Lung CT: Part 1, Mimickers of lung cancer--spectrum of CT findings with pathologic correlation.

Objective: The purpose of this article is to describe CT findings of miscellaneous pulmonary conditions that mimic lung cancers, especially primary cancers, to improve diagnosis of pulmonary lesions. Brief descriptions of patient clinical information and pathologic findings will be included and correlated with imaging findings in actual cases.

Conclusion: A wide variety of pulmonary conditions present imaging features that mimic those of primary lung cancers and are difficult to differentiate from cancer.

A huge fecalith associated with dialysis-related gastrointestinal amyloidosis.

A 60-year-old man who had been receiving dialysis for more than 30 years was admitted for treatment of cellulitis in his right thigh on November 7, 2003. He suffered from an ileus on December 14 and was found to have a huge, 7-cm-diameter, well-circumscribed fecalith, incarcerated at the splenic flexure of the colon. It was proving difficult to pass this naturally and surgical removal was thought to be too risky.

[Colorectal cancer in spouses of colorectal cancer patients].

Married couples share home environments and life style for years. In the case of colorectal cancer, an association with insulin resistance was reported. We determined the presence of the insulin-resistance syndrome (IRS, 1 or more of the following: body mass index of > 25 kg/m2, diabetes, or hyperlipidemia) in 84 colorectal cancer patients, of whom 61 patients (73%) had IRS.

Volvulus of the ileum in adult diagnosed pre-operatively by helical 3-dimensioned computed-tomography.

A 46 year-old male who was strictly diagnosed as having volvulus of the ileum based on the pre-operative information brought by computed tomography (CT) and helical (spiral) 3-dimensioned computed tomography was surgically treated. The post-operative course was satisfactory and the patient is now under observation without any exacerbation of symptoms one year after surgery.

Clinical results and prognostic factors of radiologically node-positive gastric carcinoma.

Lymph node metastasis determined by histologic examination is an important prognostic indicator in gastric carcinoma. However, prognostic value of lymph node metastasis detected by computed tomography (CT) is unknown. The aim of this study was to evaluate clinical results and prognostic factors of patients with radiologically node-positive gastric carcinoma.

[Prognosis of residual spleen after partial splenic embolization for the treatment of hypersplenism in cirrhosis].

The aim of this study was to elusidate the change in residual spleen volume after partial splenic embolization (PSE) in 43 cirrhotic patients with marked hypersplenism. Residual spleen volume was indicated as the rate (%) of residual spleen to initial spleen before PSE. Furthermore, the platelet count after PSE was observed in 23 patients followed up for 2 years.

[Partial splenic embolization for the treatment of liver cirrhosis with hypersplenism: assessment of clinical response and liver function].

We have evaluated the efficacy of partial splenic embolization (SE) in the treatment in 10 cirrhotic patients with marked hypersplenism. The mean infarction rate of the spleen was 84%. The change of spleen size, peripheral blood cell counts and liver function tests after SE were investigated during 3 years, and also 10 cirrhotic patients without SE were followed as control.

Preoperative assessment of advanced gastric carcinoma using computed tomography.

Objectives: The role of computed tomography (CT) for the staging of gastric carcinoma is controversial. The purpose of this study was to evaluate the utility of CT in assessing the perigastric spread of advanced gastric carcinoma.

Methods: The study included 56 patients who underwent dynamic CT and laparotomy for the treatment of node-positive gastric adenocarcinoma.

[Advanced gastric carcinoma with extensive lymph node metastases successfully treated by sequential methotrexate/5-fluorouracil therapy].

A 62-year-old man having advanced gastric carcinoma with extended lymph node metastases was successfully treated by a palliative gastrectomy and 6 courses of sequential methotrexate/5-fluorouracil therapy. No side effects were observed, and all enlarged abdominal lymph nodes disappeared. The complete response has continued for 11 months after the initial treatment.

[The effect of partial splenic embolization (PSE) on liver function test in patients with liver cirrhosis].

Five patients with hypersplenism associated with liver cirrhosis were treated by PSE and the changes of peripheral blood cells and liver function tests were observed. After PSE, all patients had a high fever and abdominal pain continued for a few weeks without severe complications. Peripheral blood cell counts improved soon after PSE and liver function tests (hepaplastin test and ICGR15) grew transiently worse, but they also improved within two months.