The spleen is one of the largest organ in the reticuloendothelial system and plays an important role in theac-tivation of immune response. It is the organ most commonly injured after blunt abdominal trauma, and malig-nantlesions such as lymphoma, or these due to metastasis, occur not infrequently. Even so, it is ignored even inabdominal ultrasonography. Some benign splenic lesions, however can cause severe symptoms and result in high mortality, and their accurate diagnosis is therefore essential. This study describes the imaging findings andhistopathologic features of various nontraumatic benign splenic lesions.
Diagnosis ; Lymphoma ; Mononuclear Phagocyte System ; Mortality ; Neoplasm Metastasis ; Spleen ; Ultrasonography

BACKGROUND/AIMS: The thickened gastric wall are seen in a great number of benign and malignant conditions. Sometimes the differential diagnosis with either upper gastrointestinal X-ray or endoscopy of those lesions is difficult. We evaluated the usefulness of the endoscopic ultrasonogrphy (EUS) in the differential diagnosis for the thickened gastric wall of benign and malignant lesions. METHODS: Fifty Borrmann type 4 advanced gastric cancers, 7 gastric lymphomas, 4 hypertrophic gastropathies, 3 acute gastric mucosal lesions, and one anisakiasis were included. We measured the full thickness of the gastric wall, the thickness of each layer and the preservation of the five-layered structure of the gastric wall, and then compared them with the endosonographic findings of 11 healthy controls. RESULTS: Endosonographic findings of Borrmann type 4 advanced gastric cancers showed a diffuse thickening of all five layers, especially the third and fourth layers. Endosonographic findings of gastric lymphomas showed enlargement of the second, third, and fourth layers in 4 patients, the second and third layers in 1 patient, and only the second layer in 2 patients. The second layer was thickened in hypertrophic gastropathies, the second and third layers were thickened in acute gastric mucosal lesions, and the third layer was thickened in anisakiasis. The fourth ultrasound layer corresponding to the muscularis propria was significantly thickened only in malignant lesions. CONCLUSIONS: EUS can clearly visualize the wall architecture of the thickened gastric wall. EUS may be useful for the differential diagnosis of the thickened gastric wall and the differentiation of benign from malignant gastric lesions.
Anisakiasis ; Diagnosis, Differential ; Endoscopy ; Endosonography* ; Humans ; Lymphoma ; Stomach Neoplasms ; Ultrasonography

The diagnosis of breast lymphoma is a prime consideration when a breast mass develops in a patient with a history of lymphoma either in lymphatic system or at other anatomic sites, with bilateral axillary lymph nodes enlargment. However, the radiologic findings of lymphoma in breast are known as non-specific. Breast lymphoma is extremely rare and it has never been reported in this country. We report two cases of breast lymphoma with mammographic and sonographic findings.
Breast* ; Diagnosis ; Humans ; Lymph Nodes ; Lymphatic System ; Lymphoma* ; Ultrasonography

The authors report a case of primary breast lymphoma in a 29-year-old female patient. The patient had a growing, nontender, palpable mass in the left breast. Film-screen mammogram showed a sharply marginated mass with a thin perimeter of radiolucency, halo and slight lobulation.Sonography revealed a well marginated hypoechoic mass with posterior acoustic enhancement. The patient had undergone wide excision of mass and ipsilateral axillary dissection. Histologic examination and immuno-histochemistry confirmed a diagnosis of diffuse B-cell type non-Hodgkin's lymphoma. Abdominal ultrasonography, thoracic computed tomography and bone scan, checked postoperatively, showed non-specific findings. We concluded a final diagnosis of primary breast lymphoma, and report the case with a brief review of the literatures.
Acoustics ; Adult ; B-Lymphocytes ; Breast* ; Diagnosis ; Female ; Humans ; Lymphoma* ; Lymphoma, Non-Hodgkin ; Ultrasonography

