Obscure anaemia and hepatic dysfunction in Castleman's disease.

A case is reported illustrating a rare and puzzling cause of long standing anaemia and abnormal liver function tests. The diagnosis of Castleman's disease came to light only after an adrenal mass was noted during ultrasound examination. Removal of the mass led to a rapid reversal of all the abnormalities.

Low-field (0.08 T) magnetic resonance imaging of the pancreas: comparison with computed tomography and ultrasound.

Seventy-four patients referred for computed tomography (CT) and ultrasound examination with a presumptive diagnosis of pancreatic disease have been studied using a low-field (0.08 T) magnetic resonance (MR) imaging instrument. A further 50 patients being examined for non-pancreatic disease were also examined to assess the appearances of the normal pancreas. All the MR examinations were performed using an interleaved saturation-recovery/short inversion time (TI) inversion-recovery sequence. Part or all of the pancreas was seen in 96% of normal cases. In inflammatory disease, MR was more accurate than either CT or ultrasound for diagnosis, whilst for the demonstration of pancreatic tumours, MR was found to be no better or worse than either CT or ultrasound. The use of specific T1 measurement for soft-tissue characterization was not useful because of the large overlap in values between normal, inflamed and malignant pancreatic tissue. T1 measurement was found to be useful in differentiating different pathological fluids.

Abdominal pancreatic pseudocyst--an unusual cause of dysphagia.

A 44 year old man with a long history of alcohol abuse developed progressive dysphagia. Radiological investigation revealed a pancreatic pseudocyst. Following percutaneous drainage the dysphagia resolved.

Renal carcinomas missed by urography.

It is well accepted that renal masses are missed on intravenous urography. We present 3 patients with renal carcinoma; their tumours, measuring between 3 and 5 cm, were not detected on good quality IVU but were demonstrated on ultrasound. We wish to emphasise the importance of performing an ultrasound or computed tomography examination in cases where a renal tumour is suspected when the IVU is normal.

Indications for ultrasound in the evaluation of the pathological scrotum.

Scrotal ultrasound scans carried out on 156 patients were reviewed in a retrospective study and the sonographic findings and indications evaluated. Ultrasound was able accurately to distinguish the normal from the pathological scrotum. Extratesticular lesions were readily differentiated from testicular lesions. Abnormal testicular echo patterns were usually associated with tumours, but orchitis, granulomas and haematomas were found to have a similar appearance. Occult testicular tumours could readily be identified. Ultrasound was also useful in excluding underlying pathology in hydroceles, in the diagnosis and follow-up of epididymitis and other epididymal lesions and in the assessment of underlying testicular damage in traumatic haematoceles. Ultrasound may also be useful in post-orchiectomy follow-up examinations to exclude tumour in the contralateral testis.

The value of ultrasonic scanning of the spleen in lymphoma.

In 40 patients assessed for splenic enlargement prior to splenectomy, clinical examination and ultrasonic scanning gave equally accurate results when compared with splenic weight after removal. In the 22 patients having staging laparotomy and splenectomy for Hodgkin's disease, ultrasound was unable to assess accurately the presence of tumour deposits.

Ultrasonic detection of occult testicular neoplasms in patients with gynaecomastia.

Gynaecomastia occurs in up to 10% of patients with malignant testicular tumours. In most cases a testicular mass will be easily palpable but occasionally these tumours are occult. Ultrasound has been shown to be of value in the detection of occult neoplasms in patients presenting with nodal disease. Two patients with gynaecomastia and palpably normal testes are presented in whom testicular tumour was diagnosed by ultrasonic examination of the scrotum.

An assessment of computerised isotopic renal section scanning.

The basic non-invasive investigation of renal space occupying lesions by excretion pyelography was coupled with ultrasonic scanning. Forty-one patients who have undergone isotopic section scanning as part of their investigative assessment were studied. The conditions investigated included solitary cysts, polycystic kidneys, renal tumours, tumefactive xanthomatous pyelonephritis, renal infarct and non-functioning kidneys. An analysis of the accuracy of isotopic section scanning in these different pathological states was made. Computerised isotopic section renal scanning offers a new non-invasive renal investigative technique.