scholarly journals Sino Cranial Aspergillosis Mimicking Skull Base Meningioma- A Case Report and Review of Literature

2021 ◽  
Author(s):  
Vishwanath Joshi ◽  
Saumya Rao ◽  
Neemish Kamat ◽  
Mitusha Verma ◽  
Deepak Patkar
Keyword(s):  
Fungal Infections ◽  
Sinus Surgery ◽  
Response To Treatment ◽  
Fungal Sinusitis ◽  
Imaging Features ◽  
Diagnostic Dilemma ◽  
Neoplastic Processes ◽  
Neoplastic Lesion ◽  
Axial Mass ◽  
Magnetic Resonance Imaging Mri

Fungal infections of the nose and paranasal sinuses can be categorised into invasive and noninvasive forms. Central Nervous System (CNS) Aspergillosis is extremely rare in immunocompetent individuals. Invasive fungal sinusitis affecting CNS commonly poses a diagnostic dilemma on imaging, often confused with neoplastic processes. Here, Authors report a case of invasive sino cranial aspergillosis in immunocompetent individual mimicking a meningioma on imaging. A 46-year-old male patient presented with history of seizure like episode and right eye proptosis to Neurology Department. On Magnetic Resonance Imaging (MRI), there was enhancing T2 weighted hypointense extra-axial mass lesion along right frontal convexity with associated osseous erosion, intraorbital extension and associated sinus disease. Based on clinical presentation and imaging features, initial diagnosis of a aggressive neoplastic lesion was made. Patient subsequently underwent biopsy which showed fungal elements of Aspergillus Fumigatus species. Patient underwent endoscopic sinus surgery and along intravenous and oral antifungal therapy with good response to treatment. This case highlights the key role of imaging including MRI and CT in making accurate diagnosis of fungal sinusitis especially in immunocompetent individuals and differentiate from other entities like meningioma.

scholarly journals Magnetic resonance imaging of the cirrhotic liver: diagnosis of hepatocellular carcinoma and evaluation of response to treatment – Part 2

2017 ◽  
Vol 50 (2) ◽  
pp. 115-125 ◽  
Author(s):  
Miguel Ramalho ◽  
António P. Matos ◽  
Mamdoh AlObaidy ◽  
Fernanda Velloni ◽  
Ersan Altun ◽  
...  
Keyword(s):  
Magnetic Resonance Imaging ◽  
Hepatocellular Carcinoma ◽  
Magnetic Resonance ◽  
Diagnostic Algorithm ◽  
Response To Treatment ◽  
Locoregional Therapy ◽  
Liver Imaging ◽  
Imaging Features ◽  
Resonance Imaging ◽  
Magnetic Resonance Imaging Mri

Abstract In the second part of this review, we will describe the ancillary imaging features of hepatocellular carcinoma (HCC) that can be seen on standard magnetic resonance imaging (MRI) protocol, and on novel and emerging protocols such as diffusion weighted imaging and utilization of hepatocyte-specific/hepatobiliary contrast agent. We will also describe the morphologic sub-types of HCC, and give a simplified non-invasive diagnostic algorithm for HCC, followed by a brief description of the liver imaging reporting and data system (LI-RADS), and MRI assessment of tumor response following locoregional therapy.

Imaging of CNS Fungal Infections: Review Article

2021 ◽  
Vol 104 (5) ◽  
pp. 872-885
Keyword(s):  
Magnetic Resonance Imaging ◽  
Computed Tomography ◽  
Central Nervous System ◽  
Nervous System ◽  
Magnetic Resonance ◽  
Fungal Infections ◽  
Imaging Features ◽  
Imaging Findings ◽  
Resonance Imaging ◽  
Magnetic Resonance Imaging Mri

Fungal infections of the central nervous system (CNS) are usually identified in immunocompromised patients but rare in immunocompetent hosts. The clinical and imaging manifestations are mainly influenced by types of fungal pathogen and immune status of the patients. The CNS fungal infections can develop through hematogenous dissemination from primary site of infection, cerebrospinal fluid seeding, or direct extension from adjacent sources of infection. Fungal infections can result in meningitis, meningoencephalitis, cerebritis, granuloma, or abscess formation, which imaging findings are often non-specific and difficult to distinguish from bacterial or tuberculous infection, non-infectious inflammatory disease, or even intracranial neoplasm. Vascular complications including vasculitis, cerebral infarction, or mycotic aneurysm are commonly present due to angioinvasion of fungal hyphae. In addition, some characteristic imaging features of fungal infections can be identified by computed tomography (CT) or magnetic resonance imaging (MRI), such as intracavitary projections in fungal abscesses and gelatinous pseudocysts in cryptococcosis that could help suggest the diagnosis. Recognizing the imaging findings of common intracranial fungal infections combined with appropriate clinical setting is crucial for allowing early diagnosis and leading to early specific treatment. The present article reviewed common imaging findings of CNS fungal infections and distinct imaging features of specific pathogens. Keywords: Fungal infection, Brain abscess, Cryptococcosis, Central nervous system (CNS), Computed tomography (CT), Diffusion weighted imaging (DWI), Magnetic resonance imaging (MRI)

