Unusual CT Findings Research Articles

Robotic adrenalectomy for adrenal pseudocyst: Case report and review of literature

Adrenal cysts are uncommon lesions that are usually benign, with an incidence of 0.06-0.18%. Pseudocysts are the second most common type of adrenal cyst. We present the case of a 57-year-old female whose CT scan of the abdomen incidentally revealed a 7.2 cm right adrenal tumor with peripheral calcifications. Due to its large size and unusual CT findings, resection was indicated.

Dynamic Computed Tomography Findings of Atypical Pulmonary Hamartoma and It's Pathologic Correlations: A Case Report

Pulmonary hamartoma is the third most frequent cause of solitary pulmonary nodules with an overall prevalence of up to 5.7% (1), and chondromatous hamartoma is the most common type of pulmonary hamartoma (2). Masses are composed of abnormal mixtures of epithelial and mesenchymal elements, such as cartilage, fat, fibromyxoid tissue, smooth muscle, and bone (3, 4). In spite of its relative frequency, no report has been published that details the CT findings of pulmonary hamartomas with rare pathologic patterns, such as fibrous or fibroleiomyomatous types. Here, we describe, for the first time, the unusual contrastenhanced CT findings of pulmonary hamartoma with a predominant fibroblast component and their relations with histopathologic findings. This case report was approved by our Institutional Review Board.

Acute dysphasia and reversible cognitive decline in a patient with probable cerebral amyloid angiopathy-related inflammation.

Cerebral amyloid angiopathy related inflammation (CAAri) is becoming increasingly recognised as a subset of cerebral amyloid angiopathy (CAA). CAAri generally presents with subacute cognitive decline, headaches, seizures, behavioral changes, and focal neurological deficits. We describe a patient who developed acute dysphasia and reversible cognitive decline due to probable CAAri. CT brain showed bilateral vasogenic edema in the cerebral hemispheres, predominantly involving the parietal and temporal lobes, left greater than right without enhancement. Magnetic resonance brain imaging showed extensive multifocal areas of subcortical white matter T2 hyperintensity in the frontal and temporal regions with associated mass effect, negligible enhancement, and multiple foci of microhemorrhage on susceptibility weighted imaging sequences consistent with a diagnosis of probable CAAri. She responded dramatically to a course of intravenous methylprednisolone followed by further immunosuppression with pulse intravenous cyclophosphamide. Her dysphasia resolved within 5 days of intravenous methylprednisolone therapy. Her MMSE improved from 11/30 at day 5 of admission to 28/30 at 6-month follow-up. The notable features of our case were the unusual CT findings, which were inconsistent with stroke and diagnostic utility of susceptibility-weighted magnetic resonance imaging in confirming the diagnosis which allowed for prompt institution of immunosuppression.

Atypical CT Findings in Plexiform Ameloblastoma.

Ameloblastoma is an uncommon epithelial odontogenic neoplasm that is nonmineralized, locally aggressive, and, in most cases, benign. Most ameloblastomas develop in the molar-ramus region of the mandible with 70% of them arising in the molar-ramus area. Radiologically they are unilocular or multilocular radiolucency with a honeycomb or soap bubble appearance. The radiographic appearance of ameloblastoma can vary according to the type of tumor. CT is usually helpful in determining the contours of the lesion, its contents, and its extension into soft and hard tissues. Through this case we would bring to light some of the unusual CT findings which include the destruction of the surrounding structures by the lesion which appeared to be normal routine lesion when viewed clinically.

A case of pneumoperitoneum and retropneumoperitoneum without bowel perforation due to extensive intestinal necrosis as a complication to chemotherapy: CT evaluation

Acute intestinal ischemia continues to be a challenging diagnostic problem with high mortality. We describe a rare case of acute intestinal necrosis, due to vasculitis, related with chemotherapy.A patient was examined in our emergency department, presenting with abdominal pain. Three months before he had undergone an operation for lung carcinoma (lobectomy) and received chemotherapy.CT of the abdomen demonstrated free air in 10 different locations: hepatic part of the portal vein, branches of mesenteric veins, femoral and iliac veins, the bowel wall, peritoneal cavity and retroperitoneal space, abdominal muscles, inguinal canals, meso-sigmoid space, and in the para-rectal space. Moreover, pathological findings revealed that the free air in the peritoneum and retropneumoperitoneum occurred without intestinal perforation, but with transudation through the necrotic bowel wall. This is a rare complication of chemotherapy. This case refers to the unusual CT findings which appeared in this patient. The key to a better outcome is early diagnosis of this condition and the CT examination of the abdomen plays an important role.

