Post-traumatic sialoceles and mucoceles of the salivary glands.

Three cases of post-traumatic sialocele involving the parotid region and one case of post-traumatic mucocele involving the submandibular region are presented. Computed tomography (CT) with contrast showed enhancing borders after a few weeks. Cases earlier than 2 weeks from occurrence showed no enhancement because of the absence of a well-developed capsule. Patients who had the disease longer showed better enhancement of the periphery with contrast because of capsule development. By CT scanning alone it is difficult to differentiated these lesions from other cystic lesions of the face and neck, although certain characteristics like location and rim enhancement may favor one lesion over the other.

Solitary pulmonary nodule in secondary syphilis.

A case of secondary syphilis with a solitary right upper-lobe nodule is presented. Patient presented without any pulmonary complaints or findings. This mass disappeared with residual scar after a full course of penicillin therapy. Our report is the first in the literature that reports a solitary nodule in the upper lobes in secondary syphilis. Previous reports showed nodules only in lower lobes. Our patient also presented with a rectal mass that disappeared on anti-syphilitic therapy.

Computed tomography in urothelial tumors of renal pelvis and related filling defects.

Our study includes 12 patients. Of these, six had transitional cell carcinoma, three patients with stones and three patients with blood clots. With the use of computed tomography we were able to arrive at a reasonable staging and diagnosis of the filling defects. Computed tomography is not sufficiently sensitive to recognize microscopic invasion. Reactive fibrosis and postobstructive inflammatory changes can mimic tumor invasion on computed tomography, and in such cases staging will not be accurate.

Superior mesenteric venous aneurysm.

A patient presented with recurrent upper gastrointestinal bleeding. Celiac and superior mesenteric angiography showed a superior mesenteric venous aneurysm, a normal-sized liver, an enlarged spleen, and esophageal varices. The patient gave no history of hepatitis or alcoholism. It is concluded that the portal hypertension was secondary to aneurysm of the superior mesenteric vein. Aneurysms of the portal venous system can cause chronic portal hypertension due to alteration of blood flow. We believe this to be the second case reported in the English literature of a superior mesenteric venous aneurysm.

Left lobe of the liver draping around the spleen: a pitfall in computed tomography diagnosis of perisplenic hematoma.

Computed tomography scanning has become one of the prime modalities in the diagnosis of trauma to the spleen (1-6). We present three cases of potential pitfall in computed tomography scan diagnosis. In the first case, computed tomography scan showed a high-attenuation perisplenic density in the superio-lateral region of the spleen compatible with a perisplenic hematoma. Exploratory surgery showed a left lobe of the liver draping around the spleen. The second case showed similar computed tomography findings as in the first case, but the perisplenic density showed enhancement after contrast infusion. Also, on careful evaluation, the perisplenic density was traced as part of the left lobe of the liver. The third case, an alcoholic without any history of trauma, showed a perisplenic density of lower attenuation. On careful screening, this was traced as part of the left lobe of the liver. The lower attenuation value of the liver was due to fatty infiltration. The importance of performing computed tomography with and without contrast infusion in these cases is discussed.

Computed tomography in splenic hemorrhage.

Five cases of splenic hemorrhage are discussed. In the first two cases of acute splenic laceration, the perisplenic hematoma showed higher attenuation compared with splenic parenchyma, and after contrast injection attenuation of hematoma and splenic parenchyma were similar. The third case showed pericapsular and subcapsular hemorrhage at surgery. The pericapsular hematoma in the third case also showed higher attenuation. The fourth and fifth cases demonstrated subacute or chronic subcapsular hematoma of lower attenuation. The first two cases illustrate the need for noncontrast computed tomography scan in acute splenic hemorrhages, as contrast scans can obscure hematoma. Contrast study should also be done for optimal visualization, extent of hematoma, and for showing intrasplenic hematomas and contusions.

Computerized tomography in intracardiac tumors.

Two cases of cardiac tumors were studied by computerized tomography. The first patient presented with cerebral embolization from left atrial tumor. Chest X-ray showed calcification in the region of the atria. A 2-"D" echo showed tumors of the right and left atrium. CT studies with contrast confirmed tumors of right and left atria its relationship with atrial septum and calcification. This is the first case report in the literature of multicentric biatrial tumors thought to be myxomas shown by computerized tomography. The second patient presented with weight loss, progressive weakness, shortness of breath and palpitations. A 2-"D" echo showed a large pedunculated left atrial mass prolapsing across the mitral valve into the left ventricle. CT with contrast showed large mass 3.5 X 4.5 cm in the left atrium. At surgery, this was proved to be a left atrial myxoma.

Diffuse posterior hyperostosis of the cervical spine with cord compression: a Forestier (DISH) variant.

A patient presented with signs and symptoms of cervical spinal cord compression. Computed tomography (CT) scan showed diffuse idiopathic hyperostosis of the posterior vertebral border of C4, C5, C6, and C7 cervical vertebrae, with severe spinal stenosis at C5 and C6 level. Computed tomography scan is the single most useful instrument for demonstrating the extent of bony proliferation and severity of spinal stenosis.

Benign superior vena cava syndrome caused by transvenous cardiac pacemaker.

A case of superior vena cava syndrome in an 84-year-old man caused by transvenous cardiac pacemaker is described. Computed tomograms showed lack of visualization of superior vena cava (SVC) due to thrombosis. Superior vena cavagram showed SVC obstruction with collateral circulation.