Gastrointestinal Radiology
Isolated IgG4-related gastric disease presenting as diffuse gastric wall thickening with ulcer by David Yurui Lim et al. |
Published: 2018 Sep Issue: 12(9) :: Pages: 9-20
| Abstract: An 81-year-old male presented with loss of appetite, early satiety and iron deficiency anaemia. A computed tomography (CT) scan of the abdomen and pelvis during initial work-up revealed diffuse gastric mural thickening associated with a large ulcer and adjacent gastro-hepatic lymphadenopathy. The CT appearances, together with the clinical features, were highly suspicious for an infiltrative type of gastric malignancy. Endoscopic biopsy however showed erosive inflammation, IgG4 plasmacytosis and fibrosis, raising the possibility of IgG4-related disease. A serologic assay for IgG showed normal IgG4 and elevated IgG2 serum levels. After appropriate steroid treatment, endoscopy and CT scan showed resolution of the ulcer and gastric wall thickening. This case shows yet another possible appearance of gastric involvement in IgG4-related disease on the current evolving spectrum of this disease presentation. Greater awareness and education of this disease would help in patient care, ensuring earlier diagnosis, prevention of severe organ damage and morbidity, as well as unnecessary surgery.
Available image modalities: (click on modality to browse for other articles) Computed Tomography, Macroscopic pathology, Microscopic pathology, Ultrasound, Graph, Table
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General Radiology
Ruptured Berry Aneurysm as the initial presentation of Polycystic Kidney Disease: A case report and review of literature by Dana AlNuaimi et al. |
Published: 2018 Sep Issue: 12(9) :: Pages: 1-8
| Abstract: Intra-cranial saccular aneurysms, also known as Berry aneurysms, have a well-known association with autosomal dominant polycystic kidney disease (ADPKD). Aneurysmal rupture can be the initial presentation of the disease. ADPKD has two types of gene mutations: PKD1 and PKD2.The latter one is of a milder form presenting later in life. Imaging plays a crucial role in the diagnosis and assessment in order to provide adequate management of these patients however, there are no official standardized guidelines established for screening of these intracranial aneurysms.
Available image modalities: (click on modality to browse for other articles) Computed Tomography, Angiography, Interventional, Table
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OB/GYN
Imaging features of uterine and ovarian fibromatosis in Nevoid Basal Cell Carcinoma Syndrome by Ambra Cassar Scalia et al. |
Published: 2018 Sep Issue: 12(9) :: Pages: 21-30
| Abstract: Gorlin-Goltz Syndrome also known as Nevoid Basal Cell Carcinoma Syndrome is an autosomal dominant multisystem disorder. It is characterized by basal cell carcinomas, odontogenic keratocysts, skeletal abnormalities and in a minority of female patients bilateral calcified ovarian fibromas. It is challenging to radiologically assess ovarian fibromas as they have similar imaging patterns to some malignant ovarian lesions. However, it is vitally important to differentiate between benign and malignant lesions to determine patients` suitability for fertility-sparing surgery. This report describes a case of a 25 year-old patient with Gorlin-Goltz Syndrome and bilateral ovarian fibromas.
Available image modalities: (click on modality to browse for other articles) Ultrasound, Magnetic Resonance Imaging, Computed Tomography, Macroscopic pathology, Microscopic pathology, Table
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