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    There are 30 cases available...

    Go to the top of the page   ID: 20110329123519 Original case in english  More links about this topic on Pubmed (PubMed Reader)
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    Discussion
     
    Pneumomediastinum/pneumothorax - iatrogenic
    Kraig J. Pneumomediastinum/pneumothorax - iatrogenic. PedRad [serial online] vol 11, no. 3.
    URL: www.PedRad.info/?search=20110329123519


     
     Pediatric Radiology CasesImages to this case: There are X-Ray-images available for this case. [ X-Ray ] View all modalities [ All ]   
     Pediatric Radiology CasesAuthor/s:

    Kraig J. Lage (University of Missouri Hospital and Clinics / Columbia / MO / United States)  

     
     Pediatric Radiology CasesEmail Address:

    Viewable for logged on visitors (Log on)  

     
     Pediatric Radiology CasesAge:

    N/A  

     
     Pediatric Radiology CasesGender:

    Male  

     
     Pediatric Radiology CasesRegion-Organ:

    Thorax-Lung  

     
     Pediatric Radiology CasesMost likely etiology:

    physical  

     
     Pediatric Radiology CasesHistory:

    Newborn male (39 weeks gestation) who had a forceps assisted delivery secondary to nonreassuring fetal heart tones. At delivery, infant was cyanotic, had poor tone, and no cry. Infant was dried, warmed, suctioned, and stimulated without response. Bag/mask ventillation was administered with response of heart rate rising to greater than 100. Bag/mask ventillation was continued for one minute until spontaneous respirations. Infant continued to have increased work of breathing with flaring, retractions, and tachypnea. CPAP was continued with decreased work of breathing.  

     
     Pediatric Radiology CasesPathomorphology or Pathophysiology of this disease :

    Alveolar rupture is caused by a pressure gradient between the alveolus and the surrounding interstitium. The pressure gradient is a product of either hyperinflation of the alveolus or a decrease in the surrounding interstitial pressure.

    The air forced into the interstitial tissues tracts centrally toward the peribronchial and perivascular tissue, and may continue into the mediastinum, neck and subcutaneous tissues.

    Because not all alveoli are ruptured, adjacent normal alveoli cause an equalisation of pressure between the affected and damaged alveoli with the result that the interalveolar walls remain intact and the lungs inflated.  

     
     Pediatric Radiology CasesRadiological findings:


    X-Ray 1 <- view X-Ray 1

    X-Ray 1: Large lucency surrounds the superior mediastinum with lucency crossing midline. Subtle lucency is also seen inferior and lateral of the right lung base at the costophrenic angle and hemidiaphragm.





    X-Ray 2 <- view X-Ray 2

    X-Ray 2: Large lucency surrounds the superior aspect of the anterior mediastinum with elevation of the thymic shadow.



     

     
     Pediatric Radiology CasesDiagnosis confirmation:

    Total constellation (Consens)  

     
     Pediatric Radiology CasesWhich DD would be also possible with the radiological findings:

    N/A  

     
     Pediatric Radiology CasesCourse / Prognosis / Frequency / Other :

    Pneumomediastinum occurs in approximately 0.1% of neonates and carries a good prognosis, typically without complications or long term sequella.

    Factors predisposing to pneumomediastinum include pneumonia or meconium aspiration syndrome.

    Neonatal pneumomediastinum can be attributable to pulmonary infection, immature lungs and ventilatory support. However, a significant portion of cases of spontaneous pneumomediastinum occur without identifiable risk factors.  

     
     Pediatric Radiology CasesComments of the author about the case:

    Diagnosis of pneumomediastinum is confirmed by frontal CXR.

    Typical radiologic signs are:

    1. In infants, the “spinnaker sign” which is upwards and outwards displacement of thymic lobes raised above the heart by pneumomediastinal air that separates it from the underlying cardiac silhouette.

    2. "continuous diaphragm sign", visible as lucency interposed between the pericardium and the diaphragm.

    3. Linear bands of mediastinal air parallelling the left side of the heart and the descending aorta with the pleura seen as a thin line separated from the mediastinum by the air lucency. The air may extend superiorly along the great vessels into the neck.  

     
     Pediatric Radiology CasesFirst description / History:

    Neonate presenting with respiratory distress.  

     
     Pediatric Radiology CasesLiterature:

    1. Medline: Medline
    Doug Hacking, M.D., and Michael Stewart, M.D.
    Neonatal Pneumomediastinum
    N Engl J Med 2001 June 14; 344:1839

    2. Medline: Medline
    Annik Hauri-Hohl, Oskar Baenziger, and Bernhard Frey
    Pneumomediastinum in the neonatal and paediatric intensive care unit
    Eur J Pediatr. 2008 April; 167(4): 415–418

     

     
     Pediatric Radiology CasesKeywords:

    Pneumomediastinum, Pneumothorax, continuous diaphragm sign, spinnaker sign  

     
     Pediatric Radiology Cases Cite this article:

    Kraig J. Pneumomediastinum/pneumothorax - iatrogenic. PedRad [serial online] vol 11, no. 3.
    URL: www.PedRad.info/?search=20110329123519  

     
     Pediatric Radiology Cases Read similar articles: spinnaker sign&type=1-17">corresponding keywords
    in the same field: Thorax-Lung
    or in the region: Thorax
    or in the tissue/organ: Lung
    or with the etiology: physical
     
     Pediatric Radiology CasesImages to this case: There are X-Ray-images available for this case. [ X-Ray ] View all modalities [ All ]   
     
    Pneumomediastinum/pneumothorax - iatrogenic
    Kraig J. Pneumomediastinum/pneumothorax - iatrogenic. PedRad [serial online] vol 11, no. 3.
    URL: www.PedRad.info/?search=20110329123519


     

    Search similar cases in:
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    Pneumomediastinum/pneumothorax - iatrogenic
    Other cases by these authors:

    Search Kraig J. Lage in Medline Kraig J. Lage (1)   

    Pneumomediastinum/pneumothorax - iatrogenic  
     
    Pneumomediastinum/pneumothorax - iatrogenic
    Kraig J. Pneumomediastinum/pneumothorax - iatrogenic. PedRad [serial online] vol 11, no. 3.
    URL: www.PedRad.info/?search=20110329123519


     

    Which diagnosis have other collegues guessed?


    • IRDS
      Votes: 1 (2 %)


    • Pneumothorax with pneumomediastinum
      Votes: 28 (80 %)


    • Pneumonia
      Votes: 1 (2 %)


    • Child abuse
      Votes: 1 (2 %)


    • Ebstein anomaly
      Votes: 4 (11 %)



        Total answers: 35

     
    Pneumomediastinum/pneumothorax - iatrogenic
    Kraig J. Pneumomediastinum/pneumothorax - iatrogenic. PedRad [serial online] vol 11, no. 3.
    URL: www.PedRad.info/?search=20110329123519


     

    Medical Dictionary
    Search in medical dictionary for
    Or type in a keyword
    ( Provided by The On-Line Medical Dictionary )




    1 = less interesting)
     
    Pneumomediastinum/pneumothorax - iatrogenic
    Kraig J. Pneumomediastinum/pneumothorax - iatrogenic. PedRad [serial online] vol 11, no. 3.
    URL: www.PedRad.info/?search=20110329123519


     


    Go to the top of the page   ID: 20090514012315 Original case in german  More links about this topic on Pubmed (PubMed Reader)
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    Discussion
     
    Cerebellopontine Angle Lipoma
    Achint K. Cerebellopontine Angle Lipoma. PedRad [serial online] vol 9, no. 5.
    URL: www.PedRad.info/?search=20090514012315


     
     Pediatric Radiology CasesImages to this case: There are MRI-images available for this case. [ MRI ] View all modalities [ All ]   
     Pediatric Radiology CasesAuthor/s:

    Achint K Singh  

     
     Pediatric Radiology CasesEmail Address:

    Viewable for logged on visitors (Log on)  

     
     Pediatric Radiology CasesAge:

    13 Years  

     
     Pediatric Radiology CasesGender:

    Female  

     
     Pediatric Radiology CasesRegion-Organ:

    N/A  

     
     Pediatric Radiology CasesMost likely etiology:

    N/A  

     
     Pediatric Radiology CasesHistory: *

    13 year old female with history of hearing loss in right ear. Audiogram revealed moderate sensorineural hearing loss on right side.  

     
     Pediatric Radiology CasesPathomorphology or Pathophysiology of this disease : *

    Lipoma in the CPA are maldevelopmental masses arising from abnormal differentiation of the meningeal precursor tissue.  

     
     Pediatric Radiology CasesRadiological findings: *


    X-Ray 1 <- view X-Ray 1

    X-Ray 1: Large lucency surrounds the superior mediastinum with lucency crossing midline. Subtle lucency is also seen inferior and lateral of the right lung base at the costophrenic angle and hemidiaphragm.





    X-Ray 2 <- view X-Ray 2

    X-Ray 2: Large lucency surrounds the superior aspect of the anterior mediastinum with elevation of the thymic shadow.




    MRI 1 <- view MRI 1

    MRI 1: T1W MRI showing hyperintense mass in right CP angle cistern extending into the internal auditory canal.




    MRI 2 <- view MRI 2

    MRI 2: T2W MRI showing hyperintense mass with splaying of 7th and 8th cranial nerves.




    MRI 3 <- view MRI 3

    MRI 3: T1W post gadolinium fat suppressed image showing nonenhancing mass with fat suppression.



     

     
     Pediatric Radiology CasesDiagnosis confirmation:

    N/A  

     
     Pediatric Radiology CasesWhich DD would be also possible with the radiological findings: *

    N/A  

     
     Pediatric Radiology CasesCourse / Prognosis / Frequency / Other : *

    It usually does not grow over time and malignant transformation has not been reported.

    CPA Lipoma is a rare tumor with an incidence of 10% of all intracranial lipomas and less than 0.14% of all CPA tumors. It has a tendency to infiltrate with splaying of 7th and 8th cranial nerves. Surgical excision is usually avoided due to intermingled nerve fibers and adherence to neural structures via fibrous elements.

    The most common site for intracranial lipoma is interhemispheric fissure. Other sites are quadrigeminal cistern, pineal region, CPA, suprasellar cistern and sylvian fissure.  

     
     Pediatric Radiology CasesComments of the author about the case:

    N/A  

     
     Pediatric Radiology CasesFirst description / History: *

    First reported by Klob in 1859.  

     
     Pediatric Radiology CasesLiterature:

    3. Medline: Medline
    Saunders JE, Kwartler JA, Wolf HK, et al.
    Lipomas of the internal auditory canal.
    Laryngoscope 1991;101:1031-7.  

     
     Pediatric Radiology CasesKeywords: *

    CPA Tumors, Lipoma, Cerebellopontine angle, IAC, Internal auditory canal  

     
     Pediatric Radiology Cases Cite this article:

    Achint K. Cerebellopontine Angle Lipoma. PedRad [serial online] vol 9, no. 5.
    URL: www.PedRad.info/?search=20090514012315  

     
     Pediatric Radiology Cases Read similar articles: Internal auditory canal&type=1-17">corresponding keywords
    in the same field:
    or in the region:
    or in the tissue/organ:
    or with the etiology:
     
     Pediatric Radiology CasesImages to this case: There are MRI-images available for this case. [ MRI ] View all modalities [ All ]   

    Thanks to Martina Paetzel, M.D. for translating this case!

     
    Cerebellopontine Angle Lipoma
    Achint K. Cerebellopontine Angle Lipoma. PedRad [serial online] vol 9, no. 5.
    URL: www.PedRad.info/?search=20090514012315


     

    Search similar cases in:
    More links about this topic on Pubmed  More links about this topic on Yahoo  More links about this topic on Altavista  More links about this topic on MSN  More links about this topic on Google  More links about this topic on Fireball

    Peer-reviewed Radiology Search



    Cerebellopontine Angle Lipoma
    Other cases by these authors:

    Search Kraig J. Lage in Medline Kraig J. Lage (1)   
    Search Achint K Singh in Medline Achint K Singh (17)   

    Cerebellopontine Angle Lipoma  
     
    Cerebellopontine Angle Lipoma
    Achint K. Cerebellopontine Angle Lipoma. PedRad [serial online] vol 9, no. 5.
    URL: www.PedRad.info/?search=20090514012315


     

    Which diagnosis have other collegues guessed?


    • IRDS
      Votes: 1 (2 %)


    • Pneumothorax with pneumomediastinum
      Votes: 28 (80 %)


    • Pneumonia
      Votes: 1 (2 %)


    • Child abuse
      Votes: 1 (2 %)


    • Ebstein anomaly
      Votes: 4 (11 %)



        Total answers: 35

     
    Cerebellopontine Angle Lipoma
    Achint K. Cerebellopontine Angle Lipoma. PedRad [serial online] vol 9, no. 5.
    URL: www.PedRad.info/?search=20090514012315


     

    Medical Dictionary
    Search in medical dictionary for
    Or type in a keyword
    ( Provided by The On-Line Medical Dictionary )




    1 = less interesting)
     
    Cerebellopontine Angle Lipoma
    Achint K. Cerebellopontine Angle Lipoma. PedRad [serial online] vol 9, no. 5.
    URL: www.PedRad.info/?search=20090514012315


     


    Go to the top of the page   ID: 20090427151244 Original case in german  More links about this topic on Pubmed (PubMed Reader)
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    Discussion
     
    Agenesis Of The Corpus Callosum
    Sanjeeb Kumar, GS Ahmed. Agenesis Of The Corpus Callosum. PedRad [serial online] vol 9, no. 4.
    URL: www.PedRad.info/?search=20090427151244


     
     Pediatric Radiology CasesImages to this case: There are MRI-images available for this case. [ MRI ] View all modalities [ All ]   
     Pediatric Radiology CasesAuthor/s:

    Sanjeeb Kumar Sarma (Down Town Hospital/Guwahati/India), GS Ahmed (Down Town Hospital/Guwahati/India)  

     
     Pediatric Radiology CasesEmail Address:

    Viewable for logged on visitors (Log on)  

     
     Pediatric Radiology CasesAge:

    1 Years  

     
     Pediatric Radiology CasesGender:

    Male  

     
     Pediatric Radiology CasesRegion-Organ:

    N/A  

     
     Pediatric Radiology CasesMost likely etiology:

    N/A  

     
     Pediatric Radiology CasesHistory: *

    A one year old male child was brought with history of grossly delayed milestones and repeated bouts of seizure. History of premature delivery was given by parents.  

     
     Pediatric Radiology CasesPathomorphology or Pathophysiology of this disease : *

    The corpus callosum is a white matter structure located in the midline and composed of fibers that connect both cerebral hemispheres. The development of the corpus callosum begins during the fifth week of fetal life with the formation of the primitive lamina terminalis, which thickens to form the commissural plate. Glial cells coalesce to form a bridge like structure that serves as a guide for the callosal fibers crossing the longitudinal cerebral fissure to their targets on the contra lateral side of the brain. The mature corpus callosum is formed by the seventeenth week of gestation
    Complete agenesis of the corpus callosum may occur after inflammatory or vascular lesions before its complete development. Later insults result in partial agenesis of a previously normal corpus callosum; therefore, generally only the posterior portion is affected.
    Agenesis of corpus callosum (ACC) may be an isolated finding; however, it is frequently associated with other malformations and genetic syndromes including chromosomal aberrations and inborn errors of metabolism. Associated central nervous system abnormalities include Chiari malformations, anomalies of neuronal migration including lissencephaly, schizencephaly, pachygyria and polymicrogyria, encephalocele, Dandy-Walker malformations, holoprosencephaly, and olivopontocerebellar degeneration. Extra cranial malformations include abnormalities of the face and of the cardiovascular, genitourinary, gastrointestinal, respiratory, and musculoskeletal systems.
    Here, in this case it is associated with bilateral fronto-parietal gross encephalomalacea mainly involving the white matter, possibly suggesting hypoxic ischemic encephalopathy.  

     
     Pediatric Radiology CasesRadiological findings: *


    X-Ray 1 <- view X-Ray 1

    X-Ray 1: Large lucency surrounds the superior mediastinum with lucency crossing midline. Subtle lucency is also seen inferior and lateral of the right lung base at the costophrenic angle and hemidiaphragm.





    X-Ray 2 <- view X-Ray 2

    X-Ray 2: Large lucency surrounds the superior aspect of the anterior mediastinum with elevation of the thymic shadow.




    MRI 1 <- view MRI 1

    MRI 1: T1W MRI showing hyperintense mass in right CP angle cistern extending into the internal auditory canal.




    MRI 2 <- view MRI 2

    MRI 2: T2W MRI showing hyperintense mass with splaying of 7th and 8th cranial nerves.




    MRI 3 <- view MRI 3

    MRI 3: T1W post gadolinium fat suppressed image showing nonenhancing mass with fat suppression.




    MRI 1 <- view MRI 1

    MRI 1: Axial T1WI showing dilated and separated ventricles with bilateral fronto-parietal encephalomalacic changes.





    MRI 2 <- view MRI 2

    MRI 2: Coronal T1WI showing absent corpus callosum with dilated ventricles and bilateral fronto-parietal encephalomalacea.





    MRI 3 <- view MRI 3

    MRI 3: Coronal T1WI showing colpocephaly.





    MRI 4 <- view MRI 4

    MRI 4: Sagittal T1WI showing complete absence of corpus callosum with encephalomalacic changes involving fronto-parietal white matter.





    MRI 5 <- view MRI 5

    MRI 5: Axial T2WI showing dilated ventricles with bilateral encephalomalacic changes.





    MRI 6 <- view MRI 6

    MRI 6: Axial T2WI showing absence corpus callosum more clearly.





    MRI 7 <- view MRI 7

    MRI 7: Coronal FLAIR image showing similar findings to coronal T1WI.



     

     
     Pediatric Radiology CasesDiagnosis confirmation:

    N/A  

     
     Pediatric Radiology CasesWhich DD would be also possible with the radiological findings: *

    Developmental anomaly , Infective lesion etc.  

     
     Pediatric Radiology CasesCourse / Prognosis / Frequency / Other : *

    Prognosis is dependent upon the cause of the malformation. In approximately 90% of the cases of isolated ACC, development is normal. ACC can even be an occasional finding in the investigation of children with mental retardation or microcephaly. There is no treatment for this condition
     

     
     Pediatric Radiology CasesComments of the author about the case: *

    In this case the parents were very poor to carry out any investigation as a result this was the first scan, in fact any investigation done after birth.The milestones were so much delayed that even the head lifting was not proper till one year. We did this MR scan on academic interest in our hospital and found this condition. Only palliative treatments were given. No definite improvement till date.  

     
     Pediatric Radiology CasesFirst description / History:

    N/A  

     
     Pediatric Radiology CasesLiterature:

    4. Medline: Medline
    Parrish ML, Roessmann U, Levinshon MW
    Agenesis of the corpus callosum: a study of the frequency of associated malformations
    Ann Neurol 1979;6:349-354

    5. Medline: Medline
    Jeret JS, Serur D, Wisniewski K, et al.
    Clinicopathological findings associated with agenesis of the corpus callosum
    Brain Dev 1987;9:255-60

    6. Medline: Medline
    Barkovitch AJ, Norman D
    Anomalies of the corpus callosum: correlation with further anomalies of the brain
    AJR AM J Roentgenol 1988;151:171-179
     

     
     Pediatric Radiology CasesKeywords: *

    Corpus callosum, Agenesis, Encephalomalacea, Colpocephaly  

     
     Pediatric Radiology Cases Cite this article:

    Sanjeeb Kumar, GS Ahmed. Agenesis Of The Corpus Callosum. PedRad [serial online] vol 9, no. 4.
    URL: www.PedRad.info/?search=20090427151244  

     
     Pediatric Radiology Cases Read similar articles: Colpocephaly&type=1-17">corresponding keywords
    in the same field:
    or in the region:
    or in the tissue/organ:
    or with the etiology:
     
     Pediatric Radiology CasesImages to this case: There are MRI-images available for this case. [ MRI ] View all modalities [ All ]   

    Thanks to Martina Paetzel, M.D. for translating this case!

     
    Agenesis Of The Corpus Callosum
    Sanjeeb Kumar, GS Ahmed. Agenesis Of The Corpus Callosum. PedRad [serial online] vol 9, no. 4.
    URL: www.PedRad.info/?search=20090427151244


     

    Search similar cases in:
    More links about this topic on Pubmed  More links about this topic on Yahoo  More links about this topic on Altavista  More links about this topic on MSN  More links about this topic on Google  More links about this topic on Fireball

    Peer-reviewed Radiology Search



    Agenesis Of The Corpus Callosum
    Other cases by these authors:

    Search Kraig J. Lage in Medline Kraig J. Lage (1)   
    Search Achint K Singh in Medline Achint K Singh (17)   
    Search Sanjeeb Kumar Sarma in Medline Sanjeeb Kumar Sarma (24)   
    Search GS Ahmed in Medline GS Ahmed (1)   

    Agenesis Of The Corpus Callosum  
     
    Agenesis Of The Corpus Callosum
    Sanjeeb Kumar, GS Ahmed. Agenesis Of The Corpus Callosum. PedRad [serial online] vol 9, no. 4.
    URL: www.PedRad.info/?search=20090427151244


     

    Which diagnosis have other collegues guessed?


