We report a case of stroke due to cocaine abuse in a 30-year-old woman. The initial examinations pointing to this diagnosis were CT and MRI. Magnetic Resonance Imaging revealed bilateral globus pallidus infarction charac...We report a case of stroke due to cocaine abuse in a 30-year-old woman. The initial examinations pointing to this diagnosis were CT and MRI. Magnetic Resonance Imaging revealed bilateral globus pallidus infarction characterized by restricted Diffusion with low ADC values. There was also a partial hemorrhagic component confirmed on T2* sequence. After gadolinium injection there was a ring enhancement consistent with a blood brain barrier leakage. Similar lesions have been described in post hypoxic-anoxic injuries such as following cardiac arrest, severe blood loss and CO intoxication.
We report the case of a 78-year-old man with recent diagnosis of Kahler disease and a non-tender swollen left hemiscrotum. Ultrasound findings showed an intratesticular, hypervascular hypoechoic lesion. MRI imaging demon...We report the case of a 78-year-old man with recent diagnosis of Kahler disease and a non-tender swollen left hemiscrotum. Ultrasound findings showed an intratesticular, hypervascular hypoechoic lesion. MRI imaging demonstrated general appearance of a malignant lesion. Specific characteristics however, could not be withheld on MRI. Orchidectomy was performed and plasmacytoma was demonstrated at pathological examination. Although plasmacytoma of the testis is extremely rare, it should be included in the differential diagnosis taking into account the ultrasound and MRI appearances, especially in elderly patients with known Kahler disease.
Isolated sulfite oxidase deficiency is a rare, autosomal recessive disease with a very poor prognosis. This condition usually presents in the neonatal period and is mainly characterized by neurological abnormalities, inc...Isolated sulfite oxidase deficiency is a rare, autosomal recessive disease with a very poor prognosis. This condition usually presents in the neonatal period and is mainly characterized by neurological abnormalities, including refractory seizures, abnormal muscle tone, abnormal movements, and marked developmental delay. The differentiation from hypoxic-ischemic encephalopathy is difficult based on clinical findings alone. We present a neonatal case
We report a case of a dopamine-secreting giant primary adrenal ganglioneuroma (GN) in a 29-year-old male patient. Although the patient was clinically silent, the 24-hour urine levels of dopamine, normetanephrine, homovan...We report a case of a dopamine-secreting giant primary adrenal ganglioneuroma (GN) in a 29-year-old male patient. Although the patient was clinically silent, the 24-hour urine levels of dopamine, normetanephrine, homovanillic acid and vanillyl mandelic acid were elevated. Abdominal ultrasonography and magnetic resonance imaging showed a large solid tumor with calcifications and a slightly lobular edge on the left adrenal gland. A tumor, 13 x 23 x 25 cm in size, was completely resected without morbidity. A 2-year follow-up with computed tomography showed that the postoperative course of the patient was uneventful.
Hepatocellular adenomas are rare benign liver neoplasms that commonly occur in women with a history of oral contraceptives intake for more than 2 years. Hepatic adenomatosis is characterized by the presence of multiple a...Hepatocellular adenomas are rare benign liver neoplasms that commonly occur in women with a history of oral contraceptives intake for more than 2 years. Hepatic adenomatosis is characterized by the presence of multiple adenomas, arbitrarily > than 10, involving both lobes of the liver, without any history of steroid therapy or glycogen storage disease. Although the adenomas in liver adenomatosis are histologically similar to other adenomas, liver adenomatosis appears to be a separate clinical entity. Adenomas in hepatic adenomatosis may be of the inflammatory, hepatocyte nuclear factor 1alpha-mutated, or beta-catenin-mutated subtype, and accordingly show variable imaging appearances. Hepatic adenomatosis carries the risk of impaired liver function, hemorrhage and malignant degeneration. We report a case with the inflammatory subtype of hepatic adenomatosis in a 39-year-old woman with liver steatosis. The magnetic resonance imaging features using extracellular gadolinium chelates and hepatocyte-targeted contrast agents are described.
