James P. Polga

CT appearance of mycotic abdominal aortic aneurysms.

The CT appearance of three cases of infected aortic aneurysms is reported with clinical and pathological correlation. Two of our cases had unique features: the disappearance of aortic calcifications, and an irregular, thickened aortic wall with peripheral enhancement. The nonspecific clinical presentation and high mortality make mycotic aneurysm an important consideration in the differential diagnosis of abnormal soft tissue contiguous with the aorta.

Occlusion of an Aberrant Right Hepatic Artery, Originating from the Superior Mesenteric Artery, Secondary to Blunt Trauma

Hepatic arterial injury secondary to both blunt and penetrating traumas is well documented in the literature by case reports and articles regarding management. Penetrating injuries to the hepatic arteries are more common than injuries from blunt trauma. Hepatic arterial injuries secondary to blunt traumas are often associated with injuries to other vital organs or vascular structures, resulting in higher mortality rates. We describe the case of an individual involved in a motor vehicle crash, who sustained blunt traumatic occlusion of an aberrant right hepatic artery, originating from the superior mesenteric artery. No reports describing such an injury exist in the English language literature.

Renal medullary fibroma presenting as a calcified mass with neovascularity.

Radiologic evaluation of a 70-year-old woman revealed a large calcified mass in the left kidney. Arteriography demonstrated neovascularity and left nephrectomy was performed. Pathologic evaluation revealed the lesion to be a large renal medullary fibroma.

Whole lung tomography in metastatic disease

Because pulmonary metastases in patients with primary neoplasms have both therapeutic prognostic implications, a review was undertaken of 100 patients with primary neoplasms in whom whole lung tomography and chest roentgenography had been performed. Eight (20%) of 28 patients with solitary metastases on conventional films had more than one lesion on tomography. Due to the tomographic findings, therapy was altered in six of those eight. Two (3%) of 72 patients with normal chest roentgenograms had metastases visible on their tomograms. The data indicate the high value of whole lung tomography in determining therapy whenever a solitary metastasis is visible on conventional chest roentgenograms. The 3% pickup rate of metastases in patients with normal chest roentgenograms is less clear-cut but does suggest the contribution tomography can make in patients with potentially curable lesions.

Cleft Anterior Arch of Atlas Simulating Odontoid Fracture

A case of a congenitally cleft anterior arch of the atlas is presented. Embryologic development of the atlas is reviewed. This rare entity must be distinguished from odontoid fracture.

Partially Calcified Functioning Parathyroid Adenoma

A partially calcified parathyroid adenoma demonstrated by plain film radiography is presented. Careful preoperative scrutiny of the cervicomediastinal area may reveal more tumors containing calcification.

Gallium scintigraphy in Lemierre syndrome

Lemierre syndrome, also known as postanginal sepsis, refers to an acute oropharyngeal infection with septic thrombophlebitis of the Internal jugular vein and multiple metastatic infections from septic emboli, most commonly to the lungs. The disease generally results from gram-negative anaerobic organisms, usually Fusobacterium necrophorum. This is a case report of Lemierre syndrome In an 18-year-old man with appropriate Ga-67 Imaging, CT, and chest radiographs.

Radiocolloid redistribution and multiple splenic infarcts in myelofibrosis.

A 66-year-old man had myelofibrosis with radiocolloid demonstrated splenomegaly and shift of activity to the spleen. Four months later, he experienced sudden left-sided pain. A repeat radiocolloid study showed a marked change. The spleen was represented by only a few functional areas with several photopenic regions. Radioactivity was now principally present in the liver, with considerable uptake in the vertebral marrow and lungs. The splenic lesions were multiple acute infarcts. Sudden loss of the spleens ability to extract radiocolloid was likely, followed by utilization of reticuloendothelial cells in the liver, bone marrow and lungs.

Primary angiosarcoma of the heart in identical twins.

Imaging findings of cardiac angiosarcoma in identical twins are presented and discussed.

Increased Tc-99m-sodium medronate accumulation in renal carcinoma

Technetium-99m-sodium medronate is commonly used for skeletal imaging. Renal excretion allows evaluation of the kidneys. Renal masses present as areas of diminished activity. In the cases described, a renal carcinoma showed increased radionuclide accumulation, probably because of extensive tumor calcification.