Cerebral Vasculitis Revealing Systemic Sarcoidosis: A Case Report and Review of the Literature.

Vasculitis in neurosarcoidosis is rare, with only a few cases reported in the literature. We report the clinical observation of a 51-year-old patient with no previous medical history, who was admitted to the emergency department due to sudden onset confusion, fever, sweating, weakness, and headaches. The first brain scan was normal, but a further biological exam with a lumbar puncture revealed lymphocytic meningitis. A complementary cerebral MRI revealed abnormalities in the white matter signal, suggestive of multiple sclerosis, with petechial hemorrhagic foci associated with leptomeningeal involvement and cerebral vasculitis. Thoraco-abdomino-pelvic computed tomography revealed hilar and mediastinal lymphadenopathy, as well as lymph nodes in the lower cervical region. A biopsy of the lymph nodes confirmed the presence of non-caseating granulomatous inflammation consistent with sarcoidosis. High-dose corticosteroid therapy was initiated with good clinical outcomes. Cerebral vasculitis in neurosarcoidosis is rare but can lead to neurological complications requiring long-term multidisciplinary management.

Xanthogranulomatous cholecystitis on fusion of the planes of the liver.

Xanthogranulomatous cholecystitis (CXG) is a rare entity of cholecystitis, characterized by the presence of xanthogranulomas within the gallbladder wall, that could be misdiagnosed as a vesicular carcinoma. We report a case of 66-year-old man with xanthogranulomatous cholecystitis associated with an incidental finding of a fusion of the planes of the liver which is a rare anatomic variant. Imaging especially ultrasounds, CT scan, and MRI play a key role in the characterization of those anomaly, thus avoiding a non-suitable surgical procedure.

Left renal vein compression complicating intragastric balloon insertion.

Obesity is a real public health problem and is of growing concern. People are resorting to surgical or endoscopic means to fight against overweight and obesity. In recent years, there has been a marked increase in the use of these means and in particular the insertion of a gastric balloon which seems to present less risk than surgical methods. Renal complications from intragastric balloon placement are extremely rare. We report here the case of compression of the left renal vein revealed by lumbar pain and hematuria in an overweight 39-year-old woman who benefited from the balloon gastric placement one month before symptoms. The scanner made the diagnosis and showed a good evolution after the withdrawal of the balloon.