Focal FDG uptake in mediastinal brown fat mimicking malignancy: a potential pitfall resolved on PET/CT.

Objective: A potential source of false-positive FDG PET interpretations in oncologic imaging is FDG uptake in brown fat. The purpose of this study was to determine the prevalence, location, and appearance of hypermetabolic brown fat in the mediastinum.

Materials And Methods: All PET/CT scans obtained at our cancer institution from August to October 2003 were retrospectively reviewed for increased FDG uptake in the mediastinum localized to fat on CT.

Effects of radiation therapy on the lung: radiologic appearances and differential diagnosis.

Radiation-induced lung disease (RILD) due to radiation therapy is common. Radiologic manifestations are usually confined to the lung tissue within the radiation port and are dependent on the interval after completion of treatment. In the acute phase, RILD typically manifests as ground-glass opacity or attenuation or as consolidation; in the late phase, it typically manifests as traction bronchiectasis, volume loss, and scarring.

Energetics of karate kumite.

It is speculated that anaerobic metabolism is the predominant source of energy in karate kumite. However, no experimental proof is currently available. The metabolic cost and fractions of aerobic and anaerobic energy of karate kumite fighting were investigated.

Pericardial "sleeve" recess of right inferior pulmonary vein mimicking adenopathy: computed tomography findings.

Objective: The purpose of this study was to assess the computed tomography (CT) features of the pericardial "sleeve" recess of the right inferior pulmonary vein misinterpreted as adenopathy.

Method: Six patients with fluid in the pericardial sleeve recess mistaken for adenopathy were retrospectively identified. The following CT features were assessed: location of fluid in relation to the vein, size, shape, attenuation, and mass effect on the inferior pulmonary vein.

Positron emission tomography imaging in lung cancer.

Over the past several years, positron emission tomography (PET) has become a clinically useful, noninvasive study which complements conventional imaging (chest radiographs, computed tomography [CT], and magnetic resonance imaging [MRI]) in the evaluation of patients with lung cancer. PET imaging of lung cancer is typically performed with the radiopharmaceutical 18F-2-deoxy-D-glucose (FDG), a d-glucose analog. Increased glucose metabolism by malignant cells results in increased uptake and accumulation of FDG, which serves as the basis for tumor detection.

"Crazy-paving" pattern at thin-section CT of the lungs: radiologic-pathologic overview.

The "crazy-paving" pattern is a common finding at thin-section computed tomography (CT) of the lungs. It consists of scattered or diffuse ground-glass attenuation with superimposed interlobular septal thickening and intralobular lines. This finding has a variety of causes, including infectious, neoplastic, idiopathic, inhalational, and sanguineous disorders.

Pleural effusions in lung transplant recipients: image-guided small-bore catheter drainage.

Purpose: To assess the efficacy of treating pleural effusions in lung transplant recipients with small-bore catheter drainage.

Materials And Methods: Chest radiographs and computed tomographic (CT) scans obtained in 31 lung transplant recipients who had pleural effusions treated with catheter drainage were retrospectively reviewed. Duration of drainage and volume of fluid drained were recorded.

Interobserver and intraobserver variability in measurement of non-small-cell carcinoma lung lesions: implications for assessment of tumor response.

Purpose: Response of solid malignancies to therapy is usually determined by serial measurements of tumor size. The purpose of our study was to assess the consistency of measurements performed by readers evaluating lung tumors.

Materials And Methods: The study group was composed of 33 patients with lung tumors more than 1.

Bronchiolitis obliterans syndrome in lung transplant recipients: correlation of computed tomography findings with bronchiolitis obliterans syndrome stage.

The purpose of this study was to correlate the extent of computed tomographic (CT) findings with the severity of respiratory dysfunction in lung transplant recipients with bronchiolitis obliterans syndrome (BOS). Eighty-nine conventional and 61 thin-section CT scans performed in 44 transplant recipients (17 bilateral, 27 single) with BOS were reviewed for mosaic attenuation, degree of bronchial dilation, bronchial thickening, central and peripheral bronchiectasis, mucus plugging, and air trapping. Findings on conventional and thin-section CT scans were correlated with BOS stage for bilateral and single-lung transplant recipients.

Thoracic complications of esophageal disorders.

