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35 patients with brachial and/or cerebral ischemia underwent 37 PTA's. Indications for PTA were stenosis (n = 31) or occlusion (n = 1) of the subclavian artery, stenosis of the brachiocephalic trunk (n = 2), stenosis of the axillary artery (n = 2) and stenosis of the brachial artery (n = 1). 23 patients demonstrated a subclavian steal phenomenon. However, the minority of patients (n = 10) presented with neurologic symptoms, which could be provoked by brachial exercise in only 3 patients. 7 of the 10 patients with cerebral ischaemia demonstrated additional significant stenosis of the extracranial arteries. The technical success rate for PTA was 89.2%. Two patients showed relapse of the stenosis. The clinical success rate regarding brachial ischaemia was 94.4% (follow-up: 6-37 months). Neurologic symptoms disappeared after treatment in 72.7%. Minor complications without clinical sequelae occurred in 8.6%.

35 patients with brachial and/or cerebral ischemia underwent 37 PTA's. Indications for PTA were stenosis (n = 31) or occlusion (n = 1) of the subclavian artery, stenosis of the brachiocephalic trunk (n = 2), stenosis of the axillary artery (n = 2) and stenosis of the brachial artery (n = 1). 23 patients demonstrated a subclavian steal phenomenon. However, the minority of patients (n = 10) presented with neurologic symptoms, which could be provoked by brachial exercise in only 3 patients. 7 of the 10 patients with cerebral ischaemia demonstrated additional significant stenosis of the extracranial arteries. The technical success rate for PTA was 89.2%. Two patients showed relapse of the stenosis. The clinical success rate regarding brachial ischaemia was 94.4% (follow-up: 6-37 months). Neurologic symptoms disappeared after treatment in 72.7%. Minor complications without clinical sequelae occurred in 8.6%.

Connected to testicular germ cell tumors, microcalcifications have been identified by microscopic tissue evaluation, the significance of which has not yet been discussed. Microscopic and radiographic evaluation of histologic slides and paraffin embedded tissue specimens, respectively, of 129 germ cell tumors showed that 46.4% of testes with seminoma and 68.3% of testes with teratoma display microcalcifications as round or roundish psammomatous bodies or irregular-shaped dystrophic calcifications, in teratoma as particles of bone tissue or calcified cartilage. Whereas psammomatous bodies are located within tubules in compressed residual testicular tissue arranged in a shell-like zone around the tumor mass, dystrophic calcifications and bone and cartilage tissues are identified inside the tumor. Often more than 10 microcalcifications per cm2 are present. The diagnostic importance of these findings for clinical use is discussed. Above all, it must be made dependent on a radiographic method which will not be dangerous for testicular tissue.

The intraosseous ganglion is a not very well-known cystic benign bone lesion, which has to be included in the differential diagnosis of benign bone tumors. The ganglion's pathogenesis is still uncertain. Radiologically it presents all signs of a benign epiphyseal cystic tumor and can be easily differentiated from malignant changes. The characteristic X-ray signs, together with the typical location, and especially when situated in the distal medial epiphysis of the tibia, will allow a preoperative diagnosis.

An increase in the number or the sudden appearance of multiple microcalcifications in the course of a mammographic controls series represent a further important sign of malignancy. In 14 of our cases witha non palpable breast cancer we were able to observe an increase in the number or a sudden appearance of typical calcium precipitates during an observation period, which, according to the case, lasted from 6 to 21 months. Biopsy revealed in all cases an early cancer. Our observations demonstrate the absolute indication for biopsy in all patients, which during a mammographic control series suddenly present microcalcifications, or an increase in the number of the ones that were previously observed. All patients showing clustered microcalcifications, which because of their small number are not demanding a biopsy, should be regarded as risk-cases and observed regularly in order to rule out or demonstrate an increase in the number of calcifications. Follow-up series within six months are recommended.

Gastro-intestinal mural infiltration can be diagnosed by ultra sound from a typical pattern of echos. This consists of a strong central echo surrounded by a circular structureless margin which indicates thickening of the gut wall. In the present paper, the significance of this appearance is discussed with particular reference to the differential diagnosis. The phenomenon is an important diagnostic criterion where there is suspicion of the presence of malignancy as a result of radiological or endoscopic examination. This is particularly important in cases where the suspicion of malignancy cannot be confirmed by biopsy and histology. It is to be expected that the routine use of ultra sound, and paying attention to the above phenomenon, will lead to further diagnostic measures in difficult diagnostic cases, such as intensive radiological examination or endoscopy with biopsy. This will lead to more rapid and more economical diagnoses.

