Radiologic clinics of North America
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Radiol. Clin. North Am. · May 1990
ReviewRadiographic manifestations of primary bronchogenic carcinoma.
Carcinoma of the lung continues to account for more cancer-related deaths than any other neoplasm in the United States. The World Health Organization recognizes four main classifications of cell type. Squamous cell carcinoma is most often a central lesion that locally invades the hilus and mediastinum. ⋯ Small cell carcinoma is the most aggressive of the four cell types, having the worst prognosis. The classic presentation is the detection of hilar and mediastinal metastases while the primary tumor remains occult. Grossly enlarged hilar and mediastinal lymph nodes can be seen easily on chest radiograph and CT scan.
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Nonlymphomatous pulmonary lymphoproliferative disorders include plasma cell granuloma, Castleman's disease, pseudolymphoma, lymphocytic interstitial pneumonitis, angioimmunoblastic lymphadenopathy, and lymphomatoid granulomatosis. They are thought to represent a hyperplasia of the pulmonary immune system in response to chronic antigenic stimulation. A description of the variable clinical, radiographic, and pathologic features of each entity is presented.
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Scintigraphic techniques play an important role in the diagnosis and evaluation of a wide variety of musculoskeletal injuries. They provide physiologic and pathophysiologic information but do not provide the exquisite resolution of computed tomography or magnetic resonance imaging. Thus, scintigraphy studies should be ordered only when they would be expected to provide data that will establish a diagnosis or help in planning therapy.
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The radiologic evaluation of upper extremity trauma relies primarily on standard as well as optional radiographic projections. Certain injuries are more fully evaluated with fluoroscopy, arthrography, ultrasound, computed tomography, or magnetic resonance imaging. The imaging approach to upper extremity trauma is presented, with emphasis on subtle or commonly overlooked lesions. The indications for evaluation by fluoroscopy, arthrography, and advanced imaging modalities are discussed.
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Magnetic resonance (MR) imaging has been applied toward the assessment of a wide spectrum of injuries to the musculoskeletal system. This use of MR imaging has been enthusiastically accepted by orthopedic surgeons, and the assessment of musculoskeletal trauma has emerged as one of the most commonly utilized applications of this diagnostic method. ⋯ Emphasis is placed on the most commonly encountered conditions, namely, those that are accidental, exercise-, and sports-related. Technical considerations as they pertain to the design and interpretation of trauma-related musculoskeletal MR imaging are addressed.