Pub Date : 2025-02-01DOI: 10.1016/j.radcr.2025.01.046
Riya Sood BS, Trisha Badjatia, Peeyush Bhargava MD, MBA
Mucinous rectal adenocarcinoma (MRA) is a relatively uncommon type of rectal cancer, accounting for only about 5%-10% of all adenocarcinomas of the rectum. Characterized by the presence of extracellular mucin constituting at least 50% of the tumor volume, MRA is associated with a poorer prognosis and more advanced tumor stage at presentation compared to nonmucinous rectal adenocarcinomas. We report a case of a 42-year-old male patient with no family history of colorectal cancer, who presented with chronic diarrhea and was diagnosed with T3N0 MRA. We highlight the multimodality imaging features of recurrent and metastatic disease specific to this subtype of rectal carcinoma.
{"title":"Mucinous rectal adenocarcinoma recurrence: A case report and literature review","authors":"Riya Sood BS, Trisha Badjatia, Peeyush Bhargava MD, MBA","doi":"10.1016/j.radcr.2025.01.046","DOIUrl":"10.1016/j.radcr.2025.01.046","url":null,"abstract":"<div><div>Mucinous rectal adenocarcinoma (MRA) is a relatively uncommon type of rectal cancer, accounting for only about 5%-10% of all adenocarcinomas of the rectum. Characterized by the presence of extracellular mucin constituting at least 50% of the tumor volume, MRA is associated with a poorer prognosis and more advanced tumor stage at presentation compared to nonmucinous rectal adenocarcinomas. We report a case of a 42-year-old male patient with no family history of colorectal cancer, who presented with chronic diarrhea and was diagnosed with T3N0 MRA. We highlight the multimodality imaging features of recurrent and metastatic disease specific to this subtype of rectal carcinoma.</div></div>","PeriodicalId":53472,"journal":{"name":"Radiology Case Reports","volume":"20 4","pages":"Pages 2189-2193"},"PeriodicalIF":0.0,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143133728","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-02-01DOI: 10.1016/j.radcr.2024.11.006
Ahmad Almohamed , Ayham Qatza , Haifa Alsamman , Suaad Hamsho , Mohammad Atia , Rahaf tamer , Almaya Mhd Ali , Waddah Kazkz
Bickerstaff Brainstem Encephalitis (BBE) is a rare immunologic condition characterized by CNS inflammation, presenting with ataxia, external ophthalmoplegia, altered consciousness, and quadriplegia. A 25-year-old male with no significant medical history exhibited symptoms of blurred vision, diplopia, facial numbness, and imbalance following a respiratory infection. Brain MRI revealed hyperintense lesions in the cerebral peduncle and pons on T2-weighted/FLAIR sequences but not on T1-weighted sequences, indicative of demyelination. Lumbar puncture showed clear cerebrospinal fluid with lymphocytic pleocytosis (80 cells/μl, 95% lymphocytes) and normal protein levels. The patient was treated with intravenous methylprednisolone (1000 mg/day for five days), resulting in recovery and normal follow-up MRI findings. Early diagnosis and treatment are crucial to minimize complications and improve outcomes. Additionally, airway management is essential for patients with impaired respiratory function, and long-term rehabilitation may be necessary for those recovering from encephalitis.
