Although rare, transitional cell carcinoma of the urinary tract is the second most common tumor of the kidneys. We studied retrospectively the computed tomography images of 10 patients with confirmed transitional cell carcinoma of the urinary tract. There was involvement of the bladder in 60% of the cases whereas the calyceal system and the ureters were involved in 60% and 10% of the cases, respectively. Concomitant tumors were present in 40% of the cases. The findings were sessile masses, ureteral wall thickening and renal infiltrative lesions. Calcified tumors were seen in two patients and a transitional cell tumor arising from a bladder diverticulum was identified in another patient. Local tumor dissemination was observed in 80% of the patients and distant dissemination in 20% of the patients. Computed tomography allowed the detection of local and distant tumor dissemination, thus allowing a selected group of patients to be treated conservatively.

Keywords: Transitional cell carcinoma, Computed tomography, Renal tumors

Traumatic lesions of the lung are common findings in patients with thoracic trauma. These lesions are increasingly diagnosed using computed tomography, mostly due to the fast acquisition time helical techniques that allow evaluation of critically ill patients and an efficient therapeutic management. The authors studied 150 patients with thoracic trauma submitted to computed tomography that demonstrated lung contusions, atelectasies, lacerations and hematomas. Lung contusions were the most frequent lesions appearing as consolidation or ground-glass attenuation areas. Atelectasies, in subsegmentar and compressive patterns, were the second most common lesions observed. Lacerations appeared as consolidations with air or liquid level. Lung hematomas, characterized by round opacities, were the most rare lung lesions seen in only five cases. In this study, blunt thoracic trauma accounted for the majority of 120 cases whereas penetrating trauma occurred in 30 cases. The causes of blunt trauma in decrescent order of frequency were motor vehicle accidents, pedestrian hit by car, falls, motorcycle accidents and trashing. Penetrating traumas were caused by bullets or knives.

Keywords: Lung contusion, Computed tomography, Trauma

Traumatic mediastinal lesions are unusual findings in patients with thoracic trauma but may represent poor prognosis and be associated with severe lesions. Mediastinal trauma is increasingly being diagnosed by computed tomography due to the fast acquisition times of helical techniques, allowing the evaluation of critically ill patients and the adoption of efficient therapeutic measures. The authors studied 11 patients with mediastinal lesions who were submitted to computed tomography due to thoracic trauma. The most frequent finding was mediastinal bleeding characterized by infiltration of mediastinal fat, dense material within the mediastinal spaces or hematoma. Hemopericardium was the second most common lesion in this series, appearing as dense or liquid material in the pericardium. Aortic lesions such as wall irregularities or pseudoaneurisms were less commonly seen (three patients). In this study blunt thoracic traumas were observed in six cases whereas penetrating trauma occurred in five cases. The causes of blunt trauma were pedestrians struck by car, motor vehicle accidents and falls. Penetrating trauma was due to lesions produced by bullets or knifes.

Keywords: Mediastinal bleeding, Aortic lesion, Computed tomography

Bronchioloalveolar carcinoma is a bronchogenic carcinoma that presents an insidious growth, arises from the walls of the distal air spaces and spreads using the alveolar septa as a stroma, preserving the lung architecture. In this work we analyze the high-resolution computed tomography of 17 patients with bronchioloalveolar carcinoma. Conversely to the data presented in the literature, male preponderance (71%) and a higher frequency of association between multinodular and consolidation patterns (53%) in comparison to single nodular (12%), multinodular (12%) and consolidation (23%) patterns were observed. The most common findings were: consolidation areas (76%), air bronchogram (71%), low attenuation areas (60%), thickening of interlobular septa, ground-glass attenuation and confluent nodules (54% each), and crazy paving pattern (36%). Cavitated nodules, atelectasis, halo sign and "tree in bud" pattern were observed in only one case each.

Keywords: Bronchioloalveolar, Carcinoma, High-resolution computed tomography

In this article the authors report a case of a patient with hypertrophic osteoarthropathy associated with pulmonary tuberculosis. This disorder is a rare complication of tuberculosis and may be associated with severe and fulminant disease. The imaging methods used in the diagnosis of this disease included lower limbs radiographies that showed bilateral periosteal reaction, and chest radiographies and computed tomography that revealed a mass in the upper lobe of the right lung. Although a fine needle aspiration was suggestive of tuberculosis, the definitive diagnosis was made after thoracotomy and hystopathological examination of the mass. The patient presented symptomatic and radiological improvement after treatment of tuberculosis.

