Tuberculosis (TB) is one of the commonest infectious diseases in the developing countries with rising incidence seen due to HIV and AIDS. Pulmonary tuberculosis is the commonest form seen. Renal Tuberculosis is the most common extrapulmonary form. There are no specific clinical symptoms associated with renal tuberculosis. The constitutional symptoms like low grade fever, weight loss, anorexia commonly seen with pulmonary TB are not usually seen with renal TB. Renal TB is also cause of interstitial nephritis which leads to end-stage renal failure. Hence the role of radiologist assumes importance in supporting the timely diagnosis although cultures or histologic analysis is required for definitive diagnosis. The individual imaging finding may not be diagnostic as it can be seen with other renal pathologies too, however, presence of multiple imaging findings in a single case is pointer to this disease. Renal TB involves both cortex and collecting system. This article gives review of pathophysiology and computed tomography features of Renal TB.
Lipomas are benign tumors of mature adipose tissue which can occur in subcutaneous, intramuscular, intermuscular, parosteal, and intraosseous compartments. Parosteal lipoma is a rare type of lipoma, accounting for less than 0.1% of primary bone neoplasms and 0.3% of all lipomas. Parosteal lipomas commonly arise in the femur and extremities. Around 150 cases have been reported in English literature with scapula being a rare site of involvement. They are known to be associated with underlying bony changes like focal cortical hyperostosis, pressure erosion of the underlying bone, and bowing deformity or with underlying osteochondroma. We report a rare case of a parosteal lipoma arising in the scapula with a bony excrescence in a 38-year-old male.
We report a case of pseudoaneurysm of the anterior ascending branch of the left pulmonary artery, following a left upper lobectomy for pulmonary aspergillosis, for which we have done an endovascular treatment. This is the first case where complete pseudoaneurysm occlusion was accomplished after a transcatheter intra-aneurysmal N-butyl 2-cyanoacrylate (glue) injection.
It is well known that giant cell tumours of the bone rarely occur below the age of 20 years. Many radiologists and orthopaedicians do not even consider giant cell tumours as a differential diagnosis from a lytic lesion before epiphyseal closure. This is a rare case report of a 14-year-old girl with proven giant cell tumour of the epiphysis of the distal femur.
A 23-year-old male presented with complaints of gradually increasing swelling of the left hemiscrotum. Preliminary ultrasound scan revealed a heterogeneous, predominantly solid lesion showing raised internal vascularity with few cystic areas in the paratesticular region, towards the midline with both testes seen separately from the lesion. To rule out presence of locoregional or distant metastases, a CT scan was done which revealed a well-defined, intrascotal, extratesticular, heterogeneous, moderately enhancing mass lesion with cystic areas in the scrotal sac with no significant lymphadenopathy or obvious distant metastasis. Subsequent MRI done for surgical planning revealed a heterogeneous signal intensity lesion with cystic areas and areas of haemorrhage with focal loss of fat planes with the left corpora cavernosa at the root of the penis. The patient underwent an inguinoscrotal exploration with excision of the left paratesticular mass. Final histopathology suggested an undifferentiated high grade pleomorphic sarcoma. Paratesticular tumours while rare are an important cause of scrotal swelling. Exact histological identification of tumour subtype is not possible based on imaging but preoperative multi-modality imaging has an important role in identifying tissue of origin, differentiating benign from malignant lesions, surgical planning and assessing the need for adjuvant CT/RT.
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