Pseudolymphoma presenting as a cecal tumor

A 7-yr-old with abdominal pain and melena had a barium enema which revealed a cecal lesion that proved to be a pseudolymphoma of the cecum and appendix--a site not previously reported.     

Subclavian mycotic aneurysm presenting as mediastinal abscess

A 60-year-old man was admitted to a hospital for evaluation of intermittent fever, dysphagia, hoarseness, and general chest discomfort. Great vessel mycotic aneurysm was suspected when antibiotic trials failed and chest X-ray showed paraaortic mass with pleural effusion mimicking mediastinitis. Although the correct diagnosis of mycotic aneurysm of innominate artery was made thereafter and vigorous treatment was initiated immediately, this patient succumbed to overwhelming sepsis, probably due to a 2-week delay in another hospital. This case is reported to remind readers of the possibility of this unusual location of mycotic aneurysm. A high index of suspicion should be maintained to make an earlier diagnosis and obtain better prognosis. Computed tomography and 3D magnetic resonance angiography also significantly improve the diagnosis when mycotic aneurysm location is unusual and presentation is equivocal.     

Centrocytic lymphoma presenting as a subphrenic abscess and a solitary liver nodule

Non Hodgkin's lymphoma revealed by hepatic manifestations is extremely rare. We describe here a 82-year old male patient who presented with a right subphrenic abscess and a solitary liver tumour that was shown to be a centrocytic lymphoma. Furthermore, asymptomatic cryptogenic liver cirrhosis was diagnosed. This previously unreported form of clinical presentation of a non Hodgkin's lymphoma as well as the association with liver cirrhosis are discussed in the context of the recent literature.     

Retroperitoneal fungal abscess presenting as superior mesenteric artery syndrome

We report a patient two years post-cholecystectomy for gallstone pancreatitis presenting with superior mesenteric artery syndrome due to a retroperitoneal fungal abscess.     

Liver abscess secondary to intrahepatic perforation of the gallbladder, presenting as a liver mass

We present an unusual case of a large pyogenic liver abscess containing multiple stones caused by perforation of a necrotic gallbladder and spread of the infection into the liver. It manifested by weakness, weight loss, and a palpable liver mass, pointing toward a neoplastic process. Workup for metastatic disease was negative, and tumor markers also were negative. Ultrasound and computerized tomography were inconclusive, and the diagnosis was established by laparoscopy. Open drainage and cholecystectomy were performed, with good outcome. In the literature, there have been very few reports of intrahepatic perforation of the gallbladder resulting in formation of hepatic abscess. The presentation, diagnosis, and management of liver abscesses, as well as the complications of acute cholecystitis, are discussed.     

Perinephric abscess (presenting as abdominal pain) due to Listeria monocytogenes

The development of a haematoma after wide excision of breast tumours is not uncommon. Suction drainage is commonly used to prevent this but often increases the hospital stay and can create unsightly wounds. Argon beam coagulation is a new technique which permits large 'raw' areas to be coagulated with minimal tissue damage. We believe that this technique may reduce the development of haematomas and seromas after breast surgery. We present our initial results using argon beam coagulation after wide excision of breast tumours in 80 patients without suction drainage. One patient required a single aspiration of a seroma at the site of breast lump excision and none required surgical drainage. Argon beam coagulation appears a useful adjunct in breast surgery and may help reduce hospital stay.     

Crohn's disease presenting as pyogenic liver abscess with review of previous case reports

A 40-yr-old male doctor from India presented with pyogenic liver abscesses as the first manifestation of Crohn's disease. The Crohn's disease itself was limited to the appendix and the adjacent cecum and could be diagnosed only 6 months after the presentation with liver abscess. This single case highlights three unusual features of Crohn's disease, and stresses the importance of meticulous search for a cause for pyogenic liver abscess when it occurs in an otherwise healthy adult.     

Hepatocellular carcinoma presenting as pyogenic liver abscess: characteristics, diagnosis, and management

We performed a 17-year retrospective analysis of 10 cases of hepatocellular carcinoma presenting as pyogenic liver abscess. Spontaneous tumor necrosis and biliary obstruction caused by tumor thrombi, superimposed with bacterial infection, were the two major pathogeneses. Exact diagnosis of the underlying hepatocellular carcinoma was made for five of the 10 patients before management was attempted. Main clinical manifestations included fever, chills, right-upper-quadrant pain, malaