Bimal P. Sood

Carcinoma of the gallbladder: role of sonography in diagnosis and staging.

In an attempt to define the sonographic characteristics of gallbladder cancer, we retrospectively analyzed the sonographic findings in 203 cases of gallbladder cancer confirmed by cytology or histopathology.

Sonographically guided fine needle aspiration biopsy of abdominal lymph nodes: experience in 102 patients.

We present our experience with sonographically guided fine needle aspiration biopsy of abdominal and retroperitoneal lymph nodes in 102 patients. The biopsied lymph nodes measured 1 to 6 cm (mean, 2.3 cm) and were located at the porta hepatis (n = 23), in the peripancreatic (n = 31), paraaortic (n = 22), aortocaval (n = 1), common iliac (n = 3), or external iliac (n = 6) regions, or in the mesentery (n = 16). Material sufficient for cytologic analysis was obtained in 87 (85.2%) of the 102 patients. The cytologic diagnosis in these patients included malignancy in 47 patients, tuberculosis in 28 patients, reactive lymphoid hyperplasia in 10 patients, and aspergillosis in two patients. In the other 15 patients, fine needle aspiration biopsy could not provide a definitive diagnosis. No major or minor complications occurred in our study. Thus, sonographic guidance is an effective alternative to computed tomography for biopsy of abdominal and retroperitoneal lymph nodes.

Cholecystosonographic evaluation of the prevalence of gallbladder diseases. A university hospital experience.

Ninety-five healthy volunteers and 515 patients with problems other than those of the biliary tract were examined using real-time, gray-scale, B-mode ultrasonography. Eighty-two patients (13.44%) were found to have asymptomatic gallbladder disease: 68 (11.14%) had cholelithiasis, 5 (0.81%) had acalculus cholecystitis, and 2 (0.32%) had polyps. Three cases of carcinoma of the gallbladder were also detected, suggesting that ultrasound examination of the high-risk population in an endemic area should not be confined to the disease concerned but that the gallbladder of such patients should also be screened to pick up asymptomatic gallbladder disease. Hence ultrasound can be used as a screening modality for the early detection of carcinoma of the gallbladder.

CT features of acute phlegmonous gastritis

One case of phlegmonous gastritis is presented. Radiological diagnosis of this condition is difficult. In the setting of a clinical suspicion of this condition, computed tomography (CT) is the imaging modality of choice.

Ultrasound-Guided Fine Needle Aspiration Cytology of Malignant Gallbladder Masses

OBJECTIVE To determine the accuracy and reliability of ultrasound (US)-guided fine needle aspiration cytology (FNAC) over blind aspiration in gallbladder masses. STUDY DESIGN We performed FNAC in 107 cases of carcinoma of the gallbladder; blind aspiration was done in 71 patients (66.36%) and US-guided aspiration in 36 (33.64%). In cases where FNAC after the first aspiration showed the aspirate to be inflammatory, acellular (inconclusive) or suspicious for malignancy, FNAC was repeated under US guidance. Diagnosis was later confirmed by histopathology in all cases. RESULTS After the first aspiration, gallbladder malignancy was confirmed in 77 (71.96%) cases. Of these 77 cases, 34 underwent US-guided aspiration, and the remaining 43 underwent blind aspiration. Cases with inflammatory or acellular (inconclusive) aspirates or that were suspicious for malignancy after the first aspiration underwent a second aspiration under ultrasonic guidance. On the second aspiration of 30 cases, 16 (53.33%) proved to be of adenocarcinoma, 7 (23.33%) were suspicious for malignancy, 5 (16.66%) were inflammatory, and 2 (6.66%) were acellular. Diagnosis was later confirmed by histopathology in all cases. US-guided FNAC had diagnostic accuracy of 95% as compared to 60% on blind aspiration. There was no major complication or needle tract recurrence of the disease. CONCLUSION US-guided FNAC is safe, rapid, reliable, cost-effective and accurate in diagnosing gallbladder carcinoma.

Imaging features of esophageal leiomyomatosis: A case report

Leiomyomas are the most common benign tumors of the esophagus. However, esophageal leiomyomatosis is a rare pathologic entity that has received little attention in the radiologic literature. We present a case of esophageal leiomyomatosis with imaging features on barium swallow and computed tomography (CT).