CT Findings of Primary Malignant Pulmonary Mesenchymal Tumors

PURPOSE: To describe the CT findings and charicteristic clinical manifestation of primary malignant pulmonarymesenchymal tumors. MATERIALS AND METHODS: This study involved nine histopathologically proven cases of malignantprimary pulmonary mesenchymal tumors, as follows : MFH(n=2), leiomyosarcoma(n=2), pulmonary blastoma(n=1),neurogenic sarcoma(n=1), rhabdomyosarcoma(n=1), liposarcoma(n=1) and hemangiopericytoma(n=1). Two patients weremale and seven were female; their median age was 45. We retrospectively analyzed tumor size, location,characteristic of the peripheral margin, relationship to airways, and whether there was distal atelectasis orobstructive pneumonitis and lymph node involvement. We also reviewed distant metastasis, tumor growth rate and theinterval between surgery and recurrence, as seen on follow-up CT scans(n=6). RESULTS: Lesions were located at theright upper (n=2), right middle (n=1), right lower (n=1) and left lower lobe (n=2); in three cases, the whole leftlung (left upper + left lower lobe) was involved. CT findings showed that in all cases, the largest diameter ofmasses ranged from 3 to 15 cm; a well-demarcated margin was seen (smooth in eight cases, psiculated in one) andthis was well enhanced(inhomogeneous in six cases, homogeneous in three). In six cases, masses encircled ordisplaced the peritumoral small bronchus, and in five cases, were located in the peripheral lung field. In fourpatients who underwent endobronchoscopy, no endobronchial lesions were present, and in six cases scans initial CTscans showed no lymph-node involvement. In two cases, mass size doubled within one month. On initial diagnosis,distant metastasis was seen in seven cases, and in three, recurrent lesions were detected within postoperative sixmonths. CONCLUSION: If in the differential diagnosis of lung cancer, a mass seen on CT images is well demarcated,large, peripheral, inhomogeneously enhanced, encircles or displaces the peritumoral small bronchus, shows earlydistant metastasis, is high locally invasive, and recurs early with relative sparing of the lymph nodes, thepossibility of primary malignant pulmonary mesenchymal tumor shouldbe considered.

Usefulness of Stereotactic Localization of Nonpalpable Breast Lesions

PURPOSE: To evaluate the usefulness of stereoscopic localization of nonpalpable breast lesions. MATERIALS AND METHODS: The authors retrospectively analyzed 60 cases of stereotactic localization performed for lesions whichwere mammographically visible but not palpable. Each case was reviewed for chief complaint, indication oflocalization on a mammograph, location of the lesion, pathological diagnosis, and complications during and afterthe procedure. RESULTS: Most patients(75%) had no specific complaint. Among the 60 cases, microcalcification,mass and combined lesions were found in 34(57%), 12(20%), and 14 cases(23%), respectively. The most commonlocation of the lesion was the upper outer quadrant(29 cases). A histopathologic report was available in 56 of 60cases. Among 43 benign cases(76.8%), fibrocystic disease was most common(38 cases, 67.9%), while among 13malignant cases, ductal carcinoma was most common(9 cases, 16.1%). In four of 56 cases(7.1%), failure to removethe target lesion was identified. Retrospective analysis suggests that movement of the patient during theprocedure is the most likely cause of failure. There were no major complications. CONCLUSION: Stereotacticlocalization is simple and accurate, and compared with the conventional method, requires less experience on thepart of the practitioner. Movement of the patient during the procedure may be the major cause of failure.