CT remains the best imaging modality for diagnosis of osteoid osteoma. MR images should not be interpreted without reference to plain radiographs and CT scans if serious errors in diagnosis are to be avoided.
Fifteen patients with active inoperable pulmonary aspergilloma underwent percutaneous injection of a special therapeutic paste of glycerin and amphotericin B. This paste was warmed just prior to injection, and filling of the lesional cavity was achieved in one session if it was possible to obtain anaerobic conditions for destruction of the aspergilloma. Injection was performed with computed tomographic guidance with use of an 18-gauge flexible needle and with administration of anti-coughing analgesia. Follow-up was continued for 7 months on average. Filling of the lesion cavities required three sessions on average because of cough or bronchospasm. In 12 cases the aspergilloma regressed within 3 months and results at serology became negative. In three cases, there was no change in the cavity, but hemoptysis did not recur. Results in this series confirm the feasibility and efficacy of this palliative treatment.
The aim of this study was to assess if a liver capsular retraction is a specific CT sign in malignant hepatic tumors. The authors reviewed retrospectively 320 hepatic CT scans obtained in 300 patients during a 3-year period. These patients presented with benign (n = 64) or malignant (n = 236) hepatic tumors. In 7 patients we found retraction of the capsule surrounding the tumor. All these tumors were histologically proven as malignant lesions: 4 metastases (none being chemically treated), 2 peripheral cholangiocarcinomas, and 1 epithelioid hemangioendothelioma. The prevalence of this sign was 2.18% (7 of 320) in this series. This capsular retraction pattern has never been found in hepato-cellular carcinomas (no fibrolamellar in this series) and benign lesions. Liver capsular retraction is an uncommon but specific (100%) sign in malignant hepatic tumors; however, a larger and prospective series is needed.
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