Thomas E. Sumner

Congenital cyst of the pancreas.

The case of a 4-month-old girl with a rare multilocular congenital pancreatic cyst is presented, along with radiological/pathological correlation and a review of the literature. Congenital cyst of the pancreas is a rare lesion most often seen in infant girls, although it may be demonstrated in utero. Conventional radiographic signs and clinical symptoms primarily reflect mass effects, whereas imaging modalities show the cystic nature of the mass. Although rare, this cyst should be considered in the differential diagnosis of fetal and pediatric cystic abdominal masses.

Mediastinal cystic hygroma in children

A 14-month-old child presented with severe respiratory distress from an anterior mediastinal mass. Since its gross appearance suggested malignancy, radical surgical excision was performed. In retrospect, secondary hemorrhage, fibrosis, and chronic inflammation were responsible for the atypical appearance of a benign cystic hygroma. Etiology, clinical presentations, diagnosis and recommended treatment of this relatively rare mediastinal lesion are discussed.

Intrathoracic kidney — Diagnosis by ultrasound

Portable real-time ultrasound was utilized in two infants to diagnose an intrathoracic kidney. Ultrasound is diagnostic and may eliminate the need for further radiological investigation.

Thymic calcifications in histiocytosis X

We report a case of an infant with pulmonary histiocytosis X with punctate thymic calcifications on conventional CT without an anterior mediastinal mass.

Intrapericardial teratoma in infancy

Intrapericardial teratoma in the newborn is a rare potentially fatal neoplasm. Pre-operative diagnosis depends upon recognition of specific radiographic and echocardiographic findings in a newborn with a large cardiothymic image and pericardial effusion. Surgical intervention is usually curative whereas undiagnosed intrapericardial teratoma is often fatal.

Diffuse neonatal hemangiomatosis with extensive involvement of the brain and cervical spinal cord.

Background. Diffuse neonatal hemangiomatosis (DNH) is a rare disorder first recognized at birth or during the neonatal period. DNH is characterized by numerous cutaneous and visceral hemangiomas involving three or more organ systems. Materials and methods. Although the skin and liver are most frequently affected, we present a case of DNH demonstrating an unusual predilection for the central nervous system (CNS). Results and conclusion. We report the imaging findings in a patient with this disorder, paying particular attention to the features seen on cranial sonography and spinal MR imaging.

Childhood Menetrier's disease: Four new cases and discussion of the literature

Four cases of childhood Menetriers disease are presented and their clinical and laboratory findings are compared with the other childhood cases reported in the literature. Children with Menetriers disease usually present with abdominal pain or nausea and vomiting associated with peripheral edema, ascites, or pleural effusion; these symptoms are due to gastrointestinal protein loss and resultant hypoproteinemia. There is no evidence of urinary protein loss. The favorable clinical course as well as distinctive laboratory and roentgenologic findings distinguish this entity from other causes of these symptoms. Supportive therapy is normally all that is required since the symptoms resolve spontaneously in weeks to months. Surgery may be needed in rare cases of active gastrointestinal hemorrhage.

A complex communicating bronchopulmonary foregut malformation: diagnostic imaging and pathogenesis

Abstract We report a newborn with an esophageal lung, a rare type of communicating bronchopulmonary foregut malformation (CBPFM). Associated findings included esophageal atresia, tracheoesophageal fistula (TEF) to the distal esophagus, duodenal stenosis with annular pancreas, imperforate anus, vertebral anomalies and ambiguous genitalia. Radiologic evaluation included chest radiographs, esophagrams, chest ultrasound and chest CT. After colostomy and surgical repair of duodenal stenosis and TEF, a right thoracotomy was performed to treat an esophageal lung. Radiologic features of this unusual variant of CBPFM are presented. Accurate preoperative imaging diagnosis is essential for planning surgical treatment of an esophageal lung.

Diagnosis of ectopic ureterocele using ultrasound

Three children with ectopic ureteroceles were examined with ultrasound, excretory urography, and voiding cystography. In all cases the ultrasound studies outlined the ectopic ureterocele within the bladder.

Focal nodular hyperplasia of the liver imaging by differing modalities.

The logistic approach in diagnosis of focal nodular hyperplasia (FNH) of the liver is discussed, based on the experience with three children. In only one child could the diagnosis be made without angiography. In that child the combination of hypervascularity on the radionuclide angiogram and uptake of the radiocolloid by Kupffer cells was sufficient for the diagnosis of FNH. If the radionuclide scintigraphy is inconclusive, angiography has to be done to show the typical features of FNH, seen in all three patients. Only if scintigraphy and angiography are not able to differentiate FNH from hepatic adenoma, biopsy or exploratory laparotomy is indicated as a final diagnostic procedure. Ultrasonography or computerized tomography is of value only in screening for hepatic mass lesions.