Primary angiosarcoma of the heart in identical twins

Imaging findings of cardiac angiosarcoma in identical twins are presented and discussed.

CT appearance of mycotic abdominal aortic aneurysms

The CT appearance of three cases of infected aortic aneurysms is reported with clinical and pathological correlation. Two of our cases had unique features: the disappearance of aortic calcifications, and an irregular, thickened aortic wall with peripheral enhancement. The nonspecific clinical presentation and high mortality make mycotic aneurysm an important consideration in the differential diagnosis of abnormal soft tissue contiguous with the aorta.

Radiocolloid redistribution and multiple splenic infarcts in myelofibrosis

A 66-year-old man has myelofibrosis with radiocolloid demonstrated splenomegaly and shift of activity to the sudden spleen. Four months later, he experienced sudden left-sided paid. A repeat radiocolloid study showed a marked change. The spleen was represented by only a few functional areas with several photopenic regions. Radioactivity was now principally present in the liver, with considerable uptake in the vertebral marrow and lungs. The splenic lesions were multiple acute infarcts. Sudden loss of the spleen's ability to extract radiocolloid was likely, followed by utilization of reticuloendothelial cells in the liver, bone marrow and lungs.

Menetrier's disease with occlusion of splenic and brachial arteries

A 40-year-old man presented with occlusion of the left brachial artery and sudden onset of abdominal pain. A radiocolloid scan revealed a fragmented appearance to the spleen. This was found to be due to multiple splenic infarcts. Results of an upper gastrointestinal series and tissue biopsy specimen established the diagnosis of Menetrier's disease. It was noted that at least one report in the literature suggested that vascular occlusions may be part of the natural history of Menetrier's disease.

Increased Tc-99m-sodium medronate accumulation in renal carcinoma

Technetium-99m-sodium medronate is commonly used for skeletal imaging. Renal excretion allows evaluation of the kidneys. Renal masses present as areas of diminished activity. In the cases described, a renal carcinoma showed increased radionuclide accumulation, probably because of extensive tumor calcification.

Renal medullary fibroma presenting as a calcified mass with neovascularity

Radiologic evaluation of a 70-year-old woman revealed a large calcified mass in the left kidney. Arteriography demonstrated neovascularity and left nephrectomy was performed. Pathologic evaluation revealed the lesion to be a large renal medullary fibroma.

Whole lung tomography in metastatic disease

Because pulmonary metastases in patients with primary neoplasms have both therapeutic prognostic implications, a review was undertaken of 100 patients with primary neoplasms in whom whole lung tomography and chest roentgenography had been performed. Eight (20%) of 28 patients with solitary metastases on conventional films had more than one lesion on tomography. Due to the tomographic findings, therapy was altered in six of those eight. Two (3%) of 72 patients with normal chest roentgenograms had metastases visible on their tomograms. The data indicate the high value of whole lung tomography in determining therapy whenever a solitary metastasis is visible on conventional chest roentgenograms. The 3% pickup rate of metastases in patients with normal chest roentgenograms is less clear-cut but does suggest the contribution tomography can make in patients with potentially curable lesions.