Aysegul Sarsilmaz

CT and MRI findings of developmental abnormalities and ectopia varieties of the thyroid gland.

Ectopic thyroid tissue may be observed anywhere from the tongue base to the lower neck. It is rarely seen in the mediastinum and abdominal cavity. Computed tomography and magnetic resonance imaging are very sensitive for detection and localization of ectopic thyroid tissue. This pictorial essay presents the radiological characteristics of developmental abnormalities and ectopia varieties of the thyroid gland.

Ectopic pituitary adenoma presenting as a nasopharyngeal mass: CT and MRI findings.

Recent embryologic studies indicate that the adenohypophsis (AH) is derived from the outer margins of the prosencephalic eural plate anterior to the origin of the hypothalamus and eurohypophysis (NH) [1]. And, adenohypophysis migrates from pharyngeo-cranial location to the sellar region. Along this igration route, an ectopic adenohypophysis is possible in the asopharynx [1–5]. However, there are few reported cases of an ctopic pituitary adenoma locating in the nasopharynx [5]. We eviewed the literature and report a very rare ectopic adenoma ocating in the nasopharynx with magnetic resonance imaging MRI) and computed tomography (CT) findings.

Respiratory epithelial adenomatoid hamartoma: a rare nasopharyngeal mass lesion.

Respiratory epithelial adenomatoid hamartoma (REAH) is a rare and nonneoplastic lesion of upper respiratory tract characterized by an abnormal mixture of tissues which are peculiar to the involved anatomic region. The most common site reported is nasal cavity and its nasopharyngeal origin is extremely rare. The lesion can be confused with a variety of benign and malignant entities. In this article, we report a 22-year-old female case of REAH of posterior nasopharyngeal wall. The clinical and radiological features of the lesion are discussed in the light of literature data.

A New Variation: An Anterior Cruciate Ligament Attached to the Accessory Ossicle

Anatomic variations of the anterior cruciate ligament (ACL) are very rare. The prevalence of congenital aplasia or hypoplasia of the ACL is 0.017 per 1,000 live births. The normal ACL consists of the anteromedial (AMB) and posterolateral bundles (PLB). Together, they attach to a fossa on the posteromedial aspect of the lateral femoral condyle. The PLB fibrils are smaller and shorter than those of the AMB. We report an ACL variation that had not been previously described, in which the PLB was attached to an intraarticular accessory ossicle, without causing knee instability. The large accessory ossicle caused pain. We reviewed the anatomy, anomalies, and variation in the ACL. Clin. Anat. 24:991–993, 2011.

Intraventricular glioblastoma multiforme: a pediatric case report.

SUMMARY Glioblastoma multiforme (GBM) is the most common lethal primary central nervous system tumor in adults. GBM is rarely seen in childhood and adolescence as primary intraventricular tumors. Few cases of solitary intraventricular GBM in adolescence have been reported to date. We report a 16-year-old boy with progressive disorientation, diffuse headache, vomiting, and increased intracranial pressure. Computed tomography and magnetic resonance imaging confirmed that the tumor filled posterior body and occipital horn of the left lateral ventricle and also invaded the surrounding parenchyma. Incomplete removal of the lesion was achieved and a pathologic diagnosis of GBM was carried out. We present a case with an uncommon subtype of glial tumor (GBM) in childhood located in a very rare site. The clinical course, radiologic findings, and possible treatment regimens are reviewed.

Evaluation of Iron Deposition in the Adrenal Glands of β Thalassemia Major Patients Using 3-Tesla MRI

Background Beta-thalassemia major (β-TM) patients need blood transfusions, which result in iron deposition. To regulate chelation therapy, iron load has to be measured. With MRI, the amount of signal loss and T2* decay time shortening are used for iron quantification. Objectives The aim was to measure adrenal iron load with T2* relaxometry using MRI, and to compare it with liver and cardiac iron and serum ferritin, and to find out whether adrenal iron could be predicted from those parameters. Patients and Methods Between October 2014 and March 2015, MRI was performed in 21 patients with β-TM, recieving blood transfusions and chelation therapy. The control group (n = 11) included healthy volunteers with no known history of adrenal, hematologic, chronic disease, and blood transfusion. Results Among patients, there was no significant correlation between plasma ferritin and adrenal T2*. Significant difference was detected among T2* values of adrenals between the patient and control groups. There was no significant correlation between adrenal gland and liver T2* in β-TM patients, moderate correlation was detected between adrenal T2* and cardiac T2*. Conclusion Adrenal iron in β-TM can be reliably measured in 3 Tesla MRI. The results highlight the absence of correlation between adrenal iron deposition both with serum ferritin and hepatic iron.

Primary osteosarcoma arising from subcutaneous tissue: 5-year follow-up

Extraskeletal osteosarcomas are extremely rare, high-grade neoplasms. Approximately 300 cases have been reported in the literature, with a 5-year survival of around 25%-37%. Extraskeletal osteosarcomas frequently arise from lower-extremity, deep soft tissue planes, including hemorrhagic, necrotic areas. While primary osteosarcomas have been observed in the first two decades of life, osteosarcomas arising from the skeletal system are rarely observed before 40 years of age. We present radiological findings of an osteosarcoma case arising from cruris subcutaneous tissue in a young adult (31 years old) at diagnosis and at the follow-up period during a 5-year monitoring process. Additionally, we reviewed the literature regarding this case.

