ABSTRACT
Cryptogenic organizing pneumonia (COP) is a rare entity in childhood, particularly in previously healthy children. Moreover, the spontaneous remission of the disease is exceptional. We report on the case of a previously healthy 10-year-old girl who consulted her doctor for a 2-month history of mild pyrexia, fatigue, weight loss, and exertional dyspnea with no response to amoxicillin. A chest CT revealed bilateral, asymmetrical peribronchovascular consolidation areas predominating in the lower lobes and imaging features of COP. The bronchoalveolar lavage and the biological findings were negative. On follow-up, the girl showed clinical and radiological remission of the disease with no treatment. Our report describes an extremely rare case of spontaneously resolving COP in a child, the diagnosis being made based on the imaging pattern.
Subject(s)
Cryptogenic Organizing Pneumonia/diagnostic imaging , Pediatrics , Tomography, X-Ray Computed , Child , Cryptogenic Organizing Pneumonia/complications , Dyspnea/etiology , Female , Humans , Predictive Value of Tests , Remission, Spontaneous , Sensitivity and Specificity , Tomography, X-Ray Computed/methodsABSTRACT
We present the case of a 30-year-old female, complaining of thoracic outlet compression symptoms caused by a supernumerary muscle, the subclavius posticus, accompanied by a caudally inserted middle scalenus muscle on the second rib. This rare anatomic variant was clearly shown on CT angiography and MRI images and surgical treatment was successful. As first described by Rosenmuller in 1800, subclavius posticus is a supernumerary muscle originating from the cranial surface of the sternal end of the first rib, running laterodorsally beneath the clavicle, and inserting into the superior border of the scapula. Its role in thoracic outlet syndrome has been seldom demonstrated in living patients nor described in imaging, although it is theoretically easily recognizable on modern imaging modalities. It should be taken into account during workout of patients with thoracic outlet syndrome, since it can be potentially treated.
Subject(s)
Muscle, Skeletal/abnormalities , Thoracic Outlet Syndrome/diagnosis , Thoracic Outlet Syndrome/etiology , Adult , Contrast Media , Female , Humans , Magnetic Resonance Imaging , Muscle, Skeletal/surgery , Thoracic Outlet Syndrome/surgery , Tomography, X-Ray Computed , Ultrasonography, DopplerABSTRACT
Intrathoracic appendicitis is an uncommon diagnosis. We report the case of a 6-year-old boy with elevated CRP and no fever, who complained of nonspecific abdominal pain. A diaphragmatic hernia was suspected on a chest X-ray and confirmed by an ultrasound examination. A multidetector CT scan revealed intrathoracic acute appendicitis associated with a right posterolateral Bochdalek hernia. Abdominal diseases associated with late-presenting congenital diaphragmatic hernia are often manifested by an atypical clinical presentation, which can be a source of delay or error in diagnosis. We recommend radiological exploration in the case of diaphragmatic hernia, even with subtle clinical findings in the search of associated gastrointestinal complications.
Subject(s)
Appendicitis/diagnosis , Hernia, Diaphragmatic/diagnosis , Abdominal Pain/etiology , Appendicitis/surgery , C-Reactive Protein/analysis , Child , Hernia, Diaphragmatic/surgery , Hernias, Diaphragmatic, Congenital , Humans , Male , Multidetector Computed TomographyABSTRACT
Hydatidosis is a parasitic disease found worldwide, particularly in Mediterranean countries, caused by Echinococcus granulosis infection. Humans are an intermediate and accidental host in the cycle of this parasite. The hydatid pulmonary arterial embolism is extremely rare, usually arising in the heart or the liver. We report a case of hydatid pulmonary embolism explored with multidetector scanner and MRI, and confirmed at pathology of the operative specimen. To our knowledge, this is the first case of inaugural hydatid pulmonary arterial embolism found on CT scan establishing the diagnosis of the disease in a patient who had no other location of hydatid cyst.
