Abdominal retained surgical sponges: CT appearance.

Retention of surgical sponges is rare. They cause either an aseptic reaction without significant symptoms or an exudative reaction which results in early but nonspecific symptoms. Computed tomography is very useful for recognition of retained sponges. The appearance of retained sponges is widely variable. Air trapping into a surgical sponge results in the spongiform pattern which is characteristic but unfortunately uncommon. A low-density, high-density, or complex mass is found in the majority of cases, but these patterns are not specific. Sometimes, a thin high-density capsule may be seen. Rim or internal calcification is a rare finding. Finally, a radiopaque marker is not a reliable sign. Differentiation from abscess and hematoma is sometimes difficult.

MRI of abdominal hydatid disease.

Seventy hydatid cysts in 30 patients were studied with magnetic resonance imaging (MRI) and computed tomography (CT); all cases were confirmed surgically. MRI detected all cysts when confined to solid organs, whereas small-sized cysts (< or = 2 cm) may be missed when located in the peritoneal cavity. Hydatid cysts of less than 3 cm (noncomplicated) present no specific findings of hydatid disease. MRI findings suggesting hydatid disease demonstrate a relatively thick hydatid cyst wall, daughter cysts, and germinal membrane detachment. T2-weighted images proved to be superior to T1- or PD-weighted images in demonstrating hydatid cyst wall thickness, germinal membrane detachment, and daughter cysts. In all spin-echo sequences, the maternal cystic content presented much higher signal intensities than that of daughter cysts. This difference in signal intensity is more obvious in T2-weighted images, except in complicated, infected cases. CT proved to be superior to MRI in demonstrating wall calcifications.

Combination chemotherapy with cyclophosphamide, adriamycin, and vincristine in malignant thymoma and myasthenia gravis.

Malignant thymoma (MT) is a rare tumor that is often associated with myasthenia gravis (MG). This tumor is considered resistant to chemotherapy. We had the opportunity to treat five patients with MT with cyclophosphamide 800 mg/m2, Adriamycin 50 mg/m2, and vincristine 1.4 mg/m2 (CAV) in cycles of 21 days. Two patients with MG that was resistant to antimyasthenic drugs immediately responded to this combination. One patient with only MT had a complete response, and two patients with only MT had a partial response. Two out of the five patients are still alive and free of disease. Two patients died of disease, and one died from a neutropenia-induced respiratory tract infection. It is concluded that this combination chemotherapy is active in MT and MG and deserves additional trials.

CT characterization of multivesicular hydatid cysts.

One hundred seventy-eight abdominal multivesicular hydatid cysts were classified into three types (A, B, C) based on CT densities and morphology of cysts. The CT density of viable daughter cysts was always appreciably lower than those of mother hydatid cysts. This density differential between mother and daughter hydatid cyst fluid is a useful diagnostic sign.