CT finding of primary lung cancer

Authors retrospectively analyzed the CT findings of 102 cases of histologically proven bronchogenic carcinomaduring last 4 years from January 1980 to July 1984 at Kosin Medical College. The results were as follows; 1. Thesex ratio was 86 males to 16 females and the greatest number (66.7%) of cases were seen in fourth and fifthdecades. 2. The distribution of histoligic types of primary lung cancer as follows: squamous cell carcinoma 66cases, Adenocarcinoma 10 cases, small cell carcinoma 7 cases, Large cell carcinoma 5 cases, bronchiloalveolar cellcarcinoma 1 case, Unclassifed 13 cases. 3. Location of primary lesions as follows: Right lung 61 cases, Left lung40 cases. In both lungs, the greatest number of cases were found in the upper lobes. Ratio between central andperippheral mass was 2.5:1, except adenocarcinoma(6:4). 4. CT findings were as follows; Hilar or central mass(75cases), Peipheral mass(26), Bronchial abnormalities such as narrowing, obstruction, or displacement (60),Thickening of the posterior wall of the right upper lobe bronchus, bronchus intermedius, or left mainbronchus(17), Post-obstructive changes; Atelectasis, Pneumonitis, Emphysema(34, 17, 1 respectively), Hilaradenopathy(21), Mediastinal lymph node enlargement(50). Mediastinal invasion(51), Pericardial thickening(5), SVCsyndrom with collateral vessels(3), Pleural effusion (27), Pleural thickening or invasion(14), Chest wallinvasion(2), distant metastasis(26). 5. In most of patients(92 cases), the size of mass above 3cm, but in 9 casesbelow 3cm. Margins of the masses were serrated or lobulated in most cases. In 5 cases, cavitary formations werenoted, walls of which were thick and irregular, and air-fluid level was noted in 1 case. In 2 cases, eccentriccalcification were noted within mass. 6. Among 51 cases of whom direct mediastinal invasion was suspected, 8 caseswere operated upon, and this revealed that the masses were not resectable. Among the patients in whom no direct mediastinal invasion was suggested, 12 cases were operated uppon, and this revealed that the masses wereresectable in all cases. 7. Staging was as follows: stage I, 2 cases, Stage II, 13 cases, stage III, 86 cases.

Computed tomography of the mediastinal lesions

Authors retrospectively analized the CT findings of mediastinal lesions in surgically or clinically confirmed 37 cases at kosin Medical College during the recent 4 years from Sept. 1979 to Aug. 1983. 1. Among 37 cases, malignant lymphoma were 7 cases, thymoma and vascular lesion or anomaly were 5 cases respectively, benign teratoma and tuberculous mediastinal lymphadentis and neurogenic tumor were 4 cases respectively. pericardial cyst were 2 cases, bronchogenic cyst, non-specific cyst, pancreatic pseudocyst, mesothelioma, Bochdalek hernia was 1 case respectively. 2. The sex ratio between male and female was about 1:1 and the majority of the patients with malignant lymphoma and teratoma was under 20 years old. 3. CT findings of the each mediastinal lesion. 1) Primary mediastinal malignant lymphoma. (1) A large, matted, continuous and midline-crossing mass was observed in the superior and the anterior mediastinums in all cases. (2) In 3 cases, irregular lower densities were seen in the center of the mass, representing the tumor necrosis. (3) CT was also able to show invovlement of other mediastinal lymph nodes and adjacent structures such as pleura, anterior chest wall and lung parenchyma. (4) Involving pleura,homogeneous band-like shadows were seen along the pleura, appearing denser than the associated pleural effusion.(5) Involving lung parenchyma, irregular-shaped nodules and band-llike densities were seen along the courses ofthe bronchi and the vessels. 2) Thyoma. (1) A discrete, soft tissue mass was seen in the superior and the anterior mediastinums(mainly posterior to manubrium and anterior to aortic arch) replacing the normal mediastinal fat. (2)In benign thymoma, the margin of the mass was smooth and the normal fat plane between the mass and the vascular structures was well preserved, but invasive thymoma showed obliteration of the normal fat plane, irregular and ragged tumor-lung interface, and irregular thickening of pleura and pericardium by tumor implantation to thesestructures. (3) The tumors spreaded to only one side of the chest cavity. 3) Teratoma (1) A discrete and smooth marginated mass was seen in anterior mediastinum and it has three or more of different tissue densities among fat,water, soft tissue and calcific densities. (2) 3 cases of teratomas showed the characteristic, thick-walled cystic appearances.

Computed tomographic findings of gallbladder carcinoma

It is well known the CT is very useful in the evaluation of gallbladder carcinoma. We have studied 19 cases of gallbladder carcinoma with whole body scanner from May 1980 to Aug. 1983. 1. The sex distribution were 11 males and 8 females with over 40 years of age. 2. The computed tomographic classificications of the cases were 7 of intraluminal fungating mass(single 5 and multiple 2), 5 of mass filling the gallbladder, 5 of irregular thickened GB and 2 of mixed type, irregular thickned wall and intraluminal fungating mass. 3. CT demonstrated metastasis of other organ, 8 cases of the liver, 5 cases of the extrahepatic bile duct, 3 cases of peritoneum, 2 cases of duodenum, 1 case of the stomach, 1 case of the pancreas, and 15 cases of lymph nodes. 4. Associated diseases were6 cases of gall stone, 2 cases of clonorchiasis, 1 case of pancreatic pseudocyst, and 1 case of renal cyst.

Computed tomography of pancreatic carcinoma

CT has proven useful in diagnosing pancreatic disease. It is well known that CT is a reliable, simple,noninvasive method for detecting pancreatic carcinoma and extension of the pathology. Of 1150 cases studied forabdominal pathology with Varian-360-3 whole body scanner from June 1980 to June 1982, 38 cases were confirmed tobe pancreatic carcinoma clinically or operatively. We reviewed the CT findings of above cases and the results wereas follows; 1. The sex ration was 31 males to 7 females and the greatest number of cases (31.6%) were seen infourth decade. 2. There were enlargement of pancreas in 37 cases (97.4%), peripancreatic fat obliteration in 28cases (73.7%), dilatation of bile duct in 27 cases (71.1%), enlargement of retroperitoneal lymph nodes in 32 cases(84.2%), dilatation of pancreatic duct in 12 cases (31.6%), Thick vessel sign in 10 cases (26.3%), atrophy ofpancreas body and tail in 3 cases (7.9%), and metastasis in 17 cases (44.7%). 3. In 37 cases of enlargement ofpancreas, enlargement of head in 24 cases, enlargement of head and body in 7 cases, enlargement of body in 2cases, enlargement of body and tail in 2 cases, enlargement of tail in 1 case, and diffuse enlargement of pancreasin 1 case, were observed. 4. Associated findings on CT were pleural effusion (5 cases), ascites (4 cases), livercirrhosis(3 cases), splenomegaly (2 cases), gall stones (3 cases), cholecystitis(2 cases), CBD stone (1 case), IHDstone (1 case), Hydronephrosis (2 cases), renal cyst (2 cases), intraabdominal abscess(1 case), and spinetuberculosis(1 case). 5. There were difficulties in diagnosing one case of diffuse enlargement of opancreas withhead cancer, one case of necrotic head cancer similar to pseudocyst, one case of tail cancer associated withabscess and one case of head cancer associated with pseudocyst in lesser sac.