Radiology Case Reports最新文献

Peribiliary cysts are an incidental finding in patients with advanced liver disease. They were found to be common in fibrocystic disorders such as autosomal dominant polycystic kidney disease and polycystic liver disease, as well as cirrhotic livers. They result from obstruction-induced cystic dilatation of the peribiliary glands. We report in this article the case of 2 patients, aged 41 and 71, smokers and chronic alcoholics, admitted for febrile cholestatic jaundice, for which MRI revealed the presence of peribiliary cysts.

Liver cirrhosis is a significant global health burden, accounting for approximately 2 million deaths per year worldwide. The underlying etiologies of cirrhosis include viral hepatitis (hepatitis B, C, and D), toxins (such as alcohol and drugs), autoimmune diseases, cholestatic conditions (including primary biliary cholangitis and primary sclerosing cholangitis), vascular disorders (such as Budd-Chiari syndrome, sinusoidal obstruction syndrome, and cardiac cirrhosis), and metabolic disorders (including hemochromatosis, nonalcoholic steatohepatitis, and alpha-1 antitrypsin deficiency). Patients with liver cirrhosis typically present with symptoms such as jaundice, scleral icterus, nausea, and vomiting, accompanied by abnormal liver enzyme levels. Other defining features include spider angiomas, caput medusa, and esophageal and/or rectal varices. Abdominal imaging often reveals fibrotic changes within the liver.

In this article, we present a case of a 38-year-old female presenting with signs and symptoms of cirrhosis, with subsequent imaging revealing a Porta hepatis mass compressing the inferior vena cava (IVC). The patient underwent a biopsy consistent with liver cirrhosis. This case is unique in the presentation of her liver cirrhosis as a compressive mass rather than the usual fibrotic changes within the liver parenchyma.

Extra-medullary plasmacytoma (EMP) is a rare tumor that most frequently occur in the head and neck region, with the paranasal sinuses, nasopharynx and tonsils being the most common sites. Diagnostic criteria for EMP include histological confirmation of a solitary plasma cell lesion, the presence of fewer than 5% plasma cells in the bone marrow, and the absence of end-organ damage commonly associated with multiple myeloma. CT scans and MRI features are nonspecific and can mimic those of other conditions. EMP of the nasopharynx presents as a slow-growing, radiosensitive mass with a favorable prognosis.

We present the case of a 55-year-old male patient who sought medical attention for recurrent epistaxis. An endoscopic examination revealed a tumor located in the nasopharynx, which was confirmed by MRI as a confined nasopharyngeal mass. Subsequent pathology studies, laboratory results, and bone marrow biopsy were consistent with a solitary EMP of the nasopharynx.

The indications for stent grafts (SG) placement within the dialysis vascular access include recurrent stenosis at the venous anastomosis of arteriovenous grafts, vessel rupture, pseudoaneurysm exclusion, and intra-stent stenosis. Controversy exists regarding the use of SGs within the cannulation zone due to the theoretical risks of increased infection and stent fracture. While prospective studies are lacking, several retrospective studies demonstrated the safety of SG use within the cannulation area. However, the short-term nature of these retrospective studies makes it challenging to draw any reasonable conclusions about SG's long-term safety profile. The presented case here showed that the accumulative exposure to needle injury during dialysis therapy was associated with fracturing the stent leading to life-threatening skin ulcerations that required immediate surgical intervention. Additionally, this case suggests that deploying SG within the cannulation segment should be reserved for those with poor survival and have exhausted other access options.

Chylothorax after esophageal surgery is a rare complication but can lead to death in patients due to malnutrition, fluid imbalance, and immunodeficiency. Multiple treatment options exist for postoperative chylothorax, including conservative treatment, octreotide therapy, and interventions such as thoracic duct embolization and surgical ligation of the thoracic duct. We present a case of lymphatic leakage following laparoscopic esophagectomy for esophageal cancer, confirmed by lymphangiography. The patient underwent an intervention to embolize the thoracic duct under computed tomography after an initial failure under digital subtraction angiography (DSA). One week after the intervention, the patient's pleural fluid output gradually decreased, and the patient was discharged from the hospital. At a 7-month follow-up, the patient remained stable with no recurrence of lymphatic leakage.

