Aspergilloma within Pulmonary Sequestration: A Case Report

Routine chest radiography in a 21-year-old man revealed the presence of an asymptomatic mass at the right lower lung field. Chest radiographs showed multiple cysts with air-fluid level and air-meniscus within the consolidation at the right lower lung field. Chest CT scans demonstrated a non-enhancing solid mass, with air-meniscus, within a thin walled cavity, and multiple cysts with fluid or air-fluid level at the posterior portion of the right lower lobe. An abnormal artery was seen at the level of the 12th thoracic vertebra. Thoracic aortography revealed a feeding artery arising from the descending thoracic aorta and supplying the parenchymal lesion. We report the typical radiologic findings of intralobar pulmonary sequestration with aspergilloma, a condition confirmed by surgery and the pathologic findings.

Changes of Intrathoracic Extrapulmonary Organs after Radiation Therapy for Lung and Esophageal Cancer: CT Findings

PURPOSE: To evaluate the CT findings and incidence of complications occurring in intrathoracic extrapul-monary organs due to radiation therapy. MATERIALS AND METHODS: Among 82 patients who underwent chest CT before and after radiation therapy, 23, in whom the procedure provided no evidence of pericardial invasion or pleural effusion before radiation therapy, nor of significant improvement in the tumor after this therapy, were evaulated. Changes in the pericardium, pleura and mediastinal fat were retrospectively assessed. In comparing the CT findings obtained before radiation therapy with those obtained afterwards, changes in the pericardium and pleura were classified as effusion where low density fluid was present and as thickening where there was no fluid. If an increased abundance of soft tissue strands was seen within mediastinal fat, changes in this fat were deemed to have occurred. RESULTS: Among the 23 patients evaluated, changes in the pericardium [thickening (n=3 ; 13.0%) ; effusion (n=8 ; 34.8%)] were found in 11 patients (47.8%), and changes in the pleura [thickening (n=3 ; 13.1%); effusion (n=9 ; 39.1%)] in 12 (52.2%). In no patient with pericardial or pleural effusion was thickening or contrast enhancement of the pericardium or pleura evident. In seven cases(30.4%), soft tissue strands within mediastinal fat had become more abundant. CONCLUSION: The CT findings which demonstrated complications resulting from radiation therapy were pericardial or pleural thickening or effusion and an increased abundance of soft tissue strands within mediastinal fat. In contrast to previous reports, pericardial and pleural change after radiation therapy was a common finding in our study, occurring in 69.6% of cases.

MRI Findings of the Subacute Combined Degeneration of the Spinal Cord: A Case Report

Subacute combined degeneration (SCD) of the spinal cord is a neurological complication arising from vitamin B12 deficiency. Typical findings are demyelination and axonal loss of the posterior and lateral columns of the thoracic and cervical spinal cord, leading to sensory ataxia and paresthesia. Clinical and neurological features and MRI findings all contribute to the diagnosis of this entity. In the Korean medical literature, only one case of SCD involving pre-treatment MRI has been reported. We describe one case of SCD in a post-gastrecto-my patient who initially presented with progressive sensory abnormality in both upper and lower extremities and showed T2 hyperintensity in the posterior and lateral columns of the spinal cord; this diminished, with clinical improvement, after vitamin B12 therapy. Our report includes the MR images obtained during follow up.