Colloid cysts are rare benign tumors of the third ventricle with diverse clinical presentation, which vary from incidentally found cysts to acute death. An uncommon hemorrhage in these cysts is a life threatening complication which can cause obstructive hydrocephalus with acute deterioration of the patient and sudden death. We present a case of 35-year-old man with large hemorrhagic colloid cyst of a third ventricle causing acute obstructive hydrocephalus even though magnetic resonance image with low T2 signal of the cyst suggested its clinically stable nature. Only 3 cases of in vivo diagnosed hemorrhagic colloid cysts have been reported in the literature. ÖZKolloid kistler üçüncü ventrikülün nadir benign tümörleri olup tesadüfen bulunan kistlerden akut ölüme kadar çok geniş bir klinik sunum aralığına sahiptir. Bu kistlerde sık görülmeyen bir olay olan kanama obstrüktif hidrosefaliye ve sonuçta hastanın durumunda ani bozulmaya ve ölüme neden olabilen yaşamı tehdit edici bir komplikasyondur. Üçüncü ventrikülde büyük bir hemorajik kolloid kisti olup kistte düşük T2 sinyaliyle manyetik rezonans görüntülemenin klinik olarak stabil bir durum düşündürdüğü akut obstrüktif hidrosefali bulunan 35 yaşında bir erkek sunuyoruz. Literatürde in vivo tanı konmuş sadece 3 hemorajik kolloid kist vakası mevcuttur.anaHtar sÖZcÜkLer: Kolloid kist, Kanama, Üçüncü ventrikül, Hidrosefali
Introduction: Subclavian artery stenosis is a potential cause of serious morbidity, endangering the upper extremities, brain and the heart. It is a relatively rare form of peripheral arterial disease, usually present in patients who already suffer from peripheral arterial disease on other vessels, most often lower extremity arteries. Atherosclerosis is considered to be the primary underlying cause. The current treatment of choice is endovascular approach which combines percutaneous transluminal angioplasty and stenting as its noninvasive nature yields faster recovery and less complications. Aim: The aim of this study was to examine the characteristics of subclavian atherosclerotic lesions in patients who underwent endovascular procedure and their relationship with known risk factors. Additional aim was to assess clinical and procedure characteristics of patients and compare them with similar experiences from other centers. Patients and methods: We conducted a retrospective single center review of patients treated with endovascular procedure for SA stenosis and/or occlusion. A total of 53 patients were detected. Three patients were excluded due to the arteritis origin of the stenosis, leaving 50 patients suitable for analysis. Participants' characteristics were analyzed using descriptive statistics. Normal distribution was assessed using Shapiro-Wilk test. Categorical variables were analyzed using the Chi-square test. Univariate logistic regression was used to calculate unadjusted odds ratios of factors associated with level of stenosis. Results: The mean age at the time of the first intervention was 62±8 years. All except 8 patients were symptomatic. The most common symptoms were paresthesia (32%), vertigo (30%), muscle fatigue (24%) and rest pain (22%). 58% of patients presented with Subclavian steal syndrome. The most common comorbidities and risk factors present in selected patients were hypertension 76%, smoking 60%, hyperlipidemia 60% and coronary artery disease 22%. A total of 50 lesions were treated with 59 endovascular procedures, 9 reinterventions among them. Technical success was achieved in 85% of procedures. After univariate analysis 3 items were detected suitable for multivariate logistic regression. The multivariate regression model was statistically significant χ2 (4, N = 50) = 17.94, p <0.01, explaining 42.7% of variance (Nagelkerke R 2 = .427). Female gender (p<0.05), hypertension (p<0.05) and smoking status (p<0.05) were independently associated with occlusion. Women had 7.7 times the odds of developing occlusion compared to males. Moreover, patients with a history of hypertension were 5.1 times more likely to develop occlusion. Smoking was associated with 7.8 higher chances to develop occlusion. The results of multivariate analysis are of limited significance due to the small sample size.
Due to its varying and often mimicking appearance, sarcoidosis is considered one of the great imitators in medicine. A rare form of pulmonary sarcoidosis, the nodular form, can be mistaken for disseminated malignancy. We present the case of 38-year-old patient, whose chest x ray demonstrated a large number of pulmonary nodules, more than 1 cm in diameter, predominantly in a peripheral distribution, with bilaterally enlarged hila, thus making disseminated malignant disease a part of di erential diagnosis. e sight of multiple lung nodules can be very suggestive for metastatic disease and misleading in everyday clinical practice. Sarcoidosis, Mimicking, Malignant disease, Nodules, Radiology; Nodular pulmonary sarcoidosis N Zbog svoje raznolike prezentacije i brojnih sličnosti s drugim bolestima, sarkoidoza je znana kao veliki imitator u medicini. Jedan od oblika sarkoidoze, nodularna plućna sarkoidoza, lako se može zamijeniti s malignom diseminiranom bolešću. Prikazujemo slučaj 38-godišnjeg pacijenta, čiji je torakalni rendgenogram pokazao veći broj periferno smještenih plućnih nodusa promjera većih od 1 cm uz obostrano uvećane hiluse. Takav nalaz upućivao je na diseminiranu malign bolest kao jednu od diferencijalnih dijagnoza. Cilj ovog prikaza slučaja je podsjetiti kolege na nodularnu plućnu sarkoidozu kao jednu od mogućih dijagnoza u slučaju ovako sugestivnih nalaza kod pacijenata bez ranije poznate maligne bolesti.
We presented a case of an inguinal hernia containing an incarcerated ureter in a patient with transplanted kidney. A 60-year-old man was admitted to hospital with elevated creatinine levels and trans-abdominal ultrasound recognised hydronephrosis. An unenhanced CT scan revealed an incarcerated ureter in the inguinal hernia sac. The imaging confirmed hydronephrosis of the enlarged kidney with dilated pyelon and calyces. Later control examinations reported no change of grade of hydronephrosis and kidney function, probably due to the intermittent nature of ureteral incarceration. We present this case in light of the recent increase in reporting of ureteroinguinal hernias and as a reminder to radiologists always to check the course of the ureters when they encounter or suspect inguinal hernia.
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