Resection of a Large Hemorrhagic Mediastinal Lymphangioma in an Adult Patient: A Radiologic-Pathologic Correlation.

Lymphangiomas are rare benign lesions resulting from abnormal proliferation and sequestration of lymphatic tissues that are disconnected from the rest of the lymphatic system. This is a case of a 50-year-old woman with an unusually large mediastinal lymphangioma complicated by hemorrhage. The substantial mass effect and unstable clinical status necessitated urgent operative management. The use of preoperative multimodality radiologic assessment, including CT and MRI, is illustrated throughout this case. Keywords: CT, MR Imaging, Thorax, Lung © RSNA, 2022.

Complementary role of computed tomography angiography with fixed perfusion defects on SPECT myocardial perfusion imaging.

PURPOSE: We present this case series exploring the complementary role of coronary computed tomography angiography (CCTA) to SPECT myocardial perfusion imaging (MPI) in the detection of myocardial necrosis. METHODS: A cardiac hybrid imaging database search identified 144 patients with a previous history of ST-segment elevation myocardial infarction treated with coronary revascularization. CCTA and MPI scans were evaluated to determine whether CCTA had an added value to MPI in detecting myocardial necrosis. RESULTS: Five patients with patent stents and/or bypass grafts and both fixed perfusion defects on MPI and sub-endocardial hypo-perfusion on CCTA were identified. The extent and location of the perfusion defects were closely correlated between the CCTA and SPECT MPI images. CONCLUSION: In this series, CCTA and SPECT MPI were found to play a complementary role in the assessment of fixed perfusion defect, with CCTA adding specificity to the diagnosis of myocardial necrosis.

Cortically based cystic supratentorial RELA fusion-positive ependymoma: a case report with unusual presentation and appearance and review of literature.

Ependymomas are rare central nervous system tumors that can arise anywhere in the neuroaxis. Supratentorial and posterior fossa ependymomas were identified as distinct diseases after extensive molecular analysis. The 2016 World Health Organization update further introduced RELA fusion-positive ependymoma as a novel entity as a subset of supratentorial ependymomas indicating the presence of C11orf95-RELA fusion genes. RELA fusion-positive ependymomas are commonly intraventricular, though they may rarely manifest as extraventricular, cortically-based tumors. They are commonly large solid, mixed solid/cystic tumors or rarely cystic. In this paper, we report a case of RELA fusion positive cortically based-cystic ependymoma and review the existing literature. Our patient is a 9-year-old boy who presented with an unusual presentation of right facial droop. He underwent gross total resection of the ependymoma, following resection, his facial droop resolved and there was no neurologic deficit.

A curious case of a comestible cough candy.

An 80-year-old woman was seen in the Emergency Department with a history of left jaw pain and headaches, as well as numerous additional comorbidities. Computed tomography examination of the head and face found a circumscribed, ovoid, markedly hyperattenuating mass with areas of internal air within the left buccal space - the density of which was neither that of metal nor bone. After speaking with the patient, she reported having a cough candy in her mouth during the examination. Here we review the imaging appearance of an unusual case of a comestible intraoral foreign body so as to raise awareness of this incidental pseudolesion. Correct recognition of this as an intraoral foreign body rather than true pathology of the oral cavity is important as to save patients the anguish of a significant, albeit incorrect, diagnosis and avoid the additional cost and resource utilization of unnecessary further investigations.