Biomedical subjects
Publications and source records attributed to D M Warshauer.
Esophago-arterial fistula is a rare but life-threatening complication of an aberrant subclavian artery aneurysm. We report the computed tomography appearance of such a fistula. The characteristic location, presence of rim calcification, and interspersed air and thrombus allowed for prompt preoperative diagnosis and surgery.
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Nodular liver infiltration with multiple myeloma is very rare and its findings on MR images have not been, to our knowledge, previously described. The authors report a case of light chain multiple myeloma nodular liver involvement and describe its appearance on US and MRI. Despite their rarity these lesions have distinct MRI features and should be considered in the differential diagnosis of multiple lesions with high SI on T1-weighted images.
We report the computed tomography (CT) description of a leiomyoma involving the extraperitional portion of the round ligament. Although unusual, such a lesion may mimic other mass lesions in this vicinity including adenopathy, endometriomas, and inguinal hernias.
PURPOSE: To determine the prevalence of significant variations in liver-colon anatomy in an unselected patient population and evaluate the potential effect of these variations on liver-related interventional procedures. PATIENTS AND METHODS: All abdominal computed tomographic (CT) scans were reviewed prospectively over a 4-month period. Cases that revealed variant hepatocolic anatomy were selected and analyzed for the position of the colon, gallbladder, and duodenum; liver morphology; and the anatomic relations of the right portal vein. RESULTS: Seventeen (3.3%) of 517 abdominal CT scans demonstrated variant hepatocolic anatomic relations. In seven cases, liver lobar morphology was normal, but the colon was interposed between the chest wall and the liver. The remaining 10 cases were characterized by hypoplasia or aplasia of one or both segments of the left lobe. In these cases the right portal vein was anteriorly exposed and was close to the gallbladder and transverse colon. In all 17 cases it was qualitatively judged that technical modifications might be needed in the performance of various interventional procedures, including percutaneous biliary drainage, biopsies, and transjugular intrahepatic portosystemic shunt creation. CONCLUSION: Variations in liver-colon anatomic relations in isolation or secondary to hepatic developmental anomalies may have a significant potential impact on the performance of various fluoroscopically guided hepatobiliary interventional procedures.
Focal nodular hyperplasia (FNH) is a benign liver condition, which generally does not contain fat. In this report we describe an unusual case in which multiple areas of FNH were surrounded by prominent peripheral fatty infiltration.
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PURPOSE: The goal of our study was to examine the prevalence of multiple hypodense splenic nodules and their associated diagnoses and to correlate CT appearance with clinical presentation and diagnosis. METHOD: Records of all patients undergoing contrast-enhanced CT from July 1994 through September 1997 were reviewed. Charts and CT scans of patients with multiple (more than five) hypodense splenic nodules were then evaluated. RESULTS: During the search period, there were 8,764 patients examined. Multiple hypodense splenic nodules were identified in 45 patients. Sixteen patients had malignant neoplasia as an etiology, with two patients having a benign tumor. Ten patients had an infectious etiology; nine patients had an inflammatory but noninfectious etiology; in eight patients, a diagnosis was not established; five of these patients were followed for > 18 months. CONCLUSION: Multiple hypodense splenic nodules are uncommon. Lymphoma, infection, and sarcoid were the three most common disorders in the symptomatic patient, with infection strongly correlated with a compromised immune system. In the asymptomatic patient, nonlymphomatous metastatic disease, benign tumor, and sarcoid were most common. Although overlap exists between diagnostic groups, lymphoma tends to have larger, more variable nodules, whereas infection tends to occur with smaller, more uniform nodules. Sarcoid is intermediate in appearance.
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A 45-year-old patient with focal intrahepatic extramedullary hematopoiesis is presented in which the liver was imaged by CT, ultrasound, and MR. The appearance of the lesions on MR consisted of slightly increased signal on T2-weighted images with heterogeneous enhancement of some of the lesions during bolus infusion of gadolinium. The T1-weighted images postgadolinium showed no delayed enhancement.