RESUMO
Aggregomas are rare localized masses of monoclonal nonamyloid immunoglobulin light-chain deposits. To date, there have been only a few reports of isolated aggregomas, with the majority detailing renal, lymph node and brain deposition. We present a rare case of paraspinal aggregoma in a 67-year-old female who presented with a complaint of cough and chest pain. Imaging demonstrated a left-sided paravertebral mass extending from T7-T10. Pathological analysis showed lamellar deposition of extracellular eosinophilic material with an associated lymphoplasmacytic nonamyloid infiltrate. To our knowledge, this is the first report of a paraspinal aggregoma. While exceedingly rare, this tumor can be included in the radiologic differential diagnosis of paravertebral soft tissue tumors in adults. The observation of our case adds to the limited understanding of the etiology, pathogenesis, natural history, and treatment of nonamyloid light-chain depositions.
Assuntos
Cadeias Leves de Imunoglobulina/sangue , Paraproteinemias/sangue , Paraproteinemias/diagnóstico , Neoplasias da Coluna Vertebral/sangue , Neoplasias da Coluna Vertebral/diagnóstico , Idoso , Feminino , Humanos , Neoplasias da Coluna Vertebral/cirurgia , Neoplasias Torácicas/sangue , Neoplasias Torácicas/cirurgia , Resultado do TratamentoRESUMO
Imaging evaluation of postoperative spinal infection is challenging. A systematic approach and keen understanding of multimodality imaging techniques, as well as knowledge of the patient's surgical procedure and clinical presentation, are critical for the radiologist to render an accurate diagnosis. Because of the overlap between diagnostic imaging findings in the postoperative spine and the infected spine, in those situations in which the index of clinical suspicion for spine infection is high, then immediate consideration ought to be given to performing a spine biopsy.
Assuntos
Neuroimagem/métodos , Doenças da Coluna Vertebral/cirurgia , Infecção da Ferida Cirúrgica/diagnóstico , Comportamento Cooperativo , Diagnóstico Diferencial , Discite/diagnóstico , Discite/patologia , Abscesso Epidural/diagnóstico , Abscesso Epidural/patologia , Abscesso Epidural/cirurgia , Humanos , Biópsia Guiada por Imagem/métodos , Comunicação Interdisciplinar , Imageamento por Ressonância Magnética/métodos , Osteomielite/diagnóstico , Osteomielite/patologia , Osteomielite/cirurgia , Cintilografia/métodos , Sensibilidade e Especificidade , Fusão Vertebral/instrumentação , Infecção da Ferida Cirúrgica/patologia , Infecção da Ferida Cirúrgica/cirurgia , Tomografia Computadorizada por Raios X/métodosRESUMO
Sonography is the primary imaging modality for the evaluation of pelvic pain in female patients, especially if gynaecological pathology is suspected. However, computed tomography (CT) is frequently used in patients who present to emergency departments (and elsewhere) with otherwise nonspecific abdominal and pelvic pain and may be the first imaging modality to demonstrate an acute gynaecological abnormality. Computed tomography can also be used prospectively in selected patients to further evaluate findings initially identified on sonography, although to reduce radiation exposure, magnetic resonance imaging is being used more frequently in this situation. The purpose of this article is to discuss the spectrum of gynaecological findings of the acute female pelvis that may be identified on CT by the emergency radiologist and by the general radiologist, with a brief review of the imaging literature of each specific diagnosis.
Assuntos
Abdome Agudo/diagnóstico por imagem , Doenças dos Genitais Femininos/diagnóstico por imagem , Dor Pélvica/diagnóstico por imagem , Tomografia Computadorizada por Raios X/métodos , Meios de Contraste , Feminino , Humanos , Gravidez , Proteção RadiológicaRESUMO
A broad spectrum of skin and subcutaneous (SQ) findings may be discovered in the emergency setting on CT examinations. There are some findings that are directly relevant to the reason or reasons why the patient has undergone the CT examination. However, other findings may be incidental. The skin and SQ tissues are by definition on the periphery of CT images and may be overlooked by the radiologist, although findings related to them can be of clinical importance. The purpose of this pictorial essay is to present a broad spectrum of skin and subcutaneous findings which may be identified on CT examinations in the emergency setting (and in some cases nonemergently), and to briefly review the relevant imaging literature, which surprisingly is relatively limited on this topic. Categories of cutaneous and subcutaneous abnormalities that will be covered include trauma and hemorrhage, iatrogenic findings, infection, neoplasms, calcification, and other miscellaneous entities, all of which may initially present on emergency CT examinations of the body.
Assuntos
Pele/diagnóstico por imagem , Tela Subcutânea/diagnóstico por imagem , Tomografia Computadorizada por Raios X/métodos , Emergências , Humanos , Pele/patologia , Tela Subcutânea/patologiaRESUMO
Adamantinoma is a rare primary bone malignancy with a predilection for the tibial cortex. Metastases have been reported to the long bones, lung, pleura and spine. We present a 26-year-old pregnant woman with metastatic disease to the posterior cul-de-sac, lungs, liver and retroperitoneum, which collectively have not been previously reported in a single patient to our knowledge.
