Lymphography/*methods ; Rabbits ; Thigh ; Tomography, X-Ray Computed/*methods

OBJECTIVE: We wanted to evaluate the CT findings of epithelial origin ovarian carcinoma according to the degree of histologic differentiation. MATERIALS AND METHODS: This study enrolled 124 patients with 31 well differentiated, 44 moderately differentiated and 95 poorly differentiated carcinomas with epithelial origin. The CT images were retrospectively evaluated with regard to bilateral ovarian involvement, the tumor's nature, lymphadenopathy, adjacent organ invasion, peritoneal tumor seeding, a large amount of ascites and distant metastasis. In cystic, predominantly cystic and mixed tumors, the tumor wall, septa, papillary projection and necrosis in the solid portion were assessed. RESULTS: Bilateral ovarian involvement was more common in the poorly (48%) and moderately (42%) differentiated carcinomas than in the well differentiated carcinomas (7%) (p < 0.05). The frequency of a predominantly solid or solid nature was greater in the moderately and poorly differentiated carcinomas than in the well differentiated carcinomas (p < 0.0001). In the 87 tumors with a cystic, predominantly cystic or mixed nature, septa greater than 3 mm, papillary projection and necrosis in the solid portion were more common in the poorly differentiated carcinoma (91%, 91% and 77%, respectively) than in the moderately (64%, 68% and 34%, respectively) and well differentiated carcinomas (63%, 47% and 27%, respectively) (p < 0.05). Lymphadenopathy, organ invasion, tumor seeding and a large amount of ascites were more common in the poorly differentiated carcinomas (38%, 27%, 73% and 69%, respectively) than in the moderately (13%, 10%, 48% and 45%, respectively) and well differentiated carcinomas (3%, 0%, 10% and 17%, respectively) (p < 0.05). CONCLUSION: Epithelial origin ovarian carcinoma shows different CT findings according to the degree of histologic differentiation.
Ascites/radiography ; Carcinoma/*pathology/*radiography ; Contrast Media ; Female ; Humans ; Iohexol/analogs & derivatives ; Iopamidol ; Lymphatic Metastasis ; Middle Aged ; Neoplasm Invasiveness ; Ovarian Neoplasms/*pathology/*radiography ; Retrospective Studies ; Tomography, Spiral Computed/*methods

Lung cancer begins insidiously, metastasizes early, and is frequently nonresectable at the time of diagnosis. Gastrointestinal metastases are considered the most unusual. A 60 year-old man was admitted for the evaluation of dizziness. For two weeks prior to admission, he had mild blood-tinged sputum and melena. He had right cervical lymphadenopathy, measured by 2 2 cm. Laboratory studies demonstrated hemoglobin of 3.7 g/dL. Posteroanterior and lateral chest radiographs revealed mass-like lesion of right upper lobe. An umblicated mass was found in the sigmoid colon by colonoscopic examination and biopsy was done. He developed abdominal pain, tenderness and rebound tenderness at admission 10 days. Abdominal CT showed that focal thickened wall and suspicious perforated lesion at the ileum. Operation was done. In recent time, we experienced a case in which perforation of gastrointestinal metastases developed with malignant tumors of the lung.
Abdominal Pain ; Biopsy ; Colon, Sigmoid* ; Diagnosis ; Dizziness ; Humans ; Ileum ; Lung Neoplasms* ; Lung* ; Lymphatic Diseases ; Melena ; Middle Aged ; Neoplasm Metastasis* ; Radiography, Thoracic ; Sputum ; Tomography, X-Ray Computed

