CT features of abdominal plasma cell neoplasms

The aim of this study was to describe the CT features of abdominal plasma cell neoplasms. We reviewed CT imaging findings in 11 patients (seven men, four women; mean age 62 years) with plasma cell neoplasms and abdominal involvement. Helical CT of the entire abdomen and pelvis was performed following intravenous administration of contrast material. Images were analyzed in consensus by two radiologists. Diagnoses were made from biopsy, surgery and/or clinical follow-up findings. Multiple myeloma was found in seven patients and extramedullary plasmacytoma in four patients. All patients with multiple myeloma had multifocal disease with involvement of perirenal space (4/7), retroperitoneal and pelvic lymph nodes (3/7), peritoneum (3/7), liver (2/7), subcutaneous tissues (2/7) and kidney (1/7). In three of the four patients with extramedullary plasmacytoma, a single site was involved, namely stomach, vagina and retroperitoneum. In the fourth patient, a double site of abdominal involvement was observed with rectal and jejunal masses. Plasma cell neoplasm should be considered in the differential diagnosis of single or multiple enhancing masses in the abdomen or pelvis. Abdominal plasma cell neoplasms were most frequently seen as well-defined enhancing masses (10/11).

Abdominal ultrasound findings of disseminated tuberculosis in AIDS

The sonographic findings of 76 patients with tuberculosis and HIV infection are described. These findings were compared with a control group of 76 HIV-positive patients without associated pathology. Those patients with tuberculosis and positive HIV titers commonly (p = 0.05) showed retroperitoneal and mesenteric adenopathies with node diameters greater than 1.5 cm (n = 27), and multiple, splenic, hypoechoic nodules between 0.5 cm and 1 cm (n = 11). Additional findings include hepatic hyperechoic nodules (n = 1) and retroperitoneal abscess (n = 1). The combination of ultrasound features can help in the diagnosis of abdominal tuberculosis in HIV-positive patients with non-specific clinical infections.

Echogenic focus in the gastrointestinal wall as a sign of ulceration

An ultrasound study carried out on 22 patients with ulcerated gastrointestinal lesions (20 adenocarcinomas and 2 peptic ulcers) showed, in all cases, an echogenic focus (EF) that was situated in the gastrointestinal wall. In order to find out the histopathologic significance of this focus and its location, an examination was made "in vitro" of 8 surgical specimens obtained from gastrectomies--6 from peptic and 2 from malignant ulcers. The specimens were immersed in a water bath using a 5-MHz transducer. A common finding in all the specimens was an EF similar to that seen in the clinical study and situated behind the crater of the ulcer. In this location the histopathologic findings demonstrated necrotic and inflammatory material in both the benign and malignant lesions.