Biomedical subjects
Publications and source records attributed to D J Aronberg.
Three cases of oat cell carcinoma appearing as a bronchocele on the chest radiograph are described. A bronchocele as the major radiologic manifestation of oat cell carcinoma has not been emphasized previously. Such a bronchocele may be filled with neoplastic cells rather than only inspissated mucus. Needle aspiration biopsy was definitive in two of the cases when conventional diagnostic methods failed.
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A retrospective analysis of the results of 67Ga citrate radionuclide imaging and computed tomography (CT) in 45 patients with suspected abdominal abscess was conducted to determine the mertis of each method. Both techniques were highly sensitive in detecting abdominal abscesses, and often provided complementary and supplementary diagnostic information; their combined use many times offset the limitations of each method used alone. Guidelines are suggested that permit rapid evaluation, while limiting diagnostic errors, when using 67Ga citrate radionuclide imaging and CT in the presence or absence of localizing symptoms and signs.
Computed tomography (CT) is valuable in providing a specific diagnosis of abdominal abscess and in determining its site and extent. Computed tomography is also capable of excluding an abscess with a high degree of certainty. In 31 of 34 patients with proven abdominal abscess, CT suggested the correct diagnosis and accurately defined the extent of involvement. In nine patients, the CT findings were specific for abscess. The CT appearance of abscess is diverse, largely depending on its location. The most common appearance is a low density mass often with higher density at the periphery. The presence of gas distributed within the mass or an extraalimentary air--fluid level allows an extremely confident diagnosis of abscess. Differential diagnostic possibilities are reviewed with emphasis on interpretive problems.
New imaging techniques have had a major impact on radiologic evaluation of the mediastinum. Computed tomography has led the way in defining internal anatomy noninvasively. Ultrasound plays a small but well-defined role in the evaluation of certain mediastinal masses. Digital vascular imaging has, in certain instances, replaced conventional angiography, though it seems unlikely to render conventional angiography obsolete. Other modalities such as magnetic resonance imaging are being applied and promise to become even more important in the near future. Finally, mediastinal sampling by needle biopsy under radiologic guidance has been shown to be a reliable technique when appropriately utilized.
The normal CT appearance of the superior diaphragmatic (also called cardiophrenic angle or pericardial) lymph node group was assessed in 39 adult patients who were free of diseases known to involve lymph nodes. In 15 patients there were 27 ovoid opacities, corresponding to known lymph node sites, namely in the anterior portion of the diaphragm; all except one opacity measured less than 5 mm in diameter. Superior diaphragmatic lymph nodes greater than or equal to 6 mm in diameter were observed in 30 of 190 patients with diseases known to be associated with lymphadenopathy. All but one of these patients had a pathologically proven malignant neoplasm, with bronchogenic carcinoma the most common etiology.