Primary Leiomyoma of the Liver: Case Report and Review of the Literature.

Primary leiomyoma of the liver is an extremely rare benign hepatic tumor in asymptomatic patients. While leiomyoma is frequently found in the genitourinary tract, to the best of our knowledge only 29 cases of primary hepatic leiomyoma have been reported in the English language medical literature. Primary hepatic leiomyoma in patients without an underlying systemic disease (immunosuppression) is even more uncommon. A leiomyoma is composed of bundles of smooth muscle fibers and rarely transforms into a malignant tumor. We present a previously healthy 44-year-old woman who was incidentally found to have a focal liver lesion while undergoing radiologic studies for evaluation of her low back pain. The primary leiomyoma of the liver has characteristic radiologic findings that distinguish it from other hepatic tumors. In this article we discuss the typical radiologic and pathologic findings of leiomyoma compared with other primary liver tumors.

MDCT Findings of Splenic Pathology.

The delineation and characterization of splenic lesions and other abnormalities can be challenging on computed tomography. Many splenic lesions are incidentally found, imaging features tend to overlap, and without the appropriate clinical context, differentials can range from benign to malignant. Radiologists should be familiar with the wide variety of pathologies seen on computed tomography as it is often the first imaging modality a splenic lesion is seen. The purpose of this MDCT-focused review is to understand normal splenic anatomy and its variants, to illustrate and describe typical and atypical imaging patters of inflammatory, infectious, vascular, traumatic, benign, and malignant tumors of the spleen and provide clues in reaching the appropriate differential diagnosis and management.

A Multimodality Review of Adrenal Tumors.

Adrenal tumors are very commonly encountered in the practice of radiology. They may arise from the adrenal gland itself, either the cortex or the medulla, or they could be secondary lesions. They may be benign or malignant. The functioning adrenal tumors lead to hypersecretion of adrenal hormones leading to clinical syndromes. Computed tomography is the most common imaging modality used for the initial evaluation of adrenal tumors. Magnetic resonance imaging and functional scintigraphic techniques are frequently used for atypical presentations or further evaluation. We present a multimodality review of common and uncommon adrenal tumors. We highlight their characteristic and specific imaging features which help us in making a diagnosis and suggesting an appropriate follow up for further management. The spectrum of adrenal tumors is wide with varying appearances on different imaging modalities. Imaging techniques used for adrenal tumor imaging have their own strengths and weaknesses as it relates to the final diagnosis. It is important to be familiar with imaging characteristics of adrenal tumors for appropriate diagnosis and management. Differentiation of benign (leave alone) tumors from malignant (surgical) ones along with appropriate disposition of incidentalomas are some of the challenges facing the radiologist.

Multimodality Imaging Review of Anorectal and Perirectal Diseases With Histological, Endoscopic, and Operative Correlation, Part I: Anatomy and Neoplasms.

A broad spectrum of pathology affects the rectum, anus, and perineum and understanding of its relevant anatomy is important in accurate reporting, particularly in rectal cancer. In this pictorial essay, correlative imaging, endoscopic, pathologic, and operative images are presented to illustrate normal anorectal anatomy and neoplastic conditions that affect the anus and rectum. A particular case-based focus is given to rectal adenocarcinoma with pelvic MR and surgical histopathology. Additionally, carcinoid tumor, gastrointestinal stromal tumor, condylomata acuminata, squamous cell carcinoma, melanoma, and metastatic disease about the rectum and anus are reviewed.

Hepatic adenomatosis: a rare but important liver disease with severe clinical implications.

A 56-year-old white female presented to the emergency room (ER) with acute onset of right upper quadrant abdominal pain, nausea, and vomiting, and she was found to have a sudden drop in hemoglobin. Abdominal computed tomography (CT) with and without intravenous contrast revealed multiple bilobar focal hepatic hypervascular lesions, one of them demonstrating spontaneous rupture with active intraperitoneal bleeding. A moderate hemoperitoneum was present. The patient underwent exploratory laparotomy for right hepatic posterior segmentectomy (right posterior sectionectomy) and peritoneal lavage. The histopathology evaluation revealed multiple liver adenomas. Hepatic adenomatosis is a clinical entity characterized by 10 or more hepatic adenomas. It must be distinguished from isolated hepatic adenoma as it bears a much higher risk of complications, such as spontaneous rupture, hemorrhage and malignant transformation. Here we discuss the radiologic and histopathologic findings of the current case along with a review of the English language medical literature.

Histoplasmosis brain abscesses in an immunocompetent adult. A case report and literature review.

We describe the case of a 62-year-old man, who presented with a new onset of focal seizures of his right leg. There were no other clinical symptoms, and laboratory results were normal. Brain magnetic resonance imaging revealed multiple lesions, two supratentorial lesions were ring-enhancing. The brain biopsy tissue showed Histoplasma capsulatum abscesses. He improved on treatment with Amphotericin B. This case is reported since cerebral ring-enhancing lesions are rarely associated with histoplasmosis, which is also rare in an immunocompetent individual. We review the literature and discuss the radiologic and pathologic findings of this case compared with previous reports.