80-year-old female presented with clinical findings suggestive of acute
cholecystitis. Intraoperatively we discovered a dusky gallbladder with
gangrenous patches and gallbladder torsion with 270 degrees clockwise
rotation along the longitudinal axis. Gallbladder torsion is a rare cause of
acute cholecystitis with less than 500 cases published in the literature.
Gallbladder torsion should be included in the list of differential diagnoses in
patients suspected of having acute cholecystitis especially when there are
inconsistencies between clinical features and imaging. It is worth noting
that 3-dimensional reconstructed CT may be useful in preoperative diagnosis of
gallbladder torsion.
Primary central nervous system lymphoma of T-cell lineage (PCNSTL) is an extremely rare entity, with relatively few cases reported in the literature. Presented here is a case of a 44-year-old, HIV negative woman found to have a solitary cerebellar lesion following presentation to the Emergency Department with a fall. The lesion responded to emergent dexamethasone and was followed with serial MRI imaging, which continued to show lesion regression. The lesion was shown to have recurred on MRI 14 months post-presentation and found to be T-cell lymphoma following immunophenotyping and TCR gene rearrangement studies of tissue specimen obtained via excisional biopsy.
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