Leiomyosarcomas are uncommon tumors. They have a predilection for deep soft tissues, with a rare group arising in medium-sized or large veins, far less frequently in arteries. We report a case of a 63-year-old man, with an enlarging mass located in the left pulmonary hilar region which was discovered on a routine chest radiograph. Cytology of the sputum and bronchoscopic biopsies did not reveal any malignant cells. Over 5 months observation, there was a clear progression of the mass, and the patient finally underwent a left pneumonectomy which allowed the diagnosis of an intravascular leiomyosarcoma partially destroying major arteries and veins in the hilar region. A review of the literature reveals 67 cases of leiomyosarcoma involving the pulmonary artery. None of these cases had an associated venous pathology. The disease is found mainly in adult women. Clinical diagnosis is very difficult because most of the cases have no specific clinical signs; the major differential diagnosis is that of pulmonary thrombo-embolism. Prognosis depends on histological degree of the tumor and extent of the disease, metastases occur mainly in the liver, lung, and brain and less frequently in regional lymph nodes. Treatment is always surgical, chemotherapy is ineffective and the effectiveness of radiotherapy depends on the total dose of irradiation. Sarcomas of hilar blood vessels have a very poor prognosis with a one year survival estimated, from the onset of symptoms, at 20%.

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A high-density avalanche chamber positron camera was used for tomographic imaging of the human thyroid before and after partial thyroidectomy. Images were made between 6 and 24 h after oral administration of the positron-emitting radionuclide, Na-¹²⁴I with activities varying between 0.1 and 0.3 mCi before the surgical intervention and with activities between 0.03 and 0.05 mCi following partial thyroidectomy. The results of thyroid imaging performed on 50 patients and their surgical relevance are discussed; as an illustration, one typical case is presented. As a consequence of the high spatial resolution of the camera (2.5 mm full width at half maximum), the functional volume of the thyroid may be estimated from the transaxial tomographic sections before and following partial thyroidectomy, correct to about 10%. The thyroid surface, defined by the contours from each transaxial section, may be displayed using three-dimensional shaded-graphics techniques. This new imaging technique makes possible a fully three-dimensional description of the thyroid in vivo and contributes significantly to the surgical follow-up.

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