Yehiel Barki

Cystic metastases of the neck from occult thyroid adenocarcinoma

In 9 of 118 patients with differentiated thyroid carcinomas, a solitary cystic lateral cervical mass simulating a branchial cleft anomaly was the sole presenting sign of the disease. These masses were nodal metastases of occult papillary adenocarcinoma of the thyroid that underwent liquefaction necrosis. Sonographically, the masses presented a complex pattern. Accordingly, it is suggested that, in patients presenting with an asymptomatic solitary lateral cystic cervical mass, the possibility of metastasis from an occult thyroid malignancy should be considered, and consent for definitive surgery should be obtained. The ultrasonic pattern of the cystic mass is of importance in the differentiation of a cavitated lymph node from a branchial cleft cyst.

Posterior mediastinal accessory thymus

A rare case of accessory ectopic thymus in the right upper posterior mediastinum in a 40-day-old infant is described. The clinical presentation was that of tracheal obstruction. The compression and displacement of the trachea and the identification of the mass was enabled thanks to the high KV filtration technique. The mass was further identified by ultrasonography. Surgical removal of the accessory thymus relieved the tracheal obstruction.

Rib osteomyelitis in children. Early radiologic and ultrasonic findings

The earliest radiographic changes of osteomyelitis in the long bones is deep-seated edema manifesting as soft tissue swelling and obliteration of the intermuscular planes adjacent to the affected bone. Similarly, the early change of rib osteomyelitis is pericostal edema demonstrated by soft tissue swelling of the thoracic wall accompanied by an adjacent inward pleural displacement. In both osteomyelitis of the rib and the long bones, the bony changes will appear 1–2 weeks later. Pericostal edema can be readily diagnosed by ultrasound scan. Pericostal edema, although non specific and can occur in other conditions, yet it is a strong warning sign, set within the overall clinical picture of osteomyelitis.

Giant cervical cyst: presenting symptom of an occult thyroid carcinoma.

A case of giant lateral cervical cystic metastasis from occult thyroid carcinoma mimicking branchial cleft cyst is reported. Lateral cervical cystic metastases arising from occult thyroid carcinoma and their ultrasonic differentiation from true cysts are discussed.

Ovarian fibroma in a prepubertal girl

Ovarian fibroma rarely occurs in prepubertal girls. However, we found such an asymptomatic, large, uncalcified pelvic mass in an otherwise healthy 12-year-old girl. The plain films (radiographs), US and CT findings are presented.

Ultrasound detection of anaerobic neck infection.

Anaerobic infections of the neck are life-threatening conditions. Early diagnosis and prompt treatment are mandatory in order to prevent severe consequences.l-I The anaerobic nature of the infection is indicated by culture results, although at times culture confirmation may prove difficult. I Gas production is an important feature of anaerobic infections. 1 While this manifests itself with subcutaneous crepitus and emphysema in some cases, in others a deeply seated infection precludes the clinical detection of this sign. The demonstration of gas bubbles in soft tissues of the neck by a simple imaging technique is quite important in the early recognition of the anaerobic nature of the infection.

Sonography of Acute Appendicitis in a 9-Month-Old Infant

Acute appendicitis is a rare and potentially fatal disease in infants, and early diagnosis remains a most challenging aspect. 1,2 Clinical diagnosis can be elusive. In this report, we describe sonographic findings of acute appendicitis in a 9-month-old male infant. We are unaware of other reports of preoperative sonographic diagnosis of acute appendicitis at such an early age.

Cartilage within a thyrogiossal duct anomaly

A case of thyroglossal duct anomaly showing an unusual finding of foci of cartilage is presented. Although the concept of choristoma may explain the pathogenesis of cartilage within the present congenital anomaly, the histologic features were more in favor of a metaplastic process. In addition, the history of recurrent bouts of local inflammation supports the latter view.

CT and US features of cervical lymphadenopathy due to kikuchi's disease.

Kikuchi’s disease or histiocytic necrotising lymphadenitis is a distinct benign clinicopathologic entity which is to be distinguished from malignant conditions, especially lymphoma.We report a young woman with Kikuchi’s disease presenting with cervical lymphadenopathy and mild hepatomegaly. CT and US findings are presented as well as a review of the pertinent literature