Cystic Lymphangioma Arising from the Mesoappendix: A Case Report

Intra-abdominal lymphangiomas are a rare entity. We report a case of cystic lymphangioma arising from the mesoappendix of a 21-year-old female patient. Barium enema examination revealed a pliable submucosal lesion at the cecal base, without contrast filling in the appendiceal lumen. US and CT demonstrated a multiseptated cystic mass in the pericecal and periappendiceal areas.

Reversible Posterior Leukoencephalopathy Syndrome

PURPOSE: To review reversible posterior leukoencephalopathy syndrome. MATERIALS AND METHODS: We reviewed 22 patients (M:F=3:19; age, 17-46 years) with the characteristic clinical and imaging features of reversible posterior leukoencephalopathy syndrome. All underwent brain MRI, and in three cases both CT and MRI were performed. In one, MRA was obtained, and in eleven, follow-up MR images were obtained. We evaluated the causes of this syndrome, its clinical manifestations, and MR findings including the locations of lesions, the presence or absence of contrast enhancement, and the changes seen at follow-up MRI. RESULTS: Of the 22 patients, 13 had eclampsia (six during pregnancy and seven during puerperium). Four were receiving immunosuppressive therapy (three, cyclosporine; one, FK 506). Four suffered renal failure and one had complicated migraine. The clinical manifestations included headache (n=12), visual disturbance (n=13), seizure (n=15), focal neurologic sign (n=3), and altered mental status (n=2). Fifteen patients had hypertension and the others normotension. MRI revealed that lesions were bilateral (n=20) or unilateral (n=2). In all patients the lesion was found in the cortical and subcortical areas of the parieto-occipital lobes; other locations were the basal ganglia (n=9), posterior temporal lobe (n=8), frontal lobe (n=5), cerebellum (n=5), pons (n=2), and thalamus (n=1). All lesions were of high signal intensity on T2-weighted images, and of iso to low intensity on T1-weighted images. One was combined with acute hematoma in the left basal ganglia. In eight of 11 patients who underwent postcontrast T1-weighted MRI, there was no definite enhancement; in one, enhancement was mild, and in two, patchy. CT studies showed low attenuation, and MRA revealed mild vasospasm. The symptoms of all patients improved. Follow-up MRI in nine of 11 patients depicted complete resolution of the lesions; in two, small infarctions remained but the extent of the lesions had decreased. CONCLUSION: Reversible posterior leukoencephalopathy syndrome develops in patients with toxemia of pregnancy, renal insufficiency or complicated migraine, and those who undergo immonosuppresive therapy. The characteristic MR finding is edema in cortical or subcortical areas of the parietal and occipital lobes, without enhancement after Gd-DTPA injection. Early recognition of this readily treatable condition may obviate the need for extensive, invasive investigations, and prompt treatment can lead to a favorable prognosis.

A case of preoperative angiographic uterine artery embolization for the conservative treatment of cervical pregnancy / 대한산부인과학회잡지

A 35 year old woman, gravid 5, multiparous, was admitted to our department at 6 weeks and 5 days of gestation after being diagnosed with cervical pregnancy. Before the evacuation, the uterine arteries were embolized using angiographic techniques. As a result, dilatation and curettage were performed with minimal hemorrhage. We report one case of cervical pregnancy managed, successfully with preoperative uterine artery embolization and evacuation.

A Case of Renal Teratoma / 대한비뇨기과학회지

No abstract available.