Schizophyllum commune Sinusitis: A Case Report and Radiologic Findings

1995 ◽  
Vol 9 (3) ◽  
pp. 149-154 ◽  
Author(s):  
Brian E. Emery ◽  
Arnold D. Oberle ◽  
Fleurette Abreo ◽  
Terry A. Day ◽  
Fred J. Stucker
Keyword(s):  
Chronic Sinusitis ◽  
Schizophyllum Commune ◽  
Sinus Surgery ◽  
Fungal Sinusitis ◽  
Mri Findings ◽  
Allergic Fungal Sinusitis ◽  
Common Chronic Disease ◽  
Radiologic Findings ◽  
Magnetic Resonance Imaging Mri ◽  
First Time

Chronic sinusitis is now considered the most common chronic disease seen in this country.1 The infections are commonly polymicrobial and include aerobes and anaerobes.2 Fungal sinusitis accounts for up to 10% of cases of chronic sinusitis, and the disease ranges from allergic fungal sinusitis through fungus balls to invasive fungal sinus disease.3,4 We report the case of a 19-year-old black female with nasal obstruction, clear rhinorrhea, and nasal polyps. She underwent endoscopic sinus surgery after medical management failed to eradicate her symptoms. Cultures from her paranasal sinuses grew S. commune, a mushroom, a member of the Basidiomycetes. There have been four prior reports of S. commune sinusitis described in the literature. Presented is a review of the literature, a description of the histologic, mycologic, and radiologic findings and suggested treatment. The magnetic resonance imaging (MRI) findings are presented here for the first time.

scholarly journals Multinodular and vacuolating neuronal tumor of the cerebrum: three case reports

2021 ◽  
Vol 61 (1) ◽  
pp. 1-4
Author(s):  
Antônio Gláuber Uchôa Lessa ◽  
Lucas Alverne Freitas de Albuquerque ◽  
Norma Martins de Menezes Morais ◽  
Daniel Aguiar Dias ◽  
Paulo Ribeiro Nóbrega
Keyword(s):  
Clinical Presentation ◽  
Case Reports ◽  
Low Grade ◽  
Imaging Features ◽  
Resonance Imaging ◽  
Neoplastic Lesion ◽  
Mri Features ◽  
Rare Lesion ◽  
Magnetic Resonance Imaging Mri ◽  
Neuronal Tumor

Multinodular and vacuolating neuronal tumor (MVNT) of the cerebrum is a seizure-associated rare lesion that currently appears to be a malformative lesion or hamartoma rather than a low-grade neoplastic lesion. MVNT pathognomonic magnetic resonance imaging (MRI) features allow for diagnostic accuracy in the differential diagnosis. Lesions are usually asymptomatic, nonprogressive and incidentally found requiring only imaging monitoring over time. Although uncommon, it is important to be familiar with MVNT clinical presentation and key imaging features. We here present a series of three cases with imaging findings similar to those described in the literature. These patients were followed with serial neuroimaging.

scholarly journals Diagnostic dilemma in a case of chronic invasive fungal sinusitis solved using a novel diagnostic test

2021 ◽  
Vol 7 (8) ◽  
pp. 1373
Author(s):  
Malavika Suresh ◽  
Maneesh Shivaputra Ganamukhi ◽  
Maneesh Shivaputra Ganamukhi ◽  
Sobhana Chandran ◽  
Sobhana Chandran ◽  
...  
Keyword(s):  
Fungal Infections ◽  
Invasive Fungal Disease ◽  
Immunosuppressive Drugs ◽  
Interesting Case ◽  
Fungal Sinusitis ◽  
Diagnostic Dilemma ◽  
Sinus Disease ◽  
Invasive Fungal Sinusitis ◽  
Specific Symptoms ◽  
Chronic Invasive

