Synchronous primary esophageal and gastric cancers.

The diagnosed multiple cancer cases have recently been increasing in number. The frequency of synchronous esophageal and gastric carcinomas is increasing due to development of more sophisticated invasive and non-invasive diagnostic tools and an increase in the number of elderly patients. Four cases of synchronous esophageal and gastric cancers were diagnosed in 2nd Department of Radiology, Medical University of Lublin and in Radiological Department of Hospital in Krosno between the 1996 and 2002. In all cases double-contrast barium examinations of upper gastrointestinal tract were performed. In all cases the two lesions were found, separated by normal mucous membrane. In two cases the irregular tumor masses were localized in the gastric cardia. In two patients coexistent lesions form the oval filling defect, with hazy appearance in the middle of the anterior esophageal wall. In three cases the results of contrast examinations were confirmed with CT. Endoscopy with taking the specimens for histopathological examination supplemented the radiological examination. The results of histopathological examinations confirmed the diagnosis. The possibility of multiple primary cancers should be kept in mind during the preoperative examination. In case of esophageal cancer with severe stricture, when endoscope cannot be passed through the esophagus, the stomach should be carefully examined in a barium meal study.

Dissecting aortic aneurysm in computed tomography.

The dissecting aortic aneurysm (DAA) is an emergency, and because of that it requires urgent diagnosis and treatment. Many methods may by used to diagnose dissection, including aortography, CT, MRI, traditional and transesophageal ultrasonography. The computed tomography is often used in diagnostic of DAA, thus the knowledge of morphological characteristic of dissection is very important. The most important features of dissection in CT are presence of dissection of intima and two lumens, true and false. Nevertheless, the CT pictures of dissection not always appears like this, and sometimes the two lumens are identified only by their different rates of opacification with contrast material.

Rare findings in high resolution computed tomography (HRCT) in interstitial lung diseases.

High resolution computed tomography (HRCT) is an imaging method, achieving an optimal resolution of lung interstitium images. HRCT enables more accurate diagnosis of interstitial lung diseases, in which it is a diagnostic method of choice. A lot of pathological findings specific only for HRCT were described. Some of them are relatively rare, and therefore not well known. In some cases good knowledge of them is essential in making a correct diagnosis based on HRCT results. The aim of the study was assessment of rare findings on HRCT, their morphology and diagnostic value in interstitial lung disease. The tram track sign and signet-ring sign visible on HRCT are very specific findings in bronchiectases. The tree-in-bud pattern is a specific finding for diseases of small airways, especially involving small bronchioles. The differences in sizes of vessels in hyper-lucent and hyper-dense lung areas enable differentiation of mosaic perfusion from other reasons for inhomogeneous lung density. Rounded atelectasis and comet tail sign are specific findings for asbestosis. The angiogram sign is a very specific finding for bronchoalveolar carcinoma.