Vigorous achalasia: Zebra amongst horses.

Vigorous achalasia is an oesophageal disorder with clinical and radiological characteristics of classic achalasia and diffuse oesophageal spasm. It is a rarely reported variant. A 60-year-old gentleman presented with complaints of difficulty in swallowing, regurgitation and chest pain for the past 10 years. His symptoms persisted despite the use of proton pump inhibitors. On endoscopy and barium swallow, the diagnosis of vigorous achalasia was confirmed. It is a rare variant of classic achalasia usually misdiagnosed as diffuse oesophageal spasm.

Intracranial bony ball - An ossified variant of meningioma.

An ossified variant of meningioma in the intracranial region is very rare. We report a case of a 28-year-old female who presented with headache for 4 years. Imaging revealed an extra-axial calcified mass in the left parieto-occipital lobe. The differential diagnosis included osteoblastoma both intracranial and periosteal, calcifying pseudotumor of the neural axis, hyperostosis of the cranium, and ossifying fibroma. She underwent excision of the calcified space occupying lesion. Histopathology was suggestive of an ossified meningioma. At the end of 2-year follow-up, she was asymptomatic with no signs of recurrence.

Pericardial Haemangioma: A Common Tumour in an Unusual Location: Case Report and Review of Literature.

Overall incidence of primary cardiac tumour ranges from 0.0017% and 0.27% at autopsy. Cardiac haemangiomas are rare, and account for 2.8% of benign cardiac tumours. Pericardial haemangiomas, in particular are extremely rare. Pericardial haemangiomas are reported to present with a variety of symptoms such as dyspnea, palpitation, atypical chest pain. Other symptoms like obstruction of blood vessels, cardiac tamponade, or pericardial effusion may result due to compression of surrounding structures. Here, we report a case of pericardial haemangioma in a patient who presented with breathlessness and cough.

Simple lymphangioma to generalized lymphatic anomaly: role of imaging in disclosure of a rare and morbid disease.

Generalized lymphatic anomaly is a rare multisystem congenital disorder in which multiple organs are involved. Imaging features often overlap with other complex lymphatic anomalies and diagnosis is difficult. Treatment options are limited, not remedial and prognosis is poor. We report a 12-year-old male who presented with axillary and chest wall lymphangioma but was subsequently diagnosed as having diffuse lymphangiomatosis affecting lungs, liver, spleen, and bones on computerized tomography scan. We suggest complete radiological evaluation of susceptible adolescent children with lymphangioma to avoid diagnostic delay in this morbid condition. We also discuss radiological features of other similar complex lymphatic anomalies and crucial role of imaging in diagnosis.