Purpose This study was performed to clarify the sonographic features of acute colonic diverticulitis to enable its differentiation from appendicitis. Methods Of 119 patients who were referred to our hospitals for lower abdominal pain between June 1997 and December 1998 and underwent sonography, 12 patients had a definitive diagnosis of acute colonic diverticulitis and 4 patients a tentative diagnosis. Seventy‐eight patients were diagnosed as having acute appendicitis, confirmed by appendectomy. In the 16 patients with diagnoses of diverticulitis, the sonographic and clinical features of acute colonic diverticulitis were studied. Results Among the 12 patients with definitive diagnoses of acute colonic diverticulitis, sonographic findings included localized thickening of the colonic wall (100%) and a hemispheric mass (the “dome sign”) protruding at the thickened colonic wall (100%) and consisting of a hypoechoic wall (100%) and a central echogenic area (66%). The presence of diverticula was confirmed by barium‐enema x‐ray study in all 12 patients. The 4 patients with tentative diagnoses of acute colonic diverticulitis all had colonic wall thickening but no dome sign. Colonoscopy revealed colitis in 3 of these patients. All 16 patients recovered with conservative treatment, without laparotomy. Conclusions Sonography was useful for differentiating acute colonic diverticulitis from appendicitis. The sonographic finding of the dome sign seems to be specific for acute colonic diverticulitis. © 2000 John Wiley & Sons, Inc. J Clin Ultrasound 28:340–346, 2000.

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We report two cases of male breast cancer. Case I, a 69-year-old male (T. U.) with a chief complaint of a walnut-sized firm lump on the left side of the breast (stage H: T2aN1bM0) was hospitalized for surgical treatment, and radical mastectomy was performed. Four years and five months later, he died of cerebral apoplexy. Case II, a 75-year-old male (E. K.), was found to have a hen egg-sized firm tumor on the right side of the breast and had some discomfort after eating. He was diagnosed as having synchronous double cancer, i.e., breast cancer (stage II: T1N1bM0) and gastric cancer (MAC, Borrman III type).Radical mastectomy and total gastrectomy with splenectomy and partial pancreatectomy was performed. Since estrogen receptor and progesterone receptor were recognized in the breast cancer tissue, combined endocrine chemotherapy was performed after surgery. No recurrence and symptoms or signs of gastrointestinal disturbance have been observed up to the time of writing. It was of interest that this patient had three women with breast cancer among his relatives. In the Japanese literature, 354 cases of male breast cancer have been reported up to the present. Male breast cancer accounts for only about 1% of all breast cancers.

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