No abstract

Pericardial cysts are generally described as round radiodensities typically found at the right cardiophrenic angle in asymptomatic individuals. A review of all cases of pericardial cysts from the files of this Institute reveals that approximately one third of the cysts are found in other locations and that approximately one third of patients have symptoms of chest pain, dyspnea, or persistent cough. The radiographs of 41 patients show that in all but 6 of the cases the cyst is visualized as a round radiodensity touching both the hemidiaphragm and the anterior chest wall. Surprisingly, 15 of the 41 occurred on the left border of the heart. The six cysts significantly above the diaphragm were difficult to diagnosis radiologically and were usually mistaken for thymomas or pulmonary masses; two such cysts caused bronchial obstruction. In general, the possibility that a mass in either anterior cardiophrenic angle is a pericardial cyst should be strongly considered, even if the mass is on the left side and even if the patient is symptomatic.

Objective Although most cases of swine-origin influenza A (H1N1) virus (S-OIV) have been self-limited, fatal cases raise questions about virulence and radiology's role in early detection. We describe the radiographic and CT findings in a fatal S-OIV infection. Conclusion Radiography showed peripheral lung opacities. CT revealed peripheral ground-glass opacities suggesting peribronchial injury. These imaging findings raised suspicion of S-OIV despite negative H1N1 influenza rapid antigen test results from two nasopharyngeal swabs; subsequently, those results were proven to be false-negatives by reverse transcriptase polymerase chain reaction. This case suggests a role for CT in the early recognition of severe S-OIV.

160 tumors of neural origin occurring in the thorax were analyzed. The major histological features of schwannoma, neurofibroma, neuroblastoma, ganglioneuroblastoma, ganglioneuroma, and paraganglioma are described. Radiological analysis emphasized shape and location. Calcification was relatively uncommon but may be specific. The comparatively low figures on incidence of rib and vertebral abnormalities might be increased by special studies, including vertebral tomography. Evidence of local spread such as pleura-based nodules and pleural effusion constitutes evidence of malignancy. Age may be the most important clinical parameter for distinguishing between histological types.

Pulmonary manifestations of nocardial infection were present in 21 patients, with microbiologic proof in all and pathologic proof in 12. An analysis of the findings in these patients, combined with a review of previous reports of nocardiosis, suggests several important conclusions for radiologists. First, nocardiosis may occur in otherwise healthy persons but is most common in compromised patients, especially those being treated with anti-inflammatory agents, particularly corticosteroids, for chronic obstructive pulmonary disease and other systemic diseases. As pathologic manifestations are both suppurative and granulomatous, the chest radiographic manifestations are pleomorphic and not specific. Consolidations and large irregular nodules, often cavitary, are most common; nodules, masses, and interstitial patterns also occur. Pleural effusions are quite common, and lymph nodes may be enlarged. Difficulty and slowness of culture growth, along with the lack of a serologic test for nocardiosis, necessitate its inclusion in the differential diagnosis for both compromised and noncompromised patients in whom an apparent pulmonary infection cannot be rapidly diagnosed.