Clinical history: A 42yr nulliparous female with Chronic Kidney Disease presented with acute urinary retention.She also had constipation since 1 month and irregular per-vaginal bleeding since 3 months...See details
Although rare, retroperitoneal seminomas should be kept in mind among retroperitoneal tumors’ differential in men at their 5th decade. Narrowing of the differentials is done through microscopic exam...See details
A 46 year old female presented with a new left breast mass measuring 0.8 cm in greatest dimension (image 1,2, and 3). She subsequently underwent ultrasound-guided core needle biopsy of the mass yieldi...See details
Questions and Answers:
1. The most common site of intracranial calcifications in the pediatric population is:
b. Periventricular region
c. Pineal gland
e. Falx cerebri
Answer: c. In the pediatric population, they are typically seen in the pineal gland and choroid plexus. Pineal calcifications <1cm, appear as dots and tend to be benign in 40% of individuals less than 20 years old. Whereas pineal calcifications >1cm in patients younger than 9 years should be regarded as pathologic and warrant further investigation.
2. A blush-like pattern calcifications in the bilateral basal ganglia in a child is typically seen in:
a. Tuberous sclerosis
b. Raine syndrome
c. Krabbe’s disease
d. Sturge-Weber syndrome
Answer: c. Krabbe’s disease is an autosomal recessive demyelinating disorder affecting infants due to galactocerebroside b-galactosidase deficiency leading to accumulation of abnormal lipids. A symmetrical blush-like pattern of calcifications in the bilateral basal ganglia is characteristic.
3. A 3 day-old boy was admitted to the neonatal intensive care unit after an episode of tonic-clonic seizure. His mother denied prenatal care. Non-contrast CT was showed both sub-ependymal and periventricular calcifications with cerebral volume loss. What is the most likely diagnosis?
a. Tuberous sclerosis
b. Congenital CMV
c. Congenital hypothyroidism
e. Hypoglycemia-induced seizure
Answer: b. Congenital Cytomegalovirus (CMV): Incidence is 0.2-2.4% of live births. Intracranial calcifications are seen in 77% of those with imaging abnormalities typically in the sub-ependymal and periventricular regions of the brain along with brain atrophy.
4. Among all the intra-axial brain tumors, which of the following is mostly associated with intracranial calcifications?
b. Pilocytic astrocytoma
c. Dysembryonic neuroectodermal tumors
Answer: a. Oligodendrogliomas exhibit the highest frequency of calcifications (up to 90%). Calcifications can be scattered dots or clumped together to form large nodules, located centrally or peripherally and frequently in the frontal lobes.
5. A 50-year-old female patient presented with dry cough, fatigue, and shortness of breath. On physical exam she has tender reddish bumps on the skin. Review of the systems revealed seizures and depression. CXR showed enlarged hilar lymph nodes and CT scan of the brain showed small calcified masses in the leptomeninges and periventricular white matter. What is the most likely diagnosis?
d. Chronic lead toxicity
Answer: e. Sarcoidosis affects many organs including the CNS, lungs and skin. On non-contrast CT scan of the brain, small calcified granulomas can be seen in the leptomeninges, periventricular white matter, pons, hypothalamus, pituitary stalk, and optic chiasm with varying degrees of edema.
The 43-year-old male patient presented to the emergency room due to 3 days of severe right lower quadrant abdominal pain. He complaint of fever, anorexia, nausea but no vomiting. Rebound tenderness wa...See details
A coronary cameral fistula (CCF) is an abnormal communication between a coronary artery and any cardiac chamber . CCF is an uncommon disorder with an incidence of 0.1% in patients undergoing coronary ...See details
Radiology resident at Aventura Hospital...
I am currently working as a Chief Resident in Radiology Department. (Shaukat Khanum Memorial Cancer Hospital, Lahore.) I want to learn about latest advances in the field of radiology as well as am ver...
Why is this case report worthy? Late and unusual presentation of a large paravertebral teratoma with intraspinal extension presented as radiculopathy in a young girl makes the case unusual and unique...See details
Images shows in a 45 years old chronic alcoholic patient presented with seizures, altered sensorium and bilateral lower limb paresis , T1W image shows hypointense corpus callosum and periventricular...See details
Radiology resident at University of Illinois at Chicago from 2015 to 2019. Currently a Neuroradiology fellow at University of Maryland Medical Center....