Keywords: Hypertrophic osteoarthropathy, Pulmonary tuberculosis, Radiology

Epiploic appendicitis is an uncommon inflammatory condition, which is presently better diagnosed by current imaging methods such as computed tomography and ultrasonography that allow a non-invasive and efficient diagnostic approach. The authors studied 6 patients with epiploic appendicitis. The patients were submitted to computed tomography that showed paracolic oval lesions of 1 to 2 cm of diameter, fat attenuation and a thin peripheral hyperdense rim associated with adjacent fat stranding. Ultrasound examination performed in two patients showed hyperechoic ovoid noncompressible masses at the site of maximum abdominal tenderness.

Keywords: Epiploic appendicitis, Ultrasonography, Computed tomography

Traumatic diaphragmatic rupture is an uncommon condition that has been diagnosed more frequently with the aid of computed tomography, particularly when using helical technique in association with multiplanar reconstructions. This technique allows adoption of an efficient and quick surgical therapeutic approach. The authors studied six patients with traumatic diaphragmatic rupture that were submitted to computed tomography. In four of the patients there was herniation of intraabdominal viscera through a site of rupture in the left diaphragm. The two other patients underwent surgery due to abdominal injuries, which revealed diaphragmatic lesions but no herniation of intraabdominal viscera.

Keywords: Diaphragmatic rupture, Computed tomography, Trauma

Mesenteric panniculitis is an inflammatory process that represents the second stage of a rare progressive disease involving the adipose tissue of the mesentery. Imaging methods used in the diagnosis of mesenteric panniculitis include barium studies, ultrasonography, computed tomography and magnetic resonance imaging. Computed tomography is important for both, diagnosis and evaluation of the extension of the disease and treatment monitoring. Computed tomography findings may vary according to the stage of the disease and the amount of inflammatory material or fibrosis. There is also good correlation between the computed tomography and anatomical pathology findings. The authors studied 10 patients with mesenteric panniculitis submitted to computed tomography. Magnetic resonance imaging was also performed in one patient. In all patients, computed tomography revealed a heterogeneous mass in the mesentery with density of fat, interspersed with areas of soft tissue density and dilated vessels.

Keywords: Mesenteric panniculitis. Radiology. Computed tomography.

The authors report a case of a 40-year-old male patient with sickle cell disease who presented with intra-thoracic extramedullary hematopoiesis and paravertebral expansive lesions that appeared as soft tissue density masses on conventional x-ray films. A computed tomography of the chest demonstrated soft tissue density masses in the lower third of the paravertebral spaces. These masses presented well-defined limits, lobulated edges and were heterogeneous due to areas of interposed adipose and soft density tissues. The lung parenchyma had no abnormalities. Computed tomography of the abdomen revealed diffuse hiperdensity and enlargement of the liver that was attributed to hemosiderosis, and an atrophic and calcified spleen due to repeated episodes of infarction.

Keywords: Intrathoracic extramedullary hematopoiesis. Computed tomography. Sickle cell anemia. Posterior mediastinum.

Pseudomyxoma peritonei is rare tumor that presents insidious evolution and is characterized by mucinous ascites or implants in the peritoneal cavity. The origin of this tumor is frequently the appendix or the ovaries. Diagnosis can be established by fine needle aspiration cytology, ultrasonography, computed tomography or magnetic resonance imaging . The authors report three cases of patients with pseudomyxoma peritonei arising from the ovary that were submitted to computed tomography and magnetic resonance imaging examinations of the abdomen. This paper emphasizes the importance of these imaging methods that permit greater spatial resolution, multiplanar images and different types of sequences (magnetic resonance imaging), and allow better evaluation of these lesions. Computed tomography examinations showed lobulated low-density masses with well defined limits causing "scalloping" of the hepatic and splenic borders due to extrinsic compression by adjacent peritoneal implants. Invasion of the liver and spleen was not observed. Magnetic resonance imaging examinations revealed expansive peritoneal lesions with low-intensity signal on T1-weighted images and high-intensity signal on T2-weighted images, adjacent to the hepatic and splenic borders.

