Ectopic bronchogenic cyst arising from the diaphragm: a rare case report and literature review

Background Bronchogenic cysts can be caused by errors in the growth of the ventral foregut. Localization of the bronchogenic cyst (BC) varies depending on the level of the abnormal budding. They are usually located in the lungs and mediastinum. BCs of the diaphragm are a rare form of this abnormality. Case presentation A 66-year-old woman coughs and expectorates. CT scan evaluation revealed a soft tissue shadow of 6 × 5 cm in the left lung. Under thoracoscopic surgery, we found that the mass originated from the diaphragm away from the lung tissue, we completely removed the mass and the pathological result was diagnosed as BC. Conclusions The prognosis of ectopic BC is usually optimistic for benign tumors, as long as the tumor is completely removed.

Primary Cutaneous Plasmacytosis with Calcinosis: A Rare Case Report

Primary cutaneous plasmacytosis is a rare disorder. Cases have been mostly reported from Japan. Here, a rare case of cutaneous plasmacytosis with calcium deposits was reported from southern part of India. A 47-year-old male patient presented with solitary asymptomatic nodule on the left leg present for two decades. Skin biopsy showed sheets of plasma cells in mid-dermis with bony trabeculae extending upto subcutis which was unremarkable. Serum electrophoresis did not reveal any M band and Bence Jones protein was absent in urine. Radiograph of the left leg showed focal lesion with calcific areas in soft tissue shadow with probability of calcification. Novelty of the case lies in its rare clinical presentation in this population with histopathological documentation.

Pancreatic Pseudocyst with Mediastinal Extension Presenting as Pseudo-Kirklin Sign—Multimodality Imaging

A mass lesion of the gastric cardia or fundus causing an alteration in the normal regular, translucent gastric fundal air shadow on a frontal erect chest radiograph is referred to as “the Kirklin sign.” Here we present “Pseudo-Kirklin sign” observed on the frontal radiograph of a 46-year-old male patient due to a soft tissue shadow/contour deformity of the fundal gas shadow caused by pseudocyst of the pancreas. We evaluated the patient using plain radiography, contrast enhanced computed tomography, magnetic resonance imaging, and endoscopic ultrasound (EUS) with the cyst drained under EUS guidance. So far only two cases of mediastinal pseudocysts have been drained successfully by EUS-guided aspiration.

Adult retropharyngeal abscess

ABSTRACTIntroductionThe proportion of adults suffering from retropharyngeal abscess (RPA) has increased in comparison to children.Materials and methodsEight cases of adult retropharyngeal abscess were reviewed. The diagnostic criteria were radiological evidence of widening of pre-vertebral soft tissue shadow and presence of pus in the swelling.ResultsSore throat, fever, muffled speech, painful swallow and stiffness of the neck were common presenting symptoms. Lateral X-ray of the neck was diagnostic. Commonest organism isolated was Streptococcus pyogenes. Airway obstruction was the commonest complication.DiscussionMost of the patients had history of trauma prior to the development of RPA. CT scan has an important role in planning the management in addition to lateral X-ray of the neck. Transoral surgical drainage in association with antibiotics is the treatment of choice in abscesses confined to the retropharyngeal space.ConclusionTuberculosis is no longer the commonest cause of adult retropharyngeal abscess. Sore throat or dysphagia, disproportionate to clinical findings in the throat should arouse suspicion of RPA. Early intervention with antibiotics reduces the chances of the development of complications.

A Case Report of Malignant Melanoma of the Sphenoid Sinus

Malignant melanoma of the sphenoid sinus is a very rare disease, and only 6 cases have previously been reported. The present case involved a 74-year-old woman who was examined for visual disturbance of the left eye. Computed tomography revealed a soft tissue shadow, but only mucosal hypertrophy was found on opening the sphenoid sinus under general anesthesia. One month postoperatively, visual disturbance of the right eye and paresis of cranial nerve III appeared. Malignant melanoma was diagnosed from biopsy. Multiple bone metastases were identified, but the patient declined active treatment. As a result, palliative care was provided and she died 3 months later. When there is no improvement in postoperative visual acuity as in this case, in consideration of the possibility of neoplastic lesions, rigorous followup including monitoring for neurological symptoms is warranted.

Adenoids in school-aged children

A total of 687 school children, aged six to 15 years, were examined clinically, radiologically and audiometrically. Lateral radiological examination of paranasal sinuses was carried out in 663 (96.5 per cent) children for evaluation of the size of adenoids. The size of the soft tissue shadow (adenoids) was assessed as normal or large. It was large in 133 (25 per cent) children, three times more frequently in seven-year-old than in 14-year-old children. The occurrence of adenoidal symptoms (blocked nose, mouth breathing, snoring, snuffling or rhinitis) varied from 14.3 to 30.1 per cent in children with large adenoids compared to 7 to 9.8 per cent in children with normal adenoids. Logistic regression analysis revealed that only recurrent snoring and the child's age were significantly associated with radiologically large adenoids. The hearing thresholds were 1.1 to 4.2 dB poorer and mean middle ear pressure values were 60 to 70 mmH2O lower in children with large adenoids compared to those with normal size adenoids. Large adenoids have an influence on the hearing level of a child, but probably via the negative middle ear pressure.