Pseudo Meig's Syndrome: An Unusual Presentation.

Aim: To describe the radiological findings in a case of pseudo Meig’s syndrome with rare association of pericardial effusion. Presentation of Case: We report a case of pseudo Meig's syndrome who also had pericardial effusion. The patient had sonography and MR imaging of the abdomen which showed uterine fibroid associated with bilateral pleural effusion, ascites and pericardial effusion. Subsequently, the patient underwent hysterectomy with bilateral salpingectomy following which ascites, pleural effusion and pericardial effusion resolved. Histopathological examination confirmed uterine leiomyoma with degenerative changes. Discussion: Pseudo-Meig's syndrome is a condition which describes the association of any ovarian tumor (benign or malignant) other than ovarian fibroma or any pelvic tumor with pleural effusion and ascites. Association of pericardial effusion along with this condition has been rarely reported. Most common tumors associated with this entity described in previous literature include leiomyoma of uterus and broad ligament, germ cell tumors etc. It becomes highly important to identify this condition as it is a curable condition mimicking malignancy and can avoid unnecessary interventions. Conclusion: Pseudo-Meig’s syndrome associated with pericardial effusion is a rarely reported entity which can mimic malignant condition and hence it is important to consider it as a possibility in patients who present with pericardial effusion of unknown cause.

Unusual Presentation of a Caseating Lymphadenitis Causing Abnormal Lymphadeno-Duodenal Communication.

Aim: To describe the imaging features of a case of abnormal lymphadeno-duodenal communication caused by caseating lymphadenitis. Presentation of Case: The case discussed is of a thirty-five year old Indian woman who presented with abdominal pain, vomiting, fever, loss of appetite and later diagnosed with abnormal lymphadeno-duodenal communication caused by caseating lymphadenitis. Discussion: Caseating lymphadenitis is a chronic disease process that occurs anywhere in the human body and its prevalence varies from region and country. Here, we report a case of lymph node with caseous necrosis causing abnormal lymphadeno-duodenal communication which was diagnosed by Computed tomography. This poses a great diagnostic challenge for a variety of reasons which include its non-specific symptoms, wide range of causes and the complications in the case of a delayed diagnosis. Abdominal involvement can occur in the peritoneum and the mesentery. Imaging plays a very important role to assess the cause of caseating lymph nodes and identify the complications. Conclusion: As abnormal lymphadeno-duodenal communication is an unusual condition and rarely reported, it is important to consider the possibility of tuberculosis as one of the underlying etiology. A high index of suspicion needs to be maintained for timely diagnosis and accurate treatment.