Background Focal lesions of the kidney comprise a spectrum of entities that can be broadly classified as malignant tumors, benign tumors, and non-neoplastic lesions. Malignant tumors include renal cell carcinoma subtypes, urothelial carcinoma, lymphoma, post-transplant lymphoproliferative disease, metastases to the kidney, and rare malignant lesions. Benign tumors include angiomyolipoma (fat-rich and fat-poor) and oncocytoma. Non-neoplastic lesions include infective, inflammatory, and vascular entities. Anatomical variants can also mimic focal masses. Main body of the abstract A range of imaging modalities are available to facilitate characterization; ultrasound (US), contrast-enhanced ultrasound (CEUS), computed tomography (CT), magnetic resonance (MR) imaging, and positron emission tomography (PET), each with their own strengths and limitations. Renal lesions are being detected with increasing frequency due to escalating imaging volumes. Accurate diagnosis is central to guiding clinical management and determining prognosis. Certain lesions require intervention, whereas others may be managed conservatively or deemed clinically insignificant. Challenging cases often benefit from a multimodality imaging approach combining the morphology, enhancement and metabolic features. Short conclusion Knowledge of the relevant clinical details and key imaging features is crucial for accurate characterization and differentiation of renal lesions.
Pelvic pain presents a common diagnostic conundrum with a myriad of causes ranging from benign and trivial to malignant and emergent. We present a case where a mucinous neoplasm of the appendix acted as a mimic for tubular adnexal pathology on imaging. With the associated imaging findings on ultrasound, computed tomography, and magnetic resonance imaging, we wish to raise awareness of mucinous tumors of the appendix when tubular right adnexal pathology is present both in the presence of pelvic or abdominal pain or when noted incidentally. Tubular pathology such as uncomplicated paraovarian cysts or hydrosalpinx is frequently treated conservatively with long-interval follow-up imaging or left to clinical follow-up. Thus, if incorrectly diagnosed as tubular pathology, an appendix mucocele or mucinous neoplasm of the appendix is likely to be undertreated. We wish to clarify some of the confusion around nomenclature and classification of the multiple entities that are comprised by the terms mucocele and mucinous tumor of the appendix.
parasitic hooklets were identified with polarized light microscopy, which enabled us to confirm the diagnosis of cystic Echinococcus granulosus.Hydatid disease is a global endemic parasitic infection caused by the larvae of the Echinococcus tapeworm. The typical route of human infection is from domesticated dogs (definitive host) that became carriers after they consumed infected sheep (intermediate host) offal. After the host ingests contaminated food or water, the eggs pass through the duodenal mucosa into a branch of the portal vein. The hepatic capillaries function as the initial defense from infection, and as a result, the liver is the most commonly involved organ. Eggs that pass through the hepatic capillaries have the potential to spread to other organs (1,2).The incidence rate is greatest in regions of the Middle East, Eastern Europe, China, and South America, where it can be as high as 50 per 100 000 person-years. In North America, a large proportion of reported cases have been documented in immigrants from countries where the disease is highly endemic. Echinococcus infection was first discovered in Canada in the 1950s in indigenous tribes. Over the next 2 decades, sporadic autochthonous transmission was recognized in the United States in Alaska, Arizona, California, New Mexico, and Utah (3).The hydatid cyst is composed of three layers: the outer pericyst, which is a fibrous capsule formed by the host's immune response; the middle acellular laminated membrane; and the inner germinal layer. Larvae and daughter cysts form in the inner layer (4). As in this case, a substantial proportion of patients with hepatic hydatid disease are asymptomatic, as the disease process can show a slow rate of growth. Symptoms tend to arise in adulthood as a result of local mass effect in the liver (eg, right upper quadrant pain or biliary compression). Cyst rupture is a common complication, with a severity spectrum ranging from asymptomatic cases to fatal anaphylactic reactions. Rupture leads to release of cyst contents into the peritoneal cavity, resulting in seeding and infection. Alternatively, rupture into the biliary tree may This copy is for personal use only. To order printed copies, contact
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