David Bryk

Kaposi's sarcoma of the intestinal tract: Roentgen manifestations

Five cases of generalized Kaposis sarcoma are reported with roentgen evidence of involvement of the intestinal tract. In three instances, there was extensive involvement of the small bowel with multiple intramural nodules. The fourth patient demonstrated multiple polypoid lesions of the colon, and in the fifth a constricting lesion of the ileum was present. Two patients with small bowel involvement had significant malabsorption. This latter complication of diffuse Kaposis sarcoma of the small bowel has not been previously reported. The diagnosis of the nature of the roentgen intestinal abnormality can usually be made, because intestinal involvement generally occurs late in the disease, when both extensive cutaneous nodules and edema of the extremities are apparent.

Intrapulmonary effusion. Effect of expiration on the pseudodiaphragmatic contour.

The pseudodiaphragmatic contour of infrapulmonary effusion may differ from the contour of an elevated hemidiaphragm in the frontal view in that its medial portion is straight and shows a gradual inclination upward and laterally from the cardiac shadow, so that its apex is located more laterally. Previous studies have indicated that this configuration is seen only in about 50% of cases of infrapulmonary effusion. Using expiration radiographs, it is possible to routinely demonstrate this characteristic pseudodiaphragmatic contour. This study provides an additional sign of infrapulmonary effusion and aids in the explanation of the pseudodiaphragmatic contour.

Osteodysplastia (Melnick-Needles Syndrome)

Postmortem examination of a child with osteodysplastia (Melnick-Needles syndrome) showed peculiar fibro-osseous tissue in the marrow cavity, with areas of bone constriction but no abnormality of endochondral ossification. Pectus excavatum and scalloping of the vertebral bodies were also present.

Segmental tuberculosis of the distal colon: Radiographic features in 7 cases

The radiographic features of 7 cases of segmental colonic tuberculosis are described and illustrated. The lesions are generally short (5–7 cm) and may involve any part of the colon. They present radiographically as segmental granulomatous colitis or as annular, ulcerated lesions mimicking colonic carcinoma. Cases with sinus tract formation, severe narrowing, marked distortion, and fixation may occur. The association with pulmonary tuberculosis is common but not universal. The clinical findings are non-specific, but the age group affected is mainly that of young adults. A short review of the pertinent literature is presented.

Retroperitoneal lipomatosis--report of two cases with an unusual distribution.

Two cases of retroperitoneal lipomatosis with an unusual distribution are reported. In the first case the fat was confined to the perirectal soft tissues and the sigmoid mesentery, whereas in the second case it was peripancreatic and extended into the small bowel mesentery. The lipomatous nature of these retroperitoneal masses was suggested by the lucency of the fat on the plain abdominal roentgenograms. These cases were studied prior to the availability of computed tomography, so that the diagnoses were confirmed by surgical exploration, which may have been avoided by this currently available noninvasive technique.

Shielding the Hand During Cross-Compression Angiography

A simple method of shielding the hand during cross-compression angiography is described. A standard lead glove with the fingertips cut out of the palmar aspect is used, allowing sensation and mobility while still protecting the hand.

Vicarious Visualization of Radiographs

A teaching technique is outlined wherein a single resident views and describes a radiograph to his colleagues who do not see it, but are required to arrive at a differential diagnosis on the basis of the verbal description. This method forces the viewer to sharpen his powers of description and aids in the overall learning process.