Teaching point: Transient interlobular septal nodules displaying a characteristic branched 'pearl-like' pattern may reflect acute pulmonary lymphatic overload and should not be mistaken for other common pathological processes.
Teaching point: Transient interlobular septal nodules displaying a characteristic branched 'pearl-like' pattern may reflect acute pulmonary lymphatic overload and should not be mistaken for other common pathological processes.
Teaching point: Endophthalmitis is an uncommon but severe complication of meningitis that can be visualized on MRI.
Teaching point: CT enterography/enteroclysis allows adequate evaluation of neuroendocrine small bowel tumor and extra-enteric abnormalities.
Teaching point: Consider atypical PRES and a vascular work-up in brainstem edema, especially in the setting of severe hypertension.
A rare case of hepatic gas-forming metastases secondary to Clostridium septicum infection is described. A 78-year-old woman was admitted with right lower quadrant abdominal pain and deterioration. Initial imaging revealed a right-sided colonic malignancy with hepatic metastases. Follow-up scans showed gas within metastases and minimal pneumoperitoneum, suggesting bowel perforation. However, blood cultures isolated C. septicum, supporting infected necrotic metastases as the source of free gas. Teaching point: This case emphasizes the importance of distinguishing infectious intratumoral gas from perforation in oncological patients and provides one of the few reports with sequential imaging of this process.
Teaching point: Laceration of the left hepatic vein is a rare but potentially fatal complication of cardiopulmonary resuscitation (CPR) and should be considered in patients with unexplained hemodynamic instability following resuscitation.
Teaching point: Osteofibrous dysplasia (OFD) is a rare benign fibro‑osseous lesion primarily affecting the tibial cortex in children and adolescents; simultaneous involvement of the fibula is exceptional and may mimic more aggressive tumors such as adamantinoma.
Teaching point: Gallbladder volvulus is a rare but serious diagnosis that needs urgent surgical treatment to avoid morbidity and mortality related to gallbladder ischemia and should be suspected in elderly female patients with acute right upper quadrant pain with imaging features including enlarged, abnormally positioned gallbladder and specific key findings on CT including "whirl sign" representing twisting of the cystic pedicle and "beak sign" at the gallbladder neck.
A 68-year-old woman presented with progressive hemiparesis and dysphagia, initially presumed to have subacute stroke. Serial MRI revealed fluctuating FLAIR hyperintensities and enhancing lesions in the basal ganglia and cortex, ultimately leading to the diagnosis of high-grade primary CNS B-cell lymphoma. The case highlights the importance of integrating clinical evolution with imaging features in atypical neurological presentations. Teaching point: In cases of fluctuating FLAIR hyperintensity and contrast-enhancing brain lesions, primary CNS lymphoma should be considered, even in the absence of typical imaging features.
Teaching point: Pulmonary and systemic arterial phases are needed to exclude Rasmussen aneurysm.
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