CT findings of pathology proven benign metastasizing leiomyoma

Benign metastasizing leiomyoma, originally reported in 1934 by Paul Steiner is a rare entity with less than 150 documented cases. While this entity has a favorable prognosis, without proper recognition it could be misdiagnosed as advanced stage metastasis. This case report discusses the relevant imaging findings of a case of benign metastasizing leiomyoma involving a 46-year-old woman which was detected in a preoperative work-up for hysterectomy. The patient presented with chronic cough for 2 years and a history of uterine fibroids. Because benign metastasizing leiomyoma was considered in this patient who presented with lung nodules and pelvic masses, a biopsy of the salient lesions was rapidly performed and enabled pathology to confirm a diagnosis of this entity. This case examines the differential diagnoses associated with multiple pulmonary nodules and provides an example of why the radiologist should consider benign metastasizing leiomyoma in that differential when these findings are identified in perimenopausal women.

Chest CT findings of early and progressive phase COVID-19 infection from a US patient

The SARS-CoV-2 infection (COVID-19), originally reported in Wuhan, China, has rapidly proliferated throughout several continents and the first case in the United States was reported on January 19, 2020. According to the ACR guidelines issued shortly after this disease was declared a pandemic, radiologists are expected to familiarize themselves with the CT appearance of COVID-19 infection in order to be able to identify specific findings of this entity. This case report discusses the relevant imaging findings of one of the first cases in the mid-western United States. It involves a 60-year-old man who presented with fever, dyspnea, and cough for 1 week and subsequently tested positive for COVID-19. The utility of the noncontrast CT chest in the diagnosis of COVID-19 has been controversial, but there are specific imaging findings that have been increasingly associated with this virus in the appropriate clinical context. The stages of imaging findings in COVID-19 are considered along with the implications of fibrosis throughout the stages. Future considerations include using artificial intelligence algorithms to distinguish between community acquired pneumonias and COVID-19 infection.

Nonmucinous adenocarcinoma of the cecum presenting as appendicitis complicated by hepatic abscess

A 59-year-old man presenting with right upper quadrant pain was found to have hepatic abscesses on CT imaging. After draining the abscess, a repeat CT 3 weeks later indicated that the cause of the hepatic abscesses was appendicitis. Upon surgical resection of the base of the cecum and appendix, an adenocarcinoma was demonstrated along the cecal wall both invading and occluding the appendix. The patient was initially treated for complications of appendicitis, but this case indicates the importance of considering additional etiologies for complex appendicitis. This case report provides a pathology-proven case of well-differentiated, nonmucinous adenocarcinoma of the cecum presenting as a complication of appendicitis and discusses standard treatment options. This case report also reviews the pathophysiological aspects of hepatic abscess as a complication of appendicitis as well as the importance of considering malignancy in a patient presenting with complications of appendicitis.

Traumatic arteriovenous fistula between the middle meningeal artery and the sphenoparietal sinus: a case report and review of the world literature

A fistula between a lacerated middle meningeal artery and the sphenoparietal sinus was discovered in a patient who had increased intracranial pressure following trauma.

Symptomatic middle cerebral artery stenosis

The clinical course of 16 consecutive patients with stenosis of the middle cerebral artery angiographically diagnosed between 1970 and 1977 was reviewed. All were managed nonsurgically with medical treatment including anticoagulation. Prior to therapy, transient ischemic attacks had occurred in 15 and cerebral infarction in 11. Initially, none exhibited more than a minor neurological deficit. Follow-up from one month to six years showed a benign course in 14 patients: 13 experienced no subsequent transient attacks or new stroke; 1 had repeated transient attacks for two years but not in the following four years. Two of the 16 developed a severe stroke early in the course, before medical therapy was started. No distinctive clinical or radiographic features were identified that permitted prediction of the outcome. This small series supports the need for a randomized study of bypass efficacy in these patients.

Cerebellar hemangioblastoma: computed tomographic, angiographic and clinical correlation in seven cases

Seven patients with histologically confirmed cerebellar hemangioblastomas are reviewed in order to establish computed tomographic (CT), angiographic and clinical characteristics and correlations. Noncontrast CT scans demonstrated most cystic lesions but did not always depict nodules on the cyst wall and small solid tumors. Contrast-enhanced CT scans demonstrated the solid and cystic types of tumors but in some cases angiography better delineated them and the presence of nodules. The CT appearance reflected the pathologic characteristics, which included vascular channels, cyst formation and nodules. Solid tumors enhanced homogeneously and could not be definitively distinguished from other cerebellar neoplasms by CT alone. One atypical undifferentiated tumor appeared as a solid mass with a necrotic center. The CT appearance of associated retinal angiomatosis is also described. Hydrocephalus, gait or appendicular ataxia was the initial clinical presentation in these patients.

The many faces of sarcoidosis

This is a radiographic exhibit demonstrating some of the many ways that pulmonary sarcoidosis can present. In addition to the classical stages (I-IV), sarcoidosis can sometimes present atypically. Some of these forms of sarcoid disease have been included in this exhibit.

Destructive lesions of bone: X-ray differential diagnosis

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The solitary pulmonary nodule

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Destructive lesions of bone: x-ray differential diagnosis

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Brain function and macromolecules. 3. Uridine incorporation into polysomes of mouse brain during short-term avoidance conditioning

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