Sonographic features of gastrointestinal leiomyosarcoma

Nine cases of gastrointestinal leiomyosarcoma were studied by ultrasound. Abdominal sonogram disclosed a largelobulated iso or hypoechoic mass containing a few or multiple central sonolucent cavitations in seven cases. Twocases arising from mesentery and abdominal wall were hypoechoic mass without central sonolucent area. Thesecentral sonolucent areas were condirmed to be necrotic or hemorrhagic cavities in the solid mass pathologically.Although not pathognomonic, a large lobulated exophytic gastrointestinal mass with central sonolucent areastrongly suggests the diagnosis of leiomyosarcoma.

Posterior mediastinal teratoma

Teratomas, usually arising in the anerior mediastinum, are very uncommon in the posterior mediastinum. Embryologic development of anterior mediastinal teratoma is thought to be from thymic anlage which descends fromthe third branchial cleft and pouch, while that of posterior mediastinal teratoma is thought to be from the remnant of notochord. CT findings of posterior mediastinal teratomas are not different from teratomas elsewhere,containing fat, calcification, soft tissue and thick walled cyst. Ultrasonographic findings are mixed echogenicmass containing cystic portion, highly reflective solid portion and area of acoustic shadowing. Authors recently experienced 2 cases of surgically proven posterior mediastinal teratoma and report with review of literature.

Plain chest PA evaluation of left atrial thrombosis in mitral valvular disease

Conventional posteroanterior chest radiographs of 73 patients with mitral valve disease who had surgery were analyzed, and particular attention was directed to the absence of the convexity of the left lower mid cardiacborder (left atrial segment) and to the relation with duration of illness, atrial fibrillation, pulmonary capillary wedge pressure (PCWP) as well as surgical findings. The results obtained are as follows; 1. The flatness or concavity of this segment, despite other evidence of left atrial enlargement, was observed in eleven (64.7%) of17 patients who had left atrial thrombosis and six(10.7%) of 56 patients who did not have thrombosis(false positive diagnosis). Six (35.3%) of the 17 patients who had left atrial thrombosis did not show this finding on radiographs(false positive diagnosis). Six(35.3%) of the 17 patients who had left atrial thrombosis did not showthis finding on radiographs (false negetive diagnosis). Therefore, the accuracy in the diagnosis of thrombosis of left atrium was 64.7%(eleven of seventeen) for patients who had thrombosis of left atrium. 2. The atrial fibrillation was observed in sixteen (94.1%) of 17 patients who had left atrial thrombosis. So, correlation between the presence of left atrial thrombosis and atrial fibrillation was evident. But there was no correlationbetween the duration of illness or the PCWP of patients and the presence of left atrial thrombosis.

A case of Behcet's disease with aneurysms of common carotid arteries and abdominal aorta

One case of Behcet's disease with multiple aneurysms in both common carotid arteries and abdominal aorta is presented with brief review of the literatures. A 26-year-old woman had slowly enlarging pulsatile masses in both sides of neck and recurrent ulcerations in oral cavity and genitalia. One day prior to admission, aphasia, right facial nerve palsy and right hemiplegia suddently developed. Brain CT showed acute infarction in left basal ganglia. Both Carotid Angiography and abdominal Aortography demonstrated mulitple aneurysms in both common carotid arteries and abdominal aorta with organizion thrombi and thromboembolism of internal carotid artery.