    • IRDS
      Votes: 1 (2 %)


    • Pneumothorax with pneumomediastinum
      Votes: 28 (80 %)


    • Pneumonia
      Votes: 1 (2 %)


    • Child abuse
      Votes: 1 (2 %)


    • Ebstein anomaly
      Votes: 4 (11 %)



        Total answers: 35

     
    Agenesis Of The Corpus Callosum
    Sanjeeb Kumar, GS Ahmed. Agenesis Of The Corpus Callosum. PedRad [serial online] vol 9, no. 4.
    URL: www.PedRad.info/?search=20090427151244


     

    Medical Dictionary
    Search in medical dictionary for
    Or type in a keyword
    ( Provided by The On-Line Medical Dictionary )




    1 = less interesting)
     
    Agenesis Of The Corpus Callosum
    Sanjeeb Kumar, GS Ahmed. Agenesis Of The Corpus Callosum. PedRad [serial online] vol 9, no. 4.
    URL: www.PedRad.info/?search=20090427151244


     


    Go to the top of the page   ID: 20090225131032 Original case in english  More links about this topic on Pubmed (PubMed Reader)
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    Discussion
     
    Traumatic tracheal laceration
    Johannes Gossner. Traumatic tracheal laceration. PedRad [serial online] vol 9, no. 2.
    URL: www.PedRad.info/?search=20090225131032


     
     Pediatric Radiology CasesImages to this case: There are CT-images available for this case. [ CT ] View all modalities [ All ]   
     Pediatric Radiology CasesAuthor/s:

    Johannes Gossner (Krankenhaus Oststadt- Heidehaus/Klinikum Hannover)  

     
     Pediatric Radiology CasesEmail Address:

    Viewable for logged on visitors (Log on)  

     
     Pediatric Radiology CasesAge:

    8 Years  

     
     Pediatric Radiology CasesGender:

    Female  

     
     Pediatric Radiology CasesRegion-Organ:

    N/A  

     
     Pediatric Radiology CasesMost likely etiology:

    N/A  

     
     Pediatric Radiology CasesHistory:

    8 year old girl s/p fall with the neck on the bath tub and developed subsequently dyspnea. After arrival of the EMS team, dyspnea became so severe that the girl had to be intubated. During the course, the girl developed a progressive soft tissue emphysema (with deflated endotracheal tube).  

     
     Pediatric Radiology CasesPathomorphology or Pathophysiology of this disease :

    N/A  

     
     Pediatric Radiology CasesRadiological findings:


    X-Ray 1 <- view X-Ray 1

    X-Ray 1: Large lucency surrounds the superior mediastinum with lucency crossing midline. Subtle lucency is also seen inferior and lateral of the right lung base at the costophrenic angle and hemidiaphragm.





    X-Ray 2 <- view X-Ray 2

    X-Ray 2: Large lucency surrounds the superior aspect of the anterior mediastinum with elevation of the thymic shadow.




    MRI 1 <- view MRI 1

    MRI 1: T1W MRI showing hyperintense mass in right CP angle cistern extending into the internal auditory canal.




    MRI 2 <- view MRI 2

    MRI 2: T2W MRI showing hyperintense mass with splaying of 7th and 8th cranial nerves.




    MRI 3 <- view MRI 3

    MRI 3: T1W post gadolinium fat suppressed image showing nonenhancing mass with fat suppression.




    MRI 1 <- view MRI 1

    MRI 1: Axial T1WI showing dilated and separated ventricles with bilateral fronto-parietal encephalomalacic changes.





    MRI 2 <- view MRI 2

    MRI 2: Coronal T1WI showing absent corpus callosum with dilated ventricles and bilateral fronto-parietal encephalomalacea.





    MRI 3 <- view MRI 3

    MRI 3: Coronal T1WI showing colpocephaly.





    MRI 4 <- view MRI 4

    MRI 4: Sagittal T1WI showing complete absence of corpus callosum with encephalomalacic changes involving fronto-parietal white matter.





    MRI 5 <- view MRI 5

    MRI 5: Axial T2WI showing dilated ventricles with bilateral encephalomalacic changes.





    MRI 6 <- view MRI 6

    MRI 6: Axial T2WI showing absence corpus callosum more clearly.





    MRI 7 <- view MRI 7

    MRI 7: Coronal FLAIR image showing similar findings to coronal T1WI.




    CT 1 <- view CT 1

    CT 1: Axial neck CT in lung window: There is an extensive soft tissue emphysema, which extends from the neck to mediastinum and into the chest wall.




    CT 2 <- view CT 2

    CT 2: Coronal reconstruction of a neck CT in lung window:
    Coronal reconstructed images demonstrate an extensive soft tissue emphysema, which extends from the neck to mediastinum and into the chest wall.





    CT 3 <- view CT 3

    CT 3: Magnified view of an axial neck CT in lung window:
    Visible defect in the pars membranacea (arrow). Endotracheal tube is in place with extensive air in the soft tissues.



     

     
     Pediatric Radiology CasesDiagnosis confirmation:

    N/A  

     
     Pediatric Radiology CasesWhich DD would be also possible with the radiological findings:

    N/A  

     
     Pediatric Radiology CasesCourse / Prognosis / Frequency / Other :

    Tracheal laceration is in general rare and only occurs in approximately 1% of cases with blunt thoracic trauma, because the trachea is an anatomically well protected structure. Problematic is the often delayed diagnosis because of subtle and unspecific findings and also because in case of polytrauma the attention to other more obvious inhjuries (1,2). Computed tomography allows a detailed depiction of air collections and often of the tracheal defect, as in this case. Chen et al. could show the defect in 70% of cases (3). This is especially helpful in therapeutic planning, because in a clinically stable patient with small lacerations, a conservative approcach still leads to good results (1,2). In a review of the literature 15 cases were reported by Claes et al.: all children survived a small tracheal rupture after blunt trauma and only in one patient hoarseness persisted (2).  

     
     Pediatric Radiology CasesComments of the author about the case:

    N/A  

     
     Pediatric Radiology CasesFirst description / History:

    N/A  

     
     Pediatric Radiology CasesLiterature:

    7. Medline: Medline
    Kühne CA, Kaiser GM, Kühl H, Fischer M, Nast-Kolb D, Paffrath
    Trachealeinriss nach stumpfem Halstrauma beim Kind
    Chirurg (2003); 74: 579-582

    8. Medline: Medline
    Claes I, Van Schil P, Corthous B, Jorens GP
    Posterior tracheal wall laceration after blunt neck trauma in children: a case report and review of the literature
    Resuscitation (2004); 63: 97-102

    9. Medline: Medline
    Chen JD, Shanmuganathan K, Mirvis SE, Killeen KL, Dutton RP
    Using CT to diagnose tracheal rupture
    AJR 2001; 176: 1273-1280

     

     
     Pediatric Radiology CasesKeywords:

    Trauma, Trachea, Laceration, Computed tomography  

     
     Pediatric Radiology Cases Cite this article:

    Johannes Gossner. Traumatic tracheal laceration. PedRad [serial online] vol 9, no. 2.
    URL: www.PedRad.info/?search=20090225131032  

     
     Pediatric Radiology Cases Read similar articles: Computed tomography&type=1-17">corresponding keywords
    in the same field:
    or in the region:
    or in the tissue/organ:
    or with the etiology:
     
     Pediatric Radiology CasesImages to this case: There are CT-images available for this case. [ CT ] View all modalities [ All ]   
     
    Traumatic tracheal laceration
    Johannes Gossner. Traumatic tracheal laceration. PedRad [serial online] vol 9, no. 2.
    URL: www.PedRad.info/?search=20090225131032


     

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    Traumatic tracheal laceration
    Other cases by these authors:

    Search Kraig J. Lage in Medline Kraig J. Lage (1)   
    Search Achint K Singh in Medline Achint K Singh (17)   
    Search Sanjeeb Kumar Sarma in Medline Sanjeeb Kumar Sarma (24)   
    Search GS Ahmed in Medline GS Ahmed (1)   
    Search Johannes Gossner in Medline Johannes Gossner (18)   

    Traumatic tracheal laceration  
     
    Traumatic tracheal laceration
    Johannes Gossner. Traumatic tracheal laceration. PedRad [serial online] vol 9, no. 2.
    URL: www.PedRad.info/?search=20090225131032


     

    Which diagnosis have other collegues guessed?


    • IRDS
      Votes: 1 (2 %)


    • Pneumothorax with pneumomediastinum
      Votes: 28 (80 %)


    • Pneumonia
      Votes: 1 (2 %)


    • Child abuse
      Votes: 1 (2 %)


    • Ebstein anomaly
      Votes: 4 (11 %)



        Total answers: 35

     
    Traumatic tracheal laceration
    Johannes Gossner. Traumatic tracheal laceration. PedRad [serial online] vol 9, no. 2.
    URL: www.PedRad.info/?search=20090225131032


     

    Medical Dictionary
    Search in medical dictionary for
    Or type in a keyword
    ( Provided by The On-Line Medical Dictionary )




    1 = less interesting)
     
    Traumatic tracheal laceration
    Johannes Gossner. Traumatic tracheal laceration. PedRad [serial online] vol 9, no. 2.
    URL: www.PedRad.info/?search=20090225131032


     


    Go to the top of the page   ID: 20081204115159 Original case in german  More links about this topic on Pubmed (PubMed Reader)
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    Discussion
     
    CCAM (Congenital Cystic Adenomatoid Malformation) on fetal MRI
    Galea Janabel, Samuel Stafrace, Karen Duncan, Lena Crichton. CCAM (Congenital Cystic Adenomatoid Malformation) on fetal MRI. PedRad [serial online] vol 8, no. 12.
    URL: www.PedRad.info/?search=20081204115159


     
     Pediatric Radiology CasesImages to this case: There are Ultrasound-images available for this case. [ Ultrasound ] There are MRI-images available for this case. [ MRI ] View all modalities [ All ]   
     Pediatric Radiology CasesAuthor/s:

    Galea Janabel (Aberdeen Royal Infirmary/Aberdeen/Scotland), Samuel Stafrace (Royal Aberdeen Children`s Hospital/Aberdeen/Scotland), Karen Duncan (Royal Aberdeen Childrenss Hospital/Aberdeen/Scotland), Lena Crichton (Aberdeen Maternity Hospital/Aberdeen/Scotland)  

     
     Pediatric Radiology CasesEmail Address:

    Viewable for logged on visitors (Log on)  

     
     Pediatric Radiology CasesAge:

    0 Preterm  

     
     Pediatric Radiology CasesGender:

    N/A  

     
     Pediatric Radiology CasesRegion-Organ:

    N/A  

     
     Pediatric Radiology CasesMost likely etiology:

    N/A  

     
     Pediatric Radiology CasesHistory: *

    22 week pregnant. Ultrasound shows possible abnormality involving both lung bases. MRI performed for further evaluation.  

     
     Pediatric Radiology CasesPathomorphology or Pathophysiology of this disease : *

    CCAM are pulmonary lesions with abnormal proliferation of bronchiolar structures that connect to the bronchial tree. They may contain micro or macro cysts - when the later are identified, they are rather typical of the lesion.  

     
     Pediatric Radiology CasesRadiological findings: *


    X-Ray 1 <- view X-Ray 1

    X-Ray 1: Large lucency surrounds the superior mediastinum with lucency crossing midline. Subtle lucency is also seen inferior and lateral of the right lung base at the costophrenic angle and hemidiaphragm.





    X-Ray 2 <- view X-Ray 2

    X-Ray 2: Large lucency surrounds the superior aspect of the anterior mediastinum with elevation of the thymic shadow.




    MRI 1 <- view MRI 1

    MRI 1: T1W MRI showing hyperintense mass in right CP angle cistern extending into the internal auditory canal.




    MRI 2 <- view MRI 2

    MRI 2: T2W MRI showing hyperintense mass with splaying of 7th and 8th cranial nerves.




    MRI 3 <- view MRI 3

    MRI 3: T1W post gadolinium fat suppressed image showing nonenhancing mass with fat suppression.




    MRI 1 <- view MRI 1

    MRI 1: Axial T1WI showing dilated and separated ventricles with bilateral fronto-parietal encephalomalacic changes.





    MRI 2 <- view MRI 2

    MRI 2: Coronal T1WI showing absent corpus callosum with dilated ventricles and bilateral fronto-parietal encephalomalacea.





    MRI 3 <- view MRI 3

    MRI 3: Coronal T1WI showing colpocephaly.





    MRI 4 <- view MRI 4

    MRI 4: Sagittal T1WI showing complete absence of corpus callosum with encephalomalacic changes involving fronto-parietal white matter.





    MRI 5 <- view MRI 5

    MRI 5: Axial T2WI showing dilated ventricles with bilateral encephalomalacic changes.





    MRI 6 <- view MRI 6

    MRI 6: Axial T2WI showing absence corpus callosum more clearly.





    MRI 7 <- view MRI 7

    MRI 7: Coronal FLAIR image showing similar findings to coronal T1WI.




    CT 1 <- view CT 1

    CT 1: Axial neck CT in lung window: There is an extensive soft tissue emphysema, which extends from the neck to mediastinum and into the chest wall.




    CT 2 <- view CT 2

    CT 2: Coronal reconstruction of a neck CT in lung window:
    Coronal reconstructed images demonstrate an extensive soft tissue emphysema, which extends from the neck to mediastinum and into the chest wall.





    CT 3 <- view CT 3

    CT 3: Magnified view of an axial neck CT in lung window:
    Visible defect in the pars membranacea (arrow). Endotracheal tube is in place with extensive air in the soft tissues.




    Ultrasound 1 <- view Ultrasound 1

    Ultrasound 1: Coronal image of the chest and abdomen showing hypoechoic areas in the region of the lower chest bilaterally in keeping with cysts.






    MRI 1 <- view MRI 1

    MRI 1: (Axial T2 weighted SSFSE) Shows a large high signal mass located within the lower right lung with cysts of various sizes within it with herniation of one of the cysts to the left behind the heart. Low signal flow voids represent vessels within the mass. The heart is shifted to the left and the contralateral lung is compressed by the mass.





    MRI 2 <- view MRI 2

    MRI 2: (Coronal T2 weighted SSFSE) Demonstrates the mass on the coronal plane. Note the small area of normal right lung at the apex and the compressed left lung. Both these are of slightly lower signal than the cystic mass on T2.





    MRI 3 <- view MRI 3

    MRI 3: (Coronal T1 weighted) Demonstrates the cyctic mass to be of low signal on T1. The higher signal just below the mass on this image represents the normal liver.




     

     
     Pediatric Radiology CasesDiagnosis confirmation:

    N/A  

     
     Pediatric Radiology CasesWhich DD would be also possible with the radiological findings: *

    Sequestration is also part of the same spectrum and lesions can be of mixed CCAM-sequestration pathology. Sequestrations have a systemic arterial blood supply.  

     
     Pediatric Radiology CasesCourse / Prognosis / Frequency / Other : *

    Variable prognosis - mainly dependant on size. May involute during pregnancy. The larger lesions result in mediastinal shift and pulmonary hypoplasia. These can result in vascular compromise, oesophageal compression, polyhydramnios and hydrops.  

     
     Pediatric Radiology CasesComments of the author about the case: *

    Good case showing macrocysts typically identified in CCAM  

     
     Pediatric Radiology CasesFirst description / History:

    N/A  

     
     Pediatric Radiology CasesLiterature:

    10. Medline: Medline
    Hubbard AM, Scott Adzick N, Crombleholme TM et al.
    Congenital Chest Lesions:Diagnosis and Charecterization with Prenatal MR Imaging.
    Radiology 1999;212:43-48.

    11. Medline: Medline
    12. Medline: Medline
    Levine D. Barnewolt CE, Mehta TS et al.
    Fetal Thoracic Abnormalities:MR Imaging.
    Radiology 2003;228:379.

    12. Medline: Medline
    Levine D.
    Atlas of Fetal MRI.
    Taylor and Francis Editors - 2005 pg 96-98.  

     
     Pediatric Radiology CasesKeywords: *

    CCAM, Congenital Cystic Adenomatoid Malfromation, Fetal MRI  

     
     Pediatric Radiology Cases Cite this article:

    Galea Janabel, Samuel Stafrace, Karen Duncan, Lena Crichton. CCAM (Congenital Cystic Adenomatoid Malformation) on fetal MRI. PedRad [serial online] vol 8, no. 12.
    URL: www.PedRad.info/?search=20081204115159  

     
     Pediatric Radiology Cases Read similar articles: Fetal MRI&type=1-17">corresponding keywords
    in the same field:
    or in the region:
    or in the tissue/organ:
    or with the etiology:
     
     Pediatric Radiology CasesImages to this case: There are Ultrasound-images available for this case. [ Ultrasound ] There are MRI-images available for this case. [ MRI ] View all modalities [ All ]   

    Thanks to Martina Paetzel, M.D. for translating this case!

     
    CCAM (Congenital Cystic Adenomatoid Malformation) on fetal MRI
    Galea Janabel, Samuel Stafrace, Karen Duncan, Lena Crichton. CCAM (Congenital Cystic Adenomatoid Malformation) on fetal MRI. PedRad [serial online] vol 8, no. 12.
    URL: www.PedRad.info/?search=20081204115159


     

    Search similar cases in:
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    CCAM (Congenital Cystic Adenomatoid Malformation) on fetal MRI
    Other cases by these authors:

    Search Kraig J. Lage in Medline Kraig J. Lage (1)   
    Search Achint K Singh in Medline Achint K Singh (17)   
    Search Sanjeeb Kumar Sarma in Medline Sanjeeb Kumar Sarma (24)   
    Search GS Ahmed in Medline GS Ahmed (1)   
    Search Johannes Gossner in Medline Johannes Gossner (18)   
    Search Galea Janabel in Medline Galea Janabel (17)   
    Search Samuel Stafrace in Medline Samuel Stafrace (3)   
    Search Karen Duncan in Medline Karen Duncan (1)   
    Search Lena Crichton in Medline Lena Crichton (1)   

    CCAM (Congenital Cystic Adenomatoid Malformation) on fetal MRI  
     
    CCAM (Congenital Cystic Adenomatoid Malformation) on fetal MRI
    Galea Janabel, Samuel Stafrace, Karen Duncan, Lena Crichton. CCAM (Congenital Cystic Adenomatoid Malformation) on fetal MRI. PedRad [serial online] vol 8, no. 12.
    URL: www.PedRad.info/?search=20081204115159


     

    Which diagnosis have other collegues guessed?


    • IRDS
      Votes: 1 (2 %)


    • Pneumothorax with pneumomediastinum
      Votes: 28 (80 %)


    • Pneumonia
      Votes: 1 (2 %)


    • Child abuse
      Votes: 1 (2 %)


    • Ebstein anomaly
      Votes: 4 (11 %)



        Total answers: 35

     
    CCAM (Congenital Cystic Adenomatoid Malformation) on fetal MRI
    Galea Janabel, Samuel Stafrace, Karen Duncan, Lena Crichton. CCAM (Congenital Cystic Adenomatoid Malformation) on fetal MRI. PedRad [serial online] vol 8, no. 12.
    URL: www.PedRad.info/?search=20081204115159


     

    Medical Dictionary
    Search in medical dictionary for
    Or type in a keyword
    ( Provided by The On-Line Medical Dictionary )




    1 = less interesting)
     
    CCAM (Congenital Cystic Adenomatoid Malformation) on fetal MRI
    Galea Janabel, Samuel Stafrace, Karen Duncan, Lena Crichton. CCAM (Congenital Cystic Adenomatoid Malformation) on fetal MRI. PedRad [serial online] vol 8, no. 12.
    URL: www.PedRad.info/?search=20081204115159


     


    Go to the top of the page   ID: 20051215115942 Original case in english  More links about this topic on Pubmed (PubMed Reader)
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    Discussion
     
    B-cell NHL of the Ileum (Type: Sporadic Burkitt Lymphoma)
    Dirk Schaper, P Göbel. B-cell NHL of the Ileum (Type: Sporadic Burkitt Lymphoma). PedRad [serial online] vol 5, no. 12.
    URL: www.PedRad.info/?search=20051215115942


     
     Pediatric Radiology CasesImages to this case: There are Ultrasound-images available for this case. [ Ultrasound ] There are OP-Situs-images available for this case. [ OP-Situs ] View all modalities [ All ]   
     Pediatric Radiology CasesAuthor/s:

    Dirk Schaper, P. Göbel (Klinik für Kinderchirurgie Krankenhaus St. Elisabeth und St. Barbara Halle-S.)  

