Sciatic hernia causing sciatica: MRI and MR neurography showing entrapment of sciatic nerve

Sciatic hernia is a rare condition with diverse clinical manifestations. We report a case of sciatic hernia causing sciatica, in which the diagnosis made on CT was subsequently confirmed on MRI including magnetic resonance neurography. The salient clinical and imaging features and a brief review are presented.

A rare case of combined soft-tissue and intraosseous arteriovenous malformation of the hand with diffuse periosteal elevation: imaging appearances

Arteriovenous malformations are uncommon congenital lesions of the hand. Although present at birth, they usually manifest later in life. Ultrasonography, MRI and digital subtraction angiography play an important role in the diagnosis of these lesions. We report the imaging appearances of an unusual case of combined soft-tissue and intraosseous arteriovenous malformation (AVM) of the hand with marked periosteal elevation in a 12-year-old child. Although associated skeletal changes are common, diffuse periosteal elevation owing to direct communication of the AVM with the subperiosteal space has not, to the best of our knowledge, been reported previously.

Solitary fibrous tumour of the liver: a rare imaging diagnosis using MRI and diffusion-weighted imaging

Solitary fibrous tumour of the liver is an extremely rare neoplasm, the reported imaging features of which are largely non-specific. We present a case in which dynamic contrast-enhanced CT, MRI and diffusion-weighted MRI findings suggested a diagnosis of solitary fibrous tumour of the liver that was subsequently confirmed by immunohistochemical evaluation.

Annular pancreas in an adult patient: diagnosis with endoscopic ultrasonography and magnetic resonance cholangiopancreatography

Annular pancreas is an uncommon congenital anomaly that usually presents early in childhood. The role of endoscopic ultrasonography in the diagnosis of this condition has been only sparsely reported. We present annular pancreas in a 50-year-old man; the anomaly was initially suspected during endoscopy and endoscopic ultrasonography, and subsequently confirmed on magnetic resonance cholangiopancreatography.

Symptomatic perineural extension of fungal sinusitis in an immunocompetent person: imaging features

Perineural spread is a rare mode of spread for fungal infection, even more so in immunocompetent individuals. We report a 21-year-old immunocompetent man in which symptomatic perineural extension of aspergillosis along the maxillary division of trigeminal nerve was accurately diagnosed on imaging.

Imaging appearance of parasitic infestations of the breast: a report of two cases and review of the literature

Parasitic infestations of the breast are uncommon. They may occur as a part of generalized disease, or present as primary breast infestations, making diagnosis difficult. Clinically, they are difficult to differentiate from the more common breast pathologies. However, imaging plays an important role, and different modalities often help distinguish and diagnose these rare conditions.

Invasive sinus aspergillosis with perineural spread in an immunocompetent patient

Invasive aspergillosis of paranasal sinuses is usually seen in immunocompromised patients and is associated with a very high mortality rate. The disease is distinctly uncommon in immunocompetent patients. A rare case of invasive aspergillosis of paranasal sinus and orbit with intracranial extradural extension via perineural spread along the maxillary division of the trigeminal nerve in an immunocompetent patient is presented.

Diffuse cavernous haemangioma of colon: magnetic resonance imaging features. Report of two cases

Large bowel haemangiomas are rare but can cause significant morbidity. The clinical features are non-specific, and misdiagnosis is very common. Non-invasive imaging is very useful in the diagnosis and management of this condition. Magnetic resonance imaging surpasses all other imaging modalities, as it is most specific and depicts the extent of the lesion accurately. Two cases of cavernous haemangioma of the rectum are presented highlighting the MRI features.

Solid pseudopapillary tumor of the pancreas with portal vein compression presenting as portal hypertension

Solid pseudopapillary tumour (SPT) of the pancreas is a rare neoplasm, which occurs predominantly in young females and is usually amenable to cure by surgical resection. Imaging plays an important role in its diagnosis. We present the sonographic, CT and MRI features of SPT in a young female whose chief complaint was recurrent haematemesis secondary to portal venous compression.

Congenital extrahepatic portosystemic venous shunt: imaging features

Congenital extrahepatic portosystemic venous shunt (CEPS) is a rare anomaly. It causes metabolic derangements and is often associated with liver tumours and other anomalies. Imaging plays an important role in the diagnosis of CEPS. However, it may be misleading in determining the type of shunt. We present a six-year-old girl with CEPS to illustrate the importance of histology in determining the presence of portal veins in the portal triad, which were too small to be seen on imaging.

Craniodiaphyseal dysplasia: an unusual cause of recurrent dacryocystitis

We describe a rare syndrome characterized by severe craniofacial hyperostosis, sclerosis, obliteration of paranasal sinuses and foramina of skull base, in a 10-year-old female child who presented with abnormal facial features and recurrent dacryocystitis due to narrowing of nasolacrimal duct.

Gastric teratoma

Gastric teratoma is a very rare tumour that usually manifests as an abdominal mass, resulting in gastrointestinal bleeding and/or obstructive features. We report gastric teratoma occurring in a two-year-old boy who presented with an abdominal mass. Diagnosis was aided by the classical findings of teratoma on computed tomography, seen as the presence of fat, calcifications, and both solid and cystic areas.