{"title":"First case report on Bickerstaff brainstem encephalitis in a young adult from Syria: Bridging clinical knowledge and practice","authors":"Ahmad Almohamed , Ayham Qatza , Haifa Alsamman , Suaad Hamsho , Mohammad Atia , Rahaf tamer , Almaya Mhd Ali , Waddah Kazkz","doi":"10.1016/j.radcr.2024.11.006","DOIUrl":"10.1016/j.radcr.2024.11.006","url":null,"abstract":"<div><div>Bickerstaff Brainstem Encephalitis (BBE) is a rare immunologic condition characterized by CNS inflammation, presenting with ataxia, external ophthalmoplegia, altered consciousness, and quadriplegia. A 25-year-old male with no significant medical history exhibited symptoms of blurred vision, diplopia, facial numbness, and imbalance following a respiratory infection. Brain MRI revealed hyperintense lesions in the cerebral peduncle and pons on T2-weighted/FLAIR sequences but not on T1-weighted sequences, indicative of demyelination. Lumbar puncture showed clear cerebrospinal fluid with lymphocytic pleocytosis (80 cells/μl, 95% lymphocytes) and normal protein levels. The patient was treated with intravenous methylprednisolone (1000 mg/day for five days), resulting in recovery and normal follow-up MRI findings. Early diagnosis and treatment are crucial to minimize complications and improve outcomes. Additionally, airway management is essential for patients with impaired respiratory function, and long-term rehabilitation may be necessary for those recovering from encephalitis.</div></div>","PeriodicalId":53472,"journal":{"name":"Radiology Case Reports","volume":"20 2","pages":"Pages 1211-1214"},"PeriodicalIF":0.0,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11653127/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142856790","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Fasciolosis is a zoonotic infection caused by trematodes fasciola hepatica and fasciola gigantic, and humans are incidental hosts. Although infrequently reported in developed nations, it is common in developing countries. Few cases have been reported in Africa, specifically in Ethiopia. This article reports a case of a 4-year-old Ethiopian child who presented with right upper quadrant abdominal pain. His complete blood count showed eosinophilia, and imaging demonstrated lesions at peripheral subcapsular parenchyma and central along the biliary tree. Serologic tests confirmed liver fluke infection with fasciola hepatica indirect hemagglutination test titer of 1/4000. Computed tomography imaging appearances of hepatic fasciolosis depend on the phase and course of the disease and should be considered in differential diagnosis of lesions along the biliary tree.
{"title":"Abdominal CT scan findings of a child with hepatic fascioliasis: A case report on rarely reported emerging disease","authors":"Mesay Tilahun , Leul Adane , Gashaw Arega , Melkamu Tilahun","doi":"10.1016/j.radcr.2025.01.030","DOIUrl":"10.1016/j.radcr.2025.01.030","url":null,"abstract":"<div><div>Fasciolosis is a zoonotic infection caused by trematodes fasciola hepatica and fasciola gigantic, and humans are incidental hosts. Although infrequently reported in developed nations, it is common in developing countries. Few cases have been reported in Africa, specifically in Ethiopia. This article reports a case of a 4-year-old Ethiopian child who presented with right upper quadrant abdominal pain. His complete blood count showed eosinophilia, and imaging demonstrated lesions at peripheral subcapsular parenchyma and central along the biliary tree. Serologic tests confirmed liver fluke infection with fasciola hepatica indirect hemagglutination test titer of 1/4000. Computed tomography imaging appearances of hepatic fasciolosis depend on the phase and course of the disease and should be considered in differential diagnosis of lesions along the biliary tree.</div></div>","PeriodicalId":53472,"journal":{"name":"Radiology Case Reports","volume":"20 4","pages":"Pages 2180-2183"},"PeriodicalIF":0.0,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143133725","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-02-01DOI: 10.1016/j.radcr.2025.01.041
Joy Li MD, John Kim MD
Spontaneous intracranial hypotension (SIH) occurs from cerebrospinal fluid (CSF) leak in the absence of trauma or intervention. This entity is a rare but important cause of positional headaches, as the treatment options differ greatly from those for its mimic diagnoses, such as migraines or meningitis. Known causes of spontaneous CSF leak include mechanical Dural tear or dehiscence of a meningeal diverticulum/cyst. The majority of reported cases which occur from mechanical tearing of the dura are caused by spinal osteophytes. We present a unique case of a young female adult with spontaneous CSF leak suspected to be secondary to a combination of congenital pelvic dysplasia, a prior pathologic pelvic fracture, and an inciting event that resulted in shearing of a lumbosacral nerve root sheath.
