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Most of the pulmonary endobronchial lesions are malignant in origin. In rare instances, benign lesions such as endobronchial hamartoma may be the cause of the endobronchial tree obstruction. We present the case of a 57-year-old male patient from North Africa who presents with a history of a 5-month cough. Imaging, particulary CT scan, showed a mass on the right intermediate bronchus whose radiological characteristics are consistent with hamartoma. A biopsy of the mass obtained via bronchoscopy revealed chronic inflammation with no evidence for malignancy. The patient was treated surgically, and anatomopathology confirmed the diagnosis of hamartoma.
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Prolapsed uterine tumors within the cervix or vagina, are attached to the uterine cavity by a soft tissue stalk. Malignant tumors and leiomyoma are the first diagnostic considerations for a prolapsed uterine mass with a visible stalk at MRI. This article describes 4 cases of patients who presented with large, necrotic prolapsed uterine tumors that were surgically confirmed and were diagnosed prospectively on the basis of MRI findings. Imaging, particularly MRI, plays a crucial role in the management of patients with prolapsed pedunculated uterine tumors, especially for pre-operative localization and surgical treatment. The 4 patients underwent a total hysterectomy with a complete resection of the mass. The histopathological report confirmed in the first case the diagnosis of a uterine leiomyoma with aseptic necrobiosis, in the second and third cases a sarcoma, and in the fourth case a serous adenocarcinoma.
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Rickettsiosis is a widespread infection throughout the world and in Africa, it covers a wide range of infectious diseases caused by Rickettsia species. Rickettsial infections, with the exception of Q fever, typically present with fever, rash, and vasculitis. The central nervous system (CNS) can be affected by all rickettsial diseases and is an important target for several of them. Clinical manifestations are suggestive of rickettsial infection, but serology and skin biopsy provide confirmation. Although the presence of abnormal neuroimaging is rare, its presence is associated with a worse clinical prognosis. Computed tomography (CT) and magnetic resonance imaging (MRI) scans mainly show signs of vasculitis, which may be reversible if appropriate treatment is initiated early in the course of the disease. We present here a case of infectious cerebral vasculitis due to rickettsiosis with some MRI features.
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Empyema necessitans is a rare condition where tuberculosis is the most common cause. It can be found in both immunocompromised and immunocompetent patients, especially in endemic areas. We report a case of a 29-year-old male from North Africa, with an enlarging mass on the right thoracic wall. Imaging, particularly CT showed a cystic lesion in the right chest wall communicating with homolateral pleural effusion, compatible with empyema necessitans. It also showed patterns of pulmonary tuberculosis in the right upper lung. Treatment of empyema necessitans is a combination of medical and surgicaltreatment. Our patient underwent a surgical treatment consisting of flattening of the empyema with a Gene X-pert study of the fluid and the shell, followed by an anti-TB treatment. Anatomopathology confirmed the diagnosis of caseo-follicular tuberculosis.
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Mycetoma or Madura's foot is a rare condition in Morocco. It is a chronic infection that affects deep subcutaneous tissues and may eventually spread to deep tissues, muscles, and bones. It is caused by fungi or bacteria and most often affects the foot. Biopsy and microbiological examination help to establish a definitive diagnosis, but may delay it. Imaging plays a crucial role in early diagnosis, particularly MRI findings that show a pathognomonic sign of mycetoma which is the dot-in-the-circle sign. Computed tomography provides a better analysis of bone changes than plain radiography. Treatment is very difficult, especially if the diagnosis is delayed, and may even lead to amputation. We present here a case of mycetoma of the foot with some MRI features.
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Adnexal torsion is a common gynecological emergency and a significant cause of acute pelvic pain in women. Hydrosalpinx-induced torsion of the adnexa is a rare situation and requires prompt and accurate management. Twenty-three years old nulliparous woman admitted in our structure for acute pelvic pain. The ultrasound revealed an enlarged right ovary with an adnexal cystic mass. We suspected the diagnosis of a right adnexal torsion due to cystic ovarian mass. Laparotomy revealed torsion of the right adnexa and a second large mass appearing to be a hydrosalpinx. Diagnosis of adnexal torsion is difficult and is based on a range of arguments obtained by anamnesis, clinical examination, ultrasonography and other investigations. Early diagnosis is important for preserving tubal and ovarian function, given the risk of ovarian necrosis in young women. Laparoscopy is the gold standard for diagnosing and treating adnexal torsion. The treatment can be conservative or radical, consisting of detorsion of the twisted adnexa, with or without adnexectomy.
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[This corrects the article DOI: 10.1016/j.radcr.2020.12.013.].
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Pelvic or pelviperineal cellulitis is a rare but serious complication of bartholinitis and can be life-threatening. It is described of polymicrobial nature. The diagnosis of pelvic cellulitis remains essentially clinical with signs of local inflammation. The interest of imaging, CT in particular, is to assess the extent of the infection and abcess. In this report, we describe 2 cases of pelvic cellulitis complicating a bartholin's abscess caused by negative gram bacilli in 2 diabetic women in their sixties.
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Our purpose is to illustrate the radiological aspects of the annular pancreas as an etiology of duodenal obstruction in infants. We report the case of a 4-month-old girl, who was admitted to our department with postprandial vomiting evolving since birth. The initial examination found a severely dehydrated patient. Abdominal ultrasound showed gross dilatation of the stomach and duodenum, it also showed pancreatic tissue surrounding the duodenum, suggesting a diagnosis of annular pancreas as the cause of the duodenal obstruction. Post-contrast abdominal CT showed the gastric and duodenal dilatation, and a ring of pancreatic tissue surrounding uncompletly the second portion of the duodenum. The patient underwent a bypass surgery which consisted in a duodeno-duodenostomy with simple post-operative follow-up and no recurrence of digestive symptoms. Annular pancreas is a rare pathology to be sought in neonatal obstruction. A good knowledge of radiological semiology is essential for a good diagnostic approach. However, surgery is the only effective way to diagnose and treat this pathology.
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We report the case of a 2.5-year-old child admitted for abdominal distension, whose imaging revealed a large posterior mediastinal cystic mass, with a tissue component, a calcification, and a minimal fat component. The ultrasound- guided biopsy led to the diagnosis of a benign extragonadal germ cell tumor, also called mature teratoma or dermoid cyst, whose mediastinal localization is rare, often localized in the anterior mediastinum, and rarely in the posterior mediastinum. The mainstay of treatment is complete surgical excision.
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Adnexal carcinomas are rare, accounting for less than 1% of skin carcinomas. Sclerosus carcinoma of the sweat glands was first described by Goldstein et al. in 1982. We here report the case of a 33-year-old female patient with a retracted perianal skin lesion. Histological examination of perilesional skin biopsy, immunohistochemistry, and negative results of laboratory tests, radiological and endoscopic investigations allowed for the diagnosis of eccrine sclerosus carcinoma. This is a rare tumor, usually characterized by facial localization and slow but aggressive progression. It poses problems in differential diagnosis with benign and malignant tumors; hence the challenge encountered by pathologist of suspecting this carcinoma in patients with any sclerotic and infiltrating skin lesion characterized by slow progression, in a context of preservation of the general state and in the absence of neoplastic history as well as of feeling free to ask for new deep biopsies when in doubt.
Assuntos
Neoplasias da Mama , Carcinoma de Apêndice Cutâneo , Carcinoma , Neoplasias Cutâneas , Neoplasias das Glândulas Sudoríparas , Adulto , Neoplasias da Mama/patologia , Carcinoma/patologia , Carcinoma de Apêndice Cutâneo/patologia , Diagnóstico Diferencial , Feminino , Humanos , Imuno-Histoquímica , Neoplasias Cutâneas/diagnóstico , Neoplasias Cutâneas/patologia , Neoplasias das Glândulas Sudoríparas/patologiaRESUMO
The hydatid disease is an anthropozoonose caused in humans by a larval form of Echinococcus granulosus. Adrenal gland is a rare and unsymptomatic site. We illustrate the case of a 46-year-old patient, admitted for left hypochondrial pain with back radiation. The CT reveals a multiloculated, cystic mass on the left adrenal gland, which contains septae and a calcified wall.
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Hemangioma of the facial sinuses is a rare pathology, and given the lack of clinical specificity, the differential diagnosis with a malignant lesion often arises. We report the case of a 32-year-old patient who consulted for recurrent epistaxis of moderate severity. The preoperative diagnosis of a hemangioma of the left maxillary sinus was based on computed tomography and magnetic resonance imaging data, confirmed by the anatomopathological study of the surgical specimen, preceded by an embolization that facilitated the endoscopic surgical excision.
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Primary intracranial germ cell tumors are rare, often affecting children and young patients. Germinomas are the most common type of germ cell tumors. We present the case of a 10-year-old child, who was admitted with decreased visual acuity, asthenia, polyuro-polydipsic syndrome, and gait disorder. His biological assessment showed an hypocortisolemia and diabetes insipidus. Imaging found a bifocal process in the suprasellar and pineal region, suggestive of a bifocal germinoma. Imaging data and the positivity of human chorionic gonadotrophin in the cerebrospinal fluid were in favor of the diagnosis of bifocal germinal tumor confirmed by biopsy. Currently the patient is hospitalized in pediatric oncology department. The diagnosis of germ cell tumors is based on imaging, tumor marker assays, and biopsy. They are treated by radiation therapy alone or in combination with reduction chemotherapy, and surgery for tumor residues. The location of the tumor usually makes surgery difficult.
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A brown tumor is a non-neoplastic lesion resulting from an abnormality of bone metabolism in the context of hyperparathyroidism. We report the case of a 51-year-old woman who initially consulted for edentulism and a growing mandibular mass. She benefited from a radiological and biological assessment which made the diagnosis of primary hyperparathyroidism combined with a parathyroid adenoma. We remind through this observation the difficulty to establish a correct diagnosis in patients with an osteolytic process of the maxilla and the necessity to look for hyperparathyroidism in front of a giant cell lesion given the insidious character of this endocrinopathy.
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Thymoma is a rare tumor arising from the epithelium of the thymus gland and is usually located in the anterior mediastinum. Ectopic thymoma is very rare and can be located in the neck, trachea, lung, and pleura. Through this manuscript, we report a rare case of a 50-year-old woman presenting with dyspnea and recurrent pleural effusion. Her computed tomography of the thorax showed a unilateral left pleural mass. Biopsy of the pleural mass confirmed the diagnosis of pleural thymoma and she was started on chemotherapy. To our knowledge, this is the first reported pleural thymoma in our region.
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Esophageal granular cell tumors (GCTs), or also called Abrikossoff's tumor are rare benign tumors originating from Schwann cells most commonly found in the skin, subcutaneous tissue, and tongue. Approximately 5% -8% arise in the gastrointestinal tract, and one-third of these tumors arise in the esophagus [1]. This neoplasm has a benign behavior usually, but there have been described a malignant transformation in 2% -3% of the cases. Herein, we discuss a case of a 70-year-old male patient with no pathological background, admitted for dysphagia evolving in 3 months that was explored with endoscopy and CT, the diagnosis at this level was challenging but the histopathology and Immunohistochemistry confirmed the presence of granular cells thus confirm the diagnosis. The purpose of our work is to report the uncommon evolution of an Abrikossoff 's tumor located in the esophagus, as a warning of the possible malignant transformation of this tumor mostly benign; also we made a review of the literature.
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Mediastinal bronchial artery aneurysm is very rare and only few cases have been reported in the literature. The clinical presentations are varied, ranging from an incidental radiological finding to a cataclysmic rupture leading to hemorrhagic shock. Thus, a quick treatment is indicated upon diagnosis. Therapeutic options are various including surgical resection, stent grafting with percutaneous embolization of feeding vessel or transtarterial embolization. Herein we describe a case of an incidental mediastinal bronchial artery aneurysm in a 63-year-old man, managed by transtarterial embolization.
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Pilomatrixoma is a rare benign skin tumor originating from piliferous follicles, corresponding to a firm subcutaneous nodule requiring histology for diagnosis. Breast localization is considered to be very rare . Only few breast pilomatricomas have been reported, with imaging showing well defined nodules with microcalcifications, presenting as ACR BI-RADS 4 and 5, suspicious for a breast neoplasm . We report a case of pilomatrixoma of the left breast of a 33 year old woman, appearing as a firm, deep nodule in the lower outer quadrant.The lesion had mammographic and sonographic finding mimiking a breast cancer. Percutaneous biopsy was performed to confirm the histological diagnosis.
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Proliferative myositis is a rre benign pseudosarcomatous inflammatory process that rapidly grows in muscles. Its clinical and radiological features may, however, simulate a malignant tumor. We report ultrasound and MRI appearances of a 63 years-old woman with no significant anterior pathological history presented to our radiology department with two weeks history of a painful mass in the left musculus latissimus dorsi, increasing progressively in size, without history of recent trauma. This study describes the imaging features of these pseudo inflammatory process, which may help to suggest the diagnosis, but the imaging finding are variable and nonspecific. However, histopathological examination is usually recommended to confirm the diagnosis. In our case, the final diagnosis was proved by ultrasound-guided biopsy. We also review the imaging features of this entity in the current literature.