Aquaporin-4 autoimmunity masquerading as a brainstem tumor

2014 ◽  
Vol 14 (3) ◽  
pp. 301-305 ◽  
Author(s):  
Byung Chan Lim ◽  
Jong Hee Chae ◽  
Seung-Ki Kim ◽  
Sung-Hye Park ◽  
Kyu-Chang Wang ◽  
...  

Brainstem glioma is a highly devastating disease, and any mass-like lesion in the brainstem can raise suspicion of this diagnosis. However, other inflammatory, demyelinating, or degenerative diseases can mimic brainstem glioma in clinical presentation and imaging features. Therefore, diagnosis based solely on imaging is often insufficient for brainstem lesions and may lead to incorrect diagnosis and treatment. This case report is the first description of central nervous system aquaporin-4 (AQP4) autoimmunity confined mainly to the brainstem. It demonstrates the wide spectrum of neuroinflammatory diseases in children and highlights the utility of surgical biopsy for suspicious brainstem lesions with atypical imaging features for glioma.

2021 ◽  
pp. 20210281
Author(s):  
Marijana Basta Nikolic ◽  
Aleksandar Spasic ◽  
Darka Hadnadjev Simonji ◽  
Sanja Stojanović ◽  
Olivera Nikolic ◽  
...  

Acute pelvic pain (APP) requires urgent medical evaluation and treatment. Differential diagnosis of APP is broad, including a variety of gynecologic and non-gynecologic/ urinary, gastrointestinal, vascular and other entities. Close anatomical and physiological relations of pelvic structures, together with similar clinical presentation of different disorders and overlapping of symptoms, especially in the emergency background, make the proper diagnosis of APP challenging. Imaging plays a crucial role in the fast and precise diagnosis of APP. Ultrasonography is the first-line imaging modality, often accompanied by CT, while MRI is utilized in specific cases, using short, tailored protocols. Recognizing the cause of APP in females is a challenging task, due to the wide spectrum of possible origin and overlap of their imaging features. Therefore, the radiologist has to be familiar with the possible causes of APP, and, relying on clinical presentation, together with laboratory findings, choose the best imaging strategy in order to establish a fast and accurate diagnosis.


Neurographics ◽  
2021 ◽  
Vol 11 (2) ◽  
pp. 127-148
Author(s):  
K.N. Anderson ◽  
W.B. Overcast ◽  
J.R. Brosch ◽  
B.D. Graner ◽  
M.C. Veronesi

Protein misfolding has been an area of intense research and is implicated in a number of neurodegenerative diseases. Key proteins in the brain lose their native ability to fold and instead assume abnormal conformations. Misfolded proteins cluster to form pathologic aggregates, which cause cellular dysfunction, neuronal death, and neurodegeneration. The prionopathies are best known among the neurodegenerative diseases for their ability to misfold, self-propagate, and infect other organisms. There is increasing evidence of a rationale for a prionlike mechanism of spread of other neurodegenerative diseases through a similar seeding mechanism. In this review, we detail the role of a key protein aberration known to the various prion diseases, including sporadic, variant, and iatrogenic Creutzfeldt-Jakob disease; variably protease-sensitive prionopathy; Gerstmann-Straussler-Scheinker disease; fatal familial insomnia; and kuru. We also discuss the clinical presentation, the available, and emerging imaging options for these diseases. In the second part of this review, we delineate how a prionlike seeding process may be driving the progression of other neurodegenerative diseases, including Parkinson disease, Alzheimer disease, and Huntington disease. A discussion of clinical presentation and imaging features of these example diseases follows to make a case for a common approach to developing imaging biomarkers and therapies of these diseases.Learning Objective: Upon completion of this article, one should be able to describe the various types of prion diseases, recognize and identify the common the neuro-imaging findings in prion diseases, describe seeding mechanism of prion disease, list the common amyloid PET tracers used for Alzheimer’s disease, and list common imaging biomarkers in neurodegenerative diseases.


2020 ◽  
Vol 90 (3) ◽  
Author(s):  
Kavitha Venkatnarayan ◽  
Uma Devaraj ◽  
Uma Maheswari Krishnaswamy ◽  
Priya Ramachandran ◽  
Sreekar Balasundaram ◽  
...  

The diverse clinicopathological spectrum of pulmonary aspergillosis is a consequence of varying levels of invasiveness of this ubiquitous fungus, which largely depends on the host immune response and pre-existing lung disease. The clinical presentation of pulmonary aspergillosis spans a wide spectrum from hypersensitivity to life threatening angio-invasive and disseminated disease. We report the case of a young immunocompetent male with no underlying lung disease, who presented with an incidentally detected ‘infective mass’ lesion in the lung associated with minimal respiratory symptoms. The diagnostic challenges posed by the unusual clinical, radiological and histological picture as well as the therapeutic dilemmas faced are discussed in this report.