We report a rare case of marked myocardial lipoma of the left ventricle free wall investigated with echocardiography, CT and comprehensive MRI. The case is a 52-year-old man with a history of arrhythmia, hypertension and...We report a rare case of marked myocardial lipoma of the left ventricle free wall investigated with echocardiography, CT and comprehensive MRI. The case is a 52-year-old man with a history of arrhythmia, hypertension and palpitations. Echocardiography was normal except for the base of the interventricular septum which was slightly thickened. CT and cardiac MRI showed features consistent with myocardial lipoma. This is the first report of myocardial lipoma on the left ventricle free wall depicted as perfusion defect on MR perfusion imaging.
The case of a 34-year-old man with a fast growing hard lump on the fourth digit of the right hand is presented. Radiography and MRI of the finger showed the radiologic characteristics of a bizarre parosteal osteochondrom...The case of a 34-year-old man with a fast growing hard lump on the fourth digit of the right hand is presented. Radiography and MRI of the finger showed the radiologic characteristics of a bizarre parosteal osteochondromatous proliferation. Pathologic analysis confirmed the radiologic diagnosis.
Lymphangiomas are rare congenital benign tumors arising from the lymphatic system mostly encountered in the neck and axillary regions of pediatric patients. Pancreatic cystic lymphangiomas very rarely occur in adults. Ra...Lymphangiomas are rare congenital benign tumors arising from the lymphatic system mostly encountered in the neck and axillary regions of pediatric patients. Pancreatic cystic lymphangiomas very rarely occur in adults. Radiologically, the lesion may mimic pancreatic carcinoma and should be considered in the differential diagnosis of any patient found to have an abdominal cystic mass. In this article, we present a 50-year-old man who presented with pain in the upper abdomen, nausea, and abdominal swelling. On computed tomography (CT) and magnetic resonance (MR) imaging, a gross septated cystic lesion was detected in the upper abdomen which extended from the pancreatic corpus to the left liver lobe. The patient underwent complete resection of tumor. Pathology revealed a cystic lymphangioma.
We report a rare case of endometriosis of the groin in a young woman. This case shows how difficult the diagnosis of unusual manifestations of endometriosis can be. The diagnosis was suspected by a careful history and ph...We report a rare case of endometriosis of the groin in a young woman. This case shows how difficult the diagnosis of unusual manifestations of endometriosis can be. The diagnosis was suspected by a careful history and physical examination. Diagnosis was supported by timely performed Magnetic Resonance Imaging, which illustrates its additional value. It can be argued that MRI could be the first choice of imaging technique for the assessment of young women with nonspecific or unexplained complaints of the groin. Even more important is the familiarity of physicians other than gynaecologists with rare manifestations of this common disease.
Noonan syndrome (NS) is an etiologically heterogeneous disorder caused by mutations in the RAS-MAPK signaling pathway. Noonan-Like/Multiple Giant Cell Lesion (NL/MGCL) syndrome is initially described as the occurrence of...Noonan syndrome (NS) is an etiologically heterogeneous disorder caused by mutations in the RAS-MAPK signaling pathway. Noonan-Like/Multiple Giant Cell Lesion (NL/MGCL) syndrome is initially described as the occurrence of multiple gnathic giant cell lesions in patients with phenotypic features of NS. Nowadays, NS/MGCL syndrome is considered a variant of the NS spectrum rather than a distinct entity. We report the case of a 14-year-old female patient carrying a SOS1 mutation with a unilateral giant cell lesion of the right mandible. Cross-sectional imaging such as CT and MRI are not specific for the diagnosis of oral giant cell lesions. Nonetheless, intralesional scattered foci of low SI on T2-WI, corresponding to hemosiderin deposits due to hemorrhage, can help the radiologist in narrowing down the differential diagnosis of gnathic lesions in patients with NS.
Rosai-Dorman disease (RDD) is a rare disorder of proliferative histiocytes with an unknown etiology. It is also known as sinus histiocytosis with massive lymphadenopathy. Most patients present with painless cervical lymp...Rosai-Dorman disease (RDD) is a rare disorder of proliferative histiocytes with an unknown etiology. It is also known as sinus histiocytosis with massive lymphadenopathy. Most patients present with painless cervical lymphadenopathy due to accumulation of histiocytes in the lymph nodes, often in conjunction with fever, elevated leukocyte count and erythrocyte sedimentation rate. Isolated skeletal involvement is very rare.
