Primary tumours of the heart and pericardium are extremely rare. Cardiac lipomas account for only 10% of all primary cardiac tumours. A case of surgically proven pericardial lipoma demonstrated by ultrasound, CT and MRI is presented here.

Significant eosinophilia and even eosinophilic tissue infiltration has been associated with a variety of clinical disorders including allergic and immunodeficiency states, drug reaction, infection, parasitic infestation and malignancy. Eosinophilia without an underlying aetiology and with multi-organ dysfunction has been designated idiopathic hypereosinophilic syndrome. We report a case of endomyocardial fibrosis with MRI findings.

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We present a case of renal abscess with perinephric and paranephric extension. Ultrasonography showed an intrarenal lesion. The extension into the perinephric and paranephric space was better defined on MRI.A 30-year-old woman at 25 weeks gestation was transferred for evaluation of a left renal mass. She presented to the emergency department with a 1-week history of left flank pain, which was exacerbated following a fall. On physical examination, she was afebrile and was markedly tender in the left renal flank.Microscopic urinalysis revealed 10-100 × 10 6 /L white blood cells. There was no bacterial growth on urine culture.Ultrasonography showed a complex, vascular mass measuring 11 × 6.5 cm arising from the mid to lower pole of the left kidney ( Fig. 1).As the nature of the mass was indeterminate, an MRI scan was performed at 27 weeks gestation. Axial T1-weighted gradient echo (Fig. 2a), axial T2 half-fourier acquisition single shot turbo spin echo, coronal T2 turbo spin-echo with fat suppression (Fig. 2b) and 2-D true free induction steady precession of the inferior vena cava (IVC) and renal veins were performed. Magnetic resonance imaging showed an enlarged heterogeneous mass arising from the mid and lower pole of the left kidney measuring approximately 12.0 cm in length, 8.0 cm in width and 8.5 cm in anteroposterior dimension. The mass was of both intermediate-and low-signal intensity in the T1-weighted acquisition and heterogeneous high-signal intensity in the T2-weighted sequences. The left kidney was displaced superiorly and anteromedially, and the tail of the pancreas was displaced anteriorly. There was mild dilatation of the left upper pole collecting system. The left quadratus lumborum and iliopsoas muscle showed high-signal intensity in the axial T2 and intermediate-to low-signal intensity in the T1-weighted sequences. There was loss of the fascial plane between the left renal mass and the paraspinal muscle. The M Puvaneswary MB BS, FRCR; A Bisits MB BS, FRANZCOG, Dip Clin Epi, M Med Stat; B Hosken MB BS, BSc, FRACS.Fig. 1. Ultrasound shows a large heterogeneous mass arising from the mid and lower pole of the left kidney.

A case of myocardial metastasis from a gastrointestinal carcinoid is presented. The colon was the primary site. The patient did not manifest symptoms of carcinoid syndrome and had no echocardiographic or MRI evidence of carcinoid valvular heart disease.

180 patients with end-stage renal disease (ESRD) on maintenance dialysis and those who had undergone renal transplantation were questioned retrospectively. 14 patients had consumed excessive quantities of analgesics ( > l kg) prior to the institution of long-term dialysis or transplantation. Sonographic examination done on these patients indicated that 7 had renal papillary necrosis (RPN). The sonographic features were renal papillary calcifications surrounding the central sinus in a complete or incomplete garland pattern. In 5 of these patients RPN is attibutable to the excessive consumption of paracetamol. We have earlier reported 10 cases of RPN due to excessive consumption of paracetamol. Thus 15 cases of RPN attributable to paracetamol consumption (1.0–15.3 kg over a period ranging from 3 to 23 years) have been documented. It is concluded that paracetamol may assume an increasingly important role in the causation of analgesic nephropathy (AN) and ESRD.

Mucocele of the appendix is a rare lesion caused by abnormal accumulation of mucus. Although preoperative diagnosis is important to avoid rupture of a mucocele, the diagnosis is often made at surgery. We report a case of an appendiceal mucocele that mimicked a hydrosalpinx on CT and MRI.

Two patients with histologically proven diagnosis of peritoneal mesothelioma are presented. Both patients had CT scans of the abdomen. The second patient was also examined with MRI.