A case of pulmonary choriocarcinoma metastasis with unusual FDG-PET and CT findings: correlation with pathology

A 26-year-old female who had had a hydatidiform mole at 20 years of age showed high levels of serum human chorionic gonadotropin. Because pelvic ultrasound did not show any gestational sac in her uterus, she was suspected to have had an extrauterine pregnancy and a spontaneous abortion. About 6 months later, a pulmonary nodule in the patient's right upper lung field was found on a routine chest X-ray film. Contrast- enhanced CT scans revealed a solitary lobulated nodule 2.0 × 1.3 × 3.0 cm in diameter in the S2 segment of the right lung. CT suggested a vessel malformation. Positron emission tomography using 2-deoxy-2-[(18)F]fluoro-D-glucose (FDG-PET) was performed and showed weak FDG accumulation (SUVmax = 2.0) in the nodule, which did not positively indicate malignancy. Because a follow-up CT showed a rapid increase in the size of the nodule, partial resection of S2 segment in the right upper lobe was performed. The histopathological diagnosis was a metastasis from choriocarcinoma. The tumor consisted largely of necrosis and hemorrhage, and it was considered to be a major cause of the unusual FDG-PET and CT findings.

A Type III Dens Invaginatus with Unusual Helical CT and Histologic Findings: A Case Report

Dens Invaginatus (DI) is a rare developmental anomaly which affects the tooth, which shows an infolding of enamel and dentine which extends into the pulp chamber and sometimes into the root. The aim of this case report was to describe its radiographic findings, to emphasize the bizarre morphology and the difficulties which are encountered in the diagnosis by using conventional radiographic techniques and the importance of computed tomography as a valuable diagnostic aid. Dens Invaginatus is clinically significant due to the possibility of an early pulpal involvement and the chronic periapical lesions are often associated with this anomaly without any clinical symptoms. Difficulties are encountered during the endodontic treatment, owing to the complex root canal anatomy; therefore, a proper radiologic evaluation by using different imaging modalities, is essential for its successful treatment.

Primary Pancreatic Lymphoma with Severe Dilatation of Pancreatic Duct: A Case Report

Primary pancreatic lymphoma is extremely rare and usually consists of a bulky tumor without internal necrosis and severe dilatation of the pancreatic duct. We report the unusual CT and MRI findings of a primary pancreatic lymphoma in a 27-years-old man, associated with severe dilatation of the pancreatic duct, common bile duct, and internal necrosis.

Primitive Neuroectodermal Tumor of Mediastinum in an Adult: A Case Report

A peripheral primitive neuroectodermal tumor (PNET) is a rare and aggressive malignant tumor, which most frequently occurs in children and young adults. The most well described site of origin is the chest wall. We report the case of a primitive neuroectodermal tumor in the anterior mediastinum with unusual CT findings.

Pleomorphic Adenoma with Extensive Ossified and Calcified Degeneration: Unusual CT Findings in One Case: Fig 1.

We report a case of pleomorphic adenoma, which presented as a large bone-attenuation mass in the parapharyngeal space. CT scanning showed a large lobulated bone-attenuation mass with a scanty soft-tissue component.

Hepatic Parasitic Abscess Caused by Clonorchiasis: Unusual CT Findings of Clonorchiasis

Clonorchiasis is caused by a chronic infestation of liver flukes, Clonorchis sinensis, and these reside mainly in the medium- and small-sized intrahepatic bile ducts. Therefore, diffuse, uniform, minimal or mild dilatation of these bile ducts, particularly in the periphery, without dilatation of the extrahepatic bile duct is the typical finding on several imaging modalities. We report here on the CT findings of an unusual case of hepatic parasitic abscess that was caused by clonorchiasis; this malady mimicked cholangiocarcinoma, and there was no dilatation of the intrahepatic bile ducts.