Pseudoangiomatous stromal hyperplasia is a benign mesenchymal tumor of the breast. It is a rare condition and until a few years mainly described in pathological and surgical literature. Here, we provide a case report of...Pseudoangiomatous stromal hyperplasia is a benign mesenchymal tumor of the breast. It is a rare condition and until a few years mainly described in pathological and surgical literature. Here, we provide a case report of PASH and an overview of its radiological features.
Primary aortic thrombosis remains a rare entity that can be defined as clotting of the vessel without any obvious atheromatous lesion. Cancer chemotherapy, cocaine intake, essential thrombocythemia, some hypercoagulable...Primary aortic thrombosis remains a rare entity that can be defined as clotting of the vessel without any obvious atheromatous lesion. Cancer chemotherapy, cocaine intake, essential thrombocythemia, some hypercoagulable states, heparin-induced thrombocytopenia, inflammatory disease of the digestive tract and acute pancreatitis are, beside some cases of rather unknown etiology, the causes of primary aortic thrombosis. Intravenous contrast-enhanced multislice CT, which is widely available, noninvasive and affordable in terms of cost, is the imaging modality of choice for the investigation of primary aortic thrombosis and the assessment of potential complications. Three cases due to chemotherapy, antiphospholipid syndrome and acute pancreatitis are reported.
OBJECTIVES: To evaluate the clinical significance of quadratus femoris muscle signal changes (QFMC) on MRI. METHODS: 204 consecutive bilateral MRI hip examinations (132 female, 72 male) were reviewed in retrospect for QF...OBJECTIVES: To evaluate the clinical significance of quadratus femoris muscle signal changes (QFMC) on MRI. METHODS: 204 consecutive bilateral MRI hip examinations (132 female, 72 male) were reviewed in retrospect for QFMC. Inclusion imaging parameters were edema or atrophy of the quadratus femoris muscle. The presence or absence of symptoms and additional ipsilateral and/or contralateral imaging findings were used to differentiate between isolated symptomatic, co-incidental and asymptomatic QFMC. RESULTS: 24 (11.8%) patients and 30 (7.3%) hips demonstrated QFMC. Atrophy was present in 5 symptomatic hips. Female to male ratio was 23:1. Isolated symptomatic QFMC: 4 hips (13.3%), 1 bilateral. Clinical symptoms in this group were non-specific greater trochanter pain and stiffness of the hip. Co-incidental QFMC: 19 symptomatic hips, ipsilateral associated findings present in 18 hips (94.7%) and contralateral additional findings present in 8 hips (42.1%). Asymptomatic QFMC: 7 hips (23.3%), ipsilateral associated asymptomatic findings in 5 hips (71.4%) and contralateral associated symptomatic findings in 6 hips (85.7%). Edema around the greater trochanter and hamstring insertions were the most frequent associated findings. CONCLUSION: In this study, most cases of QFMC were co-incidental or asymptomatic. In isolated symptomatic QFMC clinical complaints were non-specific. Atrophy was found only in the symptomatic hips.
Systemic primary vasculitides are rare idiopathic diseases causing an inflammatory injury to the vessel walls. A pulmonary involvement is frequent, and chest-CT is the imaging technique of reference in its assessment. An...Systemic primary vasculitides are rare idiopathic diseases causing an inflammatory injury to the vessel walls. A pulmonary involvement is frequent, and chest-CT is the imaging technique of reference in its assessment. An extremely wide variety of parenchymal, vascular and airways abnormalities, has been described and diagnosis can be challenging: knowledge of clinical data and a close cooperation with the referring physician is often crucial. The aim of this work is to describe the most common typical and atypical CT features of pulmonary vasculitis and their possible changes over time and therapy, focusing on the differential diagnosis with other inflammatory/infectious or neoplastic diseases.