OBJECTIVE: To investigate the relationship between the perfusion CT features and the clinicopathologically determined prognostic factors in advanced gastric cancer cases. MATERIALS AND METHODS: A perfusion CT was performed on 31 patients with gastric cancer one week before surgery using a 16-channel multi-detector CT (MDCT) instrument. The data were analyzed with commercially available software to calculate tumor blood flow (BF), blood volume (BV), mean transit time (MTT), and permeability surface (PS). The microvessel density (MVD), was evaluated by immunohistochemical staining of the surgical specimens with anti-CD34. All of the findings were analyzed prospectively and correlated with the clinicopathological findings, which included histological grading, presence of lymph node metastasis, serosal involvement, distant metastasis, tumor, node, metastasis (TNM) staging, and MVD. The statistical analyses used included the Student's t-test and the Spearman rank correlation were performed in SPSS 11.5. RESULTS: The mean perfusion values and MVD for tumors were as follows: BF (48.14+/-16.46 ml/100 g/min), BV (6.70+/-2.95 ml/100 g), MTT (11.75+/-4.02 s), PS (14.17+/-5.23 ml/100 g/min) and MVD (41.7+/-11.53). Moreover, a significant difference in the PS values was found between patients with or without lymphatic involvement (p = 0.038), as well as with different histological grades (p = 0.04) and TNM stagings (p = 0.026). However, BF, BV, MTT, and MVD of gastric cancer revealed no significant relationship with the clinicopathological findings described above (p > 0.05). CONCLUSION: The perfusion CT values of the permeable surface could serve as a useful prognostic indicator in patients with advanced gastric cancer.
Adult ; Aged ; Female ; Humans ; Lymphatic Metastasis ; Male ; Microcirculation ; Middle Aged ; Prognosis ; Prospective Studies ; Regional Blood Flow ; Stomach Neoplasms/*blood supply/pathology/*radiography ; *Tomography, X-Ray Computed

PURPOSE: To determine the CT findings of consolidative malignant neoplasms of the lung. MATERIALS AND METHODS: Seventeen patients in whom pulmonary consolidation was seen on chest radiography were involved in this study. In all cases malignancy was subsequently proven; the neoplasms involved were bronchioloalveolar carcinoma (n = 9), malignant lymphoma (n = 4), mucoepidermoid tumor (n = 1), metastasis from colon cancer (n = 2), and metastasis from pancreatic mucinous adenocarcinoma (n =1). CT images were retrospectively analyzed in terms of enhancement pattern of the consolidation, morphologic appearance of an air-bronchogram, CT angiogram sign, pseudocavitation, and lymphadenopathy. RESULTS: Visually assessed enhancement pattern of the consolidation showed lower attenuation than adjacent muscles in bronchioloalveolar carcinoma (8/9) and metastasis (1/3); isoattenuation in malignant lymphoma (3/4), mucoepidermoid carcinoma (1/1), and metastasis (1/3); and higher attenuation in bronchioloalveolar carcinoma (1/9), malignant lymphoma (1/4), and metastasis (1/3). Among the 15 of 17 patients for whom an air-bronchogram was available, a stretching and squeezing pattern was seen in bronchioloalveolar carcinoma (4/9), malignant lymphoma (3/4), and metastasis (1/3). CT angiogram sign was identified in bronchioloalveolar carcinoma (5/9), malignant lymphoma (2/4), and metastasis (3/3). Pseudocavitation was observed in two patients with bronchioloalveolar carcinoma, while lymphadenopathy was seen in bronchioloalveolar carcinoma (4/9), malignant lymphoma (3/4), and metastasis (1/3). Conglomerate and extrathoracic lymphadenopathy are commonly associated with malignant lymphoma. CONCLUSION: Malignant neoplasms which apper as consolidative lung lesions appear not only as bronchioloalveolar carcinoma, which is well known, but also in other forms. Although these lesions cannot be differentiated on the basis of air-bronchography and CT angiography, poor enhancement of consolidative lesion and pseudocavitation are characteristic findings of bronchioloalveolar carcinoma, and conglomerate or extrathoracic lymphadenopathy are also characteristic of malignant lymphoma.
Adenocarcinoma, Bronchiolo-Alveolar ; Adenocarcinoma, Mucinous ; Angiography ; Carcinoma, Mucoepidermoid ; Colonic Neoplasms ; Humans ; Lung ; Lung Neoplasms* ; Lymphatic Diseases ; Lymphoma ; Mucoepidermoid Tumor ; Muscles ; Neoplasm Metastasis ; Radiography ; Retrospective Studies ; Thorax

18-Fluoredeoxyglucose position emission tomography and computed tomography (F-18FDG PET/CT) scanning has been useful in the evaluation of malignant disorders and has been extensively used in cancer screening.1 However, F-18FDG uptake was not found to be specific for cancer diagnosis. Here, we describe increased F-18FDG uptake on PET/CT caused by extensive tuberculous lymphadenitis in a 62-year-old woman with malignant melanoma.
Female ; Fluorodeoxyglucose F18/*diagnostic use ; Humans ; Lymphatic Metastasis/*diagnosis ; Melanoma/*complications/*pathology/radiography ; Middle Aged ; Positron-Emission Tomography/*methods ; Tomography, X-Ray Computed/*methods