Follicular lymphoma is the most common form of low-grade B cell lymphoma. Follicular lymphoma occurs predominantly at lymph node sites and rarely in the gastrointestinal tract. Rare gastrointestinal follicular lymphoma is most commonly found in the small intestine, especially in the duodenum, and appears as multiple granules. However, gastric follicular lymphoma mostly appears as a subepithelial tumor. We observed two primary gastric follicular lymphomas that resembled subepithelial tumors located in the body of the stomach. Endoscopic ultrasound revealed hypoechoic lesions located in the submucosa layer. Since endoscopic forceps biopsies were inconclusive, we performed endoscopic submucosal dissection, which resulted in a final pathologic diagnosis of follicular lymphoma. Because of the indolent nature of gastrointestinal follicular lymphoma, the “watch and wait” strategy can be applied in the early phase. The identification of endoscopic characteristics of gastric follicular lymphoma can be helpful for differential diagnosis and decision of treatment strategy. Therefore, we report two cases of primary gastrointestinal follicular lymphoma diagnosed following endoscopic submucosal dissection.
Biopsy ; Diagnosis ; Diagnosis, Differential ; Duodenum ; Gastrointestinal Tract ; Intestine, Small ; Lymph Nodes ; Lymphoma, B-Cell ; Lymphoma, Follicular ; Stomach ; Surgical Instruments ; Ultrasonography

Cavernous hemangioma is the most common benign hepatic tumor. Typically, the most common features revealed by ultrasound(US) include its small size(4cm or less in diameter), uniform hyperechogenicity, welldefined margins, position in the subcapsular region of the right lobe of the liver, and some posterior echo enhancement. In addition, follow-up scanning may reveal changes in size, though this is rare. The US findings of hepatic hemangiomas may vary, however, especially when lesions are large and/or multiple. For that reason, differential diagnosis between this condition and hepatocellular carcinomas, metastatic lesions, lymphomas and other tumors is difficult. An understanding of the various sonographic findings of hepatic hemangioma can facilitate the early detection of the condition.
Carcinoma, Hepatocellular ; Classification* ; Diagnosis, Differential ; Follow-Up Studies ; Hemangioma* ; Hemangioma, Cavernous ; Liver ; Lymphoma ; Ultrasonography

Cavernous hemangiomas are benign neoplasms of endothelial cells. Although this neoplasm has the potential to develop in all parts of the body, it rarely develops in the axilla; in fact, there are only two case reports of axillary cavernous hemangiomas in the literature. Here, we describe a third case, which occurred in a 30-year-old Korean woman. The patient presented with a palpable mass in the left axilla that was initially thought to be either a phyllodes tumor or a lymphoma based on imaging studies. However, the results of an excisional biopsy led to a diagnosis of cavernous hemangioma. Although uncommon, a cavernous hemangioma can be encountered unexpectedly, presenting as a mass in axilla. Although usually curative, surgery may be challenging not only because of the rarity of the condition, but also because of inconsistent preoperative findings and the involvement of large vessels.
Adult ; Axilla ; Biopsy ; Diagnosis ; Endothelial Cells ; Female ; Hemangioma, Cavernous ; Humans ; Lymphoma ; Phyllodes Tumor ; Ultrasonography ; Vascular Neoplasms

PURPOSE: The purpose of this study was to evaluate the ultrasonographic and CT findings of various diseases that affect the intraparotid lymph node. MATERIALS AND METHODS: The subjects were 32 patients having various diseases involving the intraparotid lymph node. The final confirmed diagnoses were nonspecified benign inflammatory lymphadenopathy (n=20), metastasis (n=5), tuberculous lymphadenitis (n=4), and lymphoma (n=3). For the nonspecified benign inflammatory lymphadenopathy, there were multiple lesions in five patients and bilateral lesions in two patients, and a total of 26 lesions were included in this study. The pathologic proof of the diagnosis was made for 4 of 26 lesions, and by ultrasound follow-up on 22 of 26 lesions. All the patients underwent ultrasound. Color Doppler imaging was also performed in 19 patients and contrast-enhanced CT was also performed in 8 patients. All cases with metastasis, tuberculous lymphadenitis and lymphoma were pathologically confirmed and these patients were all examined with contrast-enhanced CT. RESULTS: For the nonspecified benign inflammatory lymphadenopathy, all the lesions were seen at the superficial lobe. All twenty six lesions were observed as well-defined ovoid or round hypoechoic nodules with posterior sonic enhancement on ultrasonography. A central echogenic hilum was seen in 12 of 26 inflammatory lymphadenopathies (46%), and a central hilar vascularity was noted in 13 of 19 inflammatory lymphadenopathies (68%) on color Doppler imaging. Contrast-enhanced CT showed well-defined nodules with homogeneous enhancement in most lesions. In 3 lesions, a central low density hilum was seen within a lymph node. In 12 cases with metastasis, tuberculous lymphadenitis and lymphoma, there were multiple lesions in 6 cases. CT revealed intraparotid masses with or without central necrosis and the associated multiple lymph node enlargements in the ipsilateral neck region, and their appearances were similar to that of parotid mass. CONCLUSION: Nonspecified benign inflammatory lymphadenopathy involving intraparotid lymph nodes often demonstrated characteristic ultrasonographic findings, including a central echogenic hilum on gray scale US and central hypervascularity on color Doppler ultrasonography. In the metastasic lesions, the tuberculous lymphadenitis and the lymphomas, the multiplicity of lesions and the associated enlarged lymph nodes in the ipsilateral neck region could be helpful in the differential diagnosis.
Diagnosis ; Diagnosis, Differential ; Follow-Up Studies ; Humans ; Lymph Nodes ; Lymphatic Diseases* ; Lymphoma ; Neck ; Necrosis ; Neoplasm Metastasis ; Tomography, X-Ray Computed ; Tuberculosis, Lymph Node ; Ultrasonography ; Ultrasonography, Doppler, Color