MRI Findings of Sacroiliitis in Ankylosing Spondylitis: Roles of MPGR and Delayed Post-contrast T1-weightedImages

PURPOSE: For early diagnosis of sacroiliitis in spondyloarthropathy, the MRI findings of sacroiliitis, roles of MPGR (Multiplanar Gradient Recalled Acquisition in Steady State), and delayed post-contrast T1-weighted images were evaluated. MATERIALS AND METHODS: Twenty six patients with seronegative spondyloarthropathy (probable clinical diagnosis of ankylosing spondylitis) were grouped as either less than radiographic grade I (group A) or more than grade II (group B). The MRI findings of both sacroiliac joints were evaluated in every patient, and predominant sites were determined. The two groups were then compared. In 17 patients, the number of enhancing panni seen on early and delayed post-contrast T1-weighted images was counted and compared between the two groups. RESULTS: Panni were found in all cases, and in both groups, predominant patterns of involvement were the lower and iliac aspects of the sacroiliac joints in both groups; in group A, the synovial joints and punctate pannus were predominantly involved, and in group B, the ligamentous joints as well as the synovial joints and linear pannus. In group B, more periarticular fat accumulation than periarticular osteitis was found. For the evaluation of changes in joint space, MPGR images were superior to spin echo images. For the delineation of enhancing pannus less than radiographic grade I, delayed post-contrast images were statistically superior to those which were early post-contrast. CONCLUSION: MRI can detect early sacroiliitic change according to the predominant sites of involvement, and delayed post-contrast images play a role in the diagnosis of early sacroiliitis. MPGR imaging is good for the evaluation of joint space change.

Sclerosing Hepatocellular Carcinoma: Case Report

Sclerosing hepatocellular carcinoma is a rare primary hepatocellular neoplasm which is not associated with hepatitis type B and liver cirrhosis. It is characterized by intense fibrosis in which the tubular neoplastic structures are embedded. The authors report a case of sclerosing hepatocellular carcinoma which mimics hemangioma or hypervascular metastatic tumor and on sprial CT shows early enhancement of the cellular component and delayed enhancement of the fibrotic component.

CT Findings of Automastoidectomy: Comparison with Postmastoidectomy Defect of the Temporal Bone

PURPOSE: To describe the CT findings of automastoidectomy caused by cholesteatoma, and to evaluate the natural course of cholesteatoma by comparing it with the postmastoidectomy defect of the temporal bone. MATERIALS AND METHODS: We retrospectively reviewed the CT findings of 15 cases of automastoidectomy in 13 patients with cholesteatoma and of 14 cases of postmastoidectomy in 13 patients. RESULTS: In automastoidectomy, the posterior walls of bony defects of the temporal bone were thinner (mean thickness in automastoidec/postmastoidec tomy :2mm/3.5 mm) and smoother(n=10) than those of bony defects in postmastoidectomy(n=6). Defects of the posterosuperior wall of the bony external auditory canal were present in all cases of automastoidectomy(100%) andmost of postmastoidectomy(79%). there were gross defects of the lateral bony cortex of the mastoid(71%), Henle'sspine(100%), and the postero superior extension of the exit of bony defect(100%) in cases of postmastoidectomy(n=10), but there were rare findings in cases of automastoidectomy(20%, 21%, 23%, respectively).There were soft tissue densities within the bony defect and sinus tympani in all cases of automastoidectomy(100%)and in some cases of postmastoidectomy(64% and 36% respectively). CONCLUSION: When comparing automastoidectomyand postmastoidectomy, CT findings concerning bony defects were different with regard to the remaining posteriorwall, the extent of bony defect, and the presence of findings which suggested an active disease process. These differences are helpful in differentiating automastoidectomy and postmastoidectomy and in understanding thenatural course of cholesteatoma.

Bilateral Pulmonary Sequestration: A Case Report

A 21-year-old woman presented with productive cough and hemoptysis. Chest radiograph shows a large thin-walled cystic lesion with an air-fluid level in medial portion of the left lower lung zone and opacity in paravertebral area of the right lower lung zone. Chest CT scan shows a thin-walled cavitary lesion in the posterior basal segment of left lower lobe with an air-fluid level. Area of consolidation containing air-filled cysts was also observed in medial aspect of right lower lobe. Selective angiogram obtained from aberrant artery arising from descending abdominal aorta showed two main branches of the artery supplying bilateral pulmonary lesions.