{"title":"A rare and unusual case of spontaneous intracranial hypotension in a woman with congenital left hemipelvic dysplasia","authors":"Joy Li MD, John Kim MD","doi":"10.1016/j.radcr.2025.01.041","DOIUrl":"10.1016/j.radcr.2025.01.041","url":null,"abstract":"<div><div>Spontaneous intracranial hypotension (SIH) occurs from cerebrospinal fluid (CSF) leak in the absence of trauma or intervention. This entity is a rare but important cause of positional headaches, as the treatment options differ greatly from those for its mimic diagnoses, such as migraines or meningitis. Known causes of spontaneous CSF leak include mechanical Dural tear or dehiscence of a meningeal diverticulum/cyst. The majority of reported cases which occur from mechanical tearing of the dura are caused by spinal osteophytes. We present a unique case of a young female adult with spontaneous CSF leak suspected to be secondary to a combination of congenital pelvic dysplasia, a prior pathologic pelvic fracture, and an inciting event that resulted in shearing of a lumbosacral nerve root sheath.</div></div>","PeriodicalId":53472,"journal":{"name":"Radiology Case Reports","volume":"20 4","pages":"Pages 2087-2092"},"PeriodicalIF":0.0,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143133738","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Partial anomalous pulmonary venous connection (PAPVC) is a rare congenital heart defect where some pulmonary veins drain into the right atrium instead of the left. We report a case of a 20-year-old female with worsening dyspnea and intermittent chest pain. Imaging revealed cardiomegaly and pulmonary hypertension on chest X-ray. Contrast-enhanced CT showed normal right pulmonary vein drainage but anomalous drainage of the left pulmonary veins into the left brachiocephalic vein. An incidental finding of an aberrant right subclavian artery (ARSA) was also noted. The patient underwent successful surgical correction of PAPVC, with no postoperative complications, though long-term follow-up was unavailable. PAPVC is often asymptomatic but can lead to right-sided heart failure and pulmonary hypertension if untreated. ARSA, a rare anomaly, was not clinically significant in this case. This report emphasizes the role of advanced imaging in diagnosing rare anomalies like PAPVC and ARSA, where early detection and intervention are crucial for preventing complications like right ventricular dysfunction and arrhythmias.
{"title":"Partial anomalous pulmonary venous connection and an incidental aberrant right subclavian artery: A rare case report","authors":"Ashish Khadka MD , Aakash Neupane MBBS , Pramodman Singh Yadav MBBS , Leeza Shah MD , Abinash Dev MBBS , Sabin Ghale MBBS, MBBS , Amisha Karki MBBS","doi":"10.1016/j.radcr.2025.01.027","DOIUrl":"10.1016/j.radcr.2025.01.027","url":null,"abstract":"<div><div>Partial anomalous pulmonary venous connection (PAPVC) is a rare congenital heart defect where some pulmonary veins drain into the right atrium instead of the left. We report a case of a 20-year-old female with worsening dyspnea and intermittent chest pain. Imaging revealed cardiomegaly and pulmonary hypertension on chest X-ray. Contrast-enhanced CT showed normal right pulmonary vein drainage but anomalous drainage of the left pulmonary veins into the left brachiocephalic vein. An incidental finding of an aberrant right subclavian artery (ARSA) was also noted. The patient underwent successful surgical correction of PAPVC, with no postoperative complications, though long-term follow-up was unavailable. PAPVC is often asymptomatic but can lead to right-sided heart failure and pulmonary hypertension if untreated. ARSA, a rare anomaly, was not clinically significant in this case. This report emphasizes the role of advanced imaging in diagnosing rare anomalies like PAPVC and ARSA, where early detection and intervention are crucial for preventing complications like right ventricular dysfunction and arrhythmias.</div></div>","PeriodicalId":53472,"journal":{"name":"Radiology Case Reports","volume":"20 4","pages":"Pages 2184-2188"},"PeriodicalIF":0.0,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143133581","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-01-31DOI: 10.1016/j.radcr.2025.01.052
Xiaoqi Hu, Yizhong Wu, Hui Chen
The occurrence of bezoars is a relatively rare medical condition. Seed bezoars are typically discovered in the rectum and can cause symptoms such as constipation and pain. While the ingestion of seeds can lead to rectal impaction, complete intestinal blockage is uncommon. Although bezoars with various seeds have been documented, those containing Akebia trifoliata seeds are rare. A case report describes a patient who developed lower gastrointestinal obstruction following consumption of Akebia trifoliata seeds. The patient was admitted to the hospital due to recurring abdominal pain and difficulty passing stool for 4 days. The Computed Tomography Scan revealed an intestinal obstruction in the lower gastrointestinal tract, which was later confirmed through colonoscopy and patient history as being caused by ingestion of Akebia trifoliata seeds. After receiving treatment, the intestinal tract recovered; however, multiple ulcers persisted.
{"title":"A case report and comprehensive literature review on colorectal seed bezoars caused by Akebia trifoliata seeds","authors":"Xiaoqi Hu, Yizhong Wu, Hui Chen","doi":"10.1016/j.radcr.2025.01.052","DOIUrl":"10.1016/j.radcr.2025.01.052","url":null,"abstract":"<div><div>The occurrence of bezoars is a relatively rare medical condition. Seed bezoars are typically discovered in the rectum and can cause symptoms such as constipation and pain. While the ingestion of seeds can lead to rectal impaction, complete intestinal blockage is uncommon. Although bezoars with various seeds have been documented, those containing Akebia trifoliata seeds are rare. A case report describes a patient who developed lower gastrointestinal obstruction following consumption of Akebia trifoliata seeds. The patient was admitted to the hospital due to recurring abdominal pain and difficulty passing stool for 4 days. The Computed Tomography Scan revealed an intestinal obstruction in the lower gastrointestinal tract, which was later confirmed through colonoscopy and patient history as being caused by ingestion of Akebia trifoliata seeds. After receiving treatment, the intestinal tract recovered; however, multiple ulcers persisted.</div></div>","PeriodicalId":53472,"journal":{"name":"Radiology Case Reports","volume":"20 4","pages":"Pages 2135-2139"},"PeriodicalIF":0.0,"publicationDate":"2025-01-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143133615","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-01-31DOI: 10.1016/j.radcr.2024.06.009
Marina Balbino , Federica Masino , Manuela Montatore , Francesca Anna Carpagnano , Giuseppe Guglielmi
Ovarian tumors represent a significant health concern for women, often leading to morbidity and mortality. We present the case of a 46-year-old patient without notable personal or family history of tumors, who initially presented with bilateral axillary lymphadenopathy. Given the clinical presentation and suspicion of a Cancer of Unknown Primary (CUP) syndrome, the patient underwent imaging examination, such as ultrasound of the axilla, mammography, and breast magnetic resonance imaging. The axillary tru-cut biopsy histological examination revealed ovarian metastasis. The total body computed tomography (CT) scan and pelvic MRI confirmed the presence of a left ovarian tumor. The patient underwent surgical intervention with excision of the tumor and axillary lymph node dissection. Histological analysis confirmed the diagnosis of high-grade serous ovarian carcinoma. The patient was initiated on adjuvant chemotherapy and a long-term follow-up was scheduled. This case underscores the importance of comprehensive diagnostic evaluation in patients presenting with suspicious symptoms, such as axillary lymphadenopathy, to ensure timely and appropriate management of ovarian carcinoma and related conditions.
{"title":"Unexpected encounters: The surprising link between ovarian cancer and axillary lymphadenopathy","authors":"Marina Balbino , Federica Masino , Manuela Montatore , Francesca Anna Carpagnano , Giuseppe Guglielmi","doi":"10.1016/j.radcr.2024.06.009","DOIUrl":"10.1016/j.radcr.2024.06.009","url":null,"abstract":"<div><div>Ovarian tumors represent a significant health concern for women, often leading to morbidity and mortality. We present the case of a 46-year-old patient without notable personal or family history of tumors, who initially presented with bilateral axillary lymphadenopathy. Given the clinical presentation and suspicion of a Cancer of Unknown Primary (CUP) syndrome, the patient underwent imaging examination, such as ultrasound of the axilla, mammography, and breast magnetic resonance imaging. The axillary tru-cut biopsy histological examination revealed ovarian metastasis. The total body computed tomography (CT) scan and pelvic MRI confirmed the presence of a left ovarian tumor. The patient underwent surgical intervention with excision of the tumor and axillary lymph node dissection. Histological analysis confirmed the diagnosis of high-grade serous ovarian carcinoma. The patient was initiated on adjuvant chemotherapy and a long-term follow-up was scheduled. This case underscores the importance of comprehensive diagnostic evaluation in patients presenting with suspicious symptoms, such as axillary lymphadenopathy, to ensure timely and appropriate management of ovarian carcinoma and related conditions.</div></div>","PeriodicalId":53472,"journal":{"name":"Radiology Case Reports","volume":"20 4","pages":"Pages 2148-2152"},"PeriodicalIF":0.0,"publicationDate":"2025-01-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143133722","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pneumoparotid is a rare cause of parotid swelling characterized by the presence of air in the Stensen's duct and/or the parotid gland. In children, it is often self-inflicted, due to psychiatric disorder or recreational habits (puffing the cheeks, blowing balloons, bruxism…). The diagnosis may be suggested by specific signs such as crepitus or foamy saliva flowing from the Stensen's duct. Here, we present 2 cases of involuntary self-inflicted pneumoparotid, diagnosed by ultrasound and CT, in a child and a teenager. Imaging is useful for diagnosis and excluding complications. Ultrasonography may be sufficient to make the diagnosis of pneumoparotid but is less sensitive than CT. CT can make the diagnosis, but also more completely explores the deep cervical spaces and the thorax, especially important in cases with respiratory symptoms. Treatment is usually conservative, in association with behavioral counselling or psychologic/psychiatric therapy, to avoid activities leading to intra oral pressure increase.
{"title":"US and CT of 2 pediatric cases of self-inflicted pneumoparotid and cervicofacial emphysema","authors":"François Chalard MD, Méryle Laurent MD, Eugénie Barras MD, Seema Toso MD","doi":"10.1016/j.radcr.2025.01.055","DOIUrl":"10.1016/j.radcr.2025.01.055","url":null,"abstract":"<div><div>Pneumoparotid is a rare cause of parotid swelling characterized by the presence of air in the Stensen's duct and/or the parotid gland. In children, it is often self-inflicted, due to psychiatric disorder or recreational habits (puffing the cheeks, blowing balloons, bruxism…). The diagnosis may be suggested by specific signs such as crepitus or foamy saliva flowing from the Stensen's duct. Here, we present 2 cases of involuntary self-inflicted pneumoparotid, diagnosed by ultrasound and CT, in a child and a teenager. Imaging is useful for diagnosis and excluding complications. Ultrasonography may be sufficient to make the diagnosis of pneumoparotid but is less sensitive than CT. CT can make the diagnosis, but also more completely explores the deep cervical spaces and the thorax, especially important in cases with respiratory symptoms. Treatment is usually conservative, in association with behavioral counselling or psychologic/psychiatric therapy, to avoid activities leading to intra oral pressure increase.</div></div>","PeriodicalId":53472,"journal":{"name":"Radiology Case Reports","volume":"20 4","pages":"Pages 2153-2158"},"PeriodicalIF":0.0,"publicationDate":"2025-01-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143133723","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Cavernous malformations (CMs), also known as cavernomas or cavernous hemangiomas, are vascular lesions characterized by clusters of abnormally dilated blood vessels resembling a mulberry. In this report, we present the case of a 40-year-old man who presented with a one-year history of back pain radiating into both legs, with a preference for the left leg. An MRI initially suggested a schwannoma at the T12-L1 vertebral level, with a differential diagnosis that included meningioma—2 common intradural-extramedullary spinal tumors— with distinct management and prognostic implications. However, despite imaging findings consistent with a schwannoma, the final pathology revealed an intradural extramedullary (IDEM) cavernous hemangioma in the thoracolumbar region. Although cavernous hemangiomas are very rare in the spinal region, our case underscores the importance of considering them in the differential diagnosis of IDEMs in the thoracolumbar area.
{"title":"Cavernoma of the cauda equina mimicking schwannoma: A case report","authors":"Reza Naseri MD , Maryam Haghighi-Morad MD , Zahra Mohammadi Manesh MD , Farahnaz Bidari Zerehpoosh MD , Hadi Vahedi MD , Hamidreza Ashayeri MD","doi":"10.1016/j.radcr.2025.01.043","DOIUrl":"10.1016/j.radcr.2025.01.043","url":null,"abstract":"<div><div>Cavernous malformations (CMs), also known as cavernomas or cavernous hemangiomas, are vascular lesions characterized by clusters of abnormally dilated blood vessels resembling a mulberry. In this report, we present the case of a 40-year-old man who presented with a one-year history of back pain radiating into both legs, with a preference for the left leg. An MRI initially suggested a schwannoma at the T12-L1 vertebral level, with a differential diagnosis that included meningioma—2 common intradural-extramedullary spinal tumors— with distinct management and prognostic implications. However, despite imaging findings consistent with a schwannoma, the final pathology revealed an intradural extramedullary (IDEM) cavernous hemangioma in the thoracolumbar region. Although cavernous hemangiomas are very rare in the spinal region, our case underscores the importance of considering them in the differential diagnosis of IDEMs in the thoracolumbar area.</div></div>","PeriodicalId":53472,"journal":{"name":"Radiology Case Reports","volume":"20 4","pages":"Pages 2140-2143"},"PeriodicalIF":0.0,"publicationDate":"2025-01-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143133739","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-01-31DOI: 10.1016/j.radcr.2025.01.038
Daniel De-Liang Loh , Ira Sun , Shiong Wen Low , Pin Lin Kei
Primary and secondary central nervous system lymphomas are infrequently encountered entities that present nonspecifically for which imaging plays a critical role in the diagnostic process. The conventional wisdom is that the presence of intralesional hemorrhage in an immunocompetent patient strongly counts against the diagnosis of lymphoma; however more recent evidence suggests that the distinction is more nuanced. Especially for PCNSL, there is increasing recognition that some degree of hemorrhage occurs more frequently than previously thought, and there are a number of case reports describing various types of hemorrhagic lesions that were histologically confirmed to be lymphoma. Hemorrhage in SCNSL is much rarer with only 3 cases described to date. We describe an unusual case of SCNSL with a pattern and progression of hemorrhage distinct from the prior descriptions. Awareness of the range of possible appearances of atypical presentations of CNS lymphoma is important to ensure that it is not prematurely excluded from the differential diagnosis which can delay appropriate treatment. Although rare, intralesion hemorrhage in itself should not preclude the diagnosis of lymphoma particularly when the other imaging features are congruent.
{"title":"Unusual presentation of secondary CNS lymphoma with punctate intralesional and intraventricular hemorrhage","authors":"Daniel De-Liang Loh , Ira Sun , Shiong Wen Low , Pin Lin Kei","doi":"10.1016/j.radcr.2025.01.038","DOIUrl":"10.1016/j.radcr.2025.01.038","url":null,"abstract":"<div><div>Primary and secondary central nervous system lymphomas are infrequently encountered entities that present nonspecifically for which imaging plays a critical role in the diagnostic process. The conventional wisdom is that the presence of intralesional hemorrhage in an immunocompetent patient strongly counts against the diagnosis of lymphoma; however more recent evidence suggests that the distinction is more nuanced. Especially for PCNSL, there is increasing recognition that some degree of hemorrhage occurs more frequently than previously thought, and there are a number of case reports describing various types of hemorrhagic lesions that were histologically confirmed to be lymphoma. Hemorrhage in SCNSL is much rarer with only 3 cases described to date. We describe an unusual case of SCNSL with a pattern and progression of hemorrhage distinct from the prior descriptions. Awareness of the range of possible appearances of atypical presentations of CNS lymphoma is important to ensure that it is not prematurely excluded from the differential diagnosis which can delay appropriate treatment. Although rare, intralesion hemorrhage in itself should not preclude the diagnosis of lymphoma particularly when the other imaging features are congruent.</div></div>","PeriodicalId":53472,"journal":{"name":"Radiology Case Reports","volume":"20 4","pages":"Pages 2144-2147"},"PeriodicalIF":0.0,"publicationDate":"2025-01-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143133740","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
扫码关注我们
求助内容：
应助结果提醒方式：
京公网安备 11010802042870号