We report the case of a 49-year-old patient with repeated lung infections. Chest x-rays showed a mass in the posterior basal segment of the right lung. Angiotomography and 3D reconstructions showed a blood supply coming from the descending aorta. The analysis of the surgical specimen confirmed the occurrence of intralobar pulmonary sequestration with a cavitation filled with mucus.

Keywords: Pulmonary sequestration, Pulmonary mass, Radiology

The authors report an unusual presentation of a voluminous neck schwannoma in a 53-year-old female that presented with a three-year history of progressive weakness associated with impaired movement of the limbs. Neurological examination revealed postural instability, unstable and paraparetic gait, tetraparesis and dyspnea. A preoperative magnetic resonance imaging of the neck revealed an expansive, extradural, well-circumscribed lesion, with soft-tissue attenuation, at the level of C1-C2 vertebral bodies. During surgery, the tumor was found to be extradural, lateral to the cervical spinal cord, attached to the C1 left nerve root and extending upwards through the foramen magnum. Histopathological analysis of the resected specimen confirmed the diagnosis of schwannoma. The patient showed a favorable outcome with progressive improvement of the symptoms. Magnetic resonance imaging proved to be valuable in the detection and evaluation of the lesion, although the definite diagnosis was achieved only after histopathological studies. We concluded that magnetic resonance imaging for early diagnosis and prompt surgical resection seems to be the best approach to achieve good prognosis.

Keywords: Schwannoma, Central nervous system, Foramen magnum

The authors review the main findings of primary adrenal lymphoma on abdominal and brain computed tomography (CT) scans and brain magnetic resonance imaging (MRI), and report a rare case of a 72-year-old male patient with deterioration in mental status progressing from recent memory loss to disorientation and ultimately dementia in a period of two months. The patient was investigated using imaging methods including brain (without intravenous administration of iodinated contrast media), chest and abdomen (pre and post intravenous administration of iodinated contrast media) CT scans and brain MRI (pre and post intravenous administration of gadolinium). Brain CT scan showed slightly hyperdense nodules adjacent to the lateral ventricles. No gross abnormalities were seen on the chest CT scan. CT of the abdomen showed solid nodules on both adrenals. Brain MRI showed diffuse nodular enhancement of the ependyma of the fourth ventricle, third ventricle, frontal and temporal horns, atria and body of the lateral ventricles. Definitive diagnosis was made by immunohistochemical study of the biopsed adrenal. After a comprehensive review of the literature the authors concluded that CT and MRI are essential methods for the detection and accurate evaluation of primary adrenal lymphomas, particularly when there is involvement of the central nervous system. MRI is more sensitive in the detection of extracerebral lesions in the epidural and subdural spaces, especially after intravenous administration of gadolinium.

Keywords: Adrenal lymphoma, Central nervous system metastases, Computed tomography, Magnetic resonance imaging

OBJECTIVE: To review small bowel contrast examinations in order to identify the main findings and to determine the actual benefits to the patient. MATERIALS AND METHODS: This was a retrospective and descriptive study based on data of 60 examinations performed between January, 2001 and June, 2002 at the radiology department of the "Hospital Santa Cruz/Beneficência Portuguesa de Niterói", Rio de Janeiro, Brazil. RESULTS: A total of 60 examinations were reviewed: 24 (40.0%) showed abnormal radiological findings whereas 36 (60.0%) were normal. Thirty-six patients (60%) were between 35 and 65 years of age, only two (3.32%) were below 18 years and the oldest patient was 87 years. CONCLUSION: In spite of the new diagnostic imaging modalities such as endoscopy, small bowel contrast examinations are unlikely to fall into disuse and may remain the modality of choice for the investigation of this segment of the intestines. Therefore, we should keep in mind that small bowel contrast examinations and endoscopy are complementary rather than alternative methods when the advantages and disadvantages of each method are considered. Contrast examination of the small bowel is still an important and valuable method for the investigation of this segment of the intestines.

Keywords: Small bowel diseases, Contrast examinations, Differential diagnosis

OBJECTIVE: To review upper gastrointestinal tract (UGI) contrast examinations in order to establish the main diagnoses and radiological findings, the actual benefits to the patients and the costs for the department of radiology. MATERIALS AND METHODS: This is a retrospective study of 270 UGI contrast examinations performed between 6/3/2001 and 12/4/2002 at the Department of Radiology of "Hospital Santa Cruz/Beneficência Portuguesa de Niterói", Niterói, RJ, Brazil. RESULTS: A total of 270 examinations were reviewed. Radiological findings (anatomical, congenital, acquired, peptic or surgery related findings) were seen in 115 (42.5%) examinations while 155 (57.5%) examinations were normal. The age range was 0-12 years in 197 (72.9%) patients whereas 73 (27.1%) patients were above 12 year-old. CONCLUSION: Due to the clear benefit to the patients, UGI contrast examinations should continue to be used as an important complementary method to study UGI diseases, particularly in children and surgical cases. Therefore, we should keep in mind that UGI contrast examinations and endoscopy are complementary methods of investigation when comparing its advantages and disadvantages. UGI contrast examination is a fast, simple, and relatively low cost procedure. In addition, it presents low risk to the patients.

Keywords: Upper gastrointestinal tract diseases, Contrast examination, Differential diagnosis

OBJECTIVE: To review 225 intravenous urography examinations in order to statistically analyze the main urinary tract related findings and to revalidate the usefulness of the method. MATERIALS AND METHODS: This is a retrospective and descriptive study based on data of 225 intravenous urography examinations performed between 2/1/2002 and 29/11/2002 at the Department of Radiology of "Hospital Santa Cruz/Beneficência Portuguesa de Niterói", Niterói, RJ, Brazil. RESULTS: In a total of 225 examinations, radiological findings (anatomical, congenital, acquired, functional and others) were seen in 173 (76.9%) whereas 52 (23.1%) examinations were normal. The most common finding was calculus (35.9%), followed by dilatation of the calyceal system (9.9%). One hundred and ten patients (48.9%) were male and 115 (51.1%) were female. The youngest patient was 2-month-old and the oldest was 84-year-old. CONCLUSION: In spite of the new imaging modalities such as ultrasound, computed tomography and magnetic resonance imaging, intravenous urography still remains an important and valuable method for the investigation of the urinary tract.

Keywords: Intravenous urography, Urinary tract abnormalities, Differential diagnosis