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The case of a patient with dysphonia and ingravescent dysphagia, associated with crises of lipothymia "ab ingestis" is discussed. ENT examination with videolaryngoscopy evidenced a swelling of the posterior hypopharyngeal wall. X-ray study of the upper digestive tract was discontinued for inhalation. The scintigraphic study of swalling documented marked alteration of the oropharyngeal phase with phenomena of post-deglutitory aspiration. CT of the cervical vertebral column documented anterior diffuse vertebral hyperostosis of C3-C6: this finding was suggestive of Forestier disease.

The typical presentation of breast cancer in a young woman is discussed. Diagnostic imaging of the breast showed the presence of an extensive pathological area, approximately 5 cm in size, at the level of the upper quadrants of left breast. On mammography the pathological sign was represented by numerous regional granular microcalcifications. On sonography an inhomogeneously hypoechoic area with intralesional hyperechoic spots was identified. On MRI a large area of pathological enhancement was visualized. For the tumor extent and the patient's young age neoadjuvant chemotherapy was performed. Post-treatment assessment showed good response to therapy, suggestive of possible better prognosis.

The case of a female patient who had undergone mastectomy for infiltrating ductal carcinoma and come to the Orthopedics Division for lumbosacral pain unresponsive to conventional treatment is discussed. Pelvic X-ray, CT and scintigraphy were performed. The presence of multiple areas of selerosis of the pelvis and proximal femurs were documented. The differential range could be limited to osteoblastic metastasis and osteopoikilosis. The diagnosis of osteopoikilosis was established based on scintigraphy which proved the absence of uptake of the radiotracer.

The case of a female patient admitted to the hospital for a syncopal episode characterized by mental confusion, retrograde amnesia, agnosia, lack of sphincter control and behavior disorders, is presented. Cranial CT showed a frontal bihemispheric lesion. MRI completed with DWI was then performed to better define the nature of the lesion and for an in-depth diagnostic study. The diagnostic role of conventional MRI combined with DWI and the importance of the latter in the differential diagnosis between primary central nervous system lymphoma (confirmed at histology) and glioblastoma multiforme is discussed.

The case of a 69-year-old female patient come to our observation with the diagnosis of non-Hodgkin's lymphoma on histology and cystoscopy is discussed. Symptoms were characterized by dysuria, vaginal spotting and abdominal pain. CT and NMR for staging and control CT during chemotherapy were performed. They documented marked reduction of the neoformation protruding into the bladder and concentric urethral thickening associated with volumetric stability of intercavoaortic lymph node involvement and stable condition of the other localizations.

The case of a 36-year-old female, who following a road accident, had a cervical whiplash, is discussed. A radiographic examination of the affected region was performed at the Emergency Department. It showed a transverse radiolucent line at the basal odontoid process of the axis. A definitive interpretation was not possible and fracture of the odontoid process of the axis was suggested as differential diagnosis. On coronal CT reconstruction the presence of this fracture was ruled out. The line seen on the film was actually the product of a psychophysiologic visual illusion known as "Mach band". The use of conventional radiography correlated with digital CT images shows that the practical application of Mach band theory allows a better differentiation between normal and pathologic anatomy.

The case of a 67-year-old male patient affected by ingravescent obstructive jaundice, calcific choledocholithiasis and cardiopathic hypertension, is presented. On sonography, marked dilatation of intra- and extrahepatic bile ducts with a hyperechoic round neoformation was visualized. CT was performed to ascertain the nature of the lesion. However, it did not confirm the lithiasic nature of the stenosis. Sampling for ERCP was inadequate. Cholangiopancreatography was therefore necessary to establish a correct diagnosis and the subsequent therapeutic approach. Distal choledochal obstruction was evidenced, suspicious for lithiasis obstruction. A definitive diagnosis could not be established on exclusive imaging findings. Surgery was performed with the diagnosis of cholangiocarcinoma with lithiasis.

The case of a patient with a lesion in the right breast, is discussed. Retrospective evaluation of mammography and US previously performed elsewhere were not fully helpful in the differential diagnosis between benign and malignant and MRI was necessary. Morphological and dynamic characteristics could be indicative of an expansive/infiltrating lesion of the breast and support the staging. The histological examination established the diagnosis of primary breast lymphoma.

The case of a newborn infant of 40 days of age with persistent jaundice and blood chemistry values suggestive of cholestasis is discussed. Liver and bile duct US documented missed visualization of the gallbladder. In the suspicion of biliary atresia, hepatobiliary scintigraphy was performed; it showed preserved hepatocyte function, missed visualization of the gallbladder and absence of intestinal bile flow which confirmed the diagnostic hypothesis. Based on possible diagnostic alternatives, signs perceived and interpreted, are analyzed.

The case of a 72-year-old patient affected by myasthenia gravis under pyridostigmine therapy, admitted to the hospital for the onset of oppressive thoracic pain associated with mild enzyme increase, electrocardiographic and echocardiographic disorders, is discussed. Dypiridamole/gated SPECT perfusion scintigraphy at rest evidenced reduced coronary reserve at the level of the lateral wall with apical akinesia and normokinesia of mediobasal left ventricle. On coronarography, coronary arteries were free of significant stenoses and left ventricular apical akinesia. The diagnostic approach to ischemic cardiomyopathy with the correct sequence of performed diagnostic imaging led to the presumptive identification of a rare syndrome.