Alveolar sarcoidosis with lacrimal gland involvement

A 44 -year- old male presented with orbital pain and lid swelling for 3 weeks. He complained of pain, redness, and irritation in both eyes and received medical treatment with mild improvement. Three days latter he experienced acute onset of diminution of vision. He had no systemic complaints. Slit lamp examination revealed no abnormality. The upper lids of both eyes were swollen and a firm mass was felt on the supero-lateral aspect of the orbits. The lid swelling was secondary to orbital mass. The mass was immobile and non-tender. Therefore, the patient underwent Computerized Tomography [CT] scan of the orbit that showed bilateral almost symmetrical lacrimal gland enlargement, operative biopsy was recommended. Prior to biopsy, chest X-ray was performed and showed bilateral pulmonary opacities, though there was no clinical respiratory abnormality. Consequently CT scan of thorax was done that revealed multiple alveolar opacities. Laboratory investigations showed a normal haemogram, erythrocyte sedimentation rate 70-mm at first hour, serum angiotensin converting enzyme [ACE] level was 42 units [normal: 14-70 units], intradermal purified protein derivative test for Mycobacterium tuberculosis was negative [3-mm induration], rheumatoid factor, uric acid and thyroid hormone levels were normal

MR imaging of Schistosomal myelitis

Schistomiasis is a parasitic infestation that affects an estimated 200 to 300 million people worldwide. Spinal involvement is a rare complication of schistosoma mansoni or schistosoma hematobium infestation. The prevalence of spinal cord shistosomiasis in patients with systemic disease ranges from 0.3% to 13% in different published studies. The pathological findings of spinal shistosomiasis include a granulomatous intramedullary mass of the caudal spinal cord, radicular involvement with granulomatous changes surrounding the conus medullaris and cauda equina nerve roots, granulomatous necrosis and haemorrhage and asymptomatic deposition of ova in the spinal cord. Different imaging modalities have been employed for diagnosis of spinal schistosomiasis including conventional water-soluble contrast myelography, computed tomography [CT], CT myelography and magnetic resonance imaging [MRI]. In this study, we report imaging findings in 5 patients with shistosomal myelitis on CT myelography [1 case] and MRI [4 cases]. Three patients were operated upon and two patients had follow-up MRI after 6 months of antiparasitic therapy. We concluded that MRI should be the primary diagnostic modality employed in patients suspected to have shistosomal myelitis on a clinical and laboratory basis

Superior venacaval obstruction: the commonest radiographic abnormality in 12 Egyptian patients with behcet's disease

Behcet's disease is characterized clinically by the presence of a diagnostic triad of stomatitis, genital ulceration and uveitis, multiple other organ systems may be imvolved. Prognosis is related to the presence of central nervous system, vascular or intestinal involvement. This report describes the clinical and radiological findings in 12 Egyptian patients with Behcet's disease. Venous involvement was frequent. The most common radiographic abnormality noted was superior vena cava obstruction occurring in 9 cases. CT with contrast enhanacement is optimum for its diagnosis. Other vascular abnormalities included inferior venal cava obstruction once pulmonary artery aneurysms in 2 cases. Pulmonary affection consisted of pulmonary nodules, central or peripheral and pleural effusion, the latter is probably more related to SVC obstruction. Small intestinal abnormalities included ulcers, narrowing, marginal irregularities, fistulae and separation of bowel loops. These changes were ore aggressive in the ileum near its terminal part. Pseudocystic type of artirities was seen once. The different radiographic abnormalities were mentioned and their possible a etiology discussed

role of transabdominal ultrasonography, computed tomography and magnetic resonance imaging in pre-operative staging and post-therapeutic assessment of bladder carcinoma

The most important information for treatment of cancer bladder is to know its exact staging. A total of 73 bladder cancer patients were evaluated by both transabdominal ultrasonography and computed tomography. MRI was performed in only 10 patients. The findings on different imaging techniques were compared with the histological staging. A proper diagnosis was make in 57 of 73 cases [78%] by transabdominal ultrasound in 61 of 73 cases [83.5%] by CT, and in 8 of 10 [80%] by MRI when compared with histological findings. The data showed very promising results of MRI in regional staging of bladder cancer and it is more accurate than ultrasonography and may be more useful than CT

diagnosis of lesions involving the parapharyngeal space by computed tomography

Lesions arising within or adjacent to the parapharyngeal space present difficulties in their diagnosis as well as in the choice of the ideal surgical approach. The findings on contrast enhanced computed tomography [CT] of 46 patients with lesions in this region are presented. CT can provide reliable informations regarding the size and the extent of the mass lesion, its site of origin, its relationship to the surrounding vascular structures as well as the likely histological type of the lesion in most of cases