Spontaneous pneumorrhachis in bronchial asthma

We report on an 18-year-old male with bronchial asthma who presented with swelling over the neck and upper chest after a mild episode of bronchospasm. Physical examination was suggestive of subcutaneous emphysema, which was subsequently confirmed on a radiograph. Computed tomography in addition revealed pneumomediastinum and air within the epidural space of the spinal canal. Although spontaneous pneumomediastinum and subcutaneous emphysema have been described in a variety of situations, including patients with asthma, spontaneous pneumorrhachis in asthmatics is a very rare entity.

Isolated renal mucormycosis: an unusual cause of acute renal infarction in a boy with aplastic anaemia

Mucormycosis is an opportunistic fungal infection occurring most often in immunocompromised patients. The most common clinical presentation of infection with the fungus is rhinocerebral, followed by primary pulmonary, disseminated, gastrointestinal and cutaneous manifestations. Renal involvement in disseminated mucormycosis is well described, however, there are only few case reports describing the isolated renal mucormycosis in literature. We present an unusual case of renal mucormycosis in a patient of aplastic anaemia who presented with right flank pain and, on imaging, was found to have renal infarction and thrombosis of renal vessels. Histopathology revealed fungal hyphae infiltrating the entire kidney, renal vessels and perinephric space.

Lymphostimulatory and delayed-type hypersensitivity responses to a candidate leprosy vaccine strain: Mycobacterium habana

Lymphostimulatory and delayed-type hypersensitivity (DTH) immune responses to a candidate antileprosy vaccine Mycobacterium habana have been quantified in inbred AKR mice. M. habana vaccine in three physical states, live, heat-killed and gamma-irradiated, was given intradermally to separate groups of mice and after 28 days these mice were given subcutaneous challenge with heat-killed M. leprae and heat-killed M. habana in the left hind footpad. Live BCG vaccine alone and in combination with gamma-irradiated M. habana were also compared similarly. A sufficient degree of DTH response was generated in mice by M. habana vaccine in all physical forms against two challenge antigens (lepromin and habanin). The BCG combination with M. habana did not increase the DTH response indicating internal adjuvanticity endowed in M. habana. The active hypersensitivity of immunized mice was transferable to syngeneic mice by the transfer of sensitized cells from the donor to the recipient mice intravenously. M. leprae-infected Rhesus monkey PBMC have shown comparable stimulatory response with M. habana (sonicate), and M. leprae (sonicate) antigens. The possibility of developing M. habana as a candidate antileprosy vaccine is discussed.

The 65 kDa protein of Mycobacterium habana and its putative role in immunity against experimental tuberculosis

Mycobacteria including Mycobacterium tuberculosis and Mycobacterium leprae possess multiple antigens some of which inhibit other anti-mycobacterial immune responses. Whole cell vaccines are not free from these suppressive molecules and may adversely affect the immunogenic response(s). Purified protein components having only immunogenic properties should prove to be superior vaccine(s). Mycobacterium habana, a candidate vaccine for mycobacterial infections has been dissected for analysing its antigenic myriad. A 65 kDa protein of this mycobacterium has been isolated and characterized for its protective and cell mediated immune responses. The protein was isolated in pure form using an isotachophoresis (SDS-PAGE filtration) technique and identified with low molecular weight markers along with mAb using the immunoblot technique. Mab IIH9 has identified a 65 kDa protein in M. habana. This protein has been found to be immunoprotective in mice against M. tuberculosis H37Rv infection. It generates high levels of DTH responses in mice against M. tuberculosis and M. leprae antigens and inhibits migration of sensitized cells under the antigenic influence of homologous and heterologous origin. Possibilities of developing this protein as a subunit vaccine are discussed in this report.

Tuftsin-bearing liposomes as rifampin vehicles in treatment of tuberculosis in mice

The antitubercular activity of rifampin was considerably increased when it was encapsulated in egg phosphatidylcholine liposomes. A further increase in the activity was observed when the macrophage activator tetrapeptide tuftsin was grafted on the surface of the drug-loaded liposomes. Intermittent treatments (twice weekly) with these preparations were significantly more effective than the continuous treatments. Rifampin delivered twice weekly for 2 weeks in tuftsin-bearing liposomes was at least 2,000 times more effective than the free drug in lowering the load of lung bacilli in infected animals. However, pretreatment with drug-free tuftsin-bearing liposomes did not render the pretreated animals resistant to the Mycobacterium tuberculosis infections, neither did it appreciably increase the chemotherapeutic efficacy of the liposomized rifampin. These results clearly demonstrate that liposome targeting to macrophages could considerably increase the antitubercular activity of liposomized drugs such as rifampin. Also, it shows that immunoprophylactic treatment with macrophage activators such as tuftsin does not afford any advantage in treatment of tuberculosis infections, presumably because of inactivation of the primed macrophages by the mycobacterial sulfatides.