Emergency computerized tomography of tracheoesophageal fistula in lung adenocarcinoma.

Malignant tracheoesophageal fistula occurs infrequently in patients with irradiated esophageal and lung cancer, uncommonly in patients with untreated mediastinal malignancies, infection, or trauma, and rarely in primary adenocarcinoma of the lung. The natural progression of this entity leads to rapid deterioration and death from overwhelming pulmonary infection.Definitive treatment depends on the demonstration and localization of the fistula.

Evolution of functional ovarian cysts: sonographic appearance and management.

The varying sonographic appearance of physiologic cysts in discussed and illustrated. Sonography can be used to make accurate diagnoses without operative intervention in selected cases of adnexal enlargement. An awareness of the diversity of morphology and rapidity of evolution of functional cysts will help to prevent unnecessary surgery.

Unusual presentations of tuberculosis of the pleura.

3 cases of an unusual presentation of tuberculosis of the pleura which should be differentiated from neoplasm have been described.

Exfoliative immunocytology of cervical carcinoma.

Fluorescent antibody tracing was applied to exfoliative specimens from 456 women, who were also screened by cytology and partly by histopathology for carcinoma of the cervix. Fixed cervicovaginal smears were treated with autologous serum; the smears then were added labeled antihuman globulin antibody and observed for reactivity. A pattern of cytoplasmic fluorescence was observed in cases that were cytologically diagnosed as severe dysplasia, carcinoma in situ of the cervix, or in cases with positive reactions for malignant cells.

Ultrasonic diagnosis and aspiration of loculated pleural effusion.

A method of localizing and evacuating pleural effusions under visual control is described which in the author's opinion is an improvement and enhancement over current procedures. This method is easy, rapid, safe and causes no distress to the patient. On many occasions, failures at puncture of loculated fluid by conventional methods can successfully be accomplished under ultrasonic guidance.

Primary pulmonary sporotrichosis.

A case of pulmonary sporotrichosis is described with secondary involvement of the rectum which was misdiagnosed as tuberculosis for a number of years. The authors suggest that every nondiagnosed chronic cavitary disease in the lung should include appropriate tests for sporotrichosis.

Gunshot injuries to ureter.

A brief discussion of ureteral injuries with emphasis on injuries secondary to penetrating external violence is presented. Four cases with gunshot injuries to the ureter are documented. The symptoms, diagnosis, and treatment of injuries due to penetrating missiles are presented.

Torsion of the wandering spleen.

We report 2 cases of torsion of the wandering spleen that illustrate the roentgenologic features of this unusual condition. These are an abdominal mass, usually in the left flank of pelvis; absence of the splenic shadow beneath the left diaphragm; extrinsic compression of the colon at the level of the phrenicocoloc ligaments by the elongated splenic pedicle; and evidence of splenic vein occlusion, as indicated by gastric varices in the absence of esophageal varices. A combination of these findings should permit diagnosis or lead to angiographic or isotopic studies to confirm the presence of a wandering spleen.

Diffuse small bowel involvement in malignant histiocytosis.

The extremely unusual patient reported here had malignant histiocytosis with extensive gastrointestinal involvement. The presenting symptoms were those of a gastrointestinal disorder and barium studies of the upper gastrointestinal tract revealed an infiltrative process of the entire small bowel. A biopsy of the small bowel demonstrated abnormal malignant cells and the diagnosis of malignant histiocytosis was considered and confirmed at postmortem.