Two hundred and twenty clinically occult carcinomas of the breast were discovered by mammography as part of a preventive programme. They were histologically verified and the radiological features were analysed with reference to their value as a sign of their malignancy. In all cases a radiogram of the lesion was prepared during the operation, or before histological analysis. Dense, irregular foci could be recognised in only 28% of our early carcinomas. The most important, as well as the earliest, definite sign of malignancy was well defined microcalcification: in 72%, microcalcification was the major feature which led to a correct diagnosis; in 48%, it was the only sign, so that even the radiograph of the specimen failed to show an infiltrative focus. Very early, often before infiltration can be recognised radiologically, small carcinomas produce indirect changes in neighbouring tissues. Parallel lines are particularly important. In 14% we have observed slightly dilated tortuous vessels near the tumour. The nearly microscopic details to be demonstrated, and the delicate changes in the breast and complex pathology, make the highest demands on the radiologist and on mammographic quality.

Idiopathic disseminated pulmonary ossification is a rarely recognised condition in which small pieces of marrow containing bone are found in the interstitial tissues of the lungs. The case reported here is unique in showing combination with myositis ossificans circumscripta. The extent of the lung changes was also unusual. The clinical, radiological and histological findings are compared.

This report describes the procedure of drill biopsy in 100 patients with palpable breast tumours. In 99% of the biopsies the lesion was accurately diagnosed, in 61% as invasive carcinoma.

The intraosseous ganglion must be always included in the differential diagnosis of cystic epiphysial bone lesions, which are localised in the vicinity of a joint, especially since this bone disease can be succesfully operated on. The preoperative diagnosis can be established with the help of conventional and tomographic x-rays examination. A communicating chanel, which is recognizable in tomographic cuts as a lucent line between the ganglion and a joint, is a pathognomic finding. The interpretation of the radiological symptoms can be difficult in those cases in which the lesions are not yet well developed or in which concomitant degenerative joint changes are present.

Two hundred and twenty clinically occult carcinomas of the breast were discovered by mammography as part of a preventive programme. They were histologically verified and the radiological features were analysed with reference to their value as a sign of their malignancy. In all cases a radiogram of the lesion was prepared during the operation, or before histological analysis. Dense, irregular foci could be recognised in only 28% of our early carcinomas. The most important, as well as the earliest, definite sign of malignancy was well defined microcalcification: in 72%, microcalcification was the major feature which led to a correct diagnosis; in 48%, it was the only sign, so that even the radiograph of the specimen failed to show an infiltrative focus. Very early, often before infiltration can be recognised radiologically, small carcinomas produce indirect changes in neighbouring tissues. Parallel lines are particularly important. In 14% we have observed slightly dilated tortuous vessels near the tumour. The nearly microscopic details to be demonstrated, and the delicate changes in the breast and complex pathology, make the highest demands on the radiologist and on mammographic quality.

Since microcalcifications occur in mammary carcinoma in a quite specific manner and above all very early, i.e. long before an infiltrative focal shadow can be recognized in the mammogram, the microcalcifications have proved to be a significant and in many cases the only early symptom of small, clinically still occult mammary carcinomas. On the basis of microcalcifications, we are so far been able to detect a total of 220 clinically unequivocal occult small and very small mammary carcinomas with an average tumor size of 6 X 8 mm, and were thus able to apply the necessary and decisive early therapy. Today, microcalcifications enable us to detect to an increasing extent even preinvasive stages of mammary carcinoma and also to verify them by biopsy.

Eosinophilic granuloma of the bone shows a characteristic age distribution with an incidence of 75% in children. According to our observations, however, its occurrence in adults is not as rare as one should expect from the number of cases reported in the literature. The clinical and radiologic diagnosis can be established in many cases if the possibility of an eosinophilic granuloma is considered and certain criteria are taken in consideration. Solitary osteolytic changes should be biopsied early in order to avoid unnecessary and expensive examinations. The X-ray signs which can lead to the diagnosis are discussed and illustrated, and 7 cases of eosinophilic granuloma in adults are presented.

One case of calcifications in mediastihal lymphoma after radiation therapy of Hodgkin's disease is reported. The incidence of these calcifications is remarkably low. They are mostly localized in the anterior mediastinum showing a characteristical pattern which is initially stippled, later confluent and coral-shaped. An open interval after radiation therapy is typical for this phenomenon. The cause of the calcifications is discussed.

As a rule the diagnosis of larger focal lesions of the breast can be easily confirmed by biopsy. Intraoperative localization is more difficult, however, in lesions of below 5 mm diameter as measured by mammography or malignant alterations only indirectly indicated by mammography. Experience to date in 64 patients shows that specimen radiography provides immediate confirmation of large lesions detected by mammography and localizes the area for histologic examination. So far it has been found that precisely those biopsies that are performed as a result of indirect signs of malignancy or of small lesions are the most valuable contributing factor in the early diagnosis of breast cancer.

