Journal of the Canadian Association of Radiologists最新文献

Lymphoma of the thyroid is a rare condition, classically occurring in elderly caucasian women, presenting as a rapidly enlarging, symptomatic mass. Almost all examples are due to non-Hodgkin's lymphoma, and the lesion is commonly superimposed on pre-existing Hashimoto's thyroiditis. Prognosis is best if the disease is diagnosed early and while confined to the thyroid region, there being a favourable response to radiotherapy alone. Unfortunately, lymphoma is rarely considered in the differential diagnosis of thyroid masses, often leading to unnecessary, excessive surgery. Ultrasonography of five patients was analysed to determine if any common diagnostic features were present. All had a similar pattern, with a large, circumscribed, solid hypoechoic mass. Although nonspecific, this appearance, with awareness of a rapidly growing mass, should alert the radiologist and attending clinician to the possibility of lymphoma.

Gas surrounding the right pulmonary artery has been observed in three patients, including two in whom it was demonstrated around the intrapericardial right pulmonary artery on frontal films. This would provide a pathway for occasional development of spontaneous pneumopericardium.

We report a patient in whom subependymal metastases from a primary lung cancer were demonstrated by computed tomography of the head and in whom tissue correlation became available. To our knowledge, no such patient has previously been reported.

We report two patients with bullous lung disease and suspected pneumothorax on plain chest radiographs. Chest tubes were inserted in both patients, but no clinical or radiological improvement occurred. Computed tomographic (CT) scans were then performed and showed bullous lesions without any pneumothorax. This permitted the removal of unnecessary chest tubes. In selected patients with severe bullous disease, CT may be useful, either on admission or later, when the diagnosis of pneumothorax by conventional radiographs is doubtful.

An article of adornment, a metallic ring through the nipple, was noted on plain chest radiographs of a 25-year-old man. Depending on the geographic location, the laterality of the nipple ring might alert the radiologist to the possibility of homosexuality and the potential diagnosis of AIDS in the radiographs.

Twelve patients with pathologically proven cerebral amyloid angiopathy (CAA), causing intracerebral hemorrhage, were reviewed to determine the clinical and radiographic features. All 12 patients were 62 years of age or older and presented with acute neurological syndromes. The computed tomographic scan (CT) in each showed a relatively large intracerebral lobar hemorrhage located in a cortical and subcortical area. The finding of a lobar intracerebral hematoma in an elderly patient should suggest CAA as a cause.

Omphalocele can be regularly recognized in the fetus by ultrasonographic examination. It is commonly associated with other abnormalities which may alter the management of the pregnancy. If the pregnancy continues, delivery should be planned in a centre equipped for pediatric surgery.

Intragastric balloon placement is a non-invasive treatment for morbid obesity. We report a patient who illustrates incomplete bowel obstruction and pancreatitis following dislodgement of such a balloon. Percutaneous transabdominal puncture of the balloon is an effective method of decompression.

There are many reasons for what is apparently a benign renal cyst being hyperdense on computed tomography (CT). A previous intravascular contrast material injection (intravenous urogram or arteriogram) within one to three days is cited as one of the possible causes. This prospective study of 13 patients with renal cyst was designed to investigate such a possibility. None of the patients had a hyperdense renal cyst on delayed CT scan following contrast injection. We conclude that intravenous contrast material is not a cause of hyperdensity of a renal cyst on CT.

Non-visualization of the retromammary space and ribs has been a source of concern to mammographers. In six years, 186 cancers were detected in our experience of 10 034 self-referred asymptomatic women at the University of Michigan Breast Cancer Detection Demonstration Project. These cancers were used to analyze the need to visualize the retromammary space and ribs, or both sites, if adequate technical factors were used. All the cancers were analyzed for position on the film, number of films required for visualization, relationship of the tumor to the posterior edge of the film, number of occult tumors, tumor size, histologic type, sensitivity of detection method and the number of interval cancers. Of the 186 cancers, 168 (90%) were detected on mammograms. All of the cancers were visualized on the mediolateral view; three were not visualized on the craniocaudal view. Six per cent of the cancers were within 1 cm of the posterior edge of the film; the remaining 94% were located more anteriorly in the breast. The imaged tumors were smaller and had a significantly higher percentage of non-invasive cancers than found in a symptomatic clinical population. Therefore, mammography, using proper technique, will consistently permit visualization of cancer in the breast, regardless of tumor size, histologic type, or location in the breast.