The aim of this study was to describe the clinical, mammographic, and sonographic findings of phyllodes tumor of the breast and correlate them to the benign or malignant pathological nature of the lesion and its clinical behavior. We retrospectively reviewed the clinical, radiologic, and pathologic findings of 12 cases of phyllodes tumors diagnosed in our hospital in the past 6 years, 6 of which were malignant. The surgical management and clinical course of the patients were also reviewed. Mammographically, soft tissue masses ranging from 2.5 to 15 cm were present in all patients. One patient had a mixed fat and water density mass and 2 patients had masses associated with coarse calcifications. At sonography, all tumors were well circumscribed; two of them were homogeneously hypoechoic, and the rest had heterogeneous internal echoes. Eight patients showed internal cystic areas. None of these characteristics proved to be useful in ascertaining the benign or malignant nature of the tumor. At surgery, 5 patients underwent mastectomy and 7 patients local excision of the tumor. Three of the later tumors, one benign and two malignant, recurred after several months. Fine-needle aspiration biopsy suggested the diagnosis of phyllodes tumor in only 3 cases. After surgery, six tumors were classified as benign and six as malignant, three of which being of low-grade malignancy. None of the clinical or radiologic characteristics of the tumors were useful in predicting their histological nature or their behavior after surgery. Preoperative fine-needle aspiration biopsy often misdiagnosed the tumor as benign fibroadenoma. Only the histopathologic features of the excised mass proved to be helpful in assessing malignancy.

An evaluation of 21 patients with tuberculous pleurisy was carried out to assess the role of ultrasonography in the diagnosis of tuberculous pleural effusion. Ultrasonography revealed winding structures of different lengths and thicknesses (winding bands) in 8 patients, and filiform structures of a higher echogenicity and a shorter length (linear echoes) in 13. These findings were associated with exudates having a high content of fibrin and protein, respectively, suggesting that winding bands might be formed by fibrin and linear echoes by protein macroaggregates. Based upon these observations, ultrasonography seems to be a useful method for identifying tuberculous pleural effusion.

Wandering spleen (or ectopic spleen) is a rare anomaly resulting from hyperlaxity or even absence of the ligaments that hold the spleen in its anatomical position. Although more frequently a congenital condition, it can also be acquired. Torsion of the vascular pedicle is its potential main complication with subsequent development of splenic infarct. In this paper we will describe the pathogenesis, clinical manifestations, treatment options and radiological findings which allow the diagnosis of this entity.

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