Huge endometriosis presenting like an ovarian tumor: CT appearance.

A 32-year-old female with a clinical history of abdominal swelling underwent CT of the abdomen. A huge biloculated cystic mass with a mural nodule in the abdominal and pelvic region was seen. The lesion showed slightly homogeneous enhancement. The imaging findings suggested an ovarian tumor. Histopathological evaluation after surgical resection revealed that the lesion was a bilateral ovarian endometriosis.

Unusually large cisterna chyli: US and MRI findings.

We report a rare appearance of cisterna chyli appearing as a giant cystic structure on routine abdominal ultrasonography (US). Diagnosis was established with color Doppler US and after magnetic resonance imaging. This report describes an unusual appearance of the cisterna chyli that radiologists should be familiar with, especially on the routine conventional gray-scale US to avoid mistaking it for a pathologic condition.

Pancreatic Castleman's tumour: an unusual case.

We present an uncommon case of hyaline vascular type Castleman's disease mimicking a pancreatic tumour. A 56-year-old woman with constitutional symptoms was investigated. Pre-operative interventions failed to produce a definitive diagnosis. Surgical excision was performed and the tumour was diagnosed to be the hyaline vascular type of Castleman's disease histopathologically. Pancreatic Castleman's disease should remain a consideration in the differential diagnosis of a pancreatic mass.

Colorectal carcinoma: radiological diagnosis and staging.

Colorectal carcinomas are the most common gastrointestinal tract tumors. 50-60% of the colorectal carcinomas originate in rectum and sigmoid colon. The new developments in imaging modalities have brought improvements in therapeutic aspects. The survival rates in these patients depend on the tumor penetration and the presence of regional lymph node or distant metastasis. The recurrence rates have decreased with the new operation techniques and preoperative radiotherapy, thus increasing the importance of accurate tumor staging. Double contrast barium enema studies enable the diagnosis while staging and follow-up is best done by topographic imaging techniques.

The role of diagnostic radiology in pancreatitis.

Acute pancreatitis is a frequent inflammatory and necrotic process of pancreas and peripancreatic field. To detect the presence of infected or sterile necrotic components and hemorrhage of the pancreatic paranchyma is important for therapeutic approach. Chronic pancreatitis is characterized by irreversible exocrine dysfunction, progressive loss of pancreatic tissue and morphological changes of the pancreatic canal. Imaging modalities play a primary role in the management of both acute and cronic pancreatitis. CT and MR imaging confirm the diagnosis and detect the severity of disease. In chronic pancreatitis, MRCP after Secretin administration, Spiral CT and endoscopic US seems to replace diagnostic ERCP. However differentiation of pseudotumor of chronic pancreatitis from the pancreatic carcinoma is difficult with either imaging modalities.

Mesenteric Castleman's disease: case report.

An asymptomatic case of hyaline vascular-type Castleman's disease localized to the mesentery and detected incidentally by ultrasound is presented. Computed tomographic, angiographic, and histologic findings are reported. This type of Castleman's disease predominates in the thorax and is very rare in the mesentery.

Correlative CT, MRI and histological findings of hepatic Echinococcus alveolaris: a case report.

Diagnosis of liver infestation by Echinococcus alveolaris (EA) is based on serologic, sonographic and CT findings. Literature review yielded only one report discussing the MRI findings of hepatic EA infestation. In this report, we present a case of hepatic EA infestation with its correlative CT, MRI and histological findings. CT showed hypodense mass involving more than half of the liver with rim and central calcifications. MRI revealed hypointense signal of the infiltrative mass on both T1- and T2-weighted images. On MRI, the portal vein branches were seen coursing through the lesion. Neither CT nor MRI demonstrated any contrast enhancement of the mass. On the histological examination, abundant fibrous and hyalinized tissue surrounding multiple small cysts were observed. MRI may provide invaluable information in the diagnosis of EA infestation of the liver, either by disclosing the infiltrative pattern of infestation without significant effect to vascular structures, or by the signal characteristics.

Partially thrombosed hepatic artery aneurysm mimicking pancreatic head carcinoma.

A 43-year-old man with hepatic artery aneurysm which mimicked pancreatic head carcinoma on computed tomography (CT) was studied with B-mode ultrasonography, color doppler ultrasonography, and angiography and the findings are discussed comparing the imaging modalities.

A new criterion in differentiation of pancreatitis and pancreatic carcinoma: artery-to-vein ratio using the superior mesenteric vessels.

Evaluation of infiltration of the superior mesenteric vein (SMV) and artery (SMA) fat planes has been considered in differentiating pancreatic carcinoma from pancreatitis. Some pancreatitis cases, however, can cause perivascular fat plane obliteration due to extension of the inflammatory process, mimicking appearances of carcinoma. This study investigated the diameters of SMV and SMA on CT scans, just caudal to the origin of SMA and portal confluens, in 68 pancreatitis and in 48 pancreatic carcinoma patients. SMA-to-SMV diameters (A/V diameter) were compared and ratios were obtained. In conclusion, it appears that when the A/V ratio is over 1.0, a malignant condition can be suspected. This may be used as a secondary criterion in the differential diagnosis of pancreatitis and pancreatic carcinoma.

Peutz-Jeghers syndrome: CT and US demonstration of small bowel polyps.

A family affected with Peutz-Jeghers syndrome is reported with an emphasis on radiological findings. A patient showed extensive pigmentation around the lips, buccal mucosa, and nose. Another showed prolonged transient intussusception of a jejunal loop on barium meal examination, and massive rectal bleeding. In this patient, small bowel polyps could also be seen on ultrasonography (US) and computed tomography (CT). On CT several polyps, up to 3 cm in size, were detected along with a "carpeting" pattern of several loops presumably caused by multiple small polyps.