ABSTRACT
In this study, we present findings from an analysis of 17 patients diagnosed with eosinophilic lung disease, with a majority (64.70%) being male. The average age of the patients was 54 ± 13.22 years. A history of uncontrolled asthma was noted in nine cases. The clinical picture was characterized by persistent dyspnea and cough. Blood hypereosinophilia was present in all cases, with a median of 1770 cells/ul. Two patients had a pulmonary eosinophilia greater than 25%. Radiological findings were consistent with diffuse bilateral ground-glass opacities or areas of consolidation in the majority of cases. The main etiologies identified were chronic eosinophilic pneumonia (12 cases), followed by eosinophilic granulomatosis with polyangiitis (3 cases), idiopathic hypereosinophilic syndrome (1 case) and drug-induced hypereosinophilia (1 case). All patients were treated with systemic corticosteroids, with the addition of immunosuppressive therapy necessary in three cases. Notably, five relapses were recorded after corticosteroid therapy was stopped.
ABSTRACT
Exostosis, or osteochondroma, represents the most prevalent primary benign bone tumor, often viewed as a developmental anomaly rather than a true neoplasm. This article presents 2 cases illustrating complications associated with tibial osteochondroma. The first case involves a 25-year-old patient with recurrent medial knee pain attributed to pes anserine bursitis secondary to tibial osteochondroma, managed successfully with surgical excision. The second case features a 15-year-old with similar symptoms and unsuccessful conservative management, highlighting the diagnostic challenges and therapeutic options for this condition. Discussion encompasses the clinical presentation, diagnostic modalities including MRI and ultrasound, and management strategies such as conservative measures, corticosteroid injections, and surgical excision. Recognizing and promptly managing complications like pes anserine bursitis in tibial osteochondroma is crucial to prevent chronic pain and functional impairment, emphasizing the importance of a multidisciplinary approach involving orthopedic surgeons, radiologists, and physical therapists.
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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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Ovarian dysgerminoma is a rare germ cell tumor accounting for 1%-2% of all malignant ovarian tumors and is generally associated with a good prognosis. The condition is more frequent in young women and can arise in dysgenetic gonads that contain gonadoblastomas. Imaging findings, particularly MRI, have a prominent role in the early and correct identification of ovarian dysgerminoma, the most common ovarian malignant germ cell tumor. On CT and MR images, ovarian dysgerminoma often appears as a large, solid mass. The edematous condition of characteristic fibrovascular septa can be well displayed by imaging, which can guide the radiologists to make an accurate diagnosis. This article describes 2 cases of patients with ovarian dysgerminoma who presented with pelvic pain. Imaging showed a right ovarian mass that was surgically and histologically confirmed.
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The prevalence of intracranial aneurysms (IA) is higher in patients with stenosis of the internal carotid artery (ICA), the intracavernous internal carotid aneurysm is an intracranial aneurysm causing major functional and vital complications. We report the case of a 26-year-old man who consulted for a reduction in visual acuity, converging strabismus and ptosis of the right eye evolving for 7 months before his consultation, the various neuro-radiological examinations made it possible to identify diagnose a giant aneurysm of the right intracavernous internal carotid artery associated with severe stenosis of the contralateral internal carotid artery, hence the performance of a therapeutic arteriography consisting of an occlusion of this aneurysm. In summary, we describe successful management of a giant aneurysm of the intracavernous portion of a single functional internal carotid artery, while preserving optimal cerebral vascularization.
ABSTRACT
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.
ABSTRACT
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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Blood supply to the human thalami is complex and multiple variants exist. The artery of Percheron is one of those variants and is characterized by a solitary arterial trunk that branches from one of the proximal segments of either posterior cerebral artery and sup- plies blood to the paramedian thalami. Its occlusion results in bilateral paramedian thalamic infarction sometimes extending to the midbrain. We report a case of bithalamic infarction secondary to occlusion of the artery of Percheron. We will illustrate the complex clinical symptomatology and underscore the role of imaging, especially MRI, for diagnosis.
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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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Sarcoidosis is a benign systemic disease; its diagnosis is based on a suggestive radiological presentation, and the isolation of an epithelioid and gigantocellular granuloma (EGGC) without caseous necrosis with the elimination of other causes of granuloma. However, sometimes the radiological presentation is atypical and misleading, posing problems in terms of differential diagnosis. In this report, we present a case of pseudotumor sarcoidosis, in which MRI played an essential role in characterizing the lesion and suggesting its benignity. We also discuss the role of MRI in evaluating atypical forms of sarcoidosis.
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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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Renal lymphangiectasia is a rare and benign renal lymphatics disorder. It is usually asymptomatic, and rarely revealed by lumbar pain, arterial hypertension or retroperitoneal fluid collection. Radiological diagnostic is challenging and can be done if radiologists are aware of the imaging findings. Here in, we report a case of a young woman admitted for the management of a blunt abdominal trauma. Computed tomography showed a huge right retroperitoneal fluid collection, communicating with a perirenal cyst. This perirenal collection was bilateral and symmetrical. The diagnostic of a ruptured perirenal lymphangiectasia was suspected and confirmed by needle puncture. We managed the case using percutaneous drainage. Reassessment at subsequent follow-up visits showed a total regression of the collection improvement in the patient's clinical.
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Hydatidosis is an echinococcosis caused by the development of Echinococcus granulosus larvae in humans. The lung is the second most frequent site after the liver. The primary mediastinal and pericardial localisations are extremely rare. Ultrasound and CT scans play an important role in the diagnosis of this disease.We report the case of an 11-year-old female patient from a rural environment with a history of dogs contact, whose symptomatology consisted of chest pain, dyspnoea, all evolving in a febrile context. The imagery showed the existence of multiple mediastinal and pericardial collections. This patient was rapidly managed with albendazole (ABZ) and scanography revealed an excellent therapeutic response. Primary mediastinal and pericardial hydatidosis is a very uncommon disease. It can be unfortunately revealed at the stage of vital prognosis complications. Ultrasound and computerized tomography (CT) are helpful for localizing and defining the morphologic features of hydatid cysts. It should be kept in mind, especially in patients from endemic areas.
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Spinal dural arteriovenous fistulas (SDAVFs) are rare entities and are often misdiagnosed. They usually occur in adults above the age of 50 and 60 years. While they most commonly involve the thoracolumbar region, they can occur anywhere along the spinal cord. Clinical symptoms are insidious and not specific and may progress slowly, over several years, to severe myelopathy with paraplegia. Early diagnosis is critical because the deficits are potentially reversible if carefully treated. Delayed treatment may result in severe and irreversible neurological disability. Imaging diagnosis relies on MRI and conventional spinal angiography. Once identified, the dural arteriovenous fistula should be immediately treated by either endovascular embolization or surgical ligation. In this report, we present a case of SDAVF in a 65-year-old male that was managed by open surgery.
ABSTRACT
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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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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Spinal cord infarction is an uncommon but devastating disorder caused by various conditions. It remains however a rare neurological complication in acute aortic injuries. In this context, aortic dissection is the most frequent etiological factor. Acute aortic intra mural hematoma and atheromatous penetrating ulcer remain exceptional. We encountered two cases of spinal cord infarction associated with acute aortic intra mural hematoma in one case and atheromatous penetrating ulcer in the other case that presented without typical severe pain. Thus, acute aortic injuries should be considered a cause of spinal cord infarction even if there is little or no pain.
ABSTRACT
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.