     
     Pediatric Radiology CasesEmail Address:

    Viewable for logged on visitors (Log on)  

     
     Pediatric Radiology CasesAge:

    7 Years  

     
     Pediatric Radiology CasesGender:

    Male  

     
     Pediatric Radiology CasesRegion-Organ:

    N/A  

     
     Pediatric Radiology CasesMost likely etiology:

    N/A  

     
     Pediatric Radiology CasesHistory:

    One week ago, stomach ache for the first time, partly crampy in nature, 3 times a day. There is an obvious connection to food ingestion. In the sense of primary symptoms, bloodwork was done on the 2nd of November; there, anemia noted. On the 5th of November, initial worsening of the patient's condition with lack of appetite, malaise, increased stomach aches and a repeating vomiting with acute onset.  

     
     Pediatric Radiology CasesPathomorphology or Pathophysiology of this disease :

    N/A  

     
     Pediatric Radiology CasesRadiological findings:


    X-Ray 1 <- view X-Ray 1

    X-Ray 1: Large lucency surrounds the superior mediastinum with lucency crossing midline. Subtle lucency is also seen inferior and lateral of the right lung base at the costophrenic angle and hemidiaphragm.





    X-Ray 2 <- view X-Ray 2

    X-Ray 2: Large lucency surrounds the superior aspect of the anterior mediastinum with elevation of the thymic shadow.




    MRI 1 <- view MRI 1

    MRI 1: T1W MRI showing hyperintense mass in right CP angle cistern extending into the internal auditory canal.




    MRI 2 <- view MRI 2

    MRI 2: T2W MRI showing hyperintense mass with splaying of 7th and 8th cranial nerves.




    MRI 3 <- view MRI 3

    MRI 3: T1W post gadolinium fat suppressed image showing nonenhancing mass with fat suppression.




    MRI 1 <- view MRI 1

    MRI 1: Axial T1WI showing dilated and separated ventricles with bilateral fronto-parietal encephalomalacic changes.





    MRI 2 <- view MRI 2

    MRI 2: Coronal T1WI showing absent corpus callosum with dilated ventricles and bilateral fronto-parietal encephalomalacea.





    MRI 3 <- view MRI 3

    MRI 3: Coronal T1WI showing colpocephaly.





    MRI 4 <- view MRI 4

    MRI 4: Sagittal T1WI showing complete absence of corpus callosum with encephalomalacic changes involving fronto-parietal white matter.





    MRI 5 <- view MRI 5

    MRI 5: Axial T2WI showing dilated ventricles with bilateral encephalomalacic changes.





    MRI 6 <- view MRI 6

    MRI 6: Axial T2WI showing absence corpus callosum more clearly.





    MRI 7 <- view MRI 7

    MRI 7: Coronal FLAIR image showing similar findings to coronal T1WI.




    CT 1 <- view CT 1

    CT 1: Axial neck CT in lung window: There is an extensive soft tissue emphysema, which extends from the neck to mediastinum and into the chest wall.




    CT 2 <- view CT 2

    CT 2: Coronal reconstruction of a neck CT in lung window:
    Coronal reconstructed images demonstrate an extensive soft tissue emphysema, which extends from the neck to mediastinum and into the chest wall.





    CT 3 <- view CT 3

    CT 3: Magnified view of an axial neck CT in lung window:
    Visible defect in the pars membranacea (arrow). Endotracheal tube is in place with extensive air in the soft tissues.




    Ultrasound 1 <- view Ultrasound 1

    Ultrasound 1: Coronal image of the chest and abdomen showing hypoechoic areas in the region of the lower chest bilaterally in keeping with cysts.






    MRI 1 <- view MRI 1

    MRI 1: (Axial T2 weighted SSFSE) Shows a large high signal mass located within the lower right lung with cysts of various sizes within it with herniation of one of the cysts to the left behind the heart. Low signal flow voids represent vessels within the mass. The heart is shifted to the left and the contralateral lung is compressed by the mass.





    MRI 2 <- view MRI 2

    MRI 2: (Coronal T2 weighted SSFSE) Demonstrates the mass on the coronal plane. Note the small area of normal right lung at the apex and the compressed left lung. Both these are of slightly lower signal than the cystic mass on T2.





    MRI 3 <- view MRI 3

    MRI 3: (Coronal T1 weighted) Demonstrates the cyctic mass to be of low signal on T1. The higher signal just below the mass on this image represents the normal liver.





    Ultrasound 1 <- view Ultrasound 1

    Ultrasound 1: RUQ transverse: 42x30 mm in size, irregularly marked, non-echo-free mass with incomplete, gechogenic edge. Changes position on breathing in the area of the right colonic flexure.





    Ultrasound 2 <- view Ultrasound 2

    Ultrasound 2: RUQ longitudinal: Same mass in power-mode. Homogenic vasculature, therefore not a cystic process.





    Ultrasound 3 <- view Ultrasound 3

    Ultrasound 3: RUQ diagonal: Questionable localization of the mass (in the gut?) which has a stalk-like structure. At the lower edge one got the impression that there was a intussception "bulls-eye," which was not able to be completely visualized.





    Ultrasound 4 <- view Ultrasound 4

    Ultrasound 4: RUQ diagonal: Visualization of the vessel's stalk and the branching within the mass.





    Ultrasound 5 <- view Ultrasound 5

    Ultrasound 5: RUQ transverse, paramedian: Obvious lymph node swelling medial to the mass.





    OP-Situs 1 <- view OP-Situs 1

    OP-Situs 1: Palpable tumor in the cecum.




    OP-Situs 2 <- view OP-Situs 2

    OP-Situs 2: Ileocecal transition. Lymph node in the foreground, tweezers in the partly intusscepted ileum in the cecum.




    OP-Situs 3 <- view OP-Situs 3

    OP-Situs 3: Intraoperative: Determination of the resection's edges.




    OP-Situs 4 <- view OP-Situs 4

    OP-Situs 4: Specimen luxated out of the cecum.

     

     
     Pediatric Radiology CasesDiagnosis confirmation:

    N/A  

     
     Pediatric Radiology CasesWhich DD would be also possible with the radiological findings:

    Gastrointestinal inflammatory myofibroblastic tumor, intussusception, duplication, lymphoma.  

     
     Pediatric Radiology CasesCourse / Prognosis / Frequency / Other :

    After extensive diagnostics (including CT, MRI), the ileocecal resection with end-to-end anastomosis is performed. After receiving histology, the child was transferred to the department of pediatric hematology and oncology.  

     
     Pediatric Radiology CasesComments of the author about the case:

    The sonographic categorization of the process in the lumen of the gut was difficult. Because of the connection to the gut and its partial intussusception, the categorization of which organ this belonged could be assumed. Intraoperatively, the sonographic findings of a partial intussusception were confirmed. A remarkable mobile cecum explains the localization of the tumor in a supine patient in the RUQ.  

     
     Pediatric Radiology CasesFirst description / History:

    N/A  

     
     Pediatric Radiology CasesLiterature:

    13. Medline: Medline
    Mendelson, R.M., S.Fermoyle: Primary gastrointestinal Lymphomas: A radiological-pathological review. Part1: Stomach, oesophagus and colon
    Australasian Radiology (2005) 49, 353-364

    14. Medline: Medline
    Zuti,S.,G.A.Rouse,M.de Lange:
    Burkitt´s Lymphoma: A spectrum of sonographic findings
    J Diag Med Sonograph (1993) 9(1) 19-23  

     
     Pediatric Radiology CasesKeywords:

    Burkitt Lymphoma, Gut, tumor, partial intussusception  

     
     Pediatric Radiology Cases Cite this article:

    Dirk Schaper, P Göbel. B-cell NHL of the Ileum (Type: Sporadic Burkitt Lymphoma). PedRad [serial online] vol 5, no. 12.
    URL: www.PedRad.info/?search=20051215115942  

     
     Pediatric Radiology Cases Read similar articles: partial intussusception&type=1-17">corresponding keywords
    in the same field:
    or in the region:
    or in the tissue/organ:
    or with the etiology:
     
     Pediatric Radiology CasesImages to this case: There are Ultrasound-images available for this case. [ Ultrasound ] There are OP-Situs-images available for this case. [ OP-Situs ] View all modalities [ All ]   
     
    B-cell NHL of the Ileum (Type: Sporadic Burkitt Lymphoma)
    Dirk Schaper, P Göbel. B-cell NHL of the Ileum (Type: Sporadic Burkitt Lymphoma). PedRad [serial online] vol 5, no. 12.
    URL: www.PedRad.info/?search=20051215115942


     

    Search similar cases in:
    More links about this topic on Pubmed  More links about this topic on Yahoo  More links about this topic on Altavista  More links about this topic on MSN  More links about this topic on Google  More links about this topic on Fireball

    Peer-reviewed Radiology Search



    B-cell NHL of the Ileum (Type: Sporadic Burkitt Lymphoma)
    Other cases by these authors:

    Search Kraig J. Lage in Medline Kraig J. Lage (1)   
    Search Achint K Singh in Medline Achint K Singh (17)   
    Search Sanjeeb Kumar Sarma in Medline Sanjeeb Kumar Sarma (24)   
    Search GS Ahmed in Medline GS Ahmed (1)   
    Search Johannes Gossner in Medline Johannes Gossner (18)   
    Search Galea Janabel in Medline Galea Janabel (17)   
    Search Samuel Stafrace in Medline Samuel Stafrace (3)   
    Search Karen Duncan in Medline Karen Duncan (1)   
    Search Lena Crichton in Medline Lena Crichton (1)   
    Search Dirk Schaper in Medline Dirk Schaper (59)   
    Search P. Göbel in Medline P. Göbel (6)   

    B-cell NHL of the Ileum (Type: Sporadic Burkitt Lymphoma)  
     
    B-cell NHL of the Ileum (Type: Sporadic Burkitt Lymphoma)
    Dirk Schaper, P Göbel. B-cell NHL of the Ileum (Type: Sporadic Burkitt Lymphoma). PedRad [serial online] vol 5, no. 12.
    URL: www.PedRad.info/?search=20051215115942


     

    Which diagnosis have other collegues guessed?


    • IRDS
      Votes: 1 (2 %)


    • Pneumothorax with pneumomediastinum
      Votes: 28 (80 %)


    • Pneumonia
      Votes: 1 (2 %)


    • Child abuse
      Votes: 1 (2 %)


    • Ebstein anomaly
      Votes: 4 (11 %)


    • Lymphangioleiomyoma with Intussusception
      Votes: 5 (10 %)


    • Burkitt-Lymphoma
      Votes: 6 (12 %)


    • Simple Intussusception
      Votes: 0 (0 %)


    • Ganglioneuroma of the Intestines with Intussusception
      Votes: 2 (4 %)


    • Gut Duplication
      Votes: 0 (0 %)


    • Crohn's Disease
      Votes: 0 (0 %)



        Total answers: 48

     
    B-cell NHL of the Ileum (Type: Sporadic Burkitt Lymphoma)
    Dirk Schaper, P Göbel. B-cell NHL of the Ileum (Type: Sporadic Burkitt Lymphoma). PedRad [serial online] vol 5, no. 12.
    URL: www.PedRad.info/?search=20051215115942


     

    Medical Dictionary
    Search in medical dictionary for
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    B-cell NHL of the Ileum (Type: Sporadic Burkitt Lymphoma)
    Dirk Schaper, P Göbel. B-cell NHL of the Ileum (Type: Sporadic Burkitt Lymphoma). PedRad [serial online] vol 5, no. 12.
    URL: www.PedRad.info/?search=20051215115942


     


    Go to the top of the page   ID: 20051128163422 Original case in english  More links about this topic on Pubmed (PubMed Reader)
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    Discussion
     
    Asymptomatic Solitary Gallbladder Stone in Hereditary Spherocytosis
    Dirk Schaper. Asymptomatic Solitary Gallbladder Stone in Hereditary Spherocytosis. PedRad [serial online] vol 5, no. 11.
    URL: www.PedRad.info/?search=20051128163422


     
     Pediatric Radiology CasesImages to this case: There are Ultrasound-images available for this case. [ Ultrasound ] View all modalities [ All ]   
     Pediatric Radiology CasesAuthor/s:

    Dirk Schaper (Klinik für Kinderchirurgie Krankenhaus St. Elisabeth und St. Barbara Halle/S.)  

     
     Pediatric Radiology CasesEmail Address:

    Viewable for logged on visitors (Log on)  

     
     Pediatric Radiology CasesAge:

    15 Years  

     
     Pediatric Radiology CasesGender:

    Male  

     
     Pediatric Radiology CasesRegion-Organ:

    N/A  

     
     Pediatric Radiology CasesMost likely etiology:

    N/A  

     
     Pediatric Radiology CasesHistory:

    15 year old boy presented with known history of hereditary spherocytosis. Initially nephrologic workup for hematuria. During sonography, the pathology was found. Patient was otherwise without complaints.  

     
     Pediatric Radiology CasesPathomorphology or Pathophysiology of this disease :

    Hereditary spherocytosis is the most frequent hereditary hemolytic anemia in central europe. Due to the spheric form of the erythrocytes, hemolysis and increased break down of erythrocytes in the spleen occurs. The increased accumulation of bilirubin leads to development of bilirubin gallstones.  

     
     Pediatric Radiology CasesRadiological findings:


    X-Ray 1 <- view X-Ray 1

    X-Ray 1: Large lucency surrounds the superior mediastinum with lucency crossing midline. Subtle lucency is also seen inferior and lateral of the right lung base at the costophrenic angle and hemidiaphragm.





    X-Ray 2 <- view X-Ray 2

    X-Ray 2: Large lucency surrounds the superior aspect of the anterior mediastinum with elevation of the thymic shadow.




    MRI 1 <- view MRI 1

    MRI 1: T1W MRI showing hyperintense mass in right CP angle cistern extending into the internal auditory canal.




    MRI 2 <- view MRI 2

    MRI 2: T2W MRI showing hyperintense mass with splaying of 7th and 8th cranial nerves.




    MRI 3 <- view MRI 3

    MRI 3: T1W post gadolinium fat suppressed image showing nonenhancing mass with fat suppression.




    MRI 1 <- view MRI 1

    MRI 1: Axial T1WI showing dilated and separated ventricles with bilateral fronto-parietal encephalomalacic changes.





    MRI 2 <- view MRI 2

    MRI 2: Coronal T1WI showing absent corpus callosum with dilated ventricles and bilateral fronto-parietal encephalomalacea.





    MRI 3 <- view MRI 3

    MRI 3: Coronal T1WI showing colpocephaly.





    MRI 4 <- view MRI 4

    MRI 4: Sagittal T1WI showing complete absence of corpus callosum with encephalomalacic changes involving fronto-parietal white matter.





    MRI 5 <- view MRI 5

    MRI 5: Axial T2WI showing dilated ventricles with bilateral encephalomalacic changes.





    MRI 6 <- view MRI 6

    MRI 6: Axial T2WI showing absence corpus callosum more clearly.





    MRI 7 <- view MRI 7

    MRI 7: Coronal FLAIR image showing similar findings to coronal T1WI.




    CT 1 <- view CT 1

    CT 1: Axial neck CT in lung window: There is an extensive soft tissue emphysema, which extends from the neck to mediastinum and into the chest wall.




    CT 2 <- view CT 2

    CT 2: Coronal reconstruction of a neck CT in lung window:
    Coronal reconstructed images demonstrate an extensive soft tissue emphysema, which extends from the neck to mediastinum and into the chest wall.





    CT 3 <- view CT 3

    CT 3: Magnified view of an axial neck CT in lung window:
    Visible defect in the pars membranacea (arrow). Endotracheal tube is in place with extensive air in the soft tissues.




    Ultrasound 1 <- view Ultrasound 1

    Ultrasound 1: Coronal image of the chest and abdomen showing hypoechoic areas in the region of the lower chest bilaterally in keeping with cysts.






    MRI 1 <- view MRI 1

    MRI 1: (Axial T2 weighted SSFSE) Shows a large high signal mass located within the lower right lung with cysts of various sizes within it with herniation of one of the cysts to the left behind the heart. Low signal flow voids represent vessels within the mass. The heart is shifted to the left and the contralateral lung is compressed by the mass.





    MRI 2 <- view MRI 2

    MRI 2: (Coronal T2 weighted SSFSE) Demonstrates the mass on the coronal plane. Note the small area of normal right lung at the apex and the compressed left lung. Both these are of slightly lower signal than the cystic mass on T2.





    MRI 3 <- view MRI 3

    MRI 3: (Coronal T1 weighted) Demonstrates the cyctic mass to be of low signal on T1. The higher signal just below the mass on this image represents the normal liver.





    Ultrasound 1 <- view Ultrasound 1

    Ultrasound 1: RUQ transverse: 42x30 mm in size, irregularly marked, non-echo-free mass with incomplete, gechogenic edge. Changes position on breathing in the area of the right colonic flexure.





    Ultrasound 2 <- view Ultrasound 2

    Ultrasound 2: RUQ longitudinal: Same mass in power-mode. Homogenic vasculature, therefore not a cystic process.





    Ultrasound 3 <- view Ultrasound 3

    Ultrasound 3: RUQ diagonal: Questionable localization of the mass (in the gut?) which has a stalk-like structure. At the lower edge one got the impression that there was a intussception "bulls-eye," which was not able to be completely visualized.





    Ultrasound 4 <- view Ultrasound 4

    Ultrasound 4: RUQ diagonal: Visualization of the vessel's stalk and the branching within the mass.





    Ultrasound 5 <- view Ultrasound 5

    Ultrasound 5: RUQ transverse, paramedian: Obvious lymph node swelling medial to the mass.





    OP-Situs 1 <- view OP-Situs 1

    OP-Situs 1: Palpable tumor in the cecum.




    OP-Situs 2 <- view OP-Situs 2

    OP-Situs 2: Ileocecal transition. Lymph node in the foreground, tweezers in the partly intusscepted ileum in the cecum.




    OP-Situs 3 <- view OP-Situs 3

    OP-Situs 3: Intraoperative: Determination of the resection's edges.




    OP-Situs 4 <- view OP-Situs 4

    OP-Situs 4: Specimen luxated out of the cecum.


    Ultrasound 1 <- view Ultrasound 1

    Ultrasound 1: Right upper quadrant, echogenic, partially echo mixed 18x36mm large structure in an echo-free environment subhepatic, with irregular surface.





    Ultrasound 2 <- view Ultrasound 2

    Ultrasound 2: Dito, longitudinal view with significantly irregular surface.





    Ultrasound 3 <- view Ultrasound 3

    Ultrasound 3: 8 months later, sharply demarkated structure with clear shadowing 24x37mm.





    Ultrasound 4 <- view Ultrasound 4

    Ultrasound 4: Same structure with good mobility upon changing the patient's position.


     

     
     Pediatric Radiology CasesDiagnosis confirmation:

    N/A  

     
     Pediatric Radiology CasesWhich DD would be also possible with the radiological findings:

    Cholelithiasis, Hemobilia  

     
     Pediatric Radiology CasesCourse / Prognosis / Frequency / Other :

    So far no treatment, but waiting and observing. A solel splenectomy should prevent the development of gallstones. In the case of coexisting gallstones at time of splenectomy, the simultaneous cholecystectomy is discussed. Continuous clinical and sonographic follow up exams are recommended, especially if the stones are small or the gallbladder wall appears thickened.  