PURPOSE: The purpose of this study was to evaluate the usefulness of convex probe endobronchial ultrasound-guided transbronchial needle aspiration (EBUS-TBNA) for detecting malignancy in parenchymal pulmonary lesions located adjacent to the central airways. MATERIALS AND METHODS: We retrospectively reviewed the diagnostic performance of EBUS-TBNA in consecutive patients with high clinical suspicion of a centrally located primary lung cancer who had undergone EBUS-TBNA at the Samsung Medical Center between May 2009 and June 2011. RESULTS: Thirty-seven patients underwent EBUS-TBNA for intrapulmonary lesions adjacent to the central airways. Seven lesions were located adjacent to the trachea and 30 lesions were located adjacent to the bronchi. Cytologic and histologic samples obtained via EBUS-TBNA were diagnostic in 32 of 37 (86.4%) of patients. The final diagnosis was lung cancer in 30 patients (7 small cell lung cancer, 23 non-small cell lung cancer), lymphoma in one and malignant fibrous histiocytoma in one patient. The diagnostic sensitivity of EBUS-TBNA in detecting malignancy and detecting both malignancy and benignity was 91.4% and 86.5%, respectively. Two patients experienced minor complications. CONCLUSION: EBUS-TBNA is an effective and safe method for tissue diagnosis of parenchymal lesions that lie centrally close to the airways. EBUS-TBNA should be considered the procedure of choice for patients with centrally located lesions without endobronchial involvement.
Adult ; Aged ; Aged, 80 and over ; Carcinoma, Non-Small-Cell Lung/diagnosis/ultrasonography ; Diagnosis, Differential ; Endoscopic Ultrasound-Guided Fine Needle Aspiration/*methods ; Female ; Histiocytoma, Malignant Fibrous/diagnosis/ultrasonography ; Humans ; Lung Neoplasms/*diagnosis/ultrasonography ; Lymphoma/diagnosis/ultrasonography ; Lymphoproliferative Disorders/diagnosis/microbiology ; Male ; Middle Aged ; Retrospective Studies ; Sensitivity and Specificity ; Small Cell Lung Carcinoma/diagnosis/ultrasonography ; Tomography, X-Ray Computed

Primary colorectal lymphoma accounts for only 0.2~.65% of large intestinal malignancies. Mucosa-associated lymphoid tissue lymphoma in the rectum is very rare. We report the case of a 73-year-old woman with morphologic and immunophenotypic findings consistent with mucosa-associated lymphoid tissue lymphoma of the rectum. The woman complained of consistent bloody diarrhea and recently developed abdominal pain, febrile and chilling sensation. Ultrasonography of upper abdomen detected multiple stones within the gallbladder and the gallbladder was resected using laparoscopic surgery. An ulcerative polypoid mass in the rectum was detected by colonoscopy and computerized tomography of abdomen. Microscopic and immunohistochemical studies showed a diagnosis of mucosa-associated lymphoid tissue (MALT) lymphoma. This patient was consulted to the department of radiotherapy because of poor general condition and old age. Chemotherapy was not performed. She was followed up with no relapse of the lesions during 7 months after the diagnosis.
Abdomen ; Abdominal Pain ; Aged ; Colonoscopy ; Diagnosis ; Diarrhea ; Drug Therapy ; Female ; Gallbladder ; Humans ; Laparoscopy ; Lymphoid Tissue ; Lymphoma ; Lymphoma, B-Cell, Marginal Zone* ; Radiotherapy ; Rectum* ; Recurrence ; Sensation ; Ulcer ; Ultrasonography