Immunoglobulin G4-Related Paratesticular Fibrous Pseudotumor and Retroperitoneal Fibrosis: A Case Report

2014 ◽  
Vol 94 (3) ◽  
pp. 369-372 ◽  
Author(s):  
Ki Hwan Kim ◽  
Deuk Jae Sung ◽  
Na Yeon Han ◽  
Beom Jin Park ◽  
Min Ju Kim ◽  
...  

A 46-year-old man with a past history of retroperitoneal fibrosis was admitted with an enlarged, hard right testis. The paratesticular lesion showed heterogeneous hypoechogenicity on ultrasonography, low signal intensity on T1- and T2-weighted magnetic resonance imaging (MRI), and lack of diffusion restriction on diffusion-weighted MRI. Following steroid treatment, the paratesticular mass was decreased in size on follow-up computed tomography. The radiologic and clinical features are recognized as a manifestation of immunoglobulin G4-related sclerosing disease involving the paratesticular region and retroperitoneum.

2018 ◽  
Vol 46 (3) ◽  
pp. 1277-1281 ◽  
Author(s):  
Chaoyang Jing ◽  
Lichao Sun ◽  
Zhuo Wang ◽  
Chaojia Chu ◽  
Weihong Lin

Background Reversible splenial lesion syndrome is a distinct entity radiologically characterized by a reversible lesion in the splenium of the corpus callosum. According to previous reports, this condition may be associated with antiepileptic drug use or withdrawal. We herein report a case of reversible splenial lesion syndrome associated with oxcarbazepine withdrawal. Case Report A 39-year-old man presented with an 8-year history of epileptic seizures. During the previous 3 years, he had taken oxcarbazepine irregularly. One week prior to admission, he withdrew the oxcarbazepine on his own, and the epilepsy became aggravated. Magnetic resonance imaging (MRI) revealed an isolated lesion in the splenium of the corpus callosum with slight hypointensity on T1-weighted imaging and slight hyperintensity on T2-weighted imaging. Regular oxcarbazepine was prescribed. Over a 5-month follow-up period, repeat MRI showed that the abnormal signals in the splenium of the corpus callosum had completely disappeared. Conclusion Reversible splenial lesion syndrome is a rare clinicoradiological disorder that can resolve spontaneously with a favorable outcome. Clinicians should be aware of this condition and that oxcarbazepine withdrawal is a possible etiological factor.


2019 ◽  
Vol 22 (1) ◽  
pp. 46-49
Author(s):  
Dong Hyun Kim ◽  
Seunggi Min ◽  
Hyun Joo Lee ◽  
Hee-June Kim ◽  
Hoseok Lee ◽  
...  

A 73-year-old woman presented with a recurrent cystic mass around her left olecranon. She had a history of 8 steroid injections due to elbow pain beginning 3 years ago and twice had undergone aspiration of olecranon bursitis that developed two months prior to presentation. She had been taking medications for hypertension and diabetes with no pertinent past history. On magnetic resonance imaging (MRI), there were multiple nodules in the olecranon bursa, which were isointense to muscle on T1-weighted images and hyperintense to muscle on T2-weighted images. Our initial diagnosis was synovial chondromatosis. On bursoscopy, masses of gray-white colored nodules were observed in the bursa. Finally, synovial chondromatosis and non-tuberculous mycobacterial infection were concurrently diagnosed. In conclusion, uncalcified synovial chondromatosis and rice bodies can have similar visual and MRI characteristics; therefore, we suggest that clinicians should be aware of the possibility of other infections in cases of this type.


2020 ◽  
Vol 11 ◽  
pp. 66 ◽  
Author(s):  
Zaid Aljuboori ◽  
Maxwell Boakye

Background: Dorsal arachnoid webs (DAWs) are rare clinical entities that can mimic other conditions on magnetic resonance imaging (MRI). Here, we present a case of DAW that was misdiagnosed on MR as a ventral cord herniation. Case Description: A 35-year-old female presented with a 1-year history of lower extremity weakness and numbness. The MRI of the thoracic spine showed ventral cord displacement with syringomyelia. The computed tomography myelogram demonstrated ventral cord herniation. Intraoperatively, the patient had a dorsal thoracic web in the absence of cord herniation. Within 8 postoperative weeks, the patient had improved, and the follow-up MI showed a significant reduction in the syrinx size. Conclusion: On MR scans, DAWs may look like ventral cord herniation. However, the positive “scalpel sign” and syrinx, the absence of an arachnoid cyst on myelography, and the findings on cine MR help differentiate DAWs from ventral cord herniation.


2019 ◽  
Vol 130 (6) ◽  
pp. 1997-2004 ◽  
Author(s):  
Ryuta Nakae ◽  
Masaya Nagaishi ◽  
Yosuke Kawamura ◽  
Yoshihiro Tanaka ◽  
Akio Hyodo ◽  
...  