     
     Pediatric Radiology CasesComments of the author about the case:

    N/A  

     
     Pediatric Radiology CasesFirst description / History:

    N/A  

     
     Pediatric Radiology CasesLiterature:

    15. Medline: Medline
    Guidlines for the diagnosis and management of hereditary spherocytosis.
    B.Bolton-Maggs,Stevens, R.F., N.J.Dold, G.Lamont,P.Tillensor,P.H., M.J.King
    BJ of Hematology 126 (2004) 455-474  

     
     Pediatric Radiology CasesKeywords:

    gallstone, gallbladder stone, cholelithiasis, hereditary, spherocytosis, hereditary spherocytosis, bilirubin, bilirubin stone, bilirubin gallbladderstone  

     
     Pediatric Radiology Cases Cite this article:

    Dirk Schaper. Asymptomatic Solitary Gallbladder Stone in Hereditary Spherocytosis. PedRad [serial online] vol 5, no. 11.
    URL: www.PedRad.info/?search=20051128163422  

     
     Pediatric Radiology Cases Read similar articles: bilirubin gallbladderstone&type=1-17">corresponding keywords
    in the same field:
    or in the region:
    or in the tissue/organ:
    or with the etiology:
     
     Pediatric Radiology CasesImages to this case: There are Ultrasound-images available for this case. [ Ultrasound ] View all modalities [ All ]   
     
    Asymptomatic Solitary Gallbladder Stone in Hereditary Spherocytosis
    Dirk Schaper. Asymptomatic Solitary Gallbladder Stone in Hereditary Spherocytosis. PedRad [serial online] vol 5, no. 11.
    URL: www.PedRad.info/?search=20051128163422


     

    Search similar cases in:
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    Asymptomatic Solitary Gallbladder Stone in Hereditary Spherocytosis
    Other cases by these authors:

    Search Kraig J. Lage in Medline Kraig J. Lage (1)   
    Search Achint K Singh in Medline Achint K Singh (17)   
    Search Sanjeeb Kumar Sarma in Medline Sanjeeb Kumar Sarma (24)   
    Search GS Ahmed in Medline GS Ahmed (1)   
    Search Johannes Gossner in Medline Johannes Gossner (18)   
    Search Galea Janabel in Medline Galea Janabel (17)   
    Search Samuel Stafrace in Medline Samuel Stafrace (3)   
    Search Karen Duncan in Medline Karen Duncan (1)   
    Search Lena Crichton in Medline Lena Crichton (1)   
    Search Dirk Schaper in Medline Dirk Schaper (59)   
    Search P. Göbel in Medline P. Göbel (6)   
    Search Dirk Schaper in Medline Dirk Schaper (59)   

    Asymptomatic Solitary Gallbladder Stone in Hereditary Spherocytosis  
     
    Asymptomatic Solitary Gallbladder Stone in Hereditary Spherocytosis
    Dirk Schaper. Asymptomatic Solitary Gallbladder Stone in Hereditary Spherocytosis. PedRad [serial online] vol 5, no. 11.
    URL: www.PedRad.info/?search=20051128163422


     

    Which diagnosis have other collegues guessed?


    • IRDS
      Votes: 1 (2 %)


    • Pneumothorax with pneumomediastinum
      Votes: 28 (80 %)


    • Pneumonia
      Votes: 1 (2 %)


    • Child abuse
      Votes: 1 (2 %)


    • Ebstein anomaly
      Votes: 4 (11 %)


    • Lymphangioleiomyoma with Intussusception
      Votes: 5 (10 %)


    • Burkitt-Lymphoma
      Votes: 6 (12 %)


    • Simple Intussusception
      Votes: 0 (0 %)


    • Ganglioneuroma of the Intestines with Intussusception
      Votes: 2 (4 %)


    • Gut Duplication
      Votes: 0 (0 %)


    • Crohn's Disease
      Votes: 0 (0 %)


    • Cholecystitis
      Votes: 0 (0 %)


    • Hemorrhage into the liver
      Votes: 0 (0 %)


    • Adrenal adenoma
      Votes: 0 (0 %)


    • Bilirubin gallblader stone
      Votes: 23 (31 %)


    • Cholangiocarcinoma
      Votes: 1 (1 %)



        Total answers: 72

     
    Asymptomatic Solitary Gallbladder Stone in Hereditary Spherocytosis
    Dirk Schaper. Asymptomatic Solitary Gallbladder Stone in Hereditary Spherocytosis. PedRad [serial online] vol 5, no. 11.
    URL: www.PedRad.info/?search=20051128163422


     

    Medical Dictionary
    Search in medical dictionary for
    Or type in a keyword
    ( Provided by The On-Line Medical Dictionary )




    1 = less interesting)
     
    Asymptomatic Solitary Gallbladder Stone in Hereditary Spherocytosis
    Dirk Schaper. Asymptomatic Solitary Gallbladder Stone in Hereditary Spherocytosis. PedRad [serial online] vol 5, no. 11.
    URL: www.PedRad.info/?search=20051128163422


     


    Go to the top of the page   ID: 20051118133428 Original case in english  More links about this topic on Pubmed (PubMed Reader)
    Add this case to your RSS feeder: Subscribe to RSS feed Add to Yahoo Add to Google Add to AOL Add to Furl Subscribe to Feed Burner feed

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    Discussion
     
    Spermatocele
    Dirk Schaper. Spermatocele. PedRad [serial online] vol 5, no. 11.
    URL: www.PedRad.info/?search=20051118133428


     
     Pediatric Radiology CasesImages to this case: There are Ultrasound-images available for this case. [ Ultrasound ] View all modalities [ All ]   
     Pediatric Radiology CasesAuthor/s:

    Dirk Schaper (Klinik für Kinderchirurgie Krankenhaus St. Elisabeth und St. Barbara in Halle)  

     
     Pediatric Radiology CasesEmail Address:

    Viewable for logged on visitors (Log on)  

     
     Pediatric Radiology CasesAge:

    13 Years  

     
     Pediatric Radiology CasesGender:

    Male  

     
     Pediatric Radiology CasesRegion-Organ:

    N/A  

     
     Pediatric Radiology CasesMost likely etiology:

    N/A  

     
     Pediatric Radiology CasesHistory:

    Incidental findings in sonographic examination due to acute pain in the right scrotal area.
    Left side without complaints with. On the right side, we found testicular torsion and could detorque the testes. The sonographic examination of the left side showed unchanged findings.
    Palpatory findings showed morphologically normal testes and epididymis. There were two indolent, soft masses felt at the head of the epidydimis.  

     
     Pediatric Radiology CasesPathomorphology or Pathophysiology of this disease :

    The etiology of a spermatocele is not known in-depth. One assums that it could form due to an obstruction of the epididymal tubuli. This obstruction could be of inflammatory or traumatic origin.
    If sperm are found in the cystic process, one can speak of a spermatocele. If there are no sperm found, it is an epididymal cyst.  

     
     Pediatric Radiology CasesRadiological findings:


    X-Ray 1 <- view X-Ray 1

    X-Ray 1: Large lucency surrounds the superior mediastinum with lucency crossing midline. Subtle lucency is also seen inferior and lateral of the right lung base at the costophrenic angle and hemidiaphragm.





    X-Ray 2 <- view X-Ray 2

    X-Ray 2: Large lucency surrounds the superior aspect of the anterior mediastinum with elevation of the thymic shadow.




    MRI 1 <- view MRI 1

    MRI 1: T1W MRI showing hyperintense mass in right CP angle cistern extending into the internal auditory canal.




    MRI 2 <- view MRI 2

    MRI 2: T2W MRI showing hyperintense mass with splaying of 7th and 8th cranial nerves.




    MRI 3 <- view MRI 3

    MRI 3: T1W post gadolinium fat suppressed image showing nonenhancing mass with fat suppression.




    MRI 1 <- view MRI 1

    MRI 1: Axial T1WI showing dilated and separated ventricles with bilateral fronto-parietal encephalomalacic changes.





    MRI 2 <- view MRI 2

    MRI 2: Coronal T1WI showing absent corpus callosum with dilated ventricles and bilateral fronto-parietal encephalomalacea.





    MRI 3 <- view MRI 3

    MRI 3: Coronal T1WI showing colpocephaly.





    MRI 4 <- view MRI 4

    MRI 4: Sagittal T1WI showing complete absence of corpus callosum with encephalomalacic changes involving fronto-parietal white matter.





    MRI 5 <- view MRI 5

    MRI 5: Axial T2WI showing dilated ventricles with bilateral encephalomalacic changes.





    MRI 6 <- view MRI 6

    MRI 6: Axial T2WI showing absence corpus callosum more clearly.





    MRI 7 <- view MRI 7

    MRI 7: Coronal FLAIR image showing similar findings to coronal T1WI.




    CT 1 <- view CT 1

    CT 1: Axial neck CT in lung window: There is an extensive soft tissue emphysema, which extends from the neck to mediastinum and into the chest wall.




    CT 2 <- view CT 2

    CT 2: Coronal reconstruction of a neck CT in lung window:
    Coronal reconstructed images demonstrate an extensive soft tissue emphysema, which extends from the neck to mediastinum and into the chest wall.





    CT 3 <- view CT 3

    CT 3: Magnified view of an axial neck CT in lung window:
    Visible defect in the pars membranacea (arrow). Endotracheal tube is in place with extensive air in the soft tissues.




    Ultrasound 1 <- view Ultrasound 1

    Ultrasound 1: Coronal image of the chest and abdomen showing hypoechoic areas in the region of the lower chest bilaterally in keeping with cysts.






    MRI 1 <- view MRI 1

    MRI 1: (Axial T2 weighted SSFSE) Shows a large high signal mass located within the lower right lung with cysts of various sizes within it with herniation of one of the cysts to the left behind the heart. Low signal flow voids represent vessels within the mass. The heart is shifted to the left and the contralateral lung is compressed by the mass.





    MRI 2 <- view MRI 2

    MRI 2: (Coronal T2 weighted SSFSE) Demonstrates the mass on the coronal plane. Note the small area of normal right lung at the apex and the compressed left lung. Both these are of slightly lower signal than the cystic mass on T2.





    MRI 3 <- view MRI 3

    MRI 3: (Coronal T1 weighted) Demonstrates the cyctic mass to be of low signal on T1. The higher signal just below the mass on this image represents the normal liver.





    Ultrasound 1 <- view Ultrasound 1

    Ultrasound 1: RUQ transverse: 42x30 mm in size, irregularly marked, non-echo-free mass with incomplete, gechogenic edge. Changes position on breathing in the area of the right colonic flexure.





    Ultrasound 2 <- view Ultrasound 2

    Ultrasound 2: RUQ longitudinal: Same mass in power-mode. Homogenic vasculature, therefore not a cystic process.





    Ultrasound 3 <- view Ultrasound 3

    Ultrasound 3: RUQ diagonal: Questionable localization of the mass (in the gut?) which has a stalk-like structure. At the lower edge one got the impression that there was a intussception "bulls-eye," which was not able to be completely visualized.





    Ultrasound 4 <- view Ultrasound 4

    Ultrasound 4: RUQ diagonal: Visualization of the vessel's stalk and the branching within the mass.





    Ultrasound 5 <- view Ultrasound 5

    Ultrasound 5: RUQ transverse, paramedian: Obvious lymph node swelling medial to the mass.





    OP-Situs 1 <- view OP-Situs 1

    OP-Situs 1: Palpable tumor in the cecum.




    OP-Situs 2 <- view OP-Situs 2

    OP-Situs 2: Ileocecal transition. Lymph node in the foreground, tweezers in the partly intusscepted ileum in the cecum.




    OP-Situs 3 <- view OP-Situs 3

    OP-Situs 3: Intraoperative: Determination of the resection's edges.




    OP-Situs 4 <- view OP-Situs 4

    OP-Situs 4: Specimen luxated out of the cecum.


    Ultrasound 1 <- view Ultrasound 1

    Ultrasound 1: Right upper quadrant, echogenic, partially echo mixed 18x36mm large structure in an echo-free environment subhepatic, with irregular surface.





    Ultrasound 2 <- view Ultrasound 2

    Ultrasound 2: Dito, longitudinal view with significantly irregular surface.





    Ultrasound 3 <- view Ultrasound 3

    Ultrasound 3: 8 months later, sharply demarkated structure with clear shadowing 24x37mm.





    Ultrasound 4 <- view Ultrasound 4

    Ultrasound 4: Same structure with good mobility upon changing the patient's position.



    Ultrasound 1 <- view Ultrasound 1

    Ultrasound 1: 10x6mm large, echoless mass in the upper testicular pole/head of the epididymis.





    Ultrasound 2 <- view Ultrasound 2

    Ultrasound 2: Shown are two echoless masses at the head of the epididymis. 8x6mm and 11x7mm





    Ultrasound 3 <- view Ultrasound 3

    Ultrasound 3: Echoless mass at the upper pole of the testes.


     

     
     Pediatric Radiology CasesDiagnosis confirmation:

    N/A  

     
     Pediatric Radiology CasesWhich DD would be also possible with the radiological findings:

    Epididymal cyst, Epididymal lymphangioma, Tunica albuginea cyst, epidermoid cyst.  

     
     Pediatric Radiology CasesCourse / Prognosis / Frequency / Other :

    In our patient, a prophylactic pexy was planned, so that in this surgical procedure, the cystic structures could be removed. It proved to be a spermatocele in histology.
    Normally, a spermatocele is not an indication for surgery. Usually, the patients are symptomless and don't even know that they have it. 30% of the asymptomatic patients who are sonographically examined show a spermatocele.
    A surgical indication is only warranted in pain and very large cysts, which can cause a feeling of heaviness. Since spermatoceles are rarely larger than 10 mm, a larger mass should be investigated further.
    The most fit treatment is the open surgical removal through a scrotal cut. A puncture treatment is generally dismissed, due to the risk of infection. Sclerotherapy should not be considered in reproductive years, due to the risk of abacterial epididymitis.  

     
     Pediatric Radiology CasesComments of the author about the case:

    N/A  

     
     Pediatric Radiology CasesFirst description / History:

    N/A  

     
     Pediatric Radiology CasesLiterature:

    16. Medline: Medline
    Frauscher,F., Klauser, A.,Stenzl, A., Helweg, G.,Amort, B., zur Nedden,D.
    US findings in the scrotum of extreme mountain bikers
    Radiology 2001; 219:427-431

    17. Medline: Medline
    Dogra,V.S., Gottlieb,R.H., Oka,M., Rubens,D.J.
    Sonography of the scrotum
    Radiology 2003; 227:18-36

    18. Medline: Medline
    Absikafi,N.F.
    Spermatocele
    www.emedicine.com  

     
     Pediatric Radiology CasesKeywords:

    Spermatocele, Epididymal cyst, epididymis, sonography, testes, ultrasound  

     
     Pediatric Radiology Cases Cite this article:

    Dirk Schaper. Spermatocele. PedRad [serial online] vol 5, no. 11.
    URL: www.PedRad.info/?search=20051118133428  

     
     Pediatric Radiology Cases Read similar articles: ultrasound&type=1-17">corresponding keywords
    in the same field:
    or in the region:
    or in the tissue/organ:
    or with the etiology:
     
     Pediatric Radiology CasesImages to this case: There are Ultrasound-images available for this case. [ Ultrasound ] View all modalities [ All ]   
     
    Spermatocele
    Dirk Schaper. Spermatocele. PedRad [serial online] vol 5, no. 11.
    URL: www.PedRad.info/?search=20051118133428


     

    Search similar cases in:
    More links about this topic on Pubmed  More links about this topic on Yahoo  More links about this topic on Altavista  More links about this topic on MSN  More links about this topic on Google  More links about this topic on Fireball

    Peer-reviewed Radiology Search



    Spermatocele
    Other cases by these authors:

    Search Kraig J. Lage in Medline Kraig J. Lage (1)   
    Search Achint K Singh in Medline Achint K Singh (17)   
    Search Sanjeeb Kumar Sarma in Medline Sanjeeb Kumar Sarma (24)   
    Search GS Ahmed in Medline GS Ahmed (1)   
    Search Johannes Gossner in Medline Johannes Gossner (18)   
    Search Galea Janabel in Medline Galea Janabel (17)   
    Search Samuel Stafrace in Medline Samuel Stafrace (3)   
    Search Karen Duncan in Medline Karen Duncan (1)   
    Search Lena Crichton in Medline Lena Crichton (1)   
    Search Dirk Schaper in Medline Dirk Schaper (59)   
    Search P. Göbel in Medline P. Göbel (6)   
    Search Dirk Schaper in Medline Dirk Schaper (59)   
    Search Dirk Schaper in Medline Dirk Schaper (59)   

    Spermatocele  
     
    Spermatocele
    Dirk Schaper. Spermatocele. PedRad [serial online] vol 5, no. 11.
    URL: www.PedRad.info/?search=20051118133428


     

    Which diagnosis have other collegues guessed?


    • IRDS
      Votes: 1 (2 %)


    • Pneumothorax with pneumomediastinum
      Votes: 28 (80 %)


    • Pneumonia
      Votes: 1 (2 %)


    • Child abuse
      Votes: 1 (2 %)


    • Ebstein anomaly
      Votes: 4 (11 %)


    • Lymphangioleiomyoma with Intussusception
      Votes: 5 (10 %)


    • Burkitt-Lymphoma
      Votes: 6 (12 %)


    • Simple Intussusception
      Votes: 0 (0 %)


    • Ganglioneuroma of the Intestines with Intussusception
      Votes: 2 (4 %)


    • Gut Duplication
      Votes: 0 (0 %)


    • Crohn's Disease
      Votes: 0 (0 %)


    • Cholecystitis
      Votes: 0 (0 %)


    • Hemorrhage into the liver
      Votes: 0 (0 %)


    • Adrenal adenoma
      Votes: 0 (0 %)


    • Bilirubin gallblader stone
      Votes: 23 (31 %)


    • Cholangiocarcinoma
      Votes: 1 (1 %)


    • Nuk cyst
      Votes: 2 (2 %)


    • Spermatocele
      Votes: 9 (10 %)


    • Hydatide
      Votes: 1 (1 %)


    • Leydig Cell Tumor
      Votes: 0 (0 %)


    • Rhabdomyosarcoma
      Votes: 0 (0 %)


    • Hydrocele
      Votes: 5 (5 %)



        Total answers: 89

     
    Spermatocele
    Dirk Schaper. Spermatocele. PedRad [serial online] vol 5, no. 11.
    URL: www.PedRad.info/?search=20051118133428


     

    Medical Dictionary
    Search in medical dictionary for
    Or type in a keyword
    ( Provided by The On-Line Medical Dictionary )




    1 = less interesting)
     
    Spermatocele
    Dirk Schaper. Spermatocele. PedRad [serial online] vol 5, no. 11.
    URL: www.PedRad.info/?search=20051118133428


     


    Go to the top of the page   ID: 20051117133349 Original case in english  More links about this topic on Pubmed (PubMed Reader)
    Add this case to your RSS feeder: Subscribe to RSS feed Add to Yahoo Add to Google Add to AOL Add to Furl Subscribe to Feed Burner feed

    Bookmark and Share


    Discussion
     
    Temporary Obstruction of the Appendix
    Dirk Schaper. Temporary Obstruction of the Appendix. PedRad [serial online] vol 5, no. 11.
    URL: www.PedRad.info/?search=20051117133349


     
     Pediatric Radiology CasesImages to this case: There are Ultrasound-images available for this case. [ Ultrasound ] View all modalities [ All ]   
     Pediatric Radiology CasesAuthor/s:

    Dirk Schaper (Klinik für Kinderchirurgie-Krankenhaus St. Elisabeth und St. Barbara Halle)  

     
     Pediatric Radiology CasesEmail Address:

    Viewable for logged on visitors (Log on)  

     
     Pediatric Radiology CasesAge:

    7 Years  

     
     Pediatric Radiology CasesGender:

    Male  

     
     Pediatric Radiology CasesRegion-Organ:

    N/A  

     
     Pediatric Radiology CasesMost likely etiology:

    N/A  

     
     Pediatric Radiology CasesHistory:

    7 year-old boy with slight abdominal discomfort for 10 days. No vomiting, no fever. No other symptoms.
    Abdomen is soft, no localized pain upon pressure.
    Spontaneous pain in the right lower quadrant.  

     
     Pediatric Radiology CasesPathomorphology or Pathophysiology of this disease :

    N/A  

     
     Pediatric Radiology CasesRadiological findings:


    X-Ray 1 <- view X-Ray 1

    X-Ray 1: Large lucency surrounds the superior mediastinum with lucency crossing midline. Subtle lucency is also seen inferior and lateral of the right lung base at the costophrenic angle and hemidiaphragm.





    X-Ray 2 <- view X-Ray 2

    X-Ray 2: Large lucency surrounds the superior aspect of the anterior mediastinum with elevation of the thymic shadow.




    MRI 1 <- view MRI 1

    MRI 1: T1W MRI showing hyperintense mass in right CP angle cistern extending into the internal auditory canal.




    MRI 2 <- view MRI 2

    MRI 2: T2W MRI showing hyperintense mass with splaying of 7th and 8th cranial nerves.




    MRI 3 <- view MRI 3

    MRI 3: T1W post gadolinium fat suppressed image showing nonenhancing mass with fat suppression.




    MRI 1 <- view MRI 1

    MRI 1: Axial T1WI showing dilated and separated ventricles with bilateral fronto-parietal encephalomalacic changes.





    MRI 2 <- view MRI 2

    MRI 2: Coronal T1WI showing absent corpus callosum with dilated ventricles and bilateral fronto-parietal encephalomalacea.





    MRI 3 <- view MRI 3

    MRI 3: Coronal T1WI showing colpocephaly.





    MRI 4 <- view MRI 4

    MRI 4: Sagittal T1WI showing complete absence of corpus callosum with encephalomalacic changes involving fronto-parietal white matter.





    MRI 5 <- view MRI 5

    MRI 5: Axial T2WI showing dilated ventricles with bilateral encephalomalacic changes.





    MRI 6 <- view MRI 6

    MRI 6: Axial T2WI showing absence corpus callosum more clearly.





    MRI 7 <- view MRI 7

    MRI 7: Coronal FLAIR image showing similar findings to coronal T1WI.




    CT 1 <- view CT 1

    CT 1: Axial neck CT in lung window: There is an extensive soft tissue emphysema, which extends from the neck to mediastinum and into the chest wall.




    CT 2 <- view CT 2

    CT 2: Coronal reconstruction of a neck CT in lung window:
    Coronal reconstructed images demonstrate an extensive soft tissue emphysema, which extends from the neck to mediastinum and into the chest wall.





    CT 3 <- view CT 3

    CT 3: Magnified view of an axial neck CT in lung window:
    Visible defect in the pars membranacea (arrow). Endotracheal tube is in place with extensive air in the soft tissues.




    Ultrasound 1 <- view Ultrasound 1

    Ultrasound 1: Coronal image of the chest and abdomen showing hypoechoic areas in the region of the lower chest bilaterally in keeping with cysts.






    MRI 1 <- view MRI 1

    MRI 1: (Axial T2 weighted SSFSE) Shows a large high signal mass located within the lower right lung with cysts of various sizes within it with herniation of one of the cysts to the left behind the heart. Low signal flow voids represent vessels within the mass. The heart is shifted to the left and the contralateral lung is compressed by the mass.





    MRI 2 <- view MRI 2

    MRI 2: (Coronal T2 weighted SSFSE) Demonstrates the mass on the coronal plane. Note the small area of normal right lung at the apex and the compressed left lung. Both these are of slightly lower signal than the cystic mass on T2.





    MRI 3 <- view MRI 3

    MRI 3: (Coronal T1 weighted) Demonstrates the cyctic mass to be of low signal on T1. The higher signal just below the mass on this image represents the normal liver.





    Ultrasound 1 <- view Ultrasound 1

    Ultrasound 1: RUQ transverse: 42x30 mm in size, irregularly marked, non-echo-free mass with incomplete, gechogenic edge. Changes position on breathing in the area of the right colonic flexure.





    Ultrasound 2 <- view Ultrasound 2

    Ultrasound 2: RUQ longitudinal: Same mass in power-mode. Homogenic vasculature, therefore not a cystic process.





    Ultrasound 3 <- view Ultrasound 3

    Ultrasound 3: RUQ diagonal: Questionable localization of the mass (in the gut?) which has a stalk-like structure. At the lower edge one got the impression that there was a intussception "bulls-eye," which was not able to be completely visualized.





    Ultrasound 4 <- view Ultrasound 4

    Ultrasound 4: RUQ diagonal: Visualization of the vessel's stalk and the branching within the mass.





    Ultrasound 5 <- view Ultrasound 5

    Ultrasound 5: RUQ transverse, paramedian: Obvious lymph node swelling medial to the mass.





    OP-Situs 1 <- view OP-Situs 1

    OP-Situs 1: Palpable tumor in the cecum.




    OP-Situs 2 <- view OP-Situs 2

    OP-Situs 2: Ileocecal transition. Lymph node in the foreground, tweezers in the partly intusscepted ileum in the cecum.




    OP-Situs 3 <- view OP-Situs 3

    OP-Situs 3: Intraoperative: Determination of the resection's edges.




    OP-Situs 4 <- view OP-Situs 4

    OP-Situs 4: Specimen luxated out of the cecum.


    Ultrasound 1 <- view Ultrasound 1

    Ultrasound 1: Right upper quadrant, echogenic, partially echo mixed 18x36mm large structure in an echo-free environment subhepatic, with irregular surface.





    Ultrasound 2 <- view Ultrasound 2

    Ultrasound 2: Dito, longitudinal view with significantly irregular surface.





    Ultrasound 3 <- view Ultrasound 3

    Ultrasound 3: 8 months later, sharply demarkated structure with clear shadowing 24x37mm.





    Ultrasound 4 <- view Ultrasound 4

    Ultrasound 4: Same structure with good mobility upon changing the patient's position.



    Ultrasound 1 <- view Ultrasound 1

    Ultrasound 1: 10x6mm large, echoless mass in the upper testicular pole/head of the epididymis.





    Ultrasound 2 <- view Ultrasound 2

    Ultrasound 2: Shown are two echoless masses at the head of the epididymis. 8x6mm and 11x7mm





    Ultrasound 3 <- view Ultrasound 3

    Ultrasound 3: Echoless mass at the upper pole of the testes.



    Ultrasound 1 <- view Ultrasound 1

    Ultrasound 1: Initial sonographic examination: right lower quadrant (RLQ), tubular swollen, non-echogenic structure with echogenic, intermittent internal echoes. Non-compressable, no compression pain with transducer. In the longitudinal and transverse views, composition of the walls are well-differentiated.





    Ultrasound 2 <- view Ultrasound 2

    Ultrasound 2: Initial sonographic examination: Bulls-eye in the RLQ with well-differentiated walls (base area)





    Ultrasound 3 <- view Ultrasound 3

    Ultrasound 3: Initial sonographic examination: Longitudinal image of the tubular structure, which becomes narrower more medially. (base)





    Ultrasound 4 <- view Ultrasound 4

    Ultrasound 4: Sonographic examination 3 days later: Tubular structure with normal wall structure.





    Ultrasound 5 <- view Ultrasound 5

    Ultrasound 5: Sonographic examination 3 days later: Transverse view of a bulls-eye structure which is near the cecum with normal wall structure 5.7 mm (base)





    Ultrasound 6 <- view Ultrasound 6

    Ultrasound 6: Follow-up examination after 7 days: Longitudinal view with a tubular, swollen structure with echogenic contents. Somewhat compressable, layers of the walls normal.





    Ultrasound 7 <- view Ultrasound 7

    Ultrasound 7: Follow-up examination after 7 days: Longitudinal and transverse views of the same structure.


     

     
     Pediatric Radiology CasesDiagnosis confirmation:

    N/A  

     
     Pediatric Radiology CasesWhich DD would be also possible with the radiological findings:

    Typical appendicitis  

     
     Pediatric Radiology CasesCourse / Prognosis / Frequency / Other :

    In the first sonographic examination there was a suspicion of appendicitis (images 1-3). The increased size of the internal space, which was larger than the limits of 6 mm and the fact that you could not compress the structure led us to this train of thought. The missing paraclinic and symptoms were factors that led us away from this diagnosis, and we did not operate on the patient and waited 3 days to perform our follow-up examination. Clinically, there was no further or new findings. In the ultrasound, there was an appendix that was less filled (image 4 & 5). In the follow up images (6 & 7), the appendix showed an increase if fullness, but the patient was symptomless. An operation was not yet performed. We have never seen a persistence of this before. In doppler studies, no increased in circulation was seen on any day. Since the appendix was barely compressable and since it did not empty during the examination, we assume that there was a temporary obstruction with spontaneous regression. The option of a laparoscopic appendectomy was agreed upon with the patient's parents if the symptoms persisted.  

     
     Pediatric Radiology CasesComments of the author about the case:

    N/A  

     
     Pediatric Radiology CasesFirst description / History:

    N/A  

     
     Pediatric Radiology CasesLiterature:

    N/A  

     
     Pediatric Radiology CasesKeywords:

    appendicitis, appendix, temporary obstruction, abdominal pain, appendix obstruction, appendectomy  

     
     Pediatric Radiology Cases Cite this article:

    Dirk Schaper. Temporary Obstruction of the Appendix. PedRad [serial online] vol 5, no. 11.
    URL: www.PedRad.info/?search=20051117133349  

     
     Pediatric Radiology Cases Read similar articles: appendectomy&type=1-17">corresponding keywords
    in the same field:
    or in the region:
    or in the tissue/organ:
    or with the etiology:
     
     Pediatric Radiology CasesImages to this case: There are Ultrasound-images available for this case. [ Ultrasound ] View all modalities [ All ]   
     
    Temporary Obstruction of the Appendix
    Dirk Schaper. Temporary Obstruction of the Appendix. PedRad [serial online] vol 5, no. 11.
    URL: www.PedRad.info/?search=20051117133349


     

    Search similar cases in:
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    Temporary Obstruction of the Appendix
    Other cases by these authors:

    Search Kraig J. Lage in Medline Kraig J. Lage (1)   
    Search Achint K Singh in Medline Achint K Singh (17)   
    Search Sanjeeb Kumar Sarma in Medline Sanjeeb Kumar Sarma (24)   
    Search GS Ahmed in Medline GS Ahmed (1)   
    Search Johannes Gossner in Medline Johannes Gossner (18)   
    Search Galea Janabel in Medline Galea Janabel (17)   
    Search Samuel Stafrace in Medline Samuel Stafrace (3)   
    Search Karen Duncan in Medline Karen Duncan (1)   
    Search Lena Crichton in Medline Lena Crichton (1)   
    Search Dirk Schaper in Medline Dirk Schaper (59)   
    Search P. Göbel in Medline P. Göbel (6)   
    Search Dirk Schaper in Medline Dirk Schaper (59)   
    Search Dirk Schaper in Medline Dirk Schaper (59)   
    Search Dirk Schaper in Medline Dirk Schaper (59)   

    Temporary Obstruction of the Appendix  
     
    Temporary Obstruction of the Appendix
    Dirk Schaper. Temporary Obstruction of the Appendix. PedRad [serial online] vol 5, no. 11.
    URL: www.PedRad.info/?search=20051117133349


     

    Which diagnosis have other collegues guessed?


    • IRDS
      Votes: 1 (2 %)


    • Pneumothorax with pneumomediastinum
      Votes: 28 (80 %)


    • Pneumonia
      Votes: 1 (2 %)


    • Child abuse
      Votes: 1 (2 %)


    • Ebstein anomaly
      Votes: 4 (11 %)


    • Lymphangioleiomyoma with Intussusception
      Votes: 5 (10 %)


    • Burkitt-Lymphoma
      Votes: 6 (12 %)


    • Simple Intussusception
      Votes: 0 (0 %)


    • Ganglioneuroma of the Intestines with Intussusception
      Votes: 2 (4 %)


    • Gut Duplication
      Votes: 0 (0 %)


    • Crohn's Disease
      Votes: 0 (0 %)


    • Cholecystitis
      Votes: 0 (0 %)


    • Hemorrhage into the liver
      Votes: 0 (0 %)


    • Adrenal adenoma
      Votes: 0 (0 %)


    • Bilirubin gallblader stone
      Votes: 23 (31 %)


    • Cholangiocarcinoma
      Votes: 1 (1 %)


    • Nuk cyst
      Votes: 2 (2 %)


    • Spermatocele
      Votes: 9 (10 %)


    • Hydatide
      Votes: 1 (1 %)


    • Leydig Cell Tumor
      Votes: 0 (0 %)


    • Rhabdomyosarcoma
      Votes: 0 (0 %)


    • Hydrocele
      Votes: 5 (5 %)


    • Crohn's Disease
      Votes: 0 (0 %)


    • Ulcerative colitis
      Votes: 1 (0 %)


    • Temporary Obstruction of the Appendix
      Votes: 10 (9 %)


    • Meckel's Diverticulum
      Votes: 5 (4 %)



        Total answers: 105

     
    Temporary Obstruction of the Appendix
    Dirk Schaper. Temporary Obstruction of the Appendix. PedRad [serial online] vol 5, no. 11.
    URL: www.PedRad.info/?search=20051117133349


     

    Medical Dictionary
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    Temporary Obstruction of the Appendix
    Dirk Schaper. Temporary Obstruction of the Appendix. PedRad [serial online] vol 5, no. 11.
    URL: www.PedRad.info/?search=20051117133349


     


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    Discussion
     
    Hibernoma
    K Gerlach, H Bartsch. Hibernoma. PedRad [serial online] vol 5, no. 11.
    URL: www.PedRad.info/?search=20051108092638


     
     Pediatric Radiology CasesImages to this case: There are MRI-images available for this case. [ MRI ] There are OP-Situs-images available for this case. [ OP-Situs ] View all modalities [ All ]   
     Pediatric Radiology CasesAuthor/s:

    K. Gerlach, H. Bartsch (Kinderchirurgie des Krankenhaus St.Elisabeth und St.Barbara in Halle)  

     
     Pediatric Radiology CasesEmail Address:

    Viewable for logged on visitors (Log on)  

     
     Pediatric Radiology CasesAge:

    1 Years  

     
     Pediatric Radiology CasesGender:

    Male  

     
     Pediatric Radiology CasesRegion-Organ:

    N/A  

     
     Pediatric Radiology CasesMost likely etiology:

    N/A  

     
     Pediatric Radiology CasesHistory:

    SInce birth, there was a 3.x3 cm, indolent swelling in the back with slight increase in size. Localized dorsally in the thoracic vertebral area between the shoulder blades. Otherwise, the child is unremarkable.  

     
     Pediatric Radiology CasesPathomorphology or Pathophysiology of this disease :

    In a hibernoma, the tumor is composed of brown fatty tissue, which is known in the animal-world as the hibernation gland. Brown fatty tissue is known to be located in the back area, around the kidneys and around the aorta in a baby.  

     
     Pediatric Radiology CasesRadiological findings:


    X-Ray 1 <- view X-Ray 1

    X-Ray 1: Large lucency surrounds the superior mediastinum with lucency crossing midline. Subtle lucency is also seen inferior and lateral of the right lung base at the costophrenic angle and hemidiaphragm.





    X-Ray 2 <- view X-Ray 2

    X-Ray 2: Large lucency surrounds the superior aspect of the anterior mediastinum with elevation of the thymic shadow.




    MRI 1 <- view MRI 1

    MRI 1: T1W MRI showing hyperintense mass in right CP angle cistern extending into the internal auditory canal.




    MRI 2 <- view MRI 2

    MRI 2: T2W MRI showing hyperintense mass with splaying of 7th and 8th cranial nerves.




    MRI 3 <- view MRI 3

    MRI 3: T1W post gadolinium fat suppressed image showing nonenhancing mass with fat suppression.




    MRI 1 <- view MRI 1

    MRI 1: Axial T1WI showing dilated and separated ventricles with bilateral fronto-parietal encephalomalacic changes.





    MRI 2 <- view MRI 2

    MRI 2: Coronal T1WI showing absent corpus callosum with dilated ventricles and bilateral fronto-parietal encephalomalacea.





    MRI 3 <- view MRI 3

    MRI 3: Coronal T1WI showing colpocephaly.





    MRI 4 <- view MRI 4

    MRI 4: Sagittal T1WI showing complete absence of corpus callosum with encephalomalacic changes involving fronto-parietal white matter.





    MRI 5 <- view MRI 5

    MRI 5: Axial T2WI showing dilated ventricles with bilateral encephalomalacic changes.





    MRI 6 <- view MRI 6

    MRI 6: Axial T2WI showing absence corpus callosum more clearly.





    MRI 7 <- view MRI 7

    MRI 7: Coronal FLAIR image showing similar findings to coronal T1WI.




    CT 1 <- view CT 1

    CT 1: Axial neck CT in lung window: There is an extensive soft tissue emphysema, which extends from the neck to mediastinum and into the chest wall.




    CT 2 <- view CT 2

    CT 2: Coronal reconstruction of a neck CT in lung window:
    Coronal reconstructed images demonstrate an extensive soft tissue emphysema, which extends from the neck to mediastinum and into the chest wall.





    CT 3 <- view CT 3

    CT 3: Magnified view of an axial neck CT in lung window:
    Visible defect in the pars membranacea (arrow). Endotracheal tube is in place with extensive air in the soft tissues.




    Ultrasound 1 <- view Ultrasound 1

    Ultrasound 1: Coronal image of the chest and abdomen showing hypoechoic areas in the region of the lower chest bilaterally in keeping with cysts.






    MRI 1 <- view MRI 1

    MRI 1: (Axial T2 weighted SSFSE) Shows a large high signal mass located within the lower right lung with cysts of various sizes within it with herniation of one of the cysts to the left behind the heart. Low signal flow voids represent vessels within the mass. The heart is shifted to the left and the contralateral lung is compressed by the mass.





    MRI 2 <- view MRI 2

    MRI 2: (Coronal T2 weighted SSFSE) Demonstrates the mass on the coronal plane. Note the small area of normal right lung at the apex and the compressed left lung. Both these are of slightly lower signal than the cystic mass on T2.





    MRI 3 <- view MRI 3

    MRI 3: (Coronal T1 weighted) Demonstrates the cyctic mass to be of low signal on T1. The higher signal just below the mass on this image represents the normal liver.





    Ultrasound 1 <- view Ultrasound 1

    Ultrasound 1: RUQ transverse: 42x30 mm in size, irregularly marked, non-echo-free mass with incomplete, gechogenic edge. Changes position on breathing in the area of the right colonic flexure.





    Ultrasound 2 <- view Ultrasound 2

    Ultrasound 2: RUQ longitudinal: Same mass in power-mode. Homogenic vasculature, therefore not a cystic process.





    Ultrasound 3 <- view Ultrasound 3

    Ultrasound 3: RUQ diagonal: Questionable localization of the mass (in the gut?) which has a stalk-like structure. At the lower edge one got the impression that there was a intussception "bulls-eye," which was not able to be completely visualized.





    Ultrasound 4 <- view Ultrasound 4

    Ultrasound 4: RUQ diagonal: Visualization of the vessel's stalk and the branching within the mass.





    Ultrasound 5 <- view Ultrasound 5

    Ultrasound 5: RUQ transverse, paramedian: Obvious lymph node swelling medial to the mass.





    OP-Situs 1 <- view OP-Situs 1

    OP-Situs 1: Palpable tumor in the cecum.




    OP-Situs 2 <- view OP-Situs 2

    OP-Situs 2: Ileocecal transition. Lymph node in the foreground, tweezers in the partly intusscepted ileum in the cecum.




    OP-Situs 3 <- view OP-Situs 3

    OP-Situs 3: Intraoperative: Determination of the resection's edges.




    OP-Situs 4 <- view OP-Situs 4

    OP-Situs 4: Specimen luxated out of the cecum.


    Ultrasound 1 <- view Ultrasound 1

    Ultrasound 1: Right upper quadrant, echogenic, partially echo mixed 18x36mm large structure in an echo-free environment subhepatic, with irregular surface.





    Ultrasound 2 <- view Ultrasound 2

    Ultrasound 2: Dito, longitudinal view with significantly irregular surface.





    Ultrasound 3 <- view Ultrasound 3

    Ultrasound 3: 8 months later, sharply demarkated structure with clear shadowing 24x37mm.





    Ultrasound 4 <- view Ultrasound 4

    Ultrasound 4: Same structure with good mobility upon changing the patient's position.



    Ultrasound 1 <- view Ultrasound 1

    Ultrasound 1: 10x6mm large, echoless mass in the upper testicular pole/head of the epididymis.





    Ultrasound 2 <- view Ultrasound 2

    Ultrasound 2: Shown are two echoless masses at the head of the epididymis. 8x6mm and 11x7mm





    Ultrasound 3 <- view Ultrasound 3

    Ultrasound 3: Echoless mass at the upper pole of the testes.



    Ultrasound 1 <- view Ultrasound 1

    Ultrasound 1: Initial sonographic examination: right lower quadrant (RLQ), tubular swollen, non-echogenic structure with echogenic, intermittent internal echoes. Non-compressable, no compression pain with transducer. In the longitudinal and transverse views, composition of the walls are well-differentiated.





    Ultrasound 2 <- view Ultrasound 2

    Ultrasound 2: Initial sonographic examination: Bulls-eye in the RLQ with well-differentiated walls (base area)





    Ultrasound 3 <- view Ultrasound 3

    Ultrasound 3: Initial sonographic examination: Longitudinal image of the tubular structure, which becomes narrower more medially. (base)





    Ultrasound 4 <- view Ultrasound 4

    Ultrasound 4: Sonographic examination 3 days later: Tubular structure with normal wall structure.





    Ultrasound 5 <- view Ultrasound 5

    Ultrasound 5: Sonographic examination 3 days later: Transverse view of a bulls-eye structure which is near the cecum with normal wall structure 5.7 mm (base)





    Ultrasound 6 <- view Ultrasound 6

    Ultrasound 6: Follow-up examination after 7 days: Longitudinal view with a tubular, swollen structure with echogenic contents. Somewhat compressable, layers of the walls normal.