Fungal infections of the paranasal sinuses are a spectrum of diseases rather than one distinct entity. The prevalence of fungal sinus disease has been increasing in recent decades, especially in immunocompetent individuals. The indiscriminate use of antibiotics and immunosuppressive drugs has partially been attributed to this. The diagnosis of invasive fungal disease still imposes a challenge to medical professionals occasionally. Here we present an interesting case of a middle-aged immunocompetent male who presented to us with non-specific symptoms of chronic invasive fungal sinusitis. The routine investigations for diagnosing fungal sinusitis turned out to be futile and the result of serum galactomannan test helped to identify and treat his condition. <p> </p>

scholarly journals Appearances of von Meyenburg Complex on Cross Sectional Imaging

2013 ◽  
Vol 3 ◽  
pp. 22 ◽  
Author(s):  
Phillip F. C. Lung ◽  
Ounali S. Jaffer ◽  
Nuzhat Akbar ◽  
Paul S. Sidhu ◽  
Suzanne M. Ryan
Keyword(s):  
Imaging Features ◽  
Contrast Enhanced Ultrasound ◽  
Diagnostic Dilemma ◽  
Cross Sectional ◽  
Diagnostic Uncertainty ◽  
Von Meyenburg Complex ◽  
Imaging Characteristics ◽  
Contrast Enhanced ◽  
Proven Case ◽  
Magnetic Resonance Imaging Mri

The von Meyenburg complex (VMC) is an uncommon congenital malformation and is characterized by benign bile duct hamartomas. These are usually discovered incidentally and may represent a diagnostic dilemma when liver metastases are suspected. MRI of VMC shows distinct imaging characteristics, but reporting of lesional contrast enhancement has been inconsistent, whilst microbubble contrast enhanced ultrasound provides ‘real-time’ evaluation of soft tissue vascularity. Given the diagnostic uncertainty over imaging in VMC, biopsy is often recommended as the definitive diagnosis. We report a biopsy proven case of VMC on a background of primary colonic malignancy investigated with ultrasound, contrast enhanced ultrasound, computed tomography CT, and magnetic resonance imaging MRI, and review the key imaging features.

Fungal sinusitis among patients with chronic rhinosinusitis who underwent endoscopic sinus surgery

2018 ◽  
Vol 72 (3) ◽  
pp. 1-4 ◽  
Author(s):  
Joanna Leszczyńska ◽  
Grażyna Stryjewska-Makuch ◽  
Grażyna Lisowska ◽  
Bogdan Kolebacz ◽  
Marta Michalak- Kolarz
Keyword(s):  
Endoscopic Sinus Surgery ◽  
Fungal Infections ◽  
Histopathological Examination ◽  
Fungal Spores ◽  
Sinus Surgery ◽  
Fungus Ball ◽  
Fungal Sinusitis ◽  
Non Invasive ◽  
Paranasal Sinusitis ◽  
Common Location

Introduction: Fungal paranasal sinusitis can be either invasive or non-invasive. Saprophytic infections, fungus balls (FB) and allergic fungal rhinosinusitis are non-invasive (AFR). Materials and methods: The present study examined 521 patients who underwent endoscopic sinus surgery between January 2016 and April 2017 due to chronic paranasal sinusitis at the Department of Laryngology and Laryngological Oncology of the Upper Silesian Medical Centre in Katowice. The aim of the study was to analyse the histopathological and microbiological material collected intraoperatively and to determine the incidence and type of fungal infections among patients treated for chronic sinusitis. Results: Chronic fungal sinusitis was confirmed in 10 of 521 operated patients. The study group consisted of 9 females and 1 male. Histopathological examination revealed dead mycelium in 5 patients and colonies of Aspergillus spp. in 4, while microbiological examination revealed Candida albicans infection in 1 case. Allergy to inhalant allergens of fungal spores of Alternaria and Penicillinum was confirmed in a 73-year-old patient, which, based on the whole clinical presentation, enabled to diagnose chronic allergic fungal sinusitis. The most common location of mycelium was the maxillary sinus, followed by the sphenoid sinus. Discussion: The most common form of non-invasive fungal sinusitis is the so-called fungus ball, which was also confirmed in our report (95% of the test subjects). AFRS is more likely to occur in warm, moist climates that favour the growth of fungi.

scholarly journals Primary Extra-axial Glioblastoma: Case Report and Literature Review

