On Koo Cho

Bronchobiliary Fistula after Radiofrequency Thermal Ablation of Hepatic Tumor

A broad spectrum of complications can occur after radiofrequency (RF) ablation of hepatic tumors, even though it has been accepted as a safe and effective technique for unresectable hepatic tumors. Recently, the rare complication of brochobiliary fistula was encountered after RF ablation in a patient with a metastatic tumor from stomach cancer. It was assumed to have developed from collateral damage to the adjacent diaphragm and lung base as well as biloma formation at the ablation zone. Symptomatic improvement was achieved by conservative management with an external drainage catheter, but the fistula was still persistent on a 2-month follow-up image.

Radiologic Findings of Renal Hemangioma: Report of Three Cases

Renal hemangioma is an uncommon benign tumor which usually causes painless or painful gross hematuria. Its preoperative diagnosis is extremely difficult or even impossible. We experienced three cases of renal hemangioma, located mainly at the pelvocalyceal junction or in the inner medulla. US demonstrated variable echogenecity, and CT revealed a lack of significant enhancement. Where there is gross hematuria in a young adult, especially when the renal mass located in the pelvocalyceal junction or inner medulla shows little enhancement on CT, renal hemangioma should form part of the differential diagnosis.

Heterotopic ossification developing in surgical incisions of the abdomen: analysis of its incidence and possible factors associated with its development.

Objective: To analyze the incidence of heterotopic ossification (HO) development in incision scars after abdominal surgery and to search for factors relating with its development. Methods: We retrospectively analyzed the postoperative computed tomographic scans of 152 consecutive patients who underwent abdominal incisions, recording the presence of ossification and its characteristics, the type of surgery and incision, and characteristics of the xiphoid process. The change in size upon follow-up was also evaluated. Results: Heterotopic ossifications were identified in 39 patients (25.7%). They were most commonly located in the linea alba (n = 29 [74.4%]) and associated with upper midline incisions (n = 30 [76.9%]). Twenty-four of the 29 patients who underwent postoperative computed tomography twice at least demonstrated changes in size, with decreases in 21 patients. The HO had completely disappeared in 2 patients. Conclusions: The development of HOs in abdominal incisions is a common finding and may be self-limiting. The upper midline incision seems to affect its incidence not uniquely.

Acinar cell carcinoma of the pancreas. Ultrasonography and computed tomography findings.

The radiologic findings in two cases of acinar cell carcinoma of the pancreas are described. Sonographic findings were a midrange echogenic mass with heterogeneity, containing some small- and medium-sized low echogenic areas suggesting necrosis. Ultrasonic through-transmission was good. Computed tomography findings were a well-defined, hypodense, large mass having an enhancing, thin capsule. There were multiple small- and medium-sized irregular low-density areas suggesting necrosis. Small punctate calcific foci were present in one case. With these characteristics, acinar cell carcinoma can be distinguished from the locally invasive common adenocarcinoma of the pancreas, but the differentiation from some other less common pancreatic tumors remains difficult.

Intraperitoneal Saline Infusion during Radiofrequency Ablation of Subcapsular Hepatic Tumor

From: Young Rang Lee, MD, Hyunchul Rhim, MD, Young-Sun Kim, MD, On Koo Cho, MD, Byung Hee Koh, MD, Yongsoo Kim, MD, and Sung Kyu Kim, MD Department of Diagnostic Radiology (Y.R.L., O.K.C., B.H.K., Y.K. S.K.K.) Hanyang University Hospital 17 Hangdang-dong Sungdong-Gu Seoul 133 to 792 Korea; and Department of Radiology and Center for Imaging Science (H.R., Y-S.K.) Samsung Medical Center Sungkyunkwan University School of Medicine 50, Ilwon-Dong Kangnam-Ku Seoul 135-710 Korea

Extrapelvic and extraperitoneal spread of recurrent stomach cancer: Two case reports

We report two cases of unusual combined extrapelvic and extraperitoneal extension of recurrent gastric adenocarcinoma and describe the imaging findings of the preferential anatomic pathway of disease spread. Extrapelvic and extraperitoneal extension of recurrent gastric adenocarcinoma is rare, and its symptoms may be vague and nonspecific. If patients with a surgical history of gastrointestinal neoplasm present with diffuse abdominal pain or painful swelling of the lower extremities, disease spread to the extrapelvic and extraperitoneal spaces should be suspected.

Computed Tomography of Solid Splenic Lesions

Computed tomography (CT) is excellent for evaluating size, shape and position of the spleen, as well as identifying intrasplenic pathology.