Mahender Kaur Narula

Pictorial essay: Orbital tuberculosis

Tuberculosis of the orbit is rare, even in places where tuberculosis is endemic. The disease may involve soft tissue, the lacrimal gland, or the periosteum or bones of the orbital wall. Intracranial extension, in the form of extradural abscess, and infratemporal fossa extension has been described. This pictorial essay illustrates the imaging findings of nine histopathologically confirmed cases of orbital tuberculosis. All these patients responded to antituberculous treatment.

Xanthogranulomatous cholecystitis: sonographic and CT features and differentiation from gallbladder carcinoma: a pictorial essay

The imaging features of xanthogranulomatous cholecystitis closely resemble those of gallbladder carcinoma, especially those of the wall-thickening variety. There is an overlap between these two conditions with respect to the clinical features and certain imaging findings. However, certain finer details like the presence of intramural hypoattenuating nodules and the type of mucosal enhancement may help to differentiate these two conditions. In this article, we have highlighted some of these imaging features. The importance of making an accurate diagnosis lies in the significant difference between the prognosis and the surgical management of the two disease entities.

Total pancreatic lipomatosis with malabsorption syndrome

Total fat replacement of the pancreas is rare. Focal fatty replacement is the most common degenerative lesion of pancreas. Focal fatty deposits have no major clinical significance; however, extreme fat replacement is of pathologic significance, as it is associated with marked reduction in exocrine function of pancreas, resulting in malabsorption due to pancreatic enzyme insufficiency.

Pulmonary Langerhans cell histiocytosis in children: A spectrum of radiologic findings

Pulmonary Langerhans cell histiocytosis (PLCH) is a well known entity in adults but is exceedingly rare in children. It is better described in adults than in children. We describe the current understanding of PLCH in children and a spectrum of radiological findings of PLCH in the paediatric population. On high resolution computed tomography (HRCT), PLCH may have variable appearance depending on the stage of disease, ranging from small interstitial nodular opacities to multiple thin/thick walled cysts (often bizarre in shape), eventually leading to marked parenchymal fibrosis and honeycomb pattern. CT finding of PLCH is similar in adult and paediatric populations with the exception that lung base near the costophrenic angle is spared in adults but almost always involved in children.

Neuroimaging of Langerhans cell histiocytosis: a radiological review

The neuroimaging of Langerhans cell histiocytosis (LCH), in most of the cases, is nonspecific and can vary depending on the location, especially as shown on magnetic resonance imaging (MRI). In the absence of a clinical history of LCH, isolated central nervous system (CNS) lesion presents a diagnostic challenge. LCH should be considered in the differential diagnosis of craniofacial tumors and neurodegenerative (ND) lesions of the brain. MRI is the modality of choice for investigating the CNS-LCH. Long-term follow-up with MRI is indicated in patients with ND-LCH. This retrospective study provides a comprehensive description of the spectrum of neuroimaging findings in patients with LCH, the underlying neuropathology, and follow-up study of the disease.

Imaging spectrum of primary malignant renal neoplasms in children.

Wilms’ tumor (WT) is the most common abdominal tumor in children. Many pediatric renal tumors in the past were categorized as WT; however, in recent years, several specific renal tumors have been recognized as distinct pathological entities. The age and clinical presentation of the child and distinctive imaging features may help in reaching a specific diagnosis in most cases. This is important as it has implications on the pre-operative diagnostic work-up and prognosis of the child. However, it is often not possible to differentiate one from the other pediatric renal tumor on the basis of imaging alone, and the final diagnosis is often made at histological examination of the surgical specimen. This article reviews the imaging features of primary malignant renal neoplasms in children along with their clinical presentation and pathological features.

Mesenteric cysts associated with recurrent small-bowel volvulus: cause or effect?

Recurrent small-bowel volvulus is a state of recurrent intermittent or long-standing persistent twisting of small-bowel loops around its mesentery. The association of mesenteric cysts with recurrent small-bowel volvulus as the cause or effect is a much debated issue in the literature. We report two cases of mesenteric lymphangioma and one case of enteric duplication cyst seen in association with recurrent small-bowel volvulus of long duration in absence of malrotation.

Giant omental lipoma in a child.

Omental lipomas are extremely rare tumors of childhood. We report a case of solitary giant lipoma of the omentum in a child, successfully managed by complete excision, without any recurrence on follow-up study.

Bare Orbit Sign: Classical Sign in Cranio-orbital-temporal Neurofibromatosis 1

A 10-y-old child presented in ophthalmology department with progressive proptosis of right eye since 2 y with no complaint of any diminution of vision. Local examination revealed pulsatile proptosis along with soft tissue swelling in the right orbit. General examination revealed multiple spots of hyper pigmentation (café au lait spots) over the forehead and face. Frontal radiograph of the skull revealed enlarged and bare right orbit due to the absence of the greater wing of sphenoid (Fig. 1a). Axial CECT scan of the head including orbit was done which revealed dysplasia of right sphenoid bone with enlargement and herniation of temporal lobe into right orbit with plexifom neurofibroma in the orbital soft tissues (Fig. 1b and c). Reconstructed 3D surface shaded display (SSD) image frontal view better delineated the bony anatomy (Fig. 1d). Bare Orbit sign is the appearance of the orbit due to the absence of innominate line which is the projection of the greater wing of sphenoid bone and is seen in the frontal radiograph of skull [1]. It is classically seen in cranio-orbital temporal type of neurofibromatosis Type 1 (NF-1), one of the neurocutaneous syndromes. Cranio-orbital-temporal neurofibromatosis is a rare subtype of NF-1 which is characterized by pulsatile exophthalmos, orbital neurofibromas, dysplasia of greater wing of sphenoid bone with expansion of temporal fossa and herniation of the temporal lobe into the orbit. Sphenoid dysplasia is seen in 5–10 % of cases of NF-1 and is used as one of the National Institute of Health (NIH) diagnostic

Hepatic cysticercosis: a rare entity

Hepatic cysticercosis is a very rare entity; only four cases have been reported to date. High-resolution ultrasonography of the abdomen is the initial and most reliable modality for evaluation of hepatic cysticercosis. Medical therapy is the mainstay of treatment. We report a case of hepatic cysticercosis in a 28-year-old male who presented with right upper quadrant pain, fever, and jaundice. The article also describes the imaging patterns of hepatic cysticercosis based on different stages of evolution.