Assuntos
Adamantinoma/secundário , Neoplasias Ósseas/patologia , Escavação Retouterina , Neoplasias Peritoneais/secundário , Complicações Neoplásicas na Gravidez , Tíbia , Adulto , Feminino , Humanos , Neoplasias Hepáticas/secundário , Neoplasias Pélvicas/secundário , GravidezRESUMO
There is a wide variety of uncommon and unusual gastrointestinal causes of acute abdominal and pelvic pain that may be prospectively diagnosed on computed tomography. We demonstrate 10 such diagnoses and briefly review the current computed tomography and clinical literature on intussusception occurring beyond early childhood, small bowel obstruction from internal hernia, cecal volvulus, intramural small bowel hemorrhage, Boerhaave's syndrome, gastrointestinal luminal foreign bodies, small bowel diverticulitis, hemoperitoneum secondary to abdominal tumor; gallstone ileus, and gallbladder torsion. Radiologists and clinicians need to be aware of these disorders, particularly with the widespread utilization of computed tomography (CT) in the management of patients with acute abdominal pain.
Assuntos
Abdome Agudo/diagnóstico , Abdome Agudo/etiologia , Gastroenteropatias/complicações , Gastroenteropatias/diagnóstico por imagem , Radiografia Abdominal/métodos , Tomografia Computadorizada por Raios X/métodos , Diverticulite/complicações , Diverticulite/diagnóstico , Doenças do Esôfago/complicações , Doenças do Esôfago/diagnóstico , Corpos Estranhos/complicações , Corpos Estranhos/diagnóstico , Doenças da Vesícula Biliar/complicações , Doenças da Vesícula Biliar/diagnóstico , Hemoperitônio/complicações , Hemoperitônio/diagnóstico , Hemorragia/complicações , Hemorragia/diagnóstico , Humanos , Obstrução Intestinal/complicações , Obstrução Intestinal/diagnóstico , Volvo Intestinal/complicações , Volvo Intestinal/diagnóstico , Intestino Delgado/diagnóstico por imagem , Intussuscepção/complicações , Intussuscepção/diagnósticoAssuntos
Gastroenteropatias/diagnóstico por imagem , Gastroenteropatias/etiologia , Infecções por Bactérias Gram-Negativas/diagnóstico por imagem , Infecções por Bactérias Gram-Positivas/diagnóstico por imagem , Micoses/diagnóstico por imagem , Viroses/diagnóstico por imagem , Fluoroscopia , Infecções por Bactérias Gram-Negativas/imunologia , Infecções por Bactérias Gram-Positivas/imunologia , Humanos , Hospedeiro Imunocomprometido , Micoses/imunologia , Peritonite Tuberculosa/diagnóstico por imagem , Radiografia Abdominal , Tomografia Computadorizada por Raios X , Viroses/imunologiaRESUMO
The postprocedural period is a critical time in which serious complications can manifest. Localization of suspected complications following abdominal and pelvic procedures can be difficult on clinical evaluation alone. For example, abdominal pain after a colonoscopy may vary in etiology and can result from simple colonic spasm to colonic perforation, hemoperitoneum, or even splenic rupture. Vague abdominal pain following a renal biopsy may be due to minimal postprocedural bleeding into and around the kidney or may be due to potentially life-threatening hemorrhage. In such patients, computed tomography can play a crucial role in the rapid identification of complications as well guidance of subsequent patient management. The purpose of this article is to demonstrate the benefit of computed tomography-assisted diagnosis of complications associated with routine procedures performed on or throughout the abdomen and pelvis, including cardiac catheterization, colonoscopy, endoscopy, percutaneous biopsy, and interventional radiology procedures.
Assuntos
Pelve/diagnóstico por imagem , Complicações Pós-Operatórias/diagnóstico por imagem , Radiografia Abdominal , Tomografia Computadorizada por Raios X , Biópsia/efeitos adversos , Colangiopancreatografia Retrógrada Endoscópica/efeitos adversos , Endoscopia/efeitos adversos , Humanos , Filtros de Veia Cava/efeitos adversosRESUMO
We report the radiology and pathology of a pediatric patient with lymphomatoid granulomatosis (LG) and review the literature, with an emphasis on the radiological findings and on the small subset of pediatric patients with this rare condition.
Assuntos
Pneumopatias/diagnóstico por imagem , Granulomatose Linfomatoide/diagnóstico por imagem , Adolescente , Biópsia , Humanos , Masculino , Radiografia Torácica , Tomografia Computadorizada por Raios XRESUMO
There have been few reports of the CT findings of intestinal lymphangiectasia in adults, and no CT descriptions have been reported in the literature in children. We describe the CT appearance of a biopsy-proven case of primary small intestinal lymphangiectasia in a 3-year-old boy, and we will review the limited literature on the CT findings in this disorder in adults.