Renal cell carcinoma with concurrent urothelial carcinoma of urinary bladder and non-Hodgkin lymphoma.

We report a case of a 71-year-old male with multiple primary malignancies involving kidney and urinary bladder, combined with synchronous lymphoma. The patient was admitted to the hospital because of painless gross hematuria. Examination revealed tumor of the right kidney and papillary tumor in the urinary bladder and enlarged lymph nodes along aorta and inferior vena cava. Transurethral resection of bladder tumor (TUR), radical nephrectomy of the right kidney and retroperitoneal lymphadenectomy were performed. Pathohistologic evaluation, together with immunohistochemistry, gave the patient the final diagnosis of renal cell carcinoma (RCC), urothelial carcinoma of the urinary bladder and B- small cell Non-Hodgkin lymphoma (B-CLL).

Giant right coronary artery aneurysm.

Coronary artery aneurysm (CAA) is defined as dilatation of the coronary artery that is more than 1.5 times the diameter of normal adjacent segments. A coronary artery with a diameter more than 2 cm is termed as 'giant aneurysm' and only a few cases have been described in the literature. In adults, CAA is predominantly atherosclerotic in origin; however, other causes include Kawasaki disease, autoimmune disease, trauma, infection, dissection, congenital malformation and angioplasty. Clinical presentation, prognosis and management of a giant CAA are not well defined due to limited experience. We present the case of a patient with giant aneurysm of the proximal segment of the right coronary artery.

Positive identification by a skull with multiple epigenetic traits and abnormal structure of the neurocranium, viscerocranium, and the skeleton.

Wormian bones are small ossicles appearing within the cranial sutures in more than 40% of skulls, most commonly at the lambdoid suture and pterion. During the skeletal analysis of an unidentified male war victim, we observed multiple wormian bones and a patent metopic suture. Additionally, the right elbow was deformed, probably as a consequence of an old trauma. The skull was analyzed by cranial measurements and computerized tomography, revealing the presence of cranial deformities including hyperbrachicrania, localized reduction in hemispheral widths, increased cranial capacity, and sclerosis of the viscerocranium. Besides unique anatomical features and their anthropological value, such skeletal abnormalities also have a forensic value as the evidence to support the final identification of the victim.

Anomalous origin of the left coronary artery from the right sinus of Valsalva in a 62-year-old woman with unstable angina pectoris: a case report.

Anomalous origin of the left coronary artery from the right sinus of Valsalva is a rare congenital coronary anomaly. We report a case of a 62-year-old woman with a history of hypertension, diabetes type 2 and hypercholesterolemia who was admitted to the local hospital because of unstable angina pectoris. Coronary angiography was performed revealing the anomalous left main coronary artery arising from a single ostium in the right sinus of Valsalva together with the right coronary artery which showed a 90% proximal stenosis. The patient was referred to our hospital for further management. Multislice computed tomography (MSCT) coronary angiography confirmed these findings and determined coursing of the anomalous left coronary artery anterior to the pulmonary trunk. The proximal RCA lesion was successfully treated with direct stenting. She is asymptomatic on clinical follow-up at 18 months.

Influence of bladder distension on opacification of urinary collecting system during CT urography.

The purpose of the study was to evaluate and compare opacification of the renal collecting system and ureters detected by computed tomographic urography (CTU) performed 20 min and 1 h after the ingestion of 1,000 ml of water. CTU was performed on 89 patients (55 men, 34 women; age 28-77 years) and 168 collecting systems and ureters were evaluated. A 16-detector-row scanner (Sensation 16, Siemens) was used; a two-phase protocol with a split bolus of contrast agent (total 120 ml) was applied. A combined nephrographic-excretory phase was obtained 100 s after the second injection. Three-dimensional reconstructions of the excretory phase were created and used to evaluate the degree of opacification of the collecting system and ureters. In 44 patients, water was administered 20 min before examination, and in 45 patients, 1 h before examination. CTU performed 1 h after water ingestion demonstrated complete opacification of calices in 87.5%, of renal pelvis in 97.5%, of upper ureter in 91.8% and of lower ureter in 87.5% of patients. CTU performed 20 min after water ingestion demonstrated complete opacification of calices in 79.5%, of renal pelvis in 85%, of upper ureter in 62.5% and of lower ureter in 54.5% of patients. Complete opacification of the proximal and distal ureter in the group with a 1-h delay was statistically higher (P<0.01). CTU performed on the distended bladder, 1 h after the oral ingestion of water, enables excellent opacification of collecting system, including distal ureters.