[Peritoneal carcinosis]. / Carcinosi peritoneale.

Abdominal CT yields several pieces of information for the diagnosis of secondary neoplastic involvement of the peritoneum (peritoneal carcinosis). Peritoneal carcinosis may be the first clinical sign of an occult primary tumor. CT scans of 120 patients with peritoneal carcinosis confirmed by pre/peri-operative biopsy or at autopsy, were retrospectively reviewed. The CT patterns of peritoneal carcinosis were detected in 20 of 44 patients with an occult malignancy. In 16 of 76 cases with a known malignancy there was no evidence of secondary peritoneal involvement. The incidence of CT findings and their correlation with the primary tumor are critically discussed. The authors have assessed the utility of CT in detecting peritoneal carcinosis, even though in their experience CT findings of secondary neoplastic peritoneal involvement could not be correlated with primary tumor.

[Pancreatic necrosis. Correlations of traditional radiology of the colon and CT]. / La necrosi pancreatica. Correlazioni fra radiologia tradizionale del colon e TC.

Pancreatic necrosis is a possible complication of acute pancreatitis. It is characterized by diffuse inflammation associated with exudation or leakage of pancreatic juice with its proteolytic enzymes into the peripancreatic tissues. Colonic complications of acute pancreatitis are uncommon events. The main purpose of our study was to correlate radiological findings of pancreatic necrosis as observed during barium enema to CT patterns. A retrospective study was therefore carried out on 40 patients affected with acute pancreatitis with local and systemic complications. The analysis of the results allowed different patterns to be observed, with the two techniques, in the acute and in the chronic phases. In the acute phase, barium enema of the colon showed inflammatory extrinsic processes involving the wall, with a typical localization related to the spread of pancreatic enzymes along mesenteric pathways, as described by Meyers. CT allowed a thorough evaluation of both the pathologic process and its spatial balance. In the chronic phase, barium enema showed fibrotic strictures and fistulas. CT demonstrated pseudocystic masses and irregular focal areas of decreased attenuation or irregular pancreatic margins. This correlation shows how an extrinsic inflammatory involvement of the colon with a characteristic topography may help make a diagnosis and plan therapy.

[Computerized tomography in the staging and the follow-up of Hodgkin's lymphoma of the thorax]. / La tomografia computerizzata nello staging e nel follow-up dei linfomi di Hodgkin a localizzazione toracica.

As yet, the role of Computed Tomography (CT) as a routine imaging technique in the staging and follow-up of thoracic Hodgkin's disease has not been assessed. The authors report the results obtained in 120 patients affected with thoracic Hodgkin's disease, staged and followed by means of chest X-rays and CT. CT better identified intrathoracic involvement of mediastinal nodes, of lung parenchyma, of pleura, and of pericardial and chest walls in 54/120 patients (45%), with staging modifications in 18 (15%) of them only. Treatment was changed only in 12 patients (10%) where radiation therapy had been planned. The clinical value of the additional information yielded by CT was especially evident in the follow-up: CT allowed the correct evaluation of persistent/recurrent disease in 51/117 patients (43.5%), a figure high enough to suggest the use of CT in the routine follow-up of patients affected with thoracic Hodgkin's disease.

[Computed tomography in ascites]. / La TC nelle asciti.

Ascites can be found in a variety of diseases and may represent either a late complication or the clinical sign of a pathologic condition. The presence of even small fluid collections in peritoneal recess can be easily detected by CT. A number of reports confirm CT prediction of the benign/malignant nature of ascites. The CT scans of 100 patients affected with histologically confirmed ascites were reviewed to evaluate CT contribution to the assessment of the benign/malignant nature of ascites. On the basis of our results, it can be concluded that the only highly predictive CT finding of malignant ascites is the presence of a coexisting mass. Other findings do not allow the two types of collections to be discriminated.