patient with MM and spinal involvement shows compression fracture of a myelomatous L5 vertebra.
1.MM often shows characteristic "punched out" lytic lesions in the skull.
2.However, as these lesions in the humerus show, it is frequently impossible to distinguish between MM and lytic metastases.
Calcifying peritoneal mets.cystadenoma ovary Ca
There is extensive amorphous calcification throughout the abdomen. It extends from pelvis, but includes a line of densities lateral and below the liver. The liver appears outlined by the calcifications. A similar 'negative' impression in the calcifications can be seen in the form and location of the caecum, transverse colon, occasional small-bowel loops and a vaguely round defect immediately above the left femoral canal that might be sigmoid colon. In the para-spinal region, there are occasional densities that resemble the position of lymph-nodes as well as transverse colon.
Cavernous hemangiomas of the liver on non-contrast CT are typically low attenuation lesions which on post-contrast scans demonstrate peripheral, nodular enhancement that follows the blood pool of the aorta and fills in centrally on later series.
Hepatic hemangiomas which are larger than 4 cm are termed "giant hemangiomas" and are more likely to rupture
CT demonstrates innumerable, non-enhancing, lesions throughout the liver, with attenuation and signal like that of cysts. Of note there are no cysts in the kidneys or pancreas.
MRI shows innumerable cystic lesions throughout the liver. These range in size from a few millimeters to 2.5 cm in diameter. There appear to be several areas of minimal to mild dilatation of bile ducts throughout the liver. Several of the cyst appear to communicate with adjacent dilated ducts. There is no instrinsic intra or extrahepatic duct dilatation.
Multiple biliary hamartomas
Caroli's disease
Hepatic cysts in association with autosomal-dominant polycystic kidney disease
Metastatic disease to the liver
Hepatic microabscesses
Xanthogranulomatous cholecystitis is an unusual variant of chronic cholecystitis, characterized by a lipid-laden inflammatory process comparable to xanthogranulomatous pyelonephritis.
Imaging studies show marked gallbladder wall thickening, often containing intramural nodules that are hypoechoic at sonography and hypoattenuating at CT, representing abscesses or foci of xanthogranulomatous inflammation.
These features overlap with those of gallbladder carcinoma, making preoperative distinction between these entities often impossible .
The above axial maximum-intensity projection slab from a CT cerebral angiogram shows dilatation of both superior ophthalmic veins and engorgement of the cavernous sinuses. The appearance is consistent with caroticocavernous fistula.
Midline nasopharyngeal cyst of homogeneous high T2 signal was incidentally found on MRI brain. It is well circumscribed, embedded within nasopharyngeal mucosa between prevertebral muscles.
Thornwaldt cysts are benign developmental nasopharyngeal cysts covered by mucosa anteriorly and bounded by longus muscles posteriorly
congenital aural dysplasia, or microtia, this condition is characterised by bony atresia of the external auditory canal (EAC) and a dysplastic auricle. Findings in the middle ear are variable and the inner ear and internal auditory canal are typically normal.
This lateral skull xray demonstrates many of the changes of Paget's disease, with areas of lysis, areas of sclerosis ('cotton-wool spots'), and calvarial thickening.
Scimitar syndrome is characterised by a hypoplastic lung that is drained by an anomalous vein into the systemic venous system. It is essentially a combination of pulmonary hypoplasia and partial anomalous pulmonary venous return. It almost exclusively occurs on the right side. The haemodynamics are that of an acyanotic left to right shunt. The anomalous vein most commonly drains into the IVC, right atrium or portal vein. The lung is frequently perfused by the aorta, but the bronchial tree is still connected and thus the lung is not sequestered. CXR findings are that of a small lung with ipsilateral mediastinal shift, and in one third of cases the anomalous draining vein may be seen as a tubular structure paralleling the right heart border in the shape of a Turkish sword ("scimitar"). Scimitar syndrome is associated with congenital heart disease, ipsilateral diaphragmatic anomalies and vertebral anomalies.
The appearances in the right hand are classical for reflex sympathetic dystrophy, or Sudeck's atrophy, and include:
1. Pronounced demineralization of the bones, particularly in the periarticular region.
2. No joint involvement.
3. Associated soft tissue atrophy.
This condition has been recently renamed the "complex regional pain syndrome".
The FLAIR MR image above shows changes typical of central pontine myelinolysis.
Also known as osmotic demyelination, central pontine myelinololysis is an acute demylination of the white matter tracts traversing the pons, seen in the setting of sudden osmotic changes, typically the rapid correction of hyponatraemia. Occasionally extrapontine white matter is also affected, in the basal ganglia, mid brain and subcortical white matter.