OBJECTIVEThe authors sought to demonstrate that hemorrhagic transformation of ischemic lesions is the main cause of delayed intracerebral hemorrhage (ICH) after Pipeline embolization device (PED) treatment and to estimate the rate of hemorrhagic transformation of new postprocedure ischemic lesions.METHODSPatients who underwent PED placement (PED group) from November 2015 to March 2017 or stent-mediated embolization (EN group) from December 2010 to October 2015 were retrospectively analyzed. Pre- and postprocedural MR images and 6-month follow-up MR images for each patient were scored for the presence of postprocedural bland ischemic and hemorrhagic lesions using diffusion-weighted MRI (DWI) and T2*-weighted MRI (T2*WI), respectively.RESULTSThe PED group comprised 28 patients with 30 intracranial aneurysms, and the EN group comprised 24 patients with 27 intracranial aneurysms. The mean number of ischemic lesions on DWI 1 day postprocedure was higher in the PED group than in the EN group (5.2 vs 2.7, p = 0.0010). The mean number of microbleeds detected on T2*WI 6 months postprocedure was higher in the PED group than in the EN group (0.6 vs 0.15, p = 0.028). A total of 36.7% of PED-treated patients exhibited new microbleeds on T2*WI at 6 months postprocedure, with at least 77.8% of these lesions representing hemorrhagic transformations of the new ischemic lesions observed on day 1 postprocedure. The rate of adjunctive coil embolization (27.3% vs 0.0%, p = 0.016) and the mean number of ischemic lesions observed 1 day postprocedure (6.6 vs 4.3, p = 0.020) were predictors of subsequent microbleeds in the PED group.CONCLUSIONSNew microbleeds detected using T2*WI at 6 months postprocedure were more common after PED treatment than after stent-mediated embolization. Approximately three-quarters of these lesions were hemorrhagic transformations of new ischemic lesions observed on day 1 postprocedure. Prevention of intraprocedural or postprocedural infarcts is necessary to reduce the risk of hemorrhagic complications following PED placement.


Neurosurgery ◽  
2018 ◽  
Vol 85 (6) ◽  
pp. 786-792 ◽  
Author(s):  
Thomas J Wilson ◽  
Kimberly K Amrami ◽  
B Matthew Howe ◽  
Robert J Spinner

ABSTRACT BACKGROUND Management of intraneural perineuriomas remains controversial, largely due to the lack of knowledge regarding the natural history of these lesions. OBJECTIVE To describe the typical radiological growth pattern of intraneural perineuriomas and to determine how the pattern of growth relates to clinical progression. METHODS We performed a retrospective review of the magnetic resonance imaging (MRI) studies and serial clinical examinations of a cohort of patients with biopsy-proven intraneural perineuriomas who had 2 MRI studies at least 2 yr apart. The outcome of interest was radiological growth in length or width of the intraneural perineurioma. Radiological growth was tested for association with clinical progression. RESULTS Twenty patients were included in the study. By width, the lesions were on average larger on repeat imaging (P = .009). By absolute length, the lesions were on average longer on repeat imaging (P = .02). By lesion:landmark ratio, there was no difference in length of the lesions between sequential images (P = .09), with 10 (50%) lesions being shorter and 7 (35%) showing no change. No lesions grew to involve a new nerve or division of a nerve on sequential imaging. None of the variables tested were associated with clinical progression. CONCLUSION We found that intraneural perineuriomas only rarely grow in length, do not grow to involve new nerves or nerve divisions, and growth does not correlate with clinical progression. These findings have significant ramifications for management of these tumors.


2012 ◽  
Vol 2012 ◽  
pp. 1-5 ◽  
Author(s):  
Yukiko Tabuchi ◽  
Tetsuyuki Yasuda ◽  
Hideaki Kaneto ◽  
Tetsuhiro Kitamura ◽  
Junji Kozawa ◽  
...  

We report a case of 42-year-old male patient with hypogonadotropic hypogonadism. He suffered from general fatigue and erectile dysfunction after the treatment with transdermal fentanyl for chronic pain by traffic injury. Endocrine examinations and hormone stimulating tests showed that he had hypogonadotropic hypogonadism. Brain magnetic resonance imaging (MRI) showed no abnormal findings, and he had no past history of accounting for acquired hypogonadotropic hypogonadism. Therefore, his hypogonadism was diagnosed to be caused by opioid treatment. Although opioid-induced endocrine dysfunctions are not widely recognized, this case suggests that we should consider the possibility of endocrine dysfunctions in patients with opioid treatment.


2008 ◽  
Vol 44 (5) ◽  
pp. 266-275 ◽  
Author(s):  
Jean-Laurent Thibaud ◽  
Antoine Hidalgo ◽  
Ghita Benchekroun ◽  
Laurent Fanchon ◽  
Francois Crespeau ◽  
...  

A 4-year-old, male Jack Russell terrier was presented for a 6-month history of progressive right hemiparesis with episodic cervical hyperesthesia. The neurological examination showed a right-sided, upper motoneuron syndrome and partial Horner’s syndrome. Two magnetic resonance imaging (MRI) examinations were performed 3 months apart and revealed a persistent cervical intramedullary hematoma. A dorsal myelotomy was performed. A subacute hematoma was confirmed histologically without underlying lesions. Eighteen months later, the dog’s clinical signs were minimal. Two MRI examinations were performed 2 weeks and 5 months after surgery and revealed regressing signal abnormalities at the surgical site, consistent with a surgical scar.


2021 ◽  
Vol 8 ◽  
Author(s):  
Ronit Bar-Haim ◽  
Haim Shtarker ◽  
Seema Biswas ◽  
Igor Waksman ◽  
Edward Altman

A 31-year-old male amateur bodybuilder presented with a 2-year history of chronic pain over the sternum and a clicking sensation in the chest wall on movement. Ultrasound, computed tomography (CT), and magnetic resonance imaging (MRI) showed no cause for his symptoms. Dynamic ultrasound scan performed at a specialist sports center revealed pseudoarthrosis of the manubriosternal joint (MSJ). After a period of conservative management (rest and analgesia), he failed to improve and underwent debridement and fusion of the MSJ with plates and screws. At follow-up 23 months later, he remains pain-free and has returned to weight lifting and bodybuilding.


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