S. A. Beyer-Enke

Evaluation of recurrent bronchogenic carcinoma by computed tomography.

Thirty-five patients with strongly suspected recurrent tumor of the lung and definitely positive computed tomography (CT) scan were reviewed. The patients had undergone surgery (group A, n = 17) or radiation therapy (group B, n = 18). TNM-staging of lung cancer in both groups revealed similar results. Small cell carcinoma (P less than 0.05), central tumors (P less than 0.003), and elderly patients (P less than 0.05) were more often found in group B. Disease-free interval was longer in patients with tumor resection (45.5 v 11.7 months, P less than 0.007) and depended on T-stage in irradiated cases (P less than 0.05). Local recurrence with or without mediastinal lymph node involvement occurred in all irradiated patients; 3 of 16 surgical patients showed isolated mediastinal lymph node enlargement without tumor relapse (not seen by plain chest roentgenographs). Plain films failed to detect nearly 20% of the space-occupying lesions, which could easily be identified by CT. In one patient the suspected tumor recurrence turned out to be a tuberculous infiltration. A second lung cancer (no tumor recurrence) was pathohistologically assumed in three of the resected cases with an interval from 10-181 mo after surgery. On the basis of these findings, CT-monitoring can be recommended when the patient is resected for cure. Some patients will benefit by an early diagnosis of a local-regional tumor recurrence when the time until the necessary secondary treatment may be shortened. Long-term survival may be achieved in a small group of these patients.

Pleural metastasis of malignant thymoma. A pitfall in the CT-diagnosis of pleural mesothelioma

We report two cases with metastatic thymomas mimicking the CT feature of pleural mesothelioma.

Regional lymph nodes of liver and spleen: topographic evaluation based on CT examinations of Thorotrast patients

The formerly used contrast medium Thorotrast is stored in liver (60%), spleen (30%) and their regional lymph nodes. CT scans of 22 Thorotrast patients were reviewed regarding the evaluation of the abdominal lymph nodes. Due to the high density of Thorptrast-accumulating lymph nodes (> 500 HU) and the excellen contrast sensitivity of CT, lymph nodes less that 0.4 cm in diameter can be imaged. In all more that 1300 lymph nodes could be detected (mean 63 ± 24 per patient). The goal of the study was to describe the normal topographic anatomy of the reginal lymph nodes of liver and spleen, which can not be visualised by bipedal lymphography.

Arterial Calcifications in Thoracoabdominal Computer Tomography: Frequency, and Correlation with Risk Factors and Cardiovascular Diseases

Arteriosclerosis results from various noxae acting on the vessel wall. It becomes irreversibly manifest in the terminal stage as a brace-like calcification of the vascular lumen via the prestages of intimai fat deposits and fibrous plaques (Grundy 1983). These calcifications are frequently discovered as incidental findings in computer tomograms. The resolution capacity of computer tomography (CT) is several times higher than that of conventional X-rays, so that CT is to be regarded as the method of choice for detection of calcifications (Hounsfield 1973). In the present study, the frequency of arterial calcifications was measured in computer tomograms, and their correlation with risk factors and cardiovascular diseases already known was investigated.

Lungenperfusions- und Ventilationsszintigraphie beim Plattenepithelkarzinom der Lunge

The effect of tumour size, as determined surgically, and tumour position, as determined by bronchoscopy, on ventilation and perfusion scintigraphy was examined in 53 patients with squamous cell carcinomas of the lung. The findings were compared with reduction in one-second-capacity. Central tumours were frequently associated with marked reduction in perfusion. In these patients there was a linear positive correlation between ventilation and one-second-capacity. The reduction in perfusion, and the need to measure this, became with more peripheral tumours. There was a correlation between ventilation and tumour size in patients with V/Q quotient of greater than 1.2. The results show that tumour size and position do not necessarily indicate operability. For planning surgery of central tumours, perfusion scintigraphy therefore occupies an important position.