BackgroundPre-operative assessment of middle ear cholesteatoma is a must for assessing the disease's location, extent, and complication, and high-resolution computed tomography (HRCT) is the modality of choice. Therefore, this study aims to assess the common signs of cholesteatoma on HRCT and its diagnostic ability. MethodsFifty patients with suspected cholesteatoma were considered for the study, which was carried out on an Ingenuity Core 128 slice CT scanner (Philips, Amsterdam, Netherlands). The bilateral temporal bones of 50 patients were assessed for soft tissue density and associated findings. The number of temporal bones with soft tissue density was then correlated with intra-operative and histopathological examinations (HPE). ResultsOut of 100 temporal bones, 63 were diseased, and 37 were normal temporal bones. Epitympanum/Prussak's space was the most involved site with soft tissue density seen in 60/63 (95.2%) diseased temporal bones, followed by aditus ad antrum and mesotympanum, which was seen in 51/63 (80.9%) diseased temporal bones. The majority of the soft tissue lesions were non-dependent, accounting for 43/63 (68.2%) of the diseased temporal bones. Bony erosions were seen in 54/63 (85.7%) and bony expansion in 35/63 (55.5%) of the diseased temporal bones. HRCT showed a sensitivity of 100%, specificity of 88.1%, a positive predictive value (PPV) of 92.1%, a negative predictive value (NPV) of 100%, and accuracy of 95% for detection of cholesteatoma. ConclusionHRCT of the temporal bone precisely demonstrates cholesteatoma's location, extent, and bony changes. Therefore, it has exceptional sensitivity, high specificity, and accuracy in diagnosing cholesteatoma.
Granulosa Cell Tumour (GCT) is a rare malignant ovarian tumour. Adult GCT variety is more common than juvenile variety and occurs usually in postmenopausal women. It showed a spectrum of the imaging findings due to various histological appearances. It may present with solid masses, multilocular cystic lesion or completely cystic lesion. Here, authors present an interesting case of a 27-year-old young female, who presented with a large lump in the abdomen. On Magnetic Resonance Imaging (MRI) there was a large well-defined, multilocular cystic lesion at superior aspect of the lesion and complex cystic, solid mass at inferior aspect. Functional MRI like diffusion weighted imaging which provides good image contrast helped in determining the malignancy despite a benign diagnosis on ultrasound guided biopsy and furthering the patient for histopathological examination to come to a final diagnosis.
Ectopic thyroid gland occurs due to aberrant descent of primitive thyroid gland to the final pre-tracheal position and failure of fusion of thyroid anlages. Submandibular ectopic thyroid is a rare thyroid anomaly that can present with or without an orthotopic thyroid gland. We present a case of a young female with hypothyroidism and left submandibular swelling demonstrated to be an ectopic thyroid with the colloid nodular goitre on imaging and cytology.
Paraduodenal hernias (PDH) are the most frequently occurring internal hernia, caused due to nonfusion between inferior mesentery and parietal peritoneum. The herniation of the bowel through the fossa of Landzert results in the left paraduodenal hernia which constitutes 75% of PDH. A case of a 34-year-old male with obstructed left PDH and a spontaneous reduction is demonstrated on Computed Tomography (CT). The patient had a cluster of jejunal loops forming a sac-like mass in the left anterior pararenal space, with surrounding mass effect with twisting and stretching of the mesenteric vessels at the hernia orifice, which showed a spontaneous reduction on subsequent contrast-enhanced and delayed CT studies. Despite the imaging evidence of spontaneous reduction of left PDH in our case, surgery remains the mainstay in terms of management for left paraduodenal hernia.
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