Abnormalities of the esophagus are common, and complications associated with these disorders and diseases can involve the mediastinum, tracheobronchial tree, and lungs. The most common complications include mediastinitis secondary to esophageal perforation or postoperative anastomotic leak, or both; empyema due to fistula formation; and aspiration pneumonia. The authors reviewed the radiologic appearances of those and other common thoracic complications associated with esophageal disorders to facilitate early detection, diagnosis, and management.

The retrotracheal space: normal anatomic and pathologic appearances.

A variety of diseases can arise from the normal contents of the retrotracheal space or from adjacent structures. Mediastinal diseases in the retrotracheal space typically manifest radiographically as a contour abnormality or an area of increased opacity, although computed tomography (CT) or magnetic resonance (MR) imaging is usually required for diagnosis. The most common aortic arch anomaly, a right subclavian artery that originates from an otherwise normal left-sided aortic arch, appears at posteroanterior chest radiography as an obliquely oriented soft-tissue area of increased opacity that extends superiorly to the right from the superior margin of the aortic arch.

Azygoesophageal recess.

Knowledge of the normal radiologic appearance and manifestations of disease in the azygoesophageal recess can facilitate the detection and diagnosis of intrathoracic disease. The azygoesophageal recess is located lateral or posterior to the esophagus and anterior to the spine. It extends from the anterior turn of the azygous vein to the aortic hiatus.

Usefulness of imaging-guided catheter drainage and talc sclerotherapy in patients with metastatic gynecologic malignancies and symptomatic pleural effusions.

Objective: The purpose of our study was to assess the usefulness of imaging-guided catheter drainage and talc sclerotherapy in patients with metastatic gynecologic malignancies and symptomatic pleural effusions and to assess the affect of ascites on the success rate of this treatment.

Materials And Methods: Twenty-five patients (mean age, 63 years) with metastatic gynecologic malignancies who had 26 symptomatic effusions treated at our institution over a 4-year period with imaging-guided catheter drainage and talc sclerotherapy were included in this study. Response to treatment was assessed by comparing pre-, immediate post-, and 30-day postsclerotherapy chest radiographs.

Bilateral submandibular salivary gland swelling--a report of chronic sialodochitis with eosinophilia.

A case of bilateral swelling of the submandibular salivary glands is presented. The histopathological features were diffuse periductal sclerosis with a lymphoplasmacytic infiltrate which was rich in eosinophils. Some acinar atrophy was seen.

Radiation injury of the lung after three-dimensional conformal radiation therapy.

Objective: The objective of this study is to describe the CT patterns of radiation injury in the lungs of patients who have undergone three-dimensional (3D) conformal radiation therapy (CRT).

Materials And Methods: Over a 36-month period, the chest CT scans of 19 patients with non-small cell lung cancer who were treated with 3D CRT were reviewed. CT scans were evaluated for findings of radiation injury (ground-glass opacities, consolidation, bronchiectasis, and volume loss).

Hepatic segments II and III mimicking a lung mass: diagnosis of a normal variant using reformatted multiplanar CT images.

We describe a patient misinterpreted to have a lung mass on CT owing to extension of hepatic segments II and III between the diaphragm and spleen. This report underscores the importance of being aware of this normal anatomic variant and the utility of two-dimensional multiplanar reformation in interpretation of abnormalities in the region of the thoracoabdominal junction.

Primary thoracic sarcomas.

Primary sarcomas of the thorax are rare. The diagnosis is established only after sarcomalike primary lung malignancies and metastatic disease have been excluded. Primary sarcomas of the thorax are classified according to their histologic features and constitute a large group of tumors that occur in the lung, mediastinum, pleura, and chest wall.

Drug-induced lung injury.

Lung injury is an increasing cause of morbidity and mortality in patients treated with cytotoxic and noncytotoxic drugs. Prompt diagnosis is important because early drug-induced lung injury will often regress with the cessation of therapy. Diagnosis requires a high index of suspicion because infection, radiation pneumonitis, and recurrence of the underlying disease can manifest clinically and radiologically in a similar manner.

The role of imaging in malignant pleural mesothelioma.

Imaging plays an essential role in the diagnosis, staging, and follow-up of patients with malignant pleural mesothelioma (MPM). The diagnosis is often suggested by a unilateral pleural mass with a moderate to large pleural effusion seen on chest radiographs, but computerized tomography (CT) is the most frequently used technique for evaluation of the lungs in patients with MPM. CT not only suggests pulmonary metastases typically manifested as nodules or masses, but also can demonstrate underlying lung disease often caused by prior asbestos exposure.