Joel E. Lichtenstein

Traumatic splenic cyst. RPC from the AFIP

Traumatic splenic cyst is one of many diagnostic choices when a mass is found in the left upper quadrant. In the appropriate clinical setting, demonstration of an intrasplenic, unilocular, avascular, homogeneous, fluid-filled mass with a smooth, sharply marginated wall should suggest a splenic cyst. On pathological examination, an epithelial lining implies a developmental origin. More commonly, no such lining is found and old trauma is assumed to be the etiology.

The collar button ulcer - A radiologic-pathologic correlation

The collar button-shaped ulcer is a distinctive radiographic manifestation of inflammatory disease of the GI tract. Its hallmark is mucosal ulceration with undermining submucosal extension limited by the relatively resistant underlying muscle wall. Such a process is commonly associated with ulcerative colitis where it may be seen diffusely in advanced stages of the acute disease. Occasionally, however, it may be seen in any ulcerating inflammatory disease. In the more aggressive transmural diseases, it is likely to be a localized and transient phenomenon. The same pathophysiological mechanism gives rise to the common appearance of benign ulceration anywhere in the GI tract and, particularly, in the undermined gastric ulcer.

Benign cecal villous adenoma presenting as a bladder mass.

Involvement of contiguous organs by a neoplasm is ordinarily evidence of aggressive malignant behavior. A patient presented with a bladder mass found to be arising in the cecum and diagnosed as a benign villous adenoma. Growth down a diseased appendix is proposed to explain the apparent extension of a relatively nonaggressive lesion into an adjacent organ.