Keywords: Pseudomyxoma peritonei. Computed tomography. Magnetic resonance imaging.

Objective: To analyze radiological findings observed at high-resolution computed tomography in patients with sarcoidosis, and establishing their correlation with pathological findings. Materials and Methods: High-resolution computed tomography findings in ten patients with sarcoidosis were reviewed and correlated with findings in specimens obtained by surgical biopsy or at necropsy of four of such patients. Results: The most frequently observed finding was presence of nodules with perilymphatic distribution, predominating along bronchovascular sheaths and pleural surface, with subpleural nodules and nodular scissurae. Other less frequent findings were ground-glass attenuation and interlobular septa thickening. Conclusion: In general, all the mentioned findings demonstrated anatomopathological correlation with development of granulomas in these regions.

Keywords: Computed tomography; Sarcoidosis; Pathology; Lung diseases.

The present report describes the case of a 48-year-old female patient suffering from chronic renal failure on dialysis for 13 years. She presented with hemoptysis, fever, productive cough and dyspnea. Chest radiography showed predominance of ill-defined opacities in the middle and lower lung fields, bilaterally. Chest computed tomography showed groundglass opacities associated with poorly defined centrilobular nodules with ground-glass attenuation. The patient was submitted to bronchoalveolar lavage that was negative for mycobacteria and fungi. On the basis of such findings, open lung biopsy was performed, which revealed metastatic pulmonary calcification.

Keywords: Chronic renal failure; Metastatic pulmonary calcification.

OBJECTIVE: The aim of this study was to analyze the various computed tomography findings in penetrating chest trauma, as well as to determine the frequency and extent of the lesions. MATERIAL AND METHODS: We studied the computed tomography findings from 40 cases of penetrating thoracic trauma, of which 35 (85.8%) were gunshot wounds and 5 (14.2%) were caused by another type of weapon. RESULTS: Pulmonary lesions were found in 39 cases (97.5%), manifesting as contusions in 34 cases (85%), atelectasis in 8 (20%), lacerations in 1 (2.5%) and hematomas in 1 (2.5%). Hemothorax was seen in 31 cases (77.5%), and pneumothorax was seen in 22 cases (55%). Mediastinal lesions were observed in 8 cases (20%), including mediastinal hematoma in 3 cases (7.5%), hemopericardium in 3 (7.5%), and pneumomediastinum in 2 (5%). Diaphragmatic rupture was seen in 2 cases (5%). CONCLUSION: In patients with penetrating thoracic trauma, computed tomography of the chest is an important tool for characterizing the affected organs and evaluating the path of injury, as well as the severity and extent of the lesions. The images obtained are also useful in estimating the risk of death and determining the best therapeutic approach.

Keywords: Thoracic injuries; Wounds, penetrating; Tomography, X-ray computed.

OBJECTIVE: The aim of this study was to evaluate chest computed tomography (CT) findings in patients diagnosed with neurofibromatosis type 1 (NF1). MATERIALS AND METHODS This was a retrospective study in which we reviewed the chest CT scans of 14 patients diagnosed with NF1 and neurofibromatosis-associated diffuse lung disease (NF-DLD).The sample comprised eight women and six men.The median age was 55 years (range, 11–75 years).The diagnosis of NF1 was made on the basis of the diagnostic criteria established by the U.S.National Institutes of Health.The images were analyzed by two chest radiologists, who reached decisions by consensus. RESULTS: The predominant CT finding of NF-DLD was multiple cysts, which were observed in 13 patients (92.9%), followed by emphysema, in eight (57.1%) and subpleural bullae, in six (42.9%).Other findings included subcutaneous neurofibromas, in 12 patients (85.7%), ground-glass opacities, in one (7.1%), and tracheobronchial neurofibromas, in one (7.1%).The pulmonary abnormalities were bilateral in 12 cases (85.7%).The abnormalities were predominantly in the upper lung fields in eight cases (57.1%), and their distribution was random in 11 (78.6%). CONCLUSION: Pulmonary cysts, emphysema, and subpleural bullae appear to be the chest CT findings that are most characteristic of NF-DLD.

Keywords: Neurofibromatoses; Cysts; Lung diseases; Tomography, X-ray computed.