[The echographic and computed tomographic diagnosis of polysplenia]. / Diagnosi ecografica e con Tomografia Computerizzata della polisplenia.

Polysplenia syndrome is a malformation with impaired visceral lateralization; it consists in the incomplete development of the spleen which is replaced by two or more splenules (1-3 cm phi). This malformation is often associated with other anomalies and is more frequently seen in situs inversus and situs ambiguus. On the basis of their findings in 3 cases, the authors describe the main US and radiographic patterns of polysplenia syndrome, that is: polysplenia syndrome associated with situs solitus (several splenules where the spleen should be, without other anomalies); polysplenia syndrome associated with situs ambiguus (splenules in the right hypochondrium with such anomalies as "umbrella-like" liver and the absence of the hepatic segment of the inferior vena cava and enlargement of both azygos and hemiazygos veins); polysplenia syndrome associated with situs viscerum inversus (right-sided splenules, with transposition of abdominal and thoracic organs). The splenules exhibit the same echogenicity as the liver; when situs viscerum ambiguus is present. US patterns of splenuli are equivocal and may mimic liver metastases. On the contrary, CT allows better demonstration of both the anomaly and the associated malformations.

[An evaluation of the N parameter according to the system of the American Thoracic Society (ATS) in pulmonary carcinoma. A comparison between radiology, surgery and histological diagnosis]. / La valutazione del parametro "N" secondo il sistema dell'American Thoracic Society (ATS) nel carcinoma polmonare. Confronto tra radiologia, chirurgia e diagnosi istologica.

The hilar and mediastinal lymph nodes of 36 patients with bronchogenic carcinoma were evaluated with computed tomography (CT). The American Thoracic Society (ATS) mapping was employed, which defines nodal stations in terms of well-recognized anatomic landmarks which are easily identified with CT and during thoracotomy. The differences (30 cases) between CT and surgical measurements in the 124 nodal stations which could be analyzed are discussed in detail. A better correlation was found using a 2-cm threshold value to define a "positive" or "negative" lymph node with CT. The comparison of radiologic data and the presence of metastases showed how with the 2-cm size criterion sensitivity drops from 81% to 53%, whereas specificity rises from 53% to 84%, thus affecting the subsequent diagnosis and therapy positively.