Bagnolesi P

Intraductal solitary papilloma: sonographic findings

The aim of the study was to define the ultrasonographic characteristics of intraductal solitary papilloma (ISP) and to discuss the differential diagnoses from other focal lesions of the breast. Sixteen ISP were found among 35 patients with haematic discharging breasts all of whom were submitted to sonography and cytology. The mean age of the patients was 28 years. Three types of lesions were observed: (1) a solid nodule with peripheral hypoechoic areas (56.2%); (2) papillary vegetation within a cystic cavity (25%); (3) periareolar dilated duct, filled with dense material (18.8%). The observed cases demonstrate that sonography was always reliable in detecting the lesion. This result is better than those reported in literature and may be correlated with the low mean age of the patients in our series, which allowed an optimal study with sonography. The three sonographic patterns observed seem to circumscribe the differential diagnoses, thus simplifying the diagnostic process.

Inflammatory aneurysm of the abdominal aorta: role of ultrasonography

During a 5-year period 229 aneurysms of the abdominal aorta were identified by ultrasonography (US) and subsequently submitted to CT. Of these, 41 were seen to be of the inflammatory type on the grounds of the CT scans, confirmed in 29 cases by surgical findings. The patients were 38 men and 3 women, mean age 64.9 years. US, performed using both 3.5 and 5 MHz probes, revealed the inflammatory nature of the aneurysm in 33 of 41 cases (80.5%). In the remaining cases a correct diagnosis could not be determined because of obesity and/or the distal location of the lesion. Regarding the complications associated with the inflammatory nature of the aneurysm (considered only in those cases submitted to surgery) US revealed a good diagnostic accuracy for ureteral involvement (7/7 cases detected, no false positives). Caval involvement was also correctly identified in 6 of 8 cases, although overestimated in 3 of 21. Both of these complications were correctly detected by CT in all cases. Neither US nor CT furnished reliable signs regarding duodenal and colonic involvement (surgically proven in 4 of 29 cases). US proved effective in detecting the inflammatory nature of the aneurysm. If surgery is considered, CT seems mandatory for a correct assessment of the complications.