The intraosseous ganglion is a not very well-known cystic benign bone lesion, which has to be included in the differential diagnosis of benign bone tumors. The ganglion's pathogenesis is still uncertain. Radiologically it presents all signs of a benign epiphyseal cystic tumor and can be easily differentiated from malignant changes. The characteristic X-ray signs, together with the typical location, and especially when situated in the distal medial epiphysis of the tibia, will allow a preoperative diagnosis.

Connected to testicular germ cell tumors, microcalcifications have been identified by microscopic tissue evaluation, the significance of which has not yet been discussed. Microscopic and radiographic evaluation of histologic slides and paraffin embedded tissue specimens, respectively, of 129 germ cell tumors showed that 46.4% of testes with seminoma and 68.3% of testes with teratoma display microcalcifications as round or roundish psammomatous bodies or irregular-shaped dystrophic calcifications, in teratoma as particles of bone tissue or calcified cartilage. Whereas psammomatous bodies are located within tubules in compressed residual testicular tissue arranged in a shell-like zone around the tumor mass, dystrophic calcifications and bone and cartilage tissues are identified inside the tumor. Often more than 10 microcalcifications per cm2 are present. The diagnostic importance of these findings for clinical use is discussed. Above all, it must be made dependent on a radiographic method which will not be dangerous for testicular tissue.

Idiopathic disseminated pulmonary ossification is a rarely recognised condition in which small pieces of marrow containing bone are found in the interstitial tissues of the lungs. The case reported here is unique in showing combination with myositis ossificans circumscripta. The extent of the lung changes was also unusual. The clinical, radiological and histological findings are compared.

The evaluation of total orchiectomy tissue specimens with malignant testicular tumors shows that microcalcifications can be found in a surprisingly high percentage by radiological and histological examinations. Small, often in several groups located calcifications in the parenchyma neighbouring the tumor are typical for seminoma, whereas in teratoma solitary microcalcifications and polymorphic types can also be seen. Microcalcifications are also present in not neoplastic testicular diseases but in a much smaller percentage and with a different type of calcification. The preoperative radiographic examination of testicular tumors of unknown origin seems to be indicated as a non-invasive method able to provide further information about the presence of a malignant germ cell tumor. Regarding the genetic risks of the method, there is hope to avoid other more invasive examinations with their danger of tumor spreading and to enable a radical resection of the primary tumor before its metastic formation by the mean of preoperative orchioradiography.

An increase in the number or the sudden appearance of multiple microcalcifications in the course of a mammographic controls series represent a further important sign of malignancy. In 14 of our cases witha non palpable breast cancer we were able to observe an increase in the number or a sudden appearance of typical calcium precipitates during an observation period, which, according to the case, lasted from 6 to 21 months. Biopsy revealed in all cases an early cancer. Our observations demonstrate the absolute indication for biopsy in all patients, which during a mammographic control series suddenly present microcalcifications, or an increase in the number of the ones that were previously observed. All patients showing clustered microcalcifications, which because of their small number are not demanding a biopsy, should be regarded as risk-cases and observed regularly in order to rule out or demonstrate an increase in the number of calcifications. Follow-up series within six months are recommended.

Osseous anomalies of the craniocervical junction may induce grave neurological disturbances and even lead to sudden death in exceptional cases. Therefore a correct diagnosis with painstaking demonstration of the extent of all anomalies must be established. This can be achieved exclusively by roentgenological studies. Clinical symptoms can only provide a lead to the underlying disease. In the present paper, the special problems of the radiology of craniocervical malformations are discussed and illustrated with own observations, which include specimen radiography.

Gastro-intestinal mural infiltration can be diagnosed by ultra sound from a typical pattern of echos. This consists of a strong central echo surrounded by a circular structureless margin which indicates thickening of the gut wall. In the present paper, the significance of this appearance is discussed with particular reference to the differential diagnosis. The phenomenon is an important diagnostic criterion where there is suspicion of the presence of malignancy as a result of radiological or endoscopic examination. This is particularly important in cases where the suspicion of malignancy cannot be confirmed by biopsy and histology. It is to be expected that the routine use of ultra sound, and paying attention to the above phenomenon, will lead to further diagnostic measures in difficult diagnostic cases, such as intensive radiological examination or endoscopy with biopsy. This will lead to more rapid and more economical diagnoses.

This report describes the procedure of drill biopsy in 100 patients with palpable breast tumours. In 99% of the biopsies the lesion was accurately diagnosed, in 61% as invasive carcinoma.