Use of computed tomography in the detection of pulmonary nodules.

The ability of computed tomography of the lungs to detect pulmonary nodules was compared with that of conventional chest roentgenography and whole-lung tomography. Computed tomography detected more pulmonary nodules in 10 of 29 patients studied with both computed tomography and whole-lung tomography. Computed tomography of the lungs is the most accurate noninvasive method available for detecting pulmonary nodules.

Extra-adrenal intrathoracic functioning paraganglioma (pheochromocytoma) in childhood.

Extra-adrenal pheochromocytomas are more common in children (30%) than in adults (10%). Of the extra-adrenal sites, the intrathoracic site is the most rare. A 15-year-old boy had a pheochromocytoma successfully removed from the left paraspinal region of his chest. Four years before removal, he had radiation therapy of 3,500 rads to the tumor because of its apparent nonresectability. After therapy, there was transient clinical and biochemical improvement. Preoperative angiography and computed tomography helped define the anatomy of the tumor vessels and the relationship to the thoracic aorta of the tumor. These studies also aided in discounting any other site for the pheochromocytoma, either adrenal or extramedullary. A slow-growing pulmonary metastatic lesion was subsequently identified and successfully excised.

The evaluation of tracheal abnormalities by tomography.

At present, linear plain-film tomography of the trachea is the method of choice for demonstrating the location of post-tracheostomy stenotic lesions and tracheal tumors. This technique does not further compromise the patient's respiratory status, as sometimes occurs with positive-contrast studies using iodine-containing materials, and the radiation dose to the patient from plain-film tomography is considerably less than that from xerotomography.

Computed tomography - guided removal of an osteoid osteoma: a case report.

An osteoid osteoma nidus was removed under computed tomography (CT) scan guidance. This procedure may have advantages over en bloc resection for treatment of osteoid osteoma since it ensures the removal of the nidus without producing a large bony defect such as results from en bloc resection.

Detection of pulmonary nodules by computed tomography.

In 11 of 23 patients, computed tomography of the chest detected pulmonary nodules that were not detected by conventional chest radiography or whole lung tomography. CT is recommended for patients suspected of having pulmonary metastasis and those with a solitary pulmonary nodule.

Computed tomography of the mediastinum.

Findings from the first 430 CT examinations of the thorax performed at the Mayo Clinic were compared with results of film studies and the most certain later diagnoses in the same cases. Results were analyzed by disease and by mediastinal compartment. CT was superior in staging bronchogenic carcinoma, detecting abnormal masses, and in demonstrating mediastinal normally when plain films were equivocal. It generally gave clear delineations of lesions and distinguished them better from normal structures, and, in correlation with clinical data, it was more accurate in suggesting whether they were benign or malignant.

Comparison of whole lung tomography and computed tomography for detecting pulmonary nodules.

Detecting pulmonary metastasis is important when planning surgical therapy, radiotherapy, or chemotherapy in patients with known malignancy. A series of 91 patients was studied by both whole lung tomography and computed tomography (CT) of the lungs. More pulmonary nodules were detected with CT than with whole lung tomography in 32 (35%) of the patients. Of the 91 patients in the study, 31 had resection of some or all of the pulmonary nodules. In 27 patients, the nodules were primary or metastatic malignant lesions. Bilateral pulmonary nodules were detected with CT in 13 patients when whole lung tomography had demonstrated nodules in only one lung. CT has replaced whole lung tomography as the method preferred by the authors for detecting pulmonary nodules in selected patients at risk to develop pulmonary metastasis.

Pulmonary processes of mature-appearing lymphocytes: pseudolymphoma, well-differentiated lymphocytic lymphoma, and lymphocytic interstitial pneumonitis.

Patients with pseudolymphoma, well-differentiated lymphocytic lymphoma, and lymphocytic interstitial pneumonitis were studied. Diagnoses were confirmed by recently developed immunochemical staining techniques. Radiographic findings in pseudolymphoma were different from those in well-differentiated lymphocytic lymphoma, and clinical findings in lymphocytic interstitial pneumonitis were different from those in the other two types of lesions. The interstitial infiltrate of lymphocytic interstitial pneumonitis had two patterns: basilar with an alveolar component and diffuse with associated honeycombing. Pseudolymphoma and lymphocytic interstitial pneumonitis are being polyclonal inflammatory processes without malignant potential. Well-differentiated lymphocytic lymphoma, a monoclonal neoplasm, often has an indolent course.

Current experience with digital subtraction angiography in the community medical center.

At the community medical center, we have introduced and successfully applied digital subtraction angiography (DSA) to disease processes seen in 1,144 patients. Although there is a trade-off between increased contrast resolution and decreased spatial resolution with the DSA approach, nonetheless in many vascular beds it provides rapid, safe, and accurate disease diagnosis.