ABSTRACT
Subpleural and mediastinal lipomatosis are benign intrathoracic conditions discovered incidentally on plain chest radiographs. However, diagnosis is usually made by Computed Tomography (CT). A case of both mediastinal and pleural lipomatosis associated with use of steroids in a 58-year-old male patient presented with complaints of breathlessness and dry cough is discussed in this case report. Intially, pleural effusion and bilateral upper lobe patchy opacities were suspected as a cause of breathlessness on the basis of chest x-ray findings. For which, CT scan of chest was advised.
ABSTRACT
BACKGROUND: Suprahyoid neck lesions are difficult to assess only by means of clinical inspection and therefore imaging techniques are required to precisely evaluate suprahyoid neck spaces. The aim of this study was to evaluate the distinctive role of computed tomography in the assessment of anatomical source and pathological type of masses involving the suprahyoid neck spaces. MATERIAL/METHODS: Sixty patients presenting with suprahyoid neck masses underwent computed tomography of the neck. The CT findings were correlated with histopathological findings and a final diagnosis was made. RESULTS: Overall, male preponderance was seen except in the case of parotid space lesions where female predominance was seen. The most common aetiology was squamous cell carcinoma and the majority of cases (30%) were seen in patients aged 41-50 years. The majority of lesions were found in the pharyngeal mucosal space (n=16) with squamous cell carcinoma being the most common pathology. In the parotid space, pleomorphic adenoma and in the prestyloid parapharyngeal space, squamous cell carcinoma were the most common lesions, respectively. In the retropharyngeal space, an equal incidence of malignant and inflammatory aetiologies was seen. Abscesses were the most common lesions in the prevertebral space. The pleomorphic adenoma was the most common benign tumour and was also the second most common tumour in the suprahyoid neck spaces. CT had an excellent correlation with histopathological findings with sensitivity of 96.4%, specificity of 100%, positive predictive value of 100% and a negative predictive value of 91.67%. CONCLUSIONS: Computed tomography definitely has a major role to play in the evaluation of suprahyoid neck masses as it has an excellent correlation with post-operative histopathological diagnosis.
ABSTRACT
Retrorectal cystic hamartoma, also known as tailgut cyst, is a rare congenital developmental lesion arising from postnatal primitive gut remnants in the retrorectal space. The rarity of the lesion and its anatomical position usually leads to difficulty in diagnosis and surgical management. This cyst predominantly occurs in women (female to male ratio, 3:1). Tailgut cysts can present as incidental findings during the routine examination but over half of the patients are thought to present with symptoms. Computed tomography or magnetic resonance imaging has a crucial role in diagnosing these misdiagnosed cysts. Complete surgical excision is the treatment of choice for tailgut cysts as this provides a definitive diagnosis, relieves symptoms, and prevents possible complications such as infection, fistula formation, and malignant degeneration. We present a case of a 40-year-old female, who presented to us with lower back swelling (7 cm × 5 cm) for last 2 years, which had become more prominent to her while sitting. The patient was investigated. Ultrasonography demonstrated ill-defined large cystic lesion (8 cm × 7 cm), posterior to the uterus. Fine needle aspiration cytology suggested sebaceous cyst. A lumbosacral contrast-enhanced computed tomography demonstrated well-defined fluid density mass/collection with enhancing walls in the retrorectal, presacral, precoccygeal area, and suggested tailgut duplication cyst/retrorectal cystic hamartoma. Surgical complete excision of the cystic mass was done with both anterior (transabdominal) and posterior approach. Histopathology confirmed a tailgut cyst.