Calcification in untreated mediastinal lymphoma.

Calcification was demonstrated radiographically within newly diagnosed lymphoma of the mediastinum in two patients. These patients and those in other isolated reports show that radiographic examinations may, rarely, reveal calcification in lymphomatous tissue prior to treatment.

Pathways of tumor spread through the lung: radiologic correlations with anatomy and pathology.

The pathways of tumor spread through the lung are described and their significance for radiographic interpretation is illustrated. A key to understanding the spread of bronchogenic carcinoma is the realization that although the normal flow of lymph in the pulmonary lymphatics is centripetal, lymphatic obstruction can cause reversal of flow. As a result, tumor cells are commonly carried centrifugally to the periphery in lymphatics or the connective tissue around them, and remote pleural involvement, secondary parenchymal masses, or satellite nodules may develop. Failure to appreciate peripheral spread of tumor has negative consequences for tumor staging, surgery, and radiotherapy. In the absence of hilar node involvement causing obstruction, long line shadows more than 0.5 inch (1.25 cm) in length proximal to a peripheral mass very infrequently represent tumor.

Radiographic anatomy of the interlobar fissures: a study of 100 specimens.

A review of the anatomy of the interlobar fissures is based on a detailed study of 100 fixed and inflated lung specimens (50 right and 50 left lungs). The upper part of the fissural surface of the right lower lobe almost always faces in a slightly lateral direction and is usually concave; the lower part typically faces laterally but is usually convex. The upper part of the left major fissure also almost always faces laterally and is concave; but unlike the right side, the lower part usually faces medially and is convex. The minor fissure is typically oriented so that the anterior part is lower than the posterior part and the lateral margin is lower than the medial margin. Incompleteness of the fissures (fusion between lobes) is common; this study revealed a 70% incidence of fusion across the upper right major fissure, 47% across the lower right major fissure, 40% across the upper left major fissure, 46% across the lower left major fissure, and 94% across the minor fissure. The fissural complex is a term used to describe the variable anatomic relation of the major and minor fissures. Some comments are offered concerning fissural anatomy relative to collateral air drift, the visualization and position of interlobar fissures on chest radiographs, and the appearance of inferior interlobar fluid on the lateral radiograph.

The epicardial fat pad sign: analysis of frontal and lateral chest radiographs in patients with pericardial effusion.

The epicardial fat pad sign (EFPS) has been useful in the diagnosis of pericardial effusion on plain frontal and lateral chest radiographs. In this series of 100 cases, including patients with small pericardial effusions, it was positive in 52% of cases, being seen on the lateral view in 41%, on the frontal view in 23%, and on both views in 12%. The authors consider this sign to be the most reliable plain-radiograph finding in the diagnosis of pericardial effusion.