2011 ◽  
Vol 24 (02) ◽  
pp. 146-150 ◽  
Author(s):  
M. Rabillard ◽  
L. Souchu ◽  
G. W. Niebauer ◽  
O. Gauthier

SummaryHaematogenous osteomyelitis is a rare form of bone infection in adult dogs. Most commonly the infection is iatrogenic or traumatic in origin. The authors report three different presentations of haematogenous osteomyelitis: a focal pelvic localisation in a growing dog, a vertebral lesion in an adult dog with associated neurological signs and a multifocal affection in another adult dog with concomitant pathological fractures.Clinical signs included pyrexia of undetermined origin, focal pain and lameness. Diagnostic investigation included radiographic imaging, bone scintigraphy, magnetic resonance imaging, surgical biopsy, and bacteriological culture with sensitivity testing of biopsy specimens as well as of peripheral blood samples. Treatment consisted of long-term antimicrobial therapy and surgical debridement with curettage of the pelvic abscess of the young dog and decompressive hemilaminectomy of the second dog, with excellent recovery. The dog affected by polyostotic bone involvement and suffering pathological fractures was euthanatized.Haematogenous osteomyelitis may be a diagnostic and therapeutic challenge and may present as a devastating skeletal condition, even in adult dogs, and should be considered amongst the differential diagnoses early on to allow effective treatment.


2015 ◽  
Vol 2015 ◽  
pp. 1-3 ◽  
Author(s):  
Rachelle Goldfisher ◽  
Pritish Bawa ◽  
Zachary Ibrahim ◽  
John Amodio

Congenital midline cervical cleft (CMCC) is a rare congenital anomaly. CMCC and its complications and treatment have been well described in ENT, dermatology, and pediatric surgery literature. However, to our knowledge, the imaging work-up has not been reported in the literature thus far. We present a case of CMCC in a neonate with description of clinical presentation and imaging features.


2004 ◽  
Vol 94 (6) ◽  
pp. 587-589 ◽  
Author(s):  
Tuba Karagülle Kendi ◽  
Aziz Erakar ◽  
Olcay Oktay ◽  
H. Yusuf Yildiz ◽  
Yener Saglik

Accessory soleus muscle is an uncommon anatomical variant that may present as a soft-tissue mass in the posteromedial region of the ankle. It is congenital in origin but usually presents in the second or third decade of life. Although it is a rare entity, accessory soleus muscle should be included in the differential diagnosis of soft-tissue swelling of the ankle. Awareness of the clinical presentation and specific findings of computed tomography, magnetic resonance imaging, and electromyography help with diagnosis without surgical exploration. We describe a 30-year-old patient with accessory soleus muscle. Magnetic resonance imaging features of the case are described, and the literature is briefly reviewed. (J Am Podiatr Med Assoc 94(6): 587–589, 2004)


2020 ◽  
Vol 1 (1) ◽  
pp. 75 ◽  
Author(s):  
Christoph F Dietrich ◽  
Wiem Douira-Khomsi ◽  
Hassen Gharbi ◽  
Malay Sharma ◽  
Xin Wu Cui ◽  
...  

Cystic echinococcosis (CE) or hydatidosis (hydatid cysts) is an infection with a wide spectrum of manifestations, from symptomatic infection to fatal disease. Ultrasound (US) allows screening, diagnosis, differential diagnosis, treatment guidance and follow-up of CE under many circumstances. Hydatid cysts are predominantly observed in the liver. Herewith we present a review to demonstrate established and innovative imaging features of CE of the hepatobiliary tract.


2021 ◽  
Vol 15 (8) ◽  
pp. 1-7
Author(s):  
Jonathan D. Pierce ◽  
Neal R. Shah ◽  
Ata A. Rahnemai-Azar ◽  
Amit Gupta

Tension gastrothorax is a rare, life-threatening clinical condition caused by intrathoracic herniation of the stomach through a diaphragmatic defect which becomes increasingly distended over time. If not recognized promptly, this can rapidly progress to respiratory distress, mediastinal shift, and hemodynamic compromise. Initial clinical presentation and imaging findings closely mirror those of tension pneumothorax, confounding diagnosis and potentially leading to unnecessary interventions with increased risk of morbidity and mortality. Here, we present a case of an elderly female who presented with a non-traumatic tension gastrothorax and a review of key imaging features and strategies to aid in recognition and accurate diagnosis of this emergent clinical entity.


Author(s):  
Ravikant Kaushik ◽  
Mukta Mital ◽  
Kastubh Gupta

Sign in / Sign up

Export Citation Format

Share Document