Gastric marginal zone B cell lymphoma of the duodenum.

Small bowel lymphomas of the extranodal type occur in the young and are characteristically associated with malabsorption syndrome. We present the case of an elderly in whom there was no malabsorption and the duodenal tumor was a gastric type marginal zone B cell lymphoma also known as gastric mucosa-associated lymphoid tissue (MALT) lymphoma. A 73-year-old woman presented to the emergency room with 2 weeks of general weakness, recurrent vomiting containing food particles and abdominal distension. She had been diagnosed with diabetic gastroparesis 4 years prior. CT of the abdomen and pelvis was suggestive of gastric outlet obstruction but no evidence of pancreatic or duodenal mass. Endoscopy and biopsy of the tumor obstructing the distal first part of the duodenum confirmed a gastric marginal MALT lymphoma. The patient's symptoms improved with radiotherapy. Gastric MALT lymphoma, an extranodal lymphoma primarily described in the stomach, can also present in the small bowel and is not associated with malabsorption.

MRI for evaluation of perianal inflammation.

BACKGROUND: We describe the value of using magnetic resonance imaging (MRI) in six distinct clinical settings often encountered in cases of perirectal inflammatory disease. METHODS: MRI was performed on six patients with known perianal inflammatory disease; the number, anatomic extent, location, and signal intensities of various lesions and their associated complications were assessed. RESULTS: MRI is a noninvasive technique that is useful in the diagnosis and management of perirectal inflammatory disease. CONCLUSIONS: In patients with known fistulas, MRI may determine the lesion's anatomic extent, localize unsuspected fistulas, and confirm or exclude the inflammation of the fistulous tract(s). Information obtained by MRI examination may, in turn, be used to determine treatment of patients with perirectal inflammatory lesions and can be a useful adjunct in following results of therapy.

Pulmonary artery sarcoma: diagnosis and postoperative follow-up with gadolinium-diethylenetriamine pentaacetic acid-enhanced magnetic resonance imaging.

Pulmonary artery sarcomas are infrequently encountered and are often misdiagnosed before surgical exploration or autopsy. On clinical examination and conventional imaging studies, they are frequently mistaken for pulmonary emboli. To our knowledge, this case report is the first to describe the postoperative magnetic resonance imaging (MRI) appearance of residual disease of a pulmonary artery sarcoma and to assess the potential usefulness of MRI for monitoring such lesions postoperatively. Contrast-enhanced MRI, a relatively noninvasive method, seems well suited for postsurgical follow-up of pulmonary artery sarcomas.

MR imaging in the diagnosis of a retroperitoneal schwannoma.

The computerized tomography (CT) and ultrasound characteristics of many of the primary retroperitoneal tumors are nonspecific, and thus preoperative diagnosis of these tumors is difficult. We describe a case of a retroperitoneal schwannoma in which the multiplanar capability of magnetic resonance imaging (MRI) provided anatomic information not obtainable by other modalities and helped to suggest the neural origin of the tumor.

MRI characteristics of two cases of adrenal ganglioneuromas.

Two cases of the magnetic resonance imaging (MRI) of adrenal ganglioneuromas are presented. The appearance on spin-echo sequences is that of a heterogeneous mass, increasing in signal intensity in T2-weighted images, with associated areas of decreased signal, consistent with findings in the one previously reported case. The diagnosis of adrenal ganglioneuroma should be considered in the differential diagnosis of heterogeneous adrenal masses.

Retroperitoneal germ cell neoplasm: MR and CT.

A case of germ cell neoplasm in an undescended retroperitoneal testicle is reported. CT revealed a large mass most consistent with a chronic hematoma. MRI demonstrated findings typical for neoplasm, and this was confirmed on biopsy.

Magnetic resonance imaging of an esophageal duplication cyst.

A confirmed case of an esophageal duplication is reported. We review the clinical and pathologic features of this rare anomaly, and describe its appearance on magnetic resonance imaging (MRI). The potential advantages of utilizing MRI in the diagnosis of suspected esophageal duplications, and in the detection of any associated lesions, are outlined.

MR imaging of cardiac mass in Wegener granulomatosis.

Wegener granulomatosis is a disorder of unknown etiology characterized by a necrotizing granulomatous vasculitis that primarily affects the paranasal sinuses, lungs, and kidneys. It is usually a disease of adults with infrequent cardiac involvement. We report the unusual presentation of this disorder in an adolescent with a cardiac mass. The findings on two-dimensional echocardiography and MR imaging are discussed.

Xanthogranulomatous pyelonephritis in an infant.

An unusual case of xanthogranulomatous pyelonephritis (XGP) in an infant is presented. Findings on magnetic resonance imaging, computerized tomography, ultrasound, and intravenous urography in our patient are contrasted with others reported in the literature. Absent were such commonly seen findings as nonfunctioning kidney, hydronephrosis, urinary calculi, and calcifications.

A standardized method for determination of who should be listed as authors on scholarly papers.

A handy method is described of selecting among the inevitable onslaught of 100 to 200 potential coauthors that mysteriously appear whenever a journal article is submitted for publication. The "relative authorship weighting scale" helps to decide who actually qualifies as an author and serves as an objective means of determining the appropriate order in which these various goldbrickers should be listed on the manuscript.

Urachal carcinoma: the role of magnetic resonance imaging.

Urachal carcinoma is a very rare tumor that occurs primarily in middle-aged and elderly men. Most are mucinous adenocarcinomas. The lesion's poor prognosis primarily reflects its clinically silent behavior in its early stages. Therefore, aids to preoperative diagnosis and tumor staging may be of benefit. Conventional radiographic techniques have not proved very effective at diagnosing urachal lesions. Magnetic resonance imaging (MRI) may be particularly useful in this regard, mainly due to its multiplanar imaging capability. We review the clinical, pathological, and radiological features of urachal carcinoma, and include a description of the MRI appearance of two cases.

MR appearance of cervical pregnancy.

Cervical pregnancy is a rare type of ectopic pregnancy, although its incidence appears to be increasing. Prompt recognition is important since it can be the cause of catastrophic hemorrhage. Yet the diagnosis is rarely made prior to surgery due to the rarity of cervical pregnancy and the emergent nature of its complications. This report describes the magnetic resonance (MR) appearance of a cervical gestation and discusses the potential advantages of MR in making the diagnosis.

Magnetic resonance imaging evaluation of spontaneous portosystemic collaterals.

Three patients, two of whom had histories of episodic hepatic encephalopathy, were shown by magnetic resonance imaging (MRI) to have occult spontaneous portosystemic shunts. The multiplanar imaging capabilities of MRI provided an optimal, noninvasive method of visualization of collateral anatomy in each case.

MRI of primary amyloidosis.

In a patient with primary amyloidosis, we compared T2 values and relative signal intensity ratios of involved organs to those of normal patients. T2 was significantly decreased in the spleen and adrenals, while significantly increased in the pancreas. T2 values were insignificantly changed in the liver, subcutaneous fat, bone marrow, or kidney. Ratios may facilitate detection of relative changes in T2 values.