Algorithmic workup of abnormal vaginal bleeding with endovaginal sonography and sonohysterography: self-assessment module.

The educational objectives for this self-assessment module on endovaginal sonography and sonohysterography are for the participant to exercise, self-assess, and improve his or her understanding of the imaging evaluation of abnormal vaginal bleeding and to gain familiarity with the algorithm for the workup for endometrial disorders.

Radiological reasoning: algorithmic workup of abnormal vaginal bleeding with endovaginal sonography and sonohysterography.

Objective: The workup of endometrial abnormalities can be a confusing task for radiologists because one must take into account the patient's clinical history, imaging findings, and a wide array of diagnostic options. We present two cases, one of a premenopausal woman presenting with vaginal bleeding and another of a postmenopausal woman taking tamoxifen who has abnormal findings on endovaginal sonography. The evaluations of these patients serve to illustrate the diagnostic algorithm for identification of endometrial pathology.

Does initial staging or tumor histology better identify asymptomatic brain metastases in patients with non-small cell lung cancer?

Background: To determine whether the distribution, staging features, or tumor histology of non-small cell lung cancer (NSCLC) distinguishes neurologically symptomatic from asymptomatic patients initially diagnosed with lung cancer, and to determine whether these factors may predict the presence of brain metastasis.

Methods: We performed a retrospective review of 809 patients with NSCLC and brain metastases who were treated in our institution between January 1996 and March 2003. Patients who had brain metastasis on initial staging were included.

Radiological reasoning: male breast mass with calcifications.

Objective: We encountered a mammographically calcified breast mass in a 30-year-old man. It was initially thought to be comedo-type ductal carcinoma in situ because of the dense calcifications, but sonography and MRI suggested a highly vascular lesion. The final pathologic diagnosis was hemangioma.