    Ultrasound 7 <- view Ultrasound 7

    Ultrasound 7: Follow-up examination after 7 days: Longitudinal and transverse views of the same structure.



    MRI 1 <- view MRI 1

    MRI 1: T1-weighted image, sagittal: about 3.5 x 1 x 3 cm hyperintense tumorous mass in the subcutaneous fatty tissue.






    MRI 2 <- view MRI 2

    MRI 2: T1-weighted image; transversal: about 3.5 x 1 x 3 cm hyperintense tumorous mass in the subcutaneous fatty tissue.

    Also in the T2-weighted image (no image): hyperintense. Due to the T2-weighted TSE sequence, no proof of liquid components (no image). No proof of a tethered cord.




    OP-Situs 1 <- view OP-Situs 1

    OP-Situs 1: Intraoperative Findings



    OP-Situs 2 <- view OP-Situs 2

    OP-Situs 2: Pre-operative Findings



    OP-Situs 3 <- view OP-Situs 3

    OP-Situs 3: Pre-operative Findings

     

     
     Pediatric Radiology CasesDiagnosis confirmation:

    N/A  

     
     Pediatric Radiology CasesWhich DD would be also possible with the radiological findings:

    Lipoma, lipomatous tumor in a meningocele  

     
     Pediatric Radiology CasesCourse / Prognosis / Frequency / Other :

    Rare, benign tumor with tendency for growth.
    Often, the hibernoma is asymptomatic. Treatment: Surgical resection is suggested, although no tendency for malignancy has been noted. In complete resection no regression has been described.  

     
     Pediatric Radiology CasesComments of the author about the case:

    N/A  

     
     Pediatric Radiology CasesFirst description / History:

    N/A  

     
     Pediatric Radiology CasesLiterature:

    Hibernoma: A Case Report and Discussion of a Rare Tumor: KÖSEM,M.; Turk J Med Sci 25 (2001) 175-176
    Hibernoma: distinctive light and electon microscopic features and relationship to brown adipose tissue: GAFFNEY,EF; Hum Path. 1983 Aug; 14(8):677-87
    u.a.  

     
     Pediatric Radiology CasesKeywords:

    Hibernoma-gland, brown fatty tissue, lipoma  

     
     Pediatric Radiology Cases Cite this article:

    K Gerlach, H Bartsch. Hibernoma. PedRad [serial online] vol 5, no. 11.
    URL: www.PedRad.info/?search=20051108092638  

     
     Pediatric Radiology Cases Read similar articles: lipoma&type=1-17">corresponding keywords
    in the same field:
    or in the region:
    or in the tissue/organ:
    or with the etiology:
     
     Pediatric Radiology CasesImages to this case: There are MRI-images available for this case. [ MRI ] There are OP-Situs-images available for this case. [ OP-Situs ] View all modalities [ All ]   
     
    Hibernoma
    K Gerlach, H Bartsch. Hibernoma. PedRad [serial online] vol 5, no. 11.
    URL: www.PedRad.info/?search=20051108092638


     

    Search similar cases in:
    More links about this topic on Pubmed  More links about this topic on Yahoo  More links about this topic on Altavista  More links about this topic on MSN  More links about this topic on Google  More links about this topic on Fireball

    Peer-reviewed Radiology Search



    Hibernoma
    Other cases by these authors:

    Search Kraig J. Lage in Medline Kraig J. Lage (1)   
    Search Achint K Singh in Medline Achint K Singh (17)   
    Search Sanjeeb Kumar Sarma in Medline Sanjeeb Kumar Sarma (24)   
    Search GS Ahmed in Medline GS Ahmed (1)   
    Search Johannes Gossner in Medline Johannes Gossner (18)   
    Search Galea Janabel in Medline Galea Janabel (17)   
    Search Samuel Stafrace in Medline Samuel Stafrace (3)   
    Search Karen Duncan in Medline Karen Duncan (1)   
    Search Lena Crichton in Medline Lena Crichton (1)   
    Search Dirk Schaper in Medline Dirk Schaper (59)   
    Search P. Göbel in Medline P. Göbel (6)   
    Search Dirk Schaper in Medline Dirk Schaper (59)   
    Search Dirk Schaper in Medline Dirk Schaper (59)   
    Search Dirk Schaper in Medline Dirk Schaper (59)   
    Search K. Gerlach in Medline K. Gerlach (21)   
    Search H. Bartsch in Medline H. Bartsch (1)   

    Hibernoma  
     
    Hibernoma
    K Gerlach, H Bartsch. Hibernoma. PedRad [serial online] vol 5, no. 11.
    URL: www.PedRad.info/?search=20051108092638


     

    Which diagnosis have other collegues guessed?


    • IRDS
      Votes: 1 (2 %)


    • Pneumothorax with pneumomediastinum
      Votes: 28 (80 %)


    • Pneumonia
      Votes: 1 (2 %)


    • Child abuse
      Votes: 1 (2 %)


    • Ebstein anomaly
      Votes: 4 (11 %)


    • Lymphangioleiomyoma with Intussusception
      Votes: 5 (10 %)


    • Burkitt-Lymphoma
      Votes: 6 (12 %)


    • Simple Intussusception
      Votes: 0 (0 %)


    • Ganglioneuroma of the Intestines with Intussusception
      Votes: 2 (4 %)


    • Gut Duplication
      Votes: 0 (0 %)


    • Crohn's Disease
      Votes: 0 (0 %)


    • Cholecystitis
      Votes: 0 (0 %)


    • Hemorrhage into the liver
      Votes: 0 (0 %)


    • Adrenal adenoma
      Votes: 0 (0 %)


    • Bilirubin gallblader stone
      Votes: 23 (31 %)


    • Cholangiocarcinoma
      Votes: 1 (1 %)


    • Nuk cyst
      Votes: 2 (2 %)


    • Spermatocele
      Votes: 9 (10 %)


    • Hydatide
      Votes: 1 (1 %)


    • Leydig Cell Tumor
      Votes: 0 (0 %)


    • Rhabdomyosarcoma
      Votes: 0 (0 %)


    • Hydrocele
      Votes: 5 (5 %)


    • Crohn's Disease
      Votes: 0 (0 %)


    • Ulcerative colitis
      Votes: 1 (0 %)


    • Temporary Obstruction of the Appendix
      Votes: 10 (9 %)


    • Meckel's Diverticulum
      Votes: 5 (4 %)


    • uncomplicated lipoma
      Votes: 9 (7 %)


    • neurofibroma
      Votes: 0 (0 %)


    • rhabdomyosarcoma
      Votes: 0 (0 %)


    • hibernoma
      Votes: 7 (5 %)


    • dermoid cyst
      Votes: 0 (0 %)



        Total answers: 121

     
    Hibernoma
    K Gerlach, H Bartsch. Hibernoma. PedRad [serial online] vol 5, no. 11.
    URL: www.PedRad.info/?search=20051108092638


     

    Medical Dictionary
    Search in medical dictionary for
    Or type in a keyword
    ( Provided by The On-Line Medical Dictionary )




    1 = less interesting)
     
    Hibernoma
    K Gerlach, H Bartsch. Hibernoma. PedRad [serial online] vol 5, no. 11.
    URL: www.PedRad.info/?search=20051108092638


     


    Go to the top of the page   ID: 20051005175954 Original case in english  More links about this topic on Pubmed (PubMed Reader)
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    Discussion
     
    Xanthogranulomatous Pyelonephritis
    M Zieger. Xanthogranulomatous Pyelonephritis. PedRad [serial online] vol 5, no. 10.
    URL: www.PedRad.info/?search=20051005175954


     
     Pediatric Radiology CasesImages to this case: There are Ultrasound-images available for this case. [ Ultrasound ] There are OP-Situs-images available for this case. [ OP-Situs ] View all modalities [ All ]   
     Pediatric Radiology CasesAuthor/s:

    M. Zieger (Radiologisches Institut Olgahospital Stuttgart Deutschland)  

     
     Pediatric Radiology CasesEmail Address:

    Viewable for logged on visitors (Log on)  

     
     Pediatric Radiology CasesAge:

    3 Years  

     
     Pediatric Radiology CasesGender:

    Male  

     
     Pediatric Radiology CasesRegion-Organ:

    N/A  

     
     Pediatric Radiology CasesMost likely etiology:

    N/A  

     
     Pediatric Radiology CasesHistory:

    3.5 year old boy, "never been sick until now".
    Feels fatigued for the last few weeks with leg and abdominal pain. Oral antibiotic therapy without success. Urine after urinary catheterization sterile.  

     
     Pediatric Radiology CasesPathomorphology or Pathophysiology of this disease :

    The etiology is uncler, but chronic obstructions with infections are commonly seen. Calcifications are seen in 80% of the patients. Xanthogranulomatous pyelonephritis is often associated with diabetes or immunocomprimised patients, maybe even fatty acid metabolic disorders.
    Pathology:
    Localized tissue destruction, circumducted infiltration is possible. The process holds yellowish tissiue with necroses and hemorrhages.
    Microscopically, there are spongy, fat-laden macrophages and chronic and acute inflammatory responses at the same time.  

     
     Pediatric Radiology CasesRadiological findings:


    X-Ray 1 <- view X-Ray 1

    X-Ray 1: Large lucency surrounds the superior mediastinum with lucency crossing midline. Subtle lucency is also seen inferior and lateral of the right lung base at the costophrenic angle and hemidiaphragm.





    X-Ray 2 <- view X-Ray 2

    X-Ray 2: Large lucency surrounds the superior aspect of the anterior mediastinum with elevation of the thymic shadow.




    MRI 1 <- view MRI 1

    MRI 1: T1W MRI showing hyperintense mass in right CP angle cistern extending into the internal auditory canal.




    MRI 2 <- view MRI 2

    MRI 2: T2W MRI showing hyperintense mass with splaying of 7th and 8th cranial nerves.




    MRI 3 <- view MRI 3

    MRI 3: T1W post gadolinium fat suppressed image showing nonenhancing mass with fat suppression.




    MRI 1 <- view MRI 1

    MRI 1: Axial T1WI showing dilated and separated ventricles with bilateral fronto-parietal encephalomalacic changes.





    MRI 2 <- view MRI 2

    MRI 2: Coronal T1WI showing absent corpus callosum with dilated ventricles and bilateral fronto-parietal encephalomalacea.





    MRI 3 <- view MRI 3

    MRI 3: Coronal T1WI showing colpocephaly.





    MRI 4 <- view MRI 4

    MRI 4: Sagittal T1WI showing complete absence of corpus callosum with encephalomalacic changes involving fronto-parietal white matter.





    MRI 5 <- view MRI 5

    MRI 5: Axial T2WI showing dilated ventricles with bilateral encephalomalacic changes.





    MRI 6 <- view MRI 6

    MRI 6: Axial T2WI showing absence corpus callosum more clearly.





    MRI 7 <- view MRI 7

    MRI 7: Coronal FLAIR image showing similar findings to coronal T1WI.




    CT 1 <- view CT 1

    CT 1: Axial neck CT in lung window: There is an extensive soft tissue emphysema, which extends from the neck to mediastinum and into the chest wall.




    CT 2 <- view CT 2

    CT 2: Coronal reconstruction of a neck CT in lung window:
    Coronal reconstructed images demonstrate an extensive soft tissue emphysema, which extends from the neck to mediastinum and into the chest wall.





    CT 3 <- view CT 3

    CT 3: Magnified view of an axial neck CT in lung window:
    Visible defect in the pars membranacea (arrow). Endotracheal tube is in place with extensive air in the soft tissues.




    Ultrasound 1 <- view Ultrasound 1

    Ultrasound 1: Coronal image of the chest and abdomen showing hypoechoic areas in the region of the lower chest bilaterally in keeping with cysts.






    MRI 1 <- view MRI 1

    MRI 1: (Axial T2 weighted SSFSE) Shows a large high signal mass located within the lower right lung with cysts of various sizes within it with herniation of one of the cysts to the left behind the heart. Low signal flow voids represent vessels within the mass. The heart is shifted to the left and the contralateral lung is compressed by the mass.





    MRI 2 <- view MRI 2

    MRI 2: (Coronal T2 weighted SSFSE) Demonstrates the mass on the coronal plane. Note the small area of normal right lung at the apex and the compressed left lung. Both these are of slightly lower signal than the cystic mass on T2.





    MRI 3 <- view MRI 3

    MRI 3: (Coronal T1 weighted) Demonstrates the cyctic mass to be of low signal on T1. The higher signal just below the mass on this image represents the normal liver.





    Ultrasound 1 <- view Ultrasound 1

    Ultrasound 1: RUQ transverse: 42x30 mm in size, irregularly marked, non-echo-free mass with incomplete, gechogenic edge. Changes position on breathing in the area of the right colonic flexure.





    Ultrasound 2 <- view Ultrasound 2

    Ultrasound 2: RUQ longitudinal: Same mass in power-mode. Homogenic vasculature, therefore not a cystic process.





    Ultrasound 3 <- view Ultrasound 3

    Ultrasound 3: RUQ diagonal: Questionable localization of the mass (in the gut?) which has a stalk-like structure. At the lower edge one got the impression that there was a intussception "bulls-eye," which was not able to be completely visualized.





    Ultrasound 4 <- view Ultrasound 4

    Ultrasound 4: RUQ diagonal: Visualization of the vessel's stalk and the branching within the mass.





    Ultrasound 5 <- view Ultrasound 5

    Ultrasound 5: RUQ transverse, paramedian: Obvious lymph node swelling medial to the mass.





    OP-Situs 1 <- view OP-Situs 1

    OP-Situs 1: Palpable tumor in the cecum.




    OP-Situs 2 <- view OP-Situs 2

    OP-Situs 2: Ileocecal transition. Lymph node in the foreground, tweezers in the partly intusscepted ileum in the cecum.




    OP-Situs 3 <- view OP-Situs 3

    OP-Situs 3: Intraoperative: Determination of the resection's edges.




    OP-Situs 4 <- view OP-Situs 4

    OP-Situs 4: Specimen luxated out of the cecum.


    Ultrasound 1 <- view Ultrasound 1

    Ultrasound 1: Right upper quadrant, echogenic, partially echo mixed 18x36mm large structure in an echo-free environment subhepatic, with irregular surface.





    Ultrasound 2 <- view Ultrasound 2

    Ultrasound 2: Dito, longitudinal view with significantly irregular surface.





    Ultrasound 3 <- view Ultrasound 3

    Ultrasound 3: 8 months later, sharply demarkated structure with clear shadowing 24x37mm.





    Ultrasound 4 <- view Ultrasound 4

    Ultrasound 4: Same structure with good mobility upon changing the patient's position.



    Ultrasound 1 <- view Ultrasound 1

    Ultrasound 1: 10x6mm large, echoless mass in the upper testicular pole/head of the epididymis.





    Ultrasound 2 <- view Ultrasound 2

    Ultrasound 2: Shown are two echoless masses at the head of the epididymis. 8x6mm and 11x7mm





    Ultrasound 3 <- view Ultrasound 3

    Ultrasound 3: Echoless mass at the upper pole of the testes.



    Ultrasound 1 <- view Ultrasound 1

    Ultrasound 1: Initial sonographic examination: right lower quadrant (RLQ), tubular swollen, non-echogenic structure with echogenic, intermittent internal echoes. Non-compressable, no compression pain with transducer. In the longitudinal and transverse views, composition of the walls are well-differentiated.





    Ultrasound 2 <- view Ultrasound 2

    Ultrasound 2: Initial sonographic examination: Bulls-eye in the RLQ with well-differentiated walls (base area)





    Ultrasound 3 <- view Ultrasound 3

    Ultrasound 3: Initial sonographic examination: Longitudinal image of the tubular structure, which becomes narrower more medially. (base)





    Ultrasound 4 <- view Ultrasound 4

    Ultrasound 4: Sonographic examination 3 days later: Tubular structure with normal wall structure.





    Ultrasound 5 <- view Ultrasound 5

    Ultrasound 5: Sonographic examination 3 days later: Transverse view of a bulls-eye structure which is near the cecum with normal wall structure 5.7 mm (base)





    Ultrasound 6 <- view Ultrasound 6

    Ultrasound 6: Follow-up examination after 7 days: Longitudinal view with a tubular, swollen structure with echogenic contents. Somewhat compressable, layers of the walls normal.





    Ultrasound 7 <- view Ultrasound 7

    Ultrasound 7: Follow-up examination after 7 days: Longitudinal and transverse views of the same structure.



    MRI 1 <- view MRI 1

    MRI 1: T1-weighted image, sagittal: about 3.5 x 1 x 3 cm hyperintense tumorous mass in the subcutaneous fatty tissue.






    MRI 2 <- view MRI 2

    MRI 2: T1-weighted image; transversal: about 3.5 x 1 x 3 cm hyperintense tumorous mass in the subcutaneous fatty tissue.

    Also in the T2-weighted image (no image): hyperintense. Due to the T2-weighted TSE sequence, no proof of liquid components (no image). No proof of a tethered cord.




    OP-Situs 1 <- view OP-Situs 1

    OP-Situs 1: Intraoperative Findings



    OP-Situs 2 <- view OP-Situs 2

    OP-Situs 2: Pre-operative Findings



    OP-Situs 3 <- view OP-Situs 3

    OP-Situs 3: Pre-operative Findings


    Ultrasound 1 <- view Ultrasound 1

    Ultrasound 1: Nephromegaly, Calcifications with acoustic shadowing, calyectasia, lymphnodes in the renal hilus. The renal configuration is normal, but there are abscess-like lesions (nephromegaly in papillary region, the renal cortex is maintained).



    Ultrasound 2 <- view Ultrasound 2

    Ultrasound 2: Renal hilus transversal:
    enlarged lymphnodes



    Ultrasound 3 <- view Ultrasound 3

    Ultrasound 3: Overview kidney:
    Nephromegaly, Calcifications with acoustic shadowing, calyectasia, lymph nodes in the renal hilus. The renal configuration is normal, but there are abscess-like lesions (in papillary region, the renal cortex is maintained).




    Ultrasound 4 <- view Ultrasound 4

    Ultrasound 4: Detailed image of the parenchymal structure





    OP-Situs 1 <- view OP-Situs 1

    OP-Situs 1: Renal situs opened longitudinal

     

     
     Pediatric Radiology CasesDiagnosis confirmation:

    N/A  

     
     Pediatric Radiology CasesWhich DD would be also possible with the radiological findings:

    Tumor  

     
     Pediatric Radiology CasesCourse / Prognosis / Frequency / Other :

    Surgery: Nephrectomy  

     
     Pediatric Radiology CasesComments of the author about the case:

    N/A  

     
     Pediatric Radiology CasesFirst description / History:

    1916 by Schlagenhaufer
    “Über eigentümliche Staphylmykosen der Nieren und des pararenalen Bindegewebes” 1916; 19: 139-48 Frankfurt Z Pathol  

     
     Pediatric Radiology CasesLiterature:

    N/A  

     
     Pediatric Radiology CasesKeywords:

    Kidney, Kidneys, Xanthogranuloma , Pyelonephritis, xanthogranulomatous Pyelonephritis, inflammation of the Kidney  

     
     Pediatric Radiology Cases Cite this article:

    M Zieger. Xanthogranulomatous Pyelonephritis. PedRad [serial online] vol 5, no. 10.
    URL: www.PedRad.info/?search=20051005175954  

     
     Pediatric Radiology Cases Read similar articles: inflammation of the Kidney &type=1-17">corresponding keywords
    in the same field:
    or in the region:
    or in the tissue/organ:
    or with the etiology:
     
     Pediatric Radiology CasesImages to this case: There are Ultrasound-images available for this case. [ Ultrasound ] There are OP-Situs-images available for this case. [ OP-Situs ] View all modalities [ All ]   
     
    Xanthogranulomatous Pyelonephritis
    M Zieger. Xanthogranulomatous Pyelonephritis. PedRad [serial online] vol 5, no. 10.
    URL: www.PedRad.info/?search=20051005175954


     

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    Xanthogranulomatous Pyelonephritis  
     
    Xanthogranulomatous Pyelonephritis
    M Zieger. Xanthogranulomatous Pyelonephritis. PedRad [serial online] vol 5, no. 10.
    URL: www.PedRad.info/?search=20051005175954


     

    Which diagnosis have other collegues guessed?