Unusual CT Findings of a Benign Metastasizing Leiomyoma Presenting with Multiple Cavitary Nodules: A Case Report

A benign metastasizing leiomyoma is a rare condition that affects women with a his- tory of uterine leiomyoma, usually after a myomectomy or hysterectomy. Typical radi- ographic findings include well-circumscribed solitary or multiple pulmonary nodules ranging from a few millimeters to several centimeters in diameter and scattered among the normal interstitium. We report a case of a benign metastasizing leiomyoma that manifested with multiple cavitary nodules in a 46-year-old woman with no previ- ous history of a myomectomy or hysterectomy.

Unusual CT/MR features of putative ligamentum flavum ossification in a North African woman

To display the unusual spinal CT and MR findings in a 48-year-old North African woman presenting with two adjacent intracanalar mineralized epidural outgrowths exhibiting mature bone organization with "cortical" and "trabecular" areas and pseudoarthritic changes at their interface. An unusual form of ligamentum flavum ossification (LFO) was speculated, of which features are discussed under the light of the available literature.

Unusual CT Findings in Urachus Carcinoma with an Extensive and Atypical Pattern of Metastasis. A Case Report

Carcinoma of the urachus is very rare. Usually it has a typical appearance on computed tomography, with calcifications in a midline supravesical mass, but advanced stages of this neoplasm require malignancy evaluation that is not easy to establish. We report a case of a urachal tumor where CT scan did not properly assess the response to chemotherapy, while it did show an uncommon metastatic localization in the laterocervical soft tissues.

Middle Cranial Fossa Epidermoid Cyst: A Case Report of Unusual CT and MR Findings

Intracranial epidermoid cysts usually show homogeneous hypodensity on CT scans, hypointensity on T1-weighted MR images and hyperintensity on T2-weighted MR images. Most of them arise in the cerebellopontine angle and parasellar areas. We report a case of middle cranial fossa epidermoid tumor with unusual image findings. The entire tumor mass showed inhomogeneous low density, without any enhancing solid portion on the CT scans. The lateral portion of the tumor showed homogeneous T1 low signal intensity and T2 high signal intensity. The medial portion of the tumor showed heterogeneous T1 and T2 intermediate to high signal intensity. On the gadolinium enhanced MR images, enhancement of the thickened dura was observed behind the tumor. Surgery and pathologic examination revealed the presence of an extradural epidermoid cyst.

Middle Cranial Fossa Epidermoid Cyst: A Case Report of Unusual CT and MR Findings

Middle Cranial Fossa Epidermoid Cyst: A Case Report of Unusual CT and MR Findings

Adrenoleukodystrophy - unusual CT and MR findings in two siblings

Adrenoleukodystrophy - unusual CT and MR findings in two siblings

Case report: Superior vena cava obstruction: Unusual CT findings due to venous collaterals

We describe a case of superior vena cava (SVC) obstruction in which there was intense pericardial enhancement and focal enhancement within the medial segment of the left lobe of the liver on post-contrast CT due to the collateral circulation. Pericardial collaterals have not been previously reported, but focal liver enhancement [1] and similar areas of increased uptake of radiotracers are both well recognized in SVC obstruction [2,3].

Phlegmonous enteritis: An unusual cause of abdominal pain

Phlegmonous enteritis is a rare infective inflammatory condition of the gut which is difficult to diagnose and which is often fatal. Although first described more than 150 years ago, very few cases have subsequently appeared in the literature. In this case the diagnosis of atypical small intestinal pathology was suggested by unusual CT findings. Coupled with the clinical picture, this prompted laparotomy which in turn confirmed the diagnosis of phlegmonous enteritis. A literature review discusses the epidemiology, predisposing conditions, postulated aetiologies and treatment.

Dermoid tumor with persistently low CSF glucose and unusual CT and MRI findings

A patient with dermoid tumor, presenting with persistent hypoglycorrhachia in the absence of cerebrospinal fluid pleocytosis is reported. The presence of ring enhancements without infection, surrounding edema, and mass effect on computed tomography and magnetic resonance imaging are unusual findings for these tumors.