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The authors present an atypical case of neoplastic thrombosis of the great abdominal veins, evaluated with echo-Doppler duplex scanner and computed tomographic scan with contrast enhancement. In this report the authors stress again the diagnostic accuracy of echo-Doppler methods in the study of such a phlebopathy. They describe its sonographic differential diagnosis from acute or chronic idiopathic phlebothrombosis.

The authors examined 47 subjects affected by acute phlebothrombosis of the lower limbs by means of light-reflection-rheography (LRR). The diagnosis was based on the results of clinical, Doppler, and duplex scanner evaluations. The results were compared with those obtained in 30 healthy subjects (control group). The LRR examinations were performed by two methods: the one consisting of a passive execution of postural movements of the limb, the other using the technique of plethysmographic venous occlusion. The pathological LRR curves were characteristic for each type of disease and for the site of thrombosis and were different from the normal ones. The results obtained show the usefulness of the method and it potential in studying the collateral circulation and the effects of different therapies.

The authors have studied with a light reflection rheograph (LRR) 112 cases: 54 patients with suspected "thoracic outlet syndrome" (TOS) in the functional phase, 28 patients with phlebothrombosis localized in upper limbs, and a control group of 30 healthy subjects to evaluate the upper limbs' venous outlet. They recorded a good correlation among results obtained with LRR, clinical examination, Doppler, and phlebographic examination. The data obtained lead them to propose this methodology as an important examination in the evaluation of upper thoracic pathology.

The authors present the case of a patient with phlebothrombosis of the left lower limb, not diagnosed with traditional ultrasonographic methods (Doppler c w) but recognized by the echo Doppler (duplex scanner) method. The diagno sis was made difficult by the presence of a congenital double left popliteal vein, with hypoechogenic thrombosis of only one of the two twin veins. The authors stress the diagnostic importance of the duplex scanner method in the study of the phlebobstructive pathologies of the lower limbs.