2021 ◽  
Author(s):  
Baraa Dabboucy ◽  
Philippe Younes ◽  
Abdallah Rahbani ◽  
Elie Fahed ◽  
Gérard Abadjian
Keyword(s):  
Primary Brain Tumor ◽  
Tumor Type ◽  
Resonance Imaging ◽  
Diagnostic Dilemma ◽  
Dural Tail Sign ◽  
Healthy Female ◽  
Axial Mass ◽  
Dural Tail ◽  
Magnetic Resonance Imaging Mri

AbstractGlioblastoma multiforme (GBM) is the most frequent and most aggressive primary brain tumor in adults, mainly located in the cerebral hemispheres. In the literature, few cases of primary GBM have been reported to have radiographic and intraoperative features of extra-axial lesions, leading to a diagnostic dilemma. Despite the advances in imaging modalities, the diagnosis of GBM can be challenging, and it is mainly based on the histopathologic confirmation of the excised tumor. We describe the case of a 76-year-old previously healthy female patient who presented to our hospital due to speech disturbances and cognitive impairment. The diagnosis of the tumor type on magnetic resonance imaging (MRI) was difficult, as the findings were suggestive of a malignant meningioma due to the heterogeneous enhancement of a dural-based mass with a dural tail sign. Moreover, the intraoperative findings revealed an extra-axial mass attached to the dura. A histological examination confirmed the diagnosis of glioblastoma with arachnoid infiltration. The patient underwent adjuvant radiotherapy and concomitant temozolomide treatment, she had clinical improvement postoperatively, and was stable during the six months of follow-up. Glioblastoma should be considered in the differential diagnosis of primary extra-axial mass with atypical and malignant features, especially in elderly patients.

Juvenile xanthogranuloma of the subdural spaces mimicking chronic hematoma with positive FDG uptake on PET: case report

2020 ◽  
Vol 26 (4) ◽  
pp. 449-453
Author(s):  
Jacob A. Kahn ◽  
Jeffrey T. Waltz ◽  
Ramin M. Eskandari ◽  
Cynthia T. Welsh ◽  
Michael U. Antonucci
Keyword(s):  
Potential Role ◽  
Response To Treatment ◽  
Juvenile Xanthogranuloma ◽  
Imaging Features ◽  
Limited Information ◽  
Advanced Imaging ◽  
Systemic Involvement ◽  
The Central Nervous System ◽  
Infancy And Early Childhood

The authors report an unusual presentation of juvenile xanthogranuloma (JXG), a non–Langerhans cell histiocytosis of infancy and early childhood. This entity typically presents as a cutaneous head or neck nodule but can manifest with more systemic involvement including in the central nervous system. However, currently there is limited information regarding specific imaging features differentiating JXG from other neuropathological entities, with diagnosis typically made only after tissue sampling. The authors reviewed the initial images of a young patient with shunt-treated hydrocephalus and enlarging, chronic, extraaxial processes presumed to reflect subdural collections from overshunting, and they examine the operative discovery of a mass lesion that was pathologically proven to be JXG. Their results incorporate the important associated histological and advanced imaging features, including previously unreported metabolic activity on FDG PET. Ultimately, the case underscores the need to consider JXG in differential diagnoses of pediatric intracranial masses and highlights the potential role of PET in the initial diagnosis and response to treatment.

Scytalidium dimidiatum associated invasive fungal sinusitis in an immunocompetent patient

2014 ◽  
Vol 128 (11) ◽  
pp. 1018-1021 ◽  
Author(s):  
A Hariri ◽  
N Choudhury ◽  
H A Saleh
Keyword(s):  
Corticosteroid Treatment ◽  
Fruit Trees ◽  
Immunocompetent Patient ◽  
Human Infection ◽  
Functional Endoscopic Sinus Surgery ◽  
Sinus Surgery ◽  
Fungal Sinusitis ◽  
Endemic Region ◽  
Invasive Fungal Sinusitis ◽  
First Case

AbstractBackground:Scytalidium dimidiatum is a soil and plant pathogen that frequently affects fruit trees, but can also cause human infection. There are only two reported cases of invasive fungal sinusitis involving this rare micro-organism.Objective:This paper reports the first case of invasive fungal sinusitis caused by Scytalidium dimidiatum occurring in a young immunocompetent patient from a non-endemic region, and discusses potential sources of exposure and relevance of local factors.Method:Case report.Results:The patient was treated successfully with a combination of functional endoscopic sinus surgery, and antifungal and corticosteroid treatment.Conclusion:This paper describes the first reported case of invasive fungal sinusitis secondary to Scytalidium dimidiatum in a young immunocompetent patient from a non-endemic region. Importance is placed on following a systematic process of investigation and management, and adhering to well-defined basic surgical principles.

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