    • IRDS
      Votes: 1 (2 %)


    • Pneumothorax with pneumomediastinum
      Votes: 28 (80 %)


    • Pneumonia
      Votes: 1 (2 %)


    • Child abuse
      Votes: 1 (2 %)


    • Ebstein anomaly
      Votes: 4 (11 %)


    • Lymphangioleiomyoma with Intussusception
      Votes: 5 (10 %)


    • Burkitt-Lymphoma
      Votes: 6 (12 %)


    • Simple Intussusception
      Votes: 0 (0 %)


    • Ganglioneuroma of the Intestines with Intussusception
      Votes: 2 (4 %)


    • Gut Duplication
      Votes: 0 (0 %)


    • Crohn's Disease
      Votes: 0 (0 %)


    • Cholecystitis
      Votes: 0 (0 %)


    • Hemorrhage into the liver
      Votes: 0 (0 %)


    • Adrenal adenoma
      Votes: 0 (0 %)


    • Bilirubin gallblader stone
      Votes: 23 (31 %)


    • Cholangiocarcinoma
      Votes: 1 (1 %)


    • Nuk cyst
      Votes: 2 (2 %)


    • Spermatocele
      Votes: 9 (10 %)


    • Hydatide
      Votes: 1 (1 %)


    • Leydig Cell Tumor
      Votes: 0 (0 %)


    • Rhabdomyosarcoma
      Votes: 0 (0 %)


    • Hydrocele
      Votes: 5 (5 %)


    • Crohn's Disease
      Votes: 0 (0 %)


    • Ulcerative colitis
      Votes: 1 (0 %)


    • Temporary Obstruction of the Appendix
      Votes: 10 (9 %)


    • Meckel's Diverticulum
      Votes: 5 (4 %)


    • uncomplicated lipoma
      Votes: 9 (7 %)


    • neurofibroma
      Votes: 0 (0 %)


    • rhabdomyosarcoma
      Votes: 0 (0 %)


    • hibernoma
      Votes: 7 (5 %)


    • dermoid cyst
      Votes: 0 (0 %)


    • Nephroblastoma
      Votes: 2 (1 %)


    • Xanthogranulomatous Pyelonephritis
      Votes: 14 (10 %)


    • Renal carcinoma
      Votes: 0 (0 %)


    • Refluxnephropathy
      Votes: 0 (0 %)


    • Glomerulonephritis
      Votes: 2 (1 %)



        Total answers: 139

     
    Xanthogranulomatous Pyelonephritis
    M Zieger. Xanthogranulomatous Pyelonephritis. PedRad [serial online] vol 5, no. 10.
    URL: www.PedRad.info/?search=20051005175954


     

    Medical Dictionary
    Search in medical dictionary for
    Or type in a keyword
    ( Provided by The On-Line Medical Dictionary )




    1 = less interesting)
     
    Xanthogranulomatous Pyelonephritis
    M Zieger. Xanthogranulomatous Pyelonephritis. PedRad [serial online] vol 5, no. 10.
    URL: www.PedRad.info/?search=20051005175954


     


    Go to the top of the page   ID: 20050916111510 Original case in english  More links about this topic on Pubmed (PubMed Reader)
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    Discussion
     
    Unilocular Congenital Hepatic Cyst
    Dirk Schaper, Y Riedel. Unilocular Congenital Hepatic Cyst. PedRad [serial online] vol 5, no. 9.
    URL: www.PedRad.info/?search=20050916111510


     
     Pediatric Radiology CasesImages to this case: There are Ultrasound-images available for this case. [ Ultrasound ] View all modalities [ All ]   
     Pediatric Radiology CasesAuthor/s:

    Dirk Schaper, Y. Riedel (Klinik für Kinderchirurgie Krankenhaus St. Elisabeth und St. Barbara Halle/Saale)  

     
     Pediatric Radiology CasesEmail Address:

    Viewable for logged on visitors (Log on)  

     
     Pediatric Radiology CasesAge:

    5 Months  

     
     Pediatric Radiology CasesGender:

    Male  

     
     Pediatric Radiology CasesRegion-Organ:

    N/A  

     
     Pediatric Radiology CasesMost likely etiology:

    N/A  

     
     Pediatric Radiology CasesHistory:

    5 Month old male baby without symptoms. Incidental finding during screening sonography.  

     
     Pediatric Radiology CasesPathomorphology or Pathophysiology of this disease :

    N/A  

     
     Pediatric Radiology CasesRadiological findings:


    X-Ray 1 <- view X-Ray 1

    X-Ray 1: Large lucency surrounds the superior mediastinum with lucency crossing midline. Subtle lucency is also seen inferior and lateral of the right lung base at the costophrenic angle and hemidiaphragm.





    X-Ray 2 <- view X-Ray 2

    X-Ray 2: Large lucency surrounds the superior aspect of the anterior mediastinum with elevation of the thymic shadow.




    MRI 1 <- view MRI 1

    MRI 1: T1W MRI showing hyperintense mass in right CP angle cistern extending into the internal auditory canal.




    MRI 2 <- view MRI 2

    MRI 2: T2W MRI showing hyperintense mass with splaying of 7th and 8th cranial nerves.




    MRI 3 <- view MRI 3

    MRI 3: T1W post gadolinium fat suppressed image showing nonenhancing mass with fat suppression.




    MRI 1 <- view MRI 1

    MRI 1: Axial T1WI showing dilated and separated ventricles with bilateral fronto-parietal encephalomalacic changes.





    MRI 2 <- view MRI 2

    MRI 2: Coronal T1WI showing absent corpus callosum with dilated ventricles and bilateral fronto-parietal encephalomalacea.





    MRI 3 <- view MRI 3

    MRI 3: Coronal T1WI showing colpocephaly.





    MRI 4 <- view MRI 4

    MRI 4: Sagittal T1WI showing complete absence of corpus callosum with encephalomalacic changes involving fronto-parietal white matter.





    MRI 5 <- view MRI 5

    MRI 5: Axial T2WI showing dilated ventricles with bilateral encephalomalacic changes.





    MRI 6 <- view MRI 6

    MRI 6: Axial T2WI showing absence corpus callosum more clearly.





    MRI 7 <- view MRI 7

    MRI 7: Coronal FLAIR image showing similar findings to coronal T1WI.




    CT 1 <- view CT 1

    CT 1: Axial neck CT in lung window: There is an extensive soft tissue emphysema, which extends from the neck to mediastinum and into the chest wall.




    CT 2 <- view CT 2

    CT 2: Coronal reconstruction of a neck CT in lung window:
    Coronal reconstructed images demonstrate an extensive soft tissue emphysema, which extends from the neck to mediastinum and into the chest wall.





    CT 3 <- view CT 3

    CT 3: Magnified view of an axial neck CT in lung window:
    Visible defect in the pars membranacea (arrow). Endotracheal tube is in place with extensive air in the soft tissues.




    Ultrasound 1 <- view Ultrasound 1

    Ultrasound 1: Coronal image of the chest and abdomen showing hypoechoic areas in the region of the lower chest bilaterally in keeping with cysts.






    MRI 1 <- view MRI 1

    MRI 1: (Axial T2 weighted SSFSE) Shows a large high signal mass located within the lower right lung with cysts of various sizes within it with herniation of one of the cysts to the left behind the heart. Low signal flow voids represent vessels within the mass. The heart is shifted to the left and the contralateral lung is compressed by the mass.





    MRI 2 <- view MRI 2

    MRI 2: (Coronal T2 weighted SSFSE) Demonstrates the mass on the coronal plane. Note the small area of normal right lung at the apex and the compressed left lung. Both these are of slightly lower signal than the cystic mass on T2.





    MRI 3 <- view MRI 3

    MRI 3: (Coronal T1 weighted) Demonstrates the cyctic mass to be of low signal on T1. The higher signal just below the mass on this image represents the normal liver.





    Ultrasound 1 <- view Ultrasound 1

    Ultrasound 1: RUQ transverse: 42x30 mm in size, irregularly marked, non-echo-free mass with incomplete, gechogenic edge. Changes position on breathing in the area of the right colonic flexure.





    Ultrasound 2 <- view Ultrasound 2

    Ultrasound 2: RUQ longitudinal: Same mass in power-mode. Homogenic vasculature, therefore not a cystic process.





    Ultrasound 3 <- view Ultrasound 3

    Ultrasound 3: RUQ diagonal: Questionable localization of the mass (in the gut?) which has a stalk-like structure. At the lower edge one got the impression that there was a intussception "bulls-eye," which was not able to be completely visualized.





    Ultrasound 4 <- view Ultrasound 4

    Ultrasound 4: RUQ diagonal: Visualization of the vessel's stalk and the branching within the mass.





    Ultrasound 5 <- view Ultrasound 5

    Ultrasound 5: RUQ transverse, paramedian: Obvious lymph node swelling medial to the mass.





    OP-Situs 1 <- view OP-Situs 1

    OP-Situs 1: Palpable tumor in the cecum.




    OP-Situs 2 <- view OP-Situs 2

    OP-Situs 2: Ileocecal transition. Lymph node in the foreground, tweezers in the partly intusscepted ileum in the cecum.




    OP-Situs 3 <- view OP-Situs 3

    OP-Situs 3: Intraoperative: Determination of the resection's edges.




    OP-Situs 4 <- view OP-Situs 4

    OP-Situs 4: Specimen luxated out of the cecum.


    Ultrasound 1 <- view Ultrasound 1

    Ultrasound 1: Right upper quadrant, echogenic, partially echo mixed 18x36mm large structure in an echo-free environment subhepatic, with irregular surface.





    Ultrasound 2 <- view Ultrasound 2

    Ultrasound 2: Dito, longitudinal view with significantly irregular surface.





    Ultrasound 3 <- view Ultrasound 3

    Ultrasound 3: 8 months later, sharply demarkated structure with clear shadowing 24x37mm.





    Ultrasound 4 <- view Ultrasound 4

    Ultrasound 4: Same structure with good mobility upon changing the patient's position.



    Ultrasound 1 <- view Ultrasound 1

    Ultrasound 1: 10x6mm large, echoless mass in the upper testicular pole/head of the epididymis.





    Ultrasound 2 <- view Ultrasound 2

    Ultrasound 2: Shown are two echoless masses at the head of the epididymis. 8x6mm and 11x7mm





    Ultrasound 3 <- view Ultrasound 3

    Ultrasound 3: Echoless mass at the upper pole of the testes.



    Ultrasound 1 <- view Ultrasound 1

    Ultrasound 1: Initial sonographic examination: right lower quadrant (RLQ), tubular swollen, non-echogenic structure with echogenic, intermittent internal echoes. Non-compressable, no compression pain with transducer. In the longitudinal and transverse views, composition of the walls are well-differentiated.





    Ultrasound 2 <- view Ultrasound 2

    Ultrasound 2: Initial sonographic examination: Bulls-eye in the RLQ with well-differentiated walls (base area)





    Ultrasound 3 <- view Ultrasound 3

    Ultrasound 3: Initial sonographic examination: Longitudinal image of the tubular structure, which becomes narrower more medially. (base)





    Ultrasound 4 <- view Ultrasound 4

    Ultrasound 4: Sonographic examination 3 days later: Tubular structure with normal wall structure.





    Ultrasound 5 <- view Ultrasound 5

    Ultrasound 5: Sonographic examination 3 days later: Transverse view of a bulls-eye structure which is near the cecum with normal wall structure 5.7 mm (base)





    Ultrasound 6 <- view Ultrasound 6

    Ultrasound 6: Follow-up examination after 7 days: Longitudinal view with a tubular, swollen structure with echogenic contents. Somewhat compressable, layers of the walls normal.





    Ultrasound 7 <- view Ultrasound 7

    Ultrasound 7: Follow-up examination after 7 days: Longitudinal and transverse views of the same structure.



    MRI 1 <- view MRI 1

    MRI 1: T1-weighted image, sagittal: about 3.5 x 1 x 3 cm hyperintense tumorous mass in the subcutaneous fatty tissue.






    MRI 2 <- view MRI 2

    MRI 2: T1-weighted image; transversal: about 3.5 x 1 x 3 cm hyperintense tumorous mass in the subcutaneous fatty tissue.

    Also in the T2-weighted image (no image): hyperintense. Due to the T2-weighted TSE sequence, no proof of liquid components (no image). No proof of a tethered cord.




    OP-Situs 1 <- view OP-Situs 1

    OP-Situs 1: Intraoperative Findings



    OP-Situs 2 <- view OP-Situs 2

    OP-Situs 2: Pre-operative Findings



    OP-Situs 3 <- view OP-Situs 3

    OP-Situs 3: Pre-operative Findings


    Ultrasound 1 <- view Ultrasound 1

    Ultrasound 1: Nephromegaly, Calcifications with acoustic shadowing, calyectasia, lymphnodes in the renal hilus. The renal configuration is normal, but there are abscess-like lesions (nephromegaly in papillary region, the renal cortex is maintained).



    Ultrasound 2 <- view Ultrasound 2

    Ultrasound 2: Renal hilus transversal:
    enlarged lymphnodes



    Ultrasound 3 <- view Ultrasound 3

    Ultrasound 3: Overview kidney:
    Nephromegaly, Calcifications with acoustic shadowing, calyectasia, lymph nodes in the renal hilus. The renal configuration is normal, but there are abscess-like lesions (in papillary region, the renal cortex is maintained).




    Ultrasound 4 <- view Ultrasound 4

    Ultrasound 4: Detailed image of the parenchymal structure





    OP-Situs 1 <- view OP-Situs 1

    OP-Situs 1: Renal situs opened longitudinal


    Ultrasound 1 <- view Ultrasound 1

    Ultrasound 1: Hypoechoic mass without contents within the parenchyma of liver segment VIII





    Ultrasound 2 <- view Ultrasound 2

    Ultrasound 2: Magnified view, no contents, smooth walls.





    Ultrasound 3 <- view Ultrasound 3

    Ultrasound 3: Demonstration in 2 views with size numbers.


     

     
     Pediatric Radiology CasesDiagnosis confirmation:

    N/A  

     
     Pediatric Radiology CasesWhich DD would be also possible with the radiological findings:

    Echinococcal cyst, hepatic abscess, hepatic hematoma  

     
     Pediatric Radiology CasesCourse / Prognosis / Frequency / Other :

    Sonographic follow-ups, since an increase in size has been described. Enlarging cysts may be sclerosed.  

     
     Pediatric Radiology CasesComments of the author about the case:

    N/A  

     
     Pediatric Radiology CasesFirst description / History:

    N/A  

     
     Pediatric Radiology CasesLiterature:

    20. Medline: Medline
    S. Reichel, G. Alzen, K. M. Keller, D. Weitzel
    Kongenitale solitäre Leberzyste
    Klin Pädiatr 2002; 214: 332-333  

     
     Pediatric Radiology CasesKeywords:

    hepatic, liver, cyst, congenital, unilocular, hepatic cyst, solitary hepatic cyst  

     
     Pediatric Radiology Cases Cite this article:

    Dirk Schaper, Y Riedel. Unilocular Congenital Hepatic Cyst. PedRad [serial online] vol 5, no. 9.
    URL: www.PedRad.info/?search=20050916111510  

     
     Pediatric Radiology Cases Read similar articles: solitary hepatic cyst&type=1-17">corresponding keywords
    in the same field:
    or in the region:
    or in the tissue/organ:
    or with the etiology:
     
     Pediatric Radiology CasesImages to this case: There are Ultrasound-images available for this case. [ Ultrasound ] View all modalities [ All ]   
     
    Unilocular Congenital Hepatic Cyst
    Dirk Schaper, Y Riedel. Unilocular Congenital Hepatic Cyst. PedRad [serial online] vol 5, no. 9.
    URL: www.PedRad.info/?search=20050916111510


     

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    Unilocular Congenital Hepatic Cyst
    Other cases by these authors:

    Search Kraig J. Lage in Medline Kraig J. Lage (1)   
    Search Achint K Singh in Medline Achint K Singh (17)   
    Search Sanjeeb Kumar Sarma in Medline Sanjeeb Kumar Sarma (24)   
    Search GS Ahmed in Medline GS Ahmed (1)   
    Search Johannes Gossner in Medline Johannes Gossner (18)   
    Search Galea Janabel in Medline Galea Janabel (17)   
    Search Samuel Stafrace in Medline Samuel Stafrace (3)   
    Search Karen Duncan in Medline Karen Duncan (1)   
    Search Lena Crichton in Medline Lena Crichton (1)   
    Search Dirk Schaper in Medline Dirk Schaper (59)   
    Search P. Göbel in Medline P. Göbel (6)   
    Search Dirk Schaper in Medline Dirk Schaper (59)   
    Search Dirk Schaper in Medline Dirk Schaper (59)   
    Search Dirk Schaper in Medline Dirk Schaper (59)   
    Search K. Gerlach in Medline K. Gerlach (21)   
    Search H. Bartsch in Medline H. Bartsch (1)   
    Search M. Zieger in Medline M. Zieger (17)   
    Search Dirk Schaper in Medline Dirk Schaper (59)   
    Search Y. Riedel in Medline Y. Riedel (1)   

    Unilocular Congenital Hepatic Cyst  
     
    Unilocular Congenital Hepatic Cyst
    Dirk Schaper, Y Riedel. Unilocular Congenital Hepatic Cyst. PedRad [serial online] vol 5, no. 9.
    URL: www.PedRad.info/?search=20050916111510


     

    Which diagnosis have other collegues guessed?


    • IRDS
      Votes: 1 (2 %)


    • Pneumothorax with pneumomediastinum
      Votes: 28 (80 %)


    • Pneumonia
      Votes: 1 (2 %)


    • Child abuse
      Votes: 1 (2 %)


    • Ebstein anomaly
      Votes: 4 (11 %)


    • Lymphangioleiomyoma with Intussusception
      Votes: 5 (10 %)


    • Burkitt-Lymphoma
      Votes: 6 (12 %)


    • Simple Intussusception
      Votes: 0 (0 %)


    • Ganglioneuroma of the Intestines with Intussusception
      Votes: 2 (4 %)


    • Gut Duplication
      Votes: 0 (0 %)


    • Crohn's Disease
      Votes: 0 (0 %)


    • Cholecystitis
      Votes: 0 (0 %)


    • Hemorrhage into the liver
      Votes: 0 (0 %)


    • Adrenal adenoma
      Votes: 0 (0 %)


    • Bilirubin gallblader stone
      Votes: 23 (31 %)


    • Cholangiocarcinoma
      Votes: 1 (1 %)


    • Nuk cyst
      Votes: 2 (2 %)


    • Spermatocele
      Votes: 9 (10 %)


    • Hydatide
      Votes: 1 (1 %)


    • Leydig Cell Tumor
      Votes: 0 (0 %)


    • Rhabdomyosarcoma
      Votes: 0 (0 %)


    • Hydrocele
      Votes: 5 (5 %)


    • Crohn's Disease
      Votes: 0 (0 %)


    • Ulcerative colitis
      Votes: 1 (0 %)


    • Temporary Obstruction of the Appendix
      Votes: 10 (9 %)


    • Meckel's Diverticulum
      Votes: 5 (4 %)


    • uncomplicated lipoma
      Votes: 9 (7 %)


    • neurofibroma
      Votes: 0 (0 %)


    • rhabdomyosarcoma
      Votes: 0 (0 %)


    • hibernoma
      Votes: 7 (5 %)


    • dermoid cyst
      Votes: 0 (0 %)


    • Nephroblastoma
      Votes: 2 (1 %)


    • Xanthogranulomatous Pyelonephritis
      Votes: 14 (10 %)


    • Renal carcinoma
      Votes: 0 (0 %)


    • Refluxnephropathy
      Votes: 0 (0 %)


    • Glomerulonephritis
      Votes: 2 (1 %)


    • congenital hepatic cyst
      Votes: 6 (4 %)


    • echinococcal cyst
      Votes: 0 (0 %)


    • hepatoblastoma
      Votes: 0 (0 %)


    • nephroblastoma metastasis
      Votes: 0 (0 %)


    • liver abscess
      Votes: 1 (0 %)


    • hepatic hematoma
      Votes: 0 (0 %)



        Total answers: 146

     
    Unilocular Congenital Hepatic Cyst
    Dirk Schaper, Y Riedel. Unilocular Congenital Hepatic Cyst. PedRad [serial online] vol 5, no. 9.
    URL: www.PedRad.info/?search=20050916111510


     

    Medical Dictionary
    Search in medical dictionary for
    Or type in a keyword
    ( Provided by The On-Line Medical Dictionary )




    1 = less interesting)
     
    Unilocular Congenital Hepatic Cyst
    Dirk Schaper, Y Riedel. Unilocular Congenital Hepatic Cyst. PedRad [serial online] vol 5, no. 9.
    URL: www.PedRad.info/?search=20050916111510


     


    Go to the top of the page   ID: 20050715104508 Original case in english  More links about this topic on Pubmed (PubMed Reader)
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    Discussion
     
    Epididymal Cyst with Testicular Retention, Hydatid and Hydrocele
    Dirk Schaper, K Gerlach. Epididymal Cyst with Testicular Retention, Hydatid and Hydrocele. PedRad [serial online] vol 5, no. 7.
    URL: www.PedRad.info/?search=20050715104508


     
     Pediatric Radiology CasesImages to this case: There are Ultrasound-images available for this case. [ Ultrasound ] There are OP-Situs-images available for this case. [ OP-Situs ] View all modalities [ All ]   
     Pediatric Radiology CasesAuthor/s:

    Dirk Schaper, K. Gerlach (Klinik für Kinderchirurgie Krankenhaus St. Elisabeth und St. Barbara Halle/S.)  

