Lung torsion: radiographic findings in nine cases.

Torsion of the lung, although relatively rare, can occur under three sets of circumstances: spontaneously, usually in association with some other pulmonary abnormality; following traumatic pneumothorax; and as a complication of thoracic surgery. Nine cases of pulmonary torsion were analyzed. The radiographic findings are a collapsed or consolidated lobe that occupies an unusual position at plain radiography, at plain or computed tomography, at angiography, or at bronchography; hilar displacement in a direction inappropriate for that lobe; alteration in the normal position and sweep of the pulmonary vasculature; rapid opacification of an ipsilateral lobe following trauma or thoracic surgery; marked change in position of an opacified lobe on sequential radiographs; bronchial cutoff with no evidence of a mass; or lobar air trapping. Mortality is high if the torsion goes unrecognized and surgical fixation is delayed.

Polythelia (supernumerary nipple): an update.

Supernumerary mammary gland, nipple, or areola (with neither nipple nor mammary tissue) have been well documented in the medical literature of the last two decades. Though predominantly a cosmetic blemish, the anomalous appendage may give rise to a neoplasm. Because of its atypical appearance and ectopic location, diagnosis of the anomaly may require a high index of suspicion and histologic verification. In our current concern with breast cancer, there is need to be aware of this entity.

Idiopathic pulmonary ossification.

Idiopathic pulmonary ossification is an uncommon and asymptomatic disorder of unknown etiology in which trabeculated bone is found in the lung. It is usually mistaken for more serious entities radiographically, most commonly appearing as branching linear shadows of calcific density involving a limited area of the lung and exhibiting very slow progression; however, the shadows may be round or irregular and bulky. Sometimes the trabeculae are recognizable, and occasionally the lungs demonstrate widespread involvement. The authors describe 8 proven cases, including one in which a bone scan revealed uptake by heterotopic bone in the lung.

Carcinoma of the lung complicating lipoid pneumonia.

The authors have encountered four cases of oil aspiration pneumonia complicated by carcinoma. Each had a clear-cut history of chronic intake of an oily substance, radiographic changes, and histologically documented oil aspiration pneumonia. Lung cancer later appeared in the involved area. A small number of similar cases also have been reported. The implication is that oil aspiration pneumonitis may induce bronchogenic carcinoma, particularly either the alveolar cell or the squamous cell variety. The radiographic diagnosis of the malignant transformation is difficult, and consequently the prognosis is poor.