D. Randall Radin

Computed tomography in endobronchial neoplasms

Computed tomography (CT) was performed in 86 patients with bronchoscopically proven endobronchial neoplasms. There were 76 primary and 10 metastatic lesions. CT correctly identified the abnormal airway in 95% of cases (82/86) by demonstrating either nodule, mass, or stricture. A discrete endobronchial nodule was seen in 55% (47/86). There was good morphological correlation of CT with bronchoscopic findings (89% for discrete nodule, 80% overall). Appropriate atelectasis was noted in 80% (69/86) of cases. CT is sensitive in detecting and localizing endobronchial neoplasms and correlates well with bronchoscopic findings.

Cecal volvulus: A complication of colonoscopy

Colonoscopy is a widely used procedure with low morbidity and mortality. A case of cecal volvulus following colonoscopy is presented. This potentially lethal complication should be considered in patients with persistent abdominal pain following colonoscopy because it is easily diagnosed radiographically and requires emergency surgical intervention.

Primary Esophageal Lymphoma in AIDS

In a patient with acquired immunodeficiency syndrome (AIDS) and primary esophageal lymphoma, esophagography and computed tomography (CT) demonstrated a large ulcerated mass involving the distal esophagus. Although rare, the diagnosis of esophageal lymphoma should be considered in patients at risk for AIDS when the radiologic findings are not typical for infectious esophagitis or Kaposis sarcoma.

Carcinoma of the cystic duct

Two patients with carcinoma of the cystic duct presented with obstructive jaundice due to extrinsic compression of the common hepatic duct by the tumor. Sonography and computed tomography showed dilatation of the intrahepatic bile ducts and gallbladder. In one patient, a calculus seen in the gallbladder neck suggested Mirizzi syndrome. In the other, a small soft tissue mass was indistinguishable from a common duct tumor or an enlarged lymph node. In both cases, direct cholangiography demonstrated extrinsic compression and displacement of the common duct with proximal biliary dilatation and nonvisualization of the gallbladder. Carcinoma of the cystic duct should be considered whenever there is evidence of cystic duct obstruction and/or when cholangiography shows extrinsic mass effect on the common duct.

Tumor thrombosis of the inferior vena cava due to retroperitoneal germ cell tumor

Three patients (2 males and 1 female), aged 17–28 years, with tumor thrombosis of the inferior vena cava due to retroperitoneal germ cell tumor are reported. Diagnostic and therapeutic implications of this condition are discussed.

Cavitating metastases of the stomach and duodenum.

Three patients with cavitating gastric or duodenal metastases are presented. Metastatic disease, either by direct extension or by hematogenous spread, should be included in the differential diagnosis of an excavated exoenteric gastric or duodenal mass.

Merkel Cell Carcinoma

Merkel cell carcinoma is a rare malignant neoplasm of the skin which is locally invasive and frequently metastasizes to lymph nodes, liver, lungs, bone, and brain. Computed tomographic and pathologic findings in an elderly woman with Merkel cell carcinoma of the buttock and regional nodal metastasis are reported. The presence of calcitonin and neuron-specific enolase within the tumor supports the theory that Merkel cell carcinoma is a neuroendocrine tumor derived from the APUD (amine precursor uptake and decarboxylase) system.

Hepatolithiasis complicated by cholangiocarcinoma

A case of hepatolithiasis complicated by intrahepatic cholangiocarcinoma is reported. Awareness of this association is important for the radiologist, who may detect clinically occult malignancy in patients with intrahepatic biliary calculi.

Traumatic neuroma of the intestine

A traumatic neuroma of the intestine arising at the site of a previous ileocolic anastomosis is reported. Barium enema examination showed an extramucosal mass in a patient who presented with abdominal pain, rectal bleeding, and anemia. Although rare, traumatic neuroma should be included in the differential diagnosis of an intestinal mass occurring after intestinal surgery.

Giant fibroadipose polyp of the esophagus.

A patient with giant fibroadipose polyp of the esophagus is reported. A new observation, a corrugated appearance localized to the segment of the esophagus containing the intraluminal tumor, is discussed. In addition, the computed tomography appearance of the tumor is presented.