Yersinia pseudotuberculosis sepsis presenting as multiple liver abscesses.

A 50-year-old man with diabetes was found to have sepsis with multiple small hepatic abscesses secondary to Yersinia pseudotuberculosis which were detected by computed tomography (CT) scan. Sepsis with Y. pseudotuberculosis is uncommon but usually seen in patients with underlying liver disease. Those patients with liver abscesses invariably have multiple small abscesses. Widespread use of CT scanning is likely to uncover more cases of hepatic microabscesses; in the appropriate clinical setting, Y. pseudotuberculosis should be considered as a possible cause.

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.

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.

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.

Carcinoid APUDoma of the pancreas.

A case of non-beta islet cell tumor of the pancreas with elevated vasoactive intestinal polypeptide (VIP) levels and WDHA syndrome (watery diarrhea, hypokalemia, and achlorhydria) was studied. Angiography and radio isotope scanning showed profuse abnormal vascularity. Ultrasonography showed a solid mass with small- to medium-sized cystic spaces. Histologic examination with special staining (Sevier-Munger) showed carcinoid tumor.