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Xanthogranulomatous cholecystitis (XGC) is an uncommon variant of chronic cholecystitis characterized by xanthogranulomatous inflammation of the gallbladder. Intramural accumulation of lipid-laden macrophages and acute and chronic inflammatory cells is the hallmark of the disease. The xanthogranulomatous inflammation of the gallbladder can be very severe and can spill over to the neighbouring structures like liver, bowel and stomach resulting in dense adhesions, perforation, abscess formation, fistulous communication with adjacent bowel. Striking gallbladder wall thickening and dense local adhesions can be easily mistaken for carcinoma of the gallbladder, both intraoperatively as well as on preoperative imaging. Besides, cases of concomitant gallbladder carcinoma complicating XGC have also been reported in literature. So, we have done a review of the imaging features of XGC in order to better understand the entity as well as to increase the diagnostic yield of the disease summarizing the characteristic imaging findings and associations of XGC. Among other findings, presence of intramural hypodense nodules is considered diagnostic of this entity. However, in some cases, an imaging diagnosis of XGC is virtually impossible. Fine needle aspiration cytology might be handy in such patients. A preoperative counselling should include possibility of differential diagnosis of gallbladder cancer in not so characteristic cases.

The imaging manifestations of hepatic lymphoma, both in its primary and secondary form, are extremely variable and overlap with a number of other more common hepatic diseases. However, in the appropriate clinical context, combining the imaging and laboratory features can aid in making the correct diagnosis. Since the management and prognosis of lymphomas are significantly different from other malignancies, early diagnosis and prompt commencement of therapy is of paramount importance. The various morphological appearances of hepatic lymphoma on imaging have been described here along with their possible differentials.Teaching points• Primary hepatic lymphoma is extremely rare.• Secondary liver involvement occurs in 50 % of patients with non-Hodgkin lymphoma.• The imaging manifestations of hepatic lymphoma are largely non-specific.• Some imaging features may be helpful in the appropriate clinical setting.• Management and prognosis of lymphoma is significantly different from other malignancies.

ObjectivesWe aim to illustrate the multimodal imaging spectrum of hepatic involvement in tuberculosis (TB). Whilst disseminated tuberculosis on imaging typically manifests as multiple small nodular lesions scattered in the liver parenchyma, isolated hepatic tuberculosis remains a rare and intriguing entity.MethodsIndubitably, imaging is the mainstay for detection of tubercular hepatic lesions which display a broad spectrum of imaging manifestations on different modalities. While sonography and computed tomography (CT) findings have been described in some detail, there is a paucity of literature on magnetic resonance imaging (MRI) features. Due to a significant overlap with other commoner and similar appearing hepatic lesions, hepatic tuberculosis is often either misdiagnosed or labelled as indeterminate lesions. This article is a compendium of cases highlighting the spectrum of imaging patterns that can be encountered in patients with isolated primary hepatic tuberculosis as well as disseminated (secondary) disease. Rare patterns of primary disease such as tubercular cholangitis, hypervascular liver masses, and those with vascular complications are also illustrated and discussed.ConclusionsImaging plays a valuable role in the detection of tubercular hepatic lesions. Also, imaging can be helpful in their characterisation and for assessing associated complications.Teaching points• Hepatic TB has myriad imaging manifestations and is often confounded with neoplastic lesions.• Imaging patterns include miliary TB, macronodular TB, serohepatic TB and tubercular cholangitis.• Concurrent splenic, nodal or pulmonary involvements are helpful pointers towards the diagnosis.• Miliary calcifications along the bile ducts are characteristic of tubercular cholangitis.• Histological/microbiological confirmation is often necessary to confirm the diagnosis.

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A s the global pandemic of severe acute respiratory syndrome-coronavirus 2 (SARS-CoV2) continues, nuances of the disease it precipitates in humans continue to emerge. After early reports of presentation with gastrointestinal-type symptoms in China 1 and Italy, 2 a group from Wuhan reported a series of 9 patients with purported pancreatic injury in the context of SARS-CoV2 infection 3 but did not provide robust evidence for pancreatitis. relying on mild hyperamylasemia alone. Current international consensus for a diagnosis of acute pancreatitis requires 2 of the following 3 features: abdominal pain consistent with pancreatitis, serum amylase/lipase greater than 3 times the upper limit of normal, and characteristic findings on cross-sectional imaging. 4 Simply put, there are too many causes for hyperamylasemia in the context of systemic illness, with or without SARS-CoV2, for its use in isolation as a marker of pancreatic injury. Nonetheless, we report here 5 cases of atypical but proven acute pancreatitis in the context of SARS-CoV2 infection. Methods This review was registered with the Liverpool University Hospitals NHS Foundation Trust audit department (ID TA0002744). Cases were identified by searching admission diagnoses (International Classification of Diseases, 10th revision code K85) or radiology requests and reports for "acute pancreatitis." SARS-CoV2 was diagnosed when either swabs were positive on rapid polymerase chain reaction (VIASURE, Certest Biotec, Spain) or patients had radiologic evidence of SARS-CoV2 infection (Supplementary Figure 1). Cases with pre-existing pancreatic pathology or where the etiology was clearly non-SARS-CoV2 related were excluded. Data extracted from patient and radiology records were used to calculate clinical scores and hepatic steatosis estimates by analysis of contrast-enhanced computed tomography (CECT) images as previously described. 5 Imaging findings were rereported by an expert pancreatic radiologist.

Compensated ALC have increased adiposity and relatively preserved muscularity but decompensation leads to loss of both muscle and fat mass. Prevalence of sarcopenia, based on derived ethnic cut-offs was 12.8%.

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