The Daily Resistive Index measurement useful tool in the estimation of the optimal time interval between two Shock Wave Lithotripsy sessions.

OBJECTIVE : To monitor the impact of Shock Wave Lithotripsy (SWL) on the renal resisive index (RI) and to investigate the potential of the RI measurement for the estimation of the optimal duration between 2 SWL sessions. MATERIAL AND METHODS Thirty patients with single pelvis renalis stone were included. Participitants were grouped according to their age as group 1 (<40 years, mean age 36.2+/-3.9 years) and group 2 (>/=40 years, mean age 55.4+/-6.5 years). RI measurement was performed in of all patients prior to SWL. After SWL, RI was monitored daily until RI returned to their pre-SWL values. RESULTS The mean stone size was 2 8.97+/-3.62 in group 1 and 10.08+/-4.67 mm in group 2 (p=0.077). Following SWL, the RI value of both goups increased and the higher RI value was measured at the 24th hour as compared with their pre-SWL values (p<0.001). In day 2 RI of the groups declined, but the differences were still statistically different from their pre-SWL RI values (p<0.001). However, on the third day, RI of group 1 was close to their pre-SWL level (p=0.143). But, in group 2, RI value returned to their pre-SWL limits on day 4 (p=0.229). CONCLUSIONS RI measurement gives important data regarding SWL related acute renal trauma and should be used as an US marker for recovery after SWL.AIMS To evaluate renal morphology, prevalence of urinary stone disease, renal perfusion and resistance to renal blood flow in patients with ankylosing spondylitis(AS). MATERIAL AND METHODS Thirty-eight patients diagnosed with AS and with normal basal renal functions, together with 38 healthy individuals matched in terms of age, sex, blood lipid profile and body mass index, were included. Total cholesterol, triglyceride, urea, creatinine and glucose levels were measured in both groups, as well as vitamin D, erythrocyte sedimentation rate (ESR) and C-reactive protein in the AS group. Renal dimensions, parenchymal echogenicity, presence of stone and renal resistive index (RRI) from the interlobular artery level were measured, and correlations with clinical and laboratory parameters were assessed. RESULTS Thirty-eight patients diagnosed with AS (age 42.4+/- 11.5, 24 male, 14 women) and a control group of 38 healthy individuals (age 41.7+/-10.8, 23 male, 15 female) were included in the study. Renal stone was present in 7 patients (18.4%) in the AS group and 4 subjects (10.5%) in the control group. There was no significant difference in prevalence of stone between the groups (p=0.516). RRI values were significantly higher in the patients with AS (0.63+/-0.06) compared with the control group (0.59+/-0.03, p=0.001). Significant correlations were determined between RRI and age, triglyceride level, body mass index and length of disease. CONCLUSIONS Renal Doppler is an important examination in early diagnosis and monitoring of renal changes in AS patients since renal complications in AS develop in the chronic and follow a subclinical course.

Partial achilles tendon rupture presenting with giant hematoma; MRI findings of 4 year follow up

In the young population, spontaneous rupture of Achilles tendon is very rare. The big hematoma is also rare finding of the Achilles tendon partial rupture. It is usually seen with complete rupture. We presented imaging findings of 4 years follow up of the spontaneous partial rupture of Achilles tendon presenting with giant expanding hematoma and mimicking complete rupture radiologically. We discussed the alterations of tendon signal intensity and result of conservative therapy after partial rupture with big hematoma in the long term. A 29 year-old man, applied with pain and swelling in the retrocalcaneal region of left ankle. He did not have chronic metabolic disease. He was not active in physical activities. X-ray radiograms were normal. At magnetic resonance images (MRI), there was an intratendinous big hematoma, subcutanous fat planes were edematous around tendon. The diagnosis was partial rupture and giant hematoma. Hematoma was drained. The conservative treatment was applied and his complaints disappeared. After treatment, approximately 4 years later, control MRI showed thickened and hypointense tendon in all images.

Disseminated Leptomeningeal Carcinomatosis; Presenting With Cauda Equina-conus Syndrome

ntradural ekstrameduller metastazlar, leptomeningeal karsinomatozisin alt grubudur ve spinal metastazlar n yakla k %4-6’s n olu turur. Genellikle intrakranial metastazlardan damla sekonder metastaz olarak kar m za c kar ve lomber bolgede kauda equina duzeyinde, sinir kokler boyunca yay l r. Gunumuzde, kanser olgular nda survinin uzamas nedeniyle, gec komplikasyon olarak daha s k gorulmeye ba land bildirilmi tir. Bunun yan s ra, kauda equina sendromu, ilk tablo olarak gelen ve primer malignite oda sonradan saptanan olgular da bildirilmektedir. Biz, akci er adenokarsinomu tan s alm ve takip edilmekte olan, kauda equina-konus sendromu bulgular ile gelen ve MRG’ sinde, beyin metastaz izlenmedi i halde, lomber bolgede diffuz leptomeningeal karsinomatosis saptanan olguyu sunduk. A r , alt ekstremitelerde gucsuzluk ve uriner, anal disfonksiyon triad ; kauda equina sendromu (KES) ile gelen olgularda intradural ekstrameduller metastaz, leptomeningeal karsinomatozis akla gelmelidir. MRG tetkiki, bu olgu grubunda erken tan ve bilinmiyorsa, daha erken primer malignite oda n n saptanmas ac s ndan onemlidir.