Anaplastic astrocytoma. Axial T2-weighted and enhanced Tl -weighted images demonstrate a large right temporal mass with prominent enhancement and extensive surrounding infiltration. Differential diagnosis includes lymphoma. (Click to magnify figure)
World Health Organization (WHO)Grade II infiltrating astrocytoma(low grade). Axial T2-weighted, FLAIR, and enhanced Tl -weighted images. There is a high signal intensity mass in the left frontal lobe. No significant edema or enhancement is identified. (Click to magnify figure)
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Cerebral palsy (CP) is an umbrella term encompassing a group of non-progressive, non-contagious conditions that cause physical disability in human development.
Magnetic resonance imaging showed cystic encephalomalacia of LMCA territory, suggesting prenatal insult,
- The most frequent MRI finding was a focal thinning at the isthmus of the corpus callosum
Magnetic resonance imaging (MRI) scan of a 9-day-old girl who was born full-term and had a perinatal hypoxic-ischemic event. Examination of the patient at 1 year revealed findings consistent with a mixed quadriparetic cerebral palsy notable for dystonia and spasticity. Severe hypoxic-ischemic injury to the medial aspect of the cerebellar hemispheres, medial temporal lobes, bilateral thalami, and bilateral corona radiata is observed.
Magnetic resonance imaging (MRI) scan of a 16-month-old boy who was born at term but had an anoxic event at delivery. Examination findings are consistent with a spastic quadriplegic cerebral palsy with asymmetry (more prominent right-sided deficits). Cystic encephalomalacia in the left temporal and parietal regions, delayed myelination, decreased white matter volume, and enlarged ventricles can be seen. These findings are most likely the sequelae of a neonatal insult (eg, periventricular leukomalacia with a superimposed, left-sided cerebral infarct).
Pancreatic involvement in acute lymphoblastic leukaemia is rare [1, 2, 3] and obstructive jaundice secondary to a pancreatic mass as a primary presentation of acute lymphoblastic leukaemia has not been reported in the surgical literature. Acute lymphoblastic leukaemia typically presents with symptoms of bone marrow failure such as fatigue, lethargy, infections, bruising or bleeding. Approximately half the patients will have lymphadenopathy, splenomegaly or hepatomegaly at presentation. Full blood count may reveal cytopenias or (as in this case) a raised white cell count due to circulating blast cells. Although long term survival in adults is less good than children, acute lymphoblastic leukaemia is an important diagnosis to make because it is highly chemo-sensitive, with 91% of adults achieving complete remission following induction therapy in the recent UK ALL XII trial [4]. If suspected, a haematological referral is required since the diagnostic procedure of choice is a bone marrow aspirate and trephine.
A four-year-old boy with sacrococcygeal endodermal sinus tumour. Blood culture grew Peiciliomyces lilacinus. (a) CT lungs showed tiny nodular lesions, presumed involvement of lungs by fungus. (b) After two weeks of anti-fungal therapy, CT showed the lung lesions had increased in size and number. (c) CT lungs after two months of continuous anti-fungal therapy showed more and larger lesions, which were likely to be metastases.
Fungal abscesses in intrabdominal organs. (a) A two-year-old girl with leukaemia and Aspergillus sepsis. CT showed multiple hypodense lesions in both kidneys. (b) A six-year-old girl with leukemia and presumed fungal sepsis. CT revealed multiple hypodense lesions in the liver and spleen. Fungal elements were isolated from liver biopsy, but the species could not be identified. (c) A three-year-old boy with leukemia with presumed fungal sepsis. CT abdomen showed multiple hypodense splenic lesions No fungi were isolated from biopsy.
Fungal sinusitis of a four-year-old girl with myeloid leukaemia. CT of the sinuses revealed opacification of the maxillary sinuses with bone destruction of the medial wall. Mucor species was isolated from maxillary sinus washout.
A 10-year-old girl with leukemia and biopsy proven Aspergillus infection of the lung. She later developed a mycotic aneurysm in the chest. (a) CT showed a cavity with a “crescent sign” in keeping with an Aspergilloma. The lesion was excised. (b) Chest radiograph two months later showed a round opacity in the right lung. (c) CT revealed an aneurysm of the lower lobe branch of the right pulmonary artery.
Marked FDG uptake throughout the mediastinum and in the right axilla/supraclavicular area corresponding to bulky adenopathy on the CT portion of the exam compatible with malignancy.
Chemotherapy (CHOP). Follow-up PET/CT ordered following 1 cycle.
CT non contrast
ADC MAP
DWI
Axial flair
MR perfusion CBV map
CT showed lymphadenopathy above and below the diaphragm and a lesion in L-3 vertebra consistent with a compressed or pathological fracture. The final diagnosis of lymphoma was made after biopsy of enlarged right inguinal lymph nodes and by bone marrow biopsy. There are areas of increased pathological activity in the left supra and infraclavicular region, the upper and mid-mediastinum, the right pulmonary hilus, D-8, D-12, L-2, L-3, L-4 vertebrae and the left inguinal region.
Contrast-enhanced helical CT scan demonstrates a markedly enlarged, conglomerate nodal mass with homogeneous attenuation enveloping the retroperitoneum. Lymphoma was the most likely diagnosis, but biopsy revealed adenocarcinoma.
This is 68 year old man with bilateral propotosis and lymphadenopathy. CT images are characterstic of orbital lymphoma.
PET/CT for staging of Hodgkin's lymphoma. CT showed involvement only in right neck. PET/CT (A: coronal views; B: transverse views; MIP = maximum-intensity projection) showed that normal-size (9-mm) upper mediastinal lymph node was clearly metabolically active, changing stage from I to II. This finding is relevant if consolidative radiation after chemotherapy is planned. Incidental normal scalene muscle uptake was noted on coronal PET.
Primary right atrial lymphoma. Magnetic Resonance Imaging # Description : Magnetic Resonance Imaging of primary right atrial lymphoma
Primary right atrial lymphoma. CT scan of jugular veins # Description : Contrast CT scan showing extension of the primary right atrial lymphoma through the superior vena cava up to the right jugular vein that is occluded while the contra-lateral jugular vein is opened.
Figure 1. 55-year-old man with recurrent mantle cell lymphoma. CT shows symmetric circumferential thickening of the distal trachea (arrows).
Figure 2. 55-year-old man with recurrent mantle cell lymphoma. Axial PET/CT shows intense activity in the suspected area around the distal trachea.
signet appearance due to dilated bronchus in near to
arrowhead=bronchial wall thickening in transverse section.
Transverse CT image in a 67-year-old woman with acute right upper quadrant pain due to omental infarction shows ill-defined, ovoid, fatty mass (arrows) of increased attenuation centered in the greater omentum.
Transverse CT image in a 34-year-old man with acute right lower quadrant pain caused by appendicitis with perforation. Appendiceal lumen (short black arrow) is enlarged and shows wall enhancement. Mesenteric stranding (white arrow), free intraperitoneal air (arrowhead), and thickened terminal ileum (long black arrow) due to contiguous inflammation are seen.
Transverse CT image in a 21-year-old man with right lower quadrant pain due to appendicitis shows an appendicolith (arrowhead) separated from cecal lumen by cecal wall thickening (cecal bar sign) (black arrow). Dilatation of inflamed appendix with air and debris (white arrow) is demonstrated.
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