Chronic constrictive pericarditis is a pericardial affection that causes a severe impairment of myocardial compliance. Among its many etiologies, tuberculosis is the most common cause, mainly in developing countries. Multimodal imaging methods are essential tools for guiding diagnosis. We present the case of a 64-year-old man with no past medical history who presented with dyspnea stage II of NYHA and right heart failure. At admission, he was stable, with normal blood pressure and a normal heart rate. His ECG showed a low voltage of QRS complexes. Transthoracic echocardiography revealed significant pericardial thickening enveloping the ventricles, with significant respiratory flow variation. A thoracic CT scan and cardiac MRI confirmed the presence of pericardial thickening and calcifications. The patient underwent beat-heart pericardial decortication. The anatomopathological examination of the surgical piece revealed Mycobacterium tuberculosis. The postoperative check-up after 6 months showed good clinical and echocardiographic evolution.

Osteopetrosis, also known as the disease of marbled bones, refers to a group of constitutional bone diseases resulting from a defect in bone metabolism. This condition is characterized by its manifestation, most often at a young age, and is typically revealed by its complications, primarily fractures. Diagnosis is currently confirmed through genetics but also relies on imaging such as standard radiography and computed tomography. We report the case of a child, aged 13 years, presenting with osteopetrosis revealed by atypical symptoms, confirmed by computed tomography imaging mainly in our country in Morocco where access to care is sometimes difficult for some patients.

Choriocarcinoma is a type of gestational trophoblastic disease that occurs as a complication of pregnancy-related events. The gestational trophoblastic disease includes both benign and malignant conditions including complete and partial mole, invasive mole, choriocarcinoma, and placental site trophoblastic disease. Choriocarcinoma generally presents with pervaginal bleeding, symptoms of anemia, and symptoms of its metastatic lesion. The common sites of metastasis are the lung, vagina, brain, and liver. The gastrointestinal (GI) tract is an uncommon site of metastasis occurring in <5% of patients. Upper GI bleeding as presenting complaints without pervaginal bleeding is also very rare with only a few reported cases. Here we present a case of 29 years young female who presented in our emergency department with complaints of hematemesis and altered sensorium where clinical suspicion was peptic ulcer disease but imaging modality with computed tomography showed hypervascular lesions in the brain with suspicion of choriocarcinoma. With further imaging and laboratory tests, confirmatory diagnosis of choriocarcinoma was made. This case highlights the importance of imaging in the diagnosis of choriocarcinoma where the history of the patient is misleading.

Late presentation of congenital diaphragmatic hernia (CDH) presents usually after the neonatal period and often misdiagnosed for other respiratory pathologies. It is crucial to differentiate late presentation of CDH from other potential causes of respiratory distress and gastrointestinal symptoms. Herein, we present 2 cases of delayed presentation of congenital diaphragmatic hernia in infants. Initially, both cases were managed as respiratory conditions in outpatient settings, with no significant improvement. The correct diagnosis was eventually made through radiological evaluation at our tertiary centre, leading to successful surgical management. Delayed presentation of CDH beyond the neonatal period is rare, owing to the wide spectrum of clinical manifestations. Early diagnosis and surgical management are crucial to reduce morbidity and mortality, making a high index of suspicion essential for timely intervention.

Core needle biopsy is a common diagnostic procedure in breast cancer patients, but it can occasionally lead to serious complications. We report a rare case of pseudoaneurysm formation following a core needle biopsy in a 54-year-old female patient diagnosed with breast cancer. Despite the routine nature of the procedure, the patient developed a palpable mass at the biopsy site, which prompted further diagnostic imaging and interventions. The pseudoaneurysm was effectively treated using a percutaneous approach with ultrasound-guided thrombin injection, demonstrating a minimally invasive solution that promptly addressed the complication without the need for surgical intervention. This case highlights the critical importance of detecting complications early in the biopsy process, as they have significant implications for disease staging and treatment initiation. It also underscores the importance of being prepared for immediate intervention in case of biopsy-related complications like pseudoaneurysms, to prevent severe consequences.