     
     Pediatric Radiology CasesEmail Address:

    Viewable for logged on visitors (Log on)  

     
     Pediatric Radiology CasesAge:

    8 Weeks  

     
     Pediatric Radiology CasesGender:

    Male  

     
     Pediatric Radiology CasesRegion-Organ:

    N/A  

     
     Pediatric Radiology CasesMost likely etiology:

    N/A  

     
     Pediatric Radiology CasesHistory:

    Presentation because of retention of the testes at 8 weeks of age. Right hemiscrotum was hypoplastic, the testis itself is, however, well-palpated in the right inguinal region. There is somewhat resistence. On the other side, the scrotum is well-developed with discrete testicular hydrocele. Beta-HCG and Alpha-Fetoprotein were unremarkable.  

     
     Pediatric Radiology CasesPathomorphology or Pathophysiology of this disease :

    Epididymal cysts are generally benign and spontaneously regress. They are often a chance finding of a sonographic examination of the male genitalia. They can, however, cause symptoms - especially when they are large and give the patient a weighted-down feeling. One finds epididymal cysts in children whose mothers were treated with Diethylstilbestrol (DES). But also children who have testicular retention, cystic fibrosis and von Hippel-Lindau's Disease have increased incidence of epididymal cysts. A connection with the autosomal-dominant passed on disease of Polycystic Kidney Disease is being discussed.
    Wollin et al. saw developmental rudimentary structures of the epididymis which had no connection to the tubule system of the epididymis.
    Others see a hormonal cause as a leading cause and categorize the epididymal cyst as a testicular dysgenesis.
    The increased incidence in connection to a maldescendent testis is not able to be explained at this time. How epididymal obstruction or an abnormal hormonal reaction are the causes is still unclear.  

     
     Pediatric Radiology CasesRadiological findings:


    X-Ray 1 <- view X-Ray 1

    X-Ray 1: Large lucency surrounds the superior mediastinum with lucency crossing midline. Subtle lucency is also seen inferior and lateral of the right lung base at the costophrenic angle and hemidiaphragm.





    X-Ray 2 <- view X-Ray 2

    X-Ray 2: Large lucency surrounds the superior aspect of the anterior mediastinum with elevation of the thymic shadow.




    MRI 1 <- view MRI 1

    MRI 1: T1W MRI showing hyperintense mass in right CP angle cistern extending into the internal auditory canal.




    MRI 2 <- view MRI 2

    MRI 2: T2W MRI showing hyperintense mass with splaying of 7th and 8th cranial nerves.




    MRI 3 <- view MRI 3

    MRI 3: T1W post gadolinium fat suppressed image showing nonenhancing mass with fat suppression.




    MRI 1 <- view MRI 1

    MRI 1: Axial T1WI showing dilated and separated ventricles with bilateral fronto-parietal encephalomalacic changes.





    MRI 2 <- view MRI 2

    MRI 2: Coronal T1WI showing absent corpus callosum with dilated ventricles and bilateral fronto-parietal encephalomalacea.





    MRI 3 <- view MRI 3

    MRI 3: Coronal T1WI showing colpocephaly.





    MRI 4 <- view MRI 4

    MRI 4: Sagittal T1WI showing complete absence of corpus callosum with encephalomalacic changes involving fronto-parietal white matter.





    MRI 5 <- view MRI 5

    MRI 5: Axial T2WI showing dilated ventricles with bilateral encephalomalacic changes.





    MRI 6 <- view MRI 6

    MRI 6: Axial T2WI showing absence corpus callosum more clearly.





    MRI 7 <- view MRI 7

    MRI 7: Coronal FLAIR image showing similar findings to coronal T1WI.




    CT 1 <- view CT 1

    CT 1: Axial neck CT in lung window: There is an extensive soft tissue emphysema, which extends from the neck to mediastinum and into the chest wall.




    CT 2 <- view CT 2

    CT 2: Coronal reconstruction of a neck CT in lung window:
    Coronal reconstructed images demonstrate an extensive soft tissue emphysema, which extends from the neck to mediastinum and into the chest wall.





    CT 3 <- view CT 3

    CT 3: Magnified view of an axial neck CT in lung window:
    Visible defect in the pars membranacea (arrow). Endotracheal tube is in place with extensive air in the soft tissues.




    Ultrasound 1 <- view Ultrasound 1

    Ultrasound 1: Coronal image of the chest and abdomen showing hypoechoic areas in the region of the lower chest bilaterally in keeping with cysts.






    MRI 1 <- view MRI 1

    MRI 1: (Axial T2 weighted SSFSE) Shows a large high signal mass located within the lower right lung with cysts of various sizes within it with herniation of one of the cysts to the left behind the heart. Low signal flow voids represent vessels within the mass. The heart is shifted to the left and the contralateral lung is compressed by the mass.





    MRI 2 <- view MRI 2

    MRI 2: (Coronal T2 weighted SSFSE) Demonstrates the mass on the coronal plane. Note the small area of normal right lung at the apex and the compressed left lung. Both these are of slightly lower signal than the cystic mass on T2.





    MRI 3 <- view MRI 3

    MRI 3: (Coronal T1 weighted) Demonstrates the cyctic mass to be of low signal on T1. The higher signal just below the mass on this image represents the normal liver.





    Ultrasound 1 <- view Ultrasound 1

    Ultrasound 1: RUQ transverse: 42x30 mm in size, irregularly marked, non-echo-free mass with incomplete, gechogenic edge. Changes position on breathing in the area of the right colonic flexure.





    Ultrasound 2 <- view Ultrasound 2

    Ultrasound 2: RUQ longitudinal: Same mass in power-mode. Homogenic vasculature, therefore not a cystic process.





    Ultrasound 3 <- view Ultrasound 3

    Ultrasound 3: RUQ diagonal: Questionable localization of the mass (in the gut?) which has a stalk-like structure. At the lower edge one got the impression that there was a intussception "bulls-eye," which was not able to be completely visualized.





    Ultrasound 4 <- view Ultrasound 4

    Ultrasound 4: RUQ diagonal: Visualization of the vessel's stalk and the branching within the mass.





    Ultrasound 5 <- view Ultrasound 5

    Ultrasound 5: RUQ transverse, paramedian: Obvious lymph node swelling medial to the mass.





    OP-Situs 1 <- view OP-Situs 1

    OP-Situs 1: Palpable tumor in the cecum.




    OP-Situs 2 <- view OP-Situs 2

    OP-Situs 2: Ileocecal transition. Lymph node in the foreground, tweezers in the partly intusscepted ileum in the cecum.




    OP-Situs 3 <- view OP-Situs 3

    OP-Situs 3: Intraoperative: Determination of the resection's edges.




    OP-Situs 4 <- view OP-Situs 4

    OP-Situs 4: Specimen luxated out of the cecum.


    Ultrasound 1 <- view Ultrasound 1

    Ultrasound 1: Right upper quadrant, echogenic, partially echo mixed 18x36mm large structure in an echo-free environment subhepatic, with irregular surface.





    Ultrasound 2 <- view Ultrasound 2

    Ultrasound 2: Dito, longitudinal view with significantly irregular surface.





    Ultrasound 3 <- view Ultrasound 3

    Ultrasound 3: 8 months later, sharply demarkated structure with clear shadowing 24x37mm.





    Ultrasound 4 <- view Ultrasound 4

    Ultrasound 4: Same structure with good mobility upon changing the patient's position.



    Ultrasound 1 <- view Ultrasound 1

    Ultrasound 1: 10x6mm large, echoless mass in the upper testicular pole/head of the epididymis.





    Ultrasound 2 <- view Ultrasound 2

    Ultrasound 2: Shown are two echoless masses at the head of the epididymis. 8x6mm and 11x7mm





    Ultrasound 3 <- view Ultrasound 3

    Ultrasound 3: Echoless mass at the upper pole of the testes.



    Ultrasound 1 <- view Ultrasound 1

    Ultrasound 1: Initial sonographic examination: right lower quadrant (RLQ), tubular swollen, non-echogenic structure with echogenic, intermittent internal echoes. Non-compressable, no compression pain with transducer. In the longitudinal and transverse views, composition of the walls are well-differentiated.





    Ultrasound 2 <- view Ultrasound 2

    Ultrasound 2: Initial sonographic examination: Bulls-eye in the RLQ with well-differentiated walls (base area)





    Ultrasound 3 <- view Ultrasound 3

    Ultrasound 3: Initial sonographic examination: Longitudinal image of the tubular structure, which becomes narrower more medially. (base)





    Ultrasound 4 <- view Ultrasound 4

    Ultrasound 4: Sonographic examination 3 days later: Tubular structure with normal wall structure.





    Ultrasound 5 <- view Ultrasound 5

    Ultrasound 5: Sonographic examination 3 days later: Transverse view of a bulls-eye structure which is near the cecum with normal wall structure 5.7 mm (base)





    Ultrasound 6 <- view Ultrasound 6

    Ultrasound 6: Follow-up examination after 7 days: Longitudinal view with a tubular, swollen structure with echogenic contents. Somewhat compressable, layers of the walls normal.





    Ultrasound 7 <- view Ultrasound 7

    Ultrasound 7: Follow-up examination after 7 days: Longitudinal and transverse views of the same structure.



    MRI 1 <- view MRI 1

    MRI 1: T1-weighted image, sagittal: about 3.5 x 1 x 3 cm hyperintense tumorous mass in the subcutaneous fatty tissue.






    MRI 2 <- view MRI 2

    MRI 2: T1-weighted image; transversal: about 3.5 x 1 x 3 cm hyperintense tumorous mass in the subcutaneous fatty tissue.

    Also in the T2-weighted image (no image): hyperintense. Due to the T2-weighted TSE sequence, no proof of liquid components (no image). No proof of a tethered cord.




    OP-Situs 1 <- view OP-Situs 1

    OP-Situs 1: Intraoperative Findings



    OP-Situs 2 <- view OP-Situs 2

    OP-Situs 2: Pre-operative Findings



    OP-Situs 3 <- view OP-Situs 3

    OP-Situs 3: Pre-operative Findings


    Ultrasound 1 <- view Ultrasound 1

    Ultrasound 1: Nephromegaly, Calcifications with acoustic shadowing, calyectasia, lymphnodes in the renal hilus. The renal configuration is normal, but there are abscess-like lesions (nephromegaly in papillary region, the renal cortex is maintained).



    Ultrasound 2 <- view Ultrasound 2

    Ultrasound 2: Renal hilus transversal:
    enlarged lymphnodes



    Ultrasound 3 <- view Ultrasound 3

    Ultrasound 3: Overview kidney:
    Nephromegaly, Calcifications with acoustic shadowing, calyectasia, lymph nodes in the renal hilus. The renal configuration is normal, but there are abscess-like lesions (in papillary region, the renal cortex is maintained).




    Ultrasound 4 <- view Ultrasound 4

    Ultrasound 4: Detailed image of the parenchymal structure





    OP-Situs 1 <- view OP-Situs 1

    OP-Situs 1: Renal situs opened longitudinal


    Ultrasound 1 <- view Ultrasound 1

    Ultrasound 1: Hypoechoic mass without contents within the parenchyma of liver segment VIII





    Ultrasound 2 <- view Ultrasound 2

    Ultrasound 2: Magnified view, no contents, smooth walls.





    Ultrasound 3 <- view Ultrasound 3

    Ultrasound 3: Demonstration in 2 views with size numbers.



    Ultrasound 1 <- view Ultrasound 1

    Ultrasound 1: A mass which is low in echoes in the epididymal head in testicular retention and testicular hydrocele.





    Ultrasound 2 <- view Ultrasound 2

    Ultrasound 2: 6,3 x6,7 mm mass of the right epididymal head.





    Ultrasound 3 <- view Ultrasound 3

    Ultrasound 3: Opposite side you see a 1,5mm large structure by the epididymis which is free of echoes.





    Ultrasound 4 <- view Ultrasound 4

    Ultrasound 4: Opposite side you see a 1,5mm large structure by the epididymis which is free of echoes with a testicular hydrocele.





    OP-Situs 1 <- view OP-Situs 1

    OP-Situs 1: OP: intraoperative findings

     

     
     Pediatric Radiology CasesDiagnosis confirmation:

    N/A  

     
     Pediatric Radiology CasesWhich DD would be also possible with the radiological findings:

    Cystic teratoma, large hydatide, hudatide cyst  

     
     Pediatric Radiology CasesCourse / Prognosis / Frequency / Other :

    Because of the unclear mass and the danger of torsion with the testicular retention, we decided to operate. The epididymal cyst was scraped out, the hydatide was removed and the testes were pexated. We also found kidney tissue in the spermatic cord during surgery.
    The sonographically seen hydatide of the opposite side was not operated on.  

     
     Pediatric Radiology CasesComments of the author about the case:

    N/A  

     
     Pediatric Radiology CasesFirst description / History:

    N/A  

     
     Pediatric Radiology CasesLiterature:

    21. Medline: Medline
    Homayoon,K.,Suhre,Ch.D., Steinhardt,G.F.
    Epididymal Cysts in Children: Natural History.
    J Urol. 2004 Mar; 171(3): 1247-6

    22. Medline: Medline
    Wollin,M.,Marshall,F.F.,Fink,M.P.,Malhotra,R.,Diamond,D.A.
    Abberant epididymal tissue: a significant clinical entity.
    J Urol. 1987 138: 1247,  

     
     Pediatric Radiology CasesKeywords:

    Epididymis, Cyst, Testicular retention, Hydatide, Hydatid, Hydrocele, Retentio testis, Testis, Epididymal Cyst,Testicular Retention  

     
     Pediatric Radiology Cases Cite this article:

    Dirk Schaper, K Gerlach. Epididymal Cyst with Testicular Retention, Hydatid and Hydrocele. PedRad [serial online] vol 5, no. 7.
    URL: www.PedRad.info/?search=20050715104508  

     
     Pediatric Radiology Cases Read similar articles: Testicular Retention&type=1-17">corresponding keywords
    in the same field:
    or in the region:
    or in the tissue/organ:
    or with the etiology:
     
     Pediatric Radiology CasesImages to this case: There are Ultrasound-images available for this case. [ Ultrasound ] There are OP-Situs-images available for this case. [ OP-Situs ] View all modalities [ All ]   
     
    Epididymal Cyst with Testicular Retention, Hydatid and Hydrocele
    Dirk Schaper, K Gerlach. Epididymal Cyst with Testicular Retention, Hydatid and Hydrocele. PedRad [serial online] vol 5, no. 7.
    URL: www.PedRad.info/?search=20050715104508


     

    Search similar cases in:
    More links about this topic on Pubmed  More links about this topic on Yahoo  More links about this topic on Altavista  More links about this topic on MSN  More links about this topic on Google  More links about this topic on Fireball

    Peer-reviewed Radiology Search



    Epididymal Cyst with Testicular Retention, Hydatid and Hydrocele
    Other cases by these authors:

    Search Kraig J. Lage in Medline Kraig J. Lage (1)   
    Search Achint K Singh in Medline Achint K Singh (17)   
    Search Sanjeeb Kumar Sarma in Medline Sanjeeb Kumar Sarma (24)   
    Search GS Ahmed in Medline GS Ahmed (1)   
    Search Johannes Gossner in Medline Johannes Gossner (18)   
    Search Galea Janabel in Medline Galea Janabel (17)   
    Search Samuel Stafrace in Medline Samuel Stafrace (3)   
    Search Karen Duncan in Medline Karen Duncan (1)   
    Search Lena Crichton in Medline Lena Crichton (1)   
    Search Dirk Schaper in Medline Dirk Schaper (59)   
    Search P. Göbel in Medline P. Göbel (6)   
    Search Dirk Schaper in Medline Dirk Schaper (59)   
    Search Dirk Schaper in Medline Dirk Schaper (59)   
    Search Dirk Schaper in Medline Dirk Schaper (59)   
    Search K. Gerlach in Medline K. Gerlach (21)   
    Search H. Bartsch in Medline H. Bartsch (1)   
    Search M. Zieger in Medline M. Zieger (17)   
    Search Dirk Schaper in Medline Dirk Schaper (59)   
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    Search K. Gerlach in Medline K. Gerlach (5)   

    Epididymal Cyst with Testicular Retention, Hydatid and Hydrocele  
     
    Epididymal Cyst with Testicular Retention, Hydatid and Hydrocele
    Dirk Schaper, K Gerlach. Epididymal Cyst with Testicular Retention, Hydatid and Hydrocele. PedRad [serial online] vol 5, no. 7.
    URL: www.PedRad.info/?search=20050715104508


     

    Which diagnosis have other collegues guessed?


    • IRDS
      Votes: 1 (2 %)


    • Pneumothorax with pneumomediastinum
      Votes: 28 (80 %)


    • Pneumonia
      Votes: 1 (2 %)


    • Child abuse
      Votes: 1 (2 %)


    • Ebstein anomaly
      Votes: 4 (11 %)


    • Lymphangioleiomyoma with Intussusception
      Votes: 5 (10 %)


    • Burkitt-Lymphoma
      Votes: 6 (12 %)


    • Simple Intussusception
      Votes: 0 (0 %)


    • Ganglioneuroma of the Intestines with Intussusception
      Votes: 2 (4 %)


    • Gut Duplication
      Votes: 0 (0 %)


    • Crohn's Disease
      Votes: 0 (0 %)


    • Cholecystitis
      Votes: 0 (0 %)


    • Hemorrhage into the liver
      Votes: 0 (0 %)


    • Adrenal adenoma
      Votes: 0 (0 %)


    • Bilirubin gallblader stone
      Votes: 23 (31 %)


    • Cholangiocarcinoma
      Votes: 1 (1 %)


    • Nuk cyst
      Votes: 2 (2 %)


    • Spermatocele
      Votes: 9 (10 %)


    • Hydatide
      Votes: 1 (1 %)


    • Leydig Cell Tumor
      Votes: 0 (0 %)


    • Rhabdomyosarcoma
      Votes: 0 (0 %)


    • Hydrocele
      Votes: 5 (5 %)


    • Crohn's Disease
      Votes: 0 (0 %)


    • Ulcerative colitis
      Votes: 1 (0 %)


    • Temporary Obstruction of the Appendix
      Votes: 10 (9 %)


    • Meckel's Diverticulum
      Votes: 5 (4 %)


    • uncomplicated lipoma
      Votes: 9 (7 %)


    • neurofibroma
      Votes: 0 (0 %)


    • rhabdomyosarcoma
      Votes: 0 (0 %)


    • hibernoma
      Votes: 7 (5 %)


    • dermoid cyst
      Votes: 0 (0 %)


    • Nephroblastoma
      Votes: 2 (1 %)


    • Xanthogranulomatous Pyelonephritis
      Votes: 14 (10 %)


    • Renal carcinoma
      Votes: 0 (0 %)


    • Refluxnephropathy
      Votes: 0 (0 %)


    • Glomerulonephritis
      Votes: 2 (1 %)


    • congenital hepatic cyst
      Votes: 6 (4 %)


    • echinococcal cyst
      Votes: 0 (0 %)


    • hepatoblastoma
      Votes: 0 (0 %)


    • nephroblastoma metastasis
      Votes: 0 (0 %)


    • liver abscess
      Votes: 1 (0 %)


    • hepatic hematoma
      Votes: 0 (0 %)


    • Testicular Hydrocele
      Votes: 5 (3 %)


    • Epididymal cyst
      Votes: 2 (1 %)


    • Funiculocele
      Votes: 1 (0 %)


    • Spermatocele
      Votes: 0 (0 %)


    • Nuksche Cyst
      Votes: 1 (0 %)


    • Hydatide
      Votes: 0 (0 %)


    • Cystic Teratoma
      Votes: 0 (0 %)



        Total answers: 155

     
    Epididymal Cyst with Testicular Retention, Hydatid and Hydrocele
    Dirk Schaper, K Gerlach. Epididymal Cyst with Testicular Retention, Hydatid and Hydrocele. PedRad [serial online] vol 5, no. 7.
    URL: www.PedRad.info/?search=20050715104508


     

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