Subject(s)
Echinococcosis, Pulmonary/diagnosis , Magnetic Resonance Imaging , Pulmonary Embolism/etiology , Tomography, X-Ray Computed , Aged , Anti-Bacterial Agents/therapeutic use , Bronchoscopy , Echinococcosis, Pulmonary/complications , Echinococcosis, Pulmonary/diagnostic imaging , Echinococcosis, Pulmonary/surgery , Hemoptysis/etiology , Heparin/therapeutic use , Humans , Male , Pneumonectomy/methods , Pulmonary Embolism/parasitology , Pulmonary Embolism/surgery , Smoking/adverse effectsSubject(s)
Cotton Fiber , Foreign Bodies , Thoracotomy , Foreign Bodies/diagnosis , Foreign Bodies/surgery , Humans , Male , Middle Aged , Thorax , Time FactorsABSTRACT
PURPOSE: To assess the value of US of the mastectomy site at the time of follow-up of the contralateral residual breast. MATERIALS AND METHODS: Over a 5 year period, 251 patients with previous mastectomy underwent 505 unilateral mammographies with US of the mastectomy site. The time delay between imaging and mastectomy ranged between 1-15 years, with a mean of 7.5 years. Lesions at the mastectomy site were classified as follows: BIRADS 2 for a cyst or prominent edema, BIRADS 3 for a lymph node with preserved fatty hilum or mildly echogenic cyst, BIRADS 4 for well-defined hypoechoic lesions, and BIRADS 5 for ill-defined lesions. RESULTS: None of the lesions classified as BIRADS 1, 2 or 3 was malignant. Eleven lesions were classified as BIRADS 4: 3 benign lesions, 7 malignant lesions, and 1 non-verified lesion. No lesion was classified as BIRADS 5. CONCLUSION: Systematic US evaluation of the mastectomy site appears warranted since only 1 of 7 malignant lesions was clinically palpable prior to US whereas all were retrospectively palpable after US.
Subject(s)
Breast Neoplasms/diagnostic imaging , Breast Neoplasms/surgery , Neoplasm Recurrence, Local/diagnostic imaging , Adult , Aged , Aged, 80 and over , Female , Follow-Up Studies , Humans , Middle Aged , Retrospective Studies , UltrasonographyABSTRACT
US, a non-irradiating imaging modality, is complementary to radiographs in the evaluation of limb fractures. US may in some cases demonstrate or suggest the presence of a fracture without corresponding abnormality on radiographs, or confirm or exclude a possible fracture detected on radiographs. Knowledge of the US features of fractures is necessary. In this article, the different direct and indirect US findings of fractures will be reviewed, with radiographic correlation. Direct findings include cortical discontinuity or irregularity. Indirect findings include subperiosteal or juxtaphyseal hematoma suggesting cortical or physeal fractures respectively.
Subject(s)
Arm Bones/injuries , Fractures, Bone/diagnostic imaging , Arm Bones/diagnostic imaging , Carpal Bones/diagnostic imaging , Carpal Bones/injuries , Hematoma/diagnostic imaging , Humans , Periosteum/diagnostic imaging , Periosteum/injuries , UltrasonographySubject(s)
Bile Duct Neoplasms/complications , Bile Ducts, Intrahepatic , Cholangiocarcinoma/complications , Hepatitis B, Chronic/complications , Jaundice/etiology , Bile Duct Neoplasms/diagnosis , Carcinoma, Hepatocellular/complications , Carcinoma, Hepatocellular/diagnosis , Carrier State , Cholangiocarcinoma/diagnosis , Humans , Liver Neoplasms/complications , Liver Neoplasms/diagnosis , Male , Middle Aged , Mixed Tumor, Malignant/complications , Mixed Tumor, Malignant/diagnosisABSTRACT
We describe the imaging features of a tailgut cyst mistaken for an adnexal mass. A pelvic ultrasound in a 28-year-old woman showed a 10-cm hypoechoic left pelvic mass. Having not seen the left ovary, the radiologist concluded that the mass was an endometrioma. CT disclosed a retrorectal cystic lesion with wall calcifications and internal septa. MR confirmed the extra-ovarian location of the tumor, which was hyperintense on T2-weighted images and had an intermediate signal on T1-weighted images. Surgery revealed a retrorectal cystic hamartoma. Radiological diagnosis of a tailgut cyst requires first correct localization of the tumor and then differentiation from other retrorectal masses.