Magnetic resonance imaging findings in diffuse lymphangiomatosis: neuroradiological manifestations

2007 ◽  
Vol 48 (5) ◽  
pp. 560-564 ◽  
Author(s):  
A. Ozturk ◽  
D. M. Yousem

We report magnetic resonance (MR) findings in a patient with histologically proven lymphangiomatosis with a history of chylothorax, diffuse lung infiltrates, spinal involvement, cystic lesions of the mediastinum, and mesentery thickening. The patient also had diffuse infiltration of the right brachial plexus, with similar imaging findings as the spinal lesions. Although osseous and extraosseous involvement may be seen frequently with lymphangiomatosis, involvement of the brachial plexus has not been previously reported.

2020 ◽  
pp. 014556132097485
Author(s):  
Takahiro Kusaka ◽  
Shigeru Kuwashima ◽  
Harukazu Hiraumi ◽  
Hiroaki Sato

Actinomycosis is an infrequent infectious disease caused by Actinomyces species. Actinomycoses in the nasopharynx are extremely rare, especially in the Rosenmüller’s fossa. This report presents a case of actinomycosis in the Rosenmüller’s fossa. A 75-year-old woman presented with a 6-month history of bloody sputum. A grayish-white caseous tissue was found in the right Rosenmüller’s fossa after retracting the torus tubarius. Magnetic resonance imaging showed a well-defined lesion with low-signal intensity on T1- and T2-weighted images; small low-signal areas were interspersed inside. The lesion was removed under an endoscope. Histopathological examination revealed eosinophilic, club-shaped structures surrounding a hematoxylophilic center, leading to the diagnosis of actinomycosis. The symptoms improved after 3 months of amoxicillin administration but recurred quickly. After 6 months of amoxicillin administration, the bloody sputum disappeared, and local and imaging findings were normal.


2021 ◽  
pp. 20-21
Author(s):  
Samantha A. Banks ◽  
Eoin P. Flanagan

A 59-year-old White man with a history of excised basal and squamous cell skin cancers was evaluated for gait difficulties. He had erectile dysfunction but no bowel or bladder dysfunction. He also reported fatigue. He began using a cane for ambulation 2 weeks before evaluation at our facility. His medications included vitamin D and sildenafil. He was a lifelong nonsmoker and had no family history of multiple sclerosis. Neurologic examination at the time of our evaluation 3 years after onset was notable for a positive Hoffman sign on the right and mild weakness of the right triceps but preserved strength elsewhere. He had a spastic gait with moderate spasticity in both lower extremities, hyperreflexic patellar and ankle jerks bilaterally, and bilateral positive Babinski sign. The remainder of the examination was essentially normal. Magnetic resonance imaging of the brain showed a single lesion at the cervicomedullary junction and medullary pyramids, more prominent on the right. There was also some accompanying atrophy that was also visible on cervical spine magnetic resonance imaging. Results of cerebrospinal fluid analysis showed a normal white blood cell count, increased protein concentration (108 mg/dL), and positive oligoclonal bands. The progressive nature of his symptoms, spinal fluid results, and lesion appearance were all consistent with a diagnosis of progressive solitary sclerosis. At the time this patient was seen, no immunomodulatory medications for progressive solitary sclerosis were approved, so no immunomodulatory medication was tried. Ongoing symptomatic management was recommended. Progressive solitary sclerosis is a rare variant of multiple sclerosis in which patients have a single central nervous system demyelinating lesion and development of motor progression attributable to that lesion. Patients can initially have a clinical episode followed by progression or can have a progressive course without an initial relapse.


2018 ◽  
Vol 6 ◽  
pp. 2050313X1878172
Author(s):  
Florian Reinhardt ◽  
Britta Mathys ◽  
Petra Reinecke ◽  
Hans Neubauer ◽  
Tanja Fehm ◽  
...  

Ductal carcinoma in situ in men is incredibly rare and detection by conventional mammography and ultrasound is often challenging. We report an unusual case of a 50-year-old male, with no family history of breast cancer, who presented with an 8-year history of left-sided breast pain and recurrent bloody nipple discharge without any significant suspicious imaging features in mammography and targeted high-resolution ultrasound. Breast magnetic resonance imaging was performed as an adjunct modality. Magnetic resonance imaging findings revealed a suspicious retroareolar non-mass abnormality of segmental, linear and dendritic pattern, which was highly suspicious for a ductal carcinoma in situ. Stereotactic guided biopsy and subsequent mastectomy were consistent with pure high-grade ductal carcinoma in situ of the left breast. Overall, this case highlights the challenges in diagnosing ductal carcinoma in situ in men and demonstrates the importance for further investigating clinical suspicions of the male breast.


2021 ◽  
Vol 2021 ◽  
pp. 1-6
Author(s):  
Giulia Cinelli ◽  
Vitaliana Loizzo ◽  
Lisa Montanari ◽  
Ilaria Filareto ◽  
Elisa Caramaschi ◽  
...  

Internal carotid artery (ICA) dissection is a cause of stroke, but it is often underdiagnosed in children. ICAs’ risk factors and pathogenic mechanisms are poorly understood, and the treatment is still empirical. We report the case of a previously healthy 9-year-old girl who presented with involuntary hypertonic closure of the right hand associated with transient difficulty for both fine movements of the right arm and speech. She had a history of minor cervical trauma occurring 20 days prior to our observation without other associated risk factors. Magnetic resonance imaging and magnetic resonance angiography showed ischemic lesions due to the left ICA dissection. Treatment with both acetylsalicylic acid and levetiracetam allowed recanalization of the ICA associated with the resolution of clinical signs. Our clinical case suggests that the ICA dissection must be suspected early whenever a child manifests mild neurologic deficits after a cervical trauma, especially if they are associated with headache and/or cervical pain. Moreover, the management of ICA dissection must be improved.


Neurosurgery ◽  
2004 ◽  
Vol 55 (6) ◽  
pp. E1450-E1452 ◽  
Author(s):  
Ahmet Bekar ◽  
Hasan Kocaeli ◽  
Emel Yilmaz ◽  
Şeref Doğan

Abstract OBJECTIVE AND IMPORTANCE: Various intracranial abnormalities, including infectious conditions, may manifest as trigeminal neuralgia. CLINICAL PRESENTATION: A 33-year-old man presented with a 15-day history of right-sided facial pain and numbness. Neurological examination revealed diminished corneal reflex and facial sensation in the right V1–V2 distribution. Magnetic resonance imaging revealed a contrast-enhancing lesion centered at the right pons with extension of the enhancement to the sphenoid sinus. INTERVENTION: Broad-spectrum antibiotics were administered for 6 weeks. This resulted in alleviation of symptoms and resolution of the lesion as revealed by repeat magnetic resonance imaging. CONCLUSION: Presentation of a pons abscess with trigeminal neuralgia is rare, and to the best of our knowledge has not been reported previously. The patient was treated successfully with antibiotics alone.


2019 ◽  
Vol 19 (1) ◽  
pp. E49-E49
Author(s):  
David Gallardo-Ceja ◽  
Thalia E Sanchez-Correa ◽  
Diego Mendez-Rosito

Abstract We describe the case of a 42-yr-old female patient with a 2-yr history of headache that has progressively worsened. Physical examination revealed no neurological deficit. Magnetic resonance imaging showed a large tumor of the left lesser sphenoid wing that enhanced with gadolinium and produced displacement of the midline and the Sylvian fissure. A thorough analysis of the origin of the tumor was done to establish the surgical strategy. With the patient positioned supine with the head slightly turned to the right side, fixed in a 3-pin head clamp, a pterional craniotomy was performed. Since the origin of the tumor is in the lesser wing an early extradural devascularization of the tumor was done with drilling out all the hyperostotic bone of the lesser sphenoid wing, including the lateral base of the anterior clinoid process. Intradural debulking and resection showed the effect of extradural devascularization with an important decrease in bleeding, allowing the total resection of the tumor. An immediate postop magnetic resonance showed a complete removal of the tumor. The patient presented a paresis of the oculomotor nerve that completely resolved in the 3-mo follow-up. In the following video illustration, we narrate this operative case and highlight the nuances of this approach.1 The patient has given assent and written consent for videos, images, or clinical or genetic information to be published.


2012 ◽  
Vol 45 (4) ◽  
pp. 205-209 ◽  
Author(s):  
Marcelo Novelino Simão ◽  
Clyde A. Helms ◽  
William J. Richardson

OBJECTIVE: To demonstrate five discal cysts with detailed magnetic resonance imaging findings in nonsurgical and following postoperative microdiscectomy. MATERIALS AND METHODS: Five discal cysts in four patients who underwent magnetic resonance imaging were found through a search in our database and referral from a single orthopedic spine surgeon. Computed tomography in two cases and computed tomography discography in one case were also performed. RESULTS: Five discal cysts were present in four patients. Three patients had no history of previous lumbar surgery and the other patient presented with two discal cysts and recurrent symptoms after partial laminectomy and microdiscectomy. All were oval shaped and seated in the anterior epidural space. Four were ventrolateral, and the other one was centrally positioned in the anterior spinal canal. One showed continuity with the central disc following discography. Three were surgically removed. CONCLUSION: Magnetic resonance imaging can easily depict an epidural cyst and the diagnosis of a discal cyst should be raised when an homogeneous ventrolateral epidural cyst contiguous to a mild degenerated disc is identified.


2019 ◽  
Author(s):  
Peng-Peng Niu ◽  
Bo Song ◽  
Yu-Ming Xu

Abstract Background Magnetic resonance imaging findings of anti-N-methyl-D-aspartate (anti-NMDA) receptor encephalitis have been reported to lack specificity. The hippocampus, frontal lobe, white matter, basal ganglia, and even spinal cord can be involved. However, isolated leptomeningeal enhancement is rare in anti-NMDA receptor encephalitis. Case presentation We report a 17-year-old boy who presented with a 2-week history of mild fever and progressive encephalopathy with behavioral and psychological abnormalities. Finally, a diagnosis of anti-NMDA receptor encephalitis was made. Initial magnetic resonance imaging results revealed diffuse contrast enhancement of the leptomeninges without parenchymal lesions. After treatment with high-dose intravenous methylprednisolone, plasma exchange, and intravenous immunoglobulin, the enhancement showed substantially decrease at the 3-week follow-up. Conclusions This case is unusual because isolated leptomeningeal enhancement is rare in anti-NMDA receptor encephalitis. The present case suggests that isolated diffuse leptomeningeal enhancement could be one of the imaging findings in patients with anti-NMDA receptor encephalitis.


2016 ◽  
Vol 98 (5) ◽  
pp. e74-e76 ◽  
Author(s):  
T Shah ◽  
O Abu-Sanad ◽  
H Marsh

Introduction Paratesticular lesions are common, and one subgroup is paratesticular rhabdomyosarcoma. The latter is a relatively uncommon (but aggressive) tumour that affects children and adolescents predominantly. Ultrasound is the first-line investigation, but can be inconclusive. Magnetic resonance imaging (MRI) can provide useful information, but its role in the diagnosis of rhabdomyosarcoma is not clear. Case History We report a 17-year-old male who presented with a one-month history of a rapidly enlarging, non-tender, lump in the right testicle. Urgent ultrasound of the scrotum revealed a heterogenous paratesticular mass that was hypervascular and showed calcification in the right inguinal area. MRI of the pelvis showed a solid, enhancing lesion of dimension located superior to the upper pole of the right testes and a slightly heterogeneous T2 signal, but was homogenous post-contrast. The patient underwent right radical orchidectomy, and histology results were assessed. He received chemotherapy and is being followed up. Conclusions Improvements in imaging in addition to early surgical intervention and chemotherapy treatment are crucial to improve survival chances against rhabdomyosarcoma. Ultrasound findings for benign diseases may mimic those seen in rhabdomyosarcoma. In such cases of diagnostic uncertainty, our surgical team suggest MRI to reduce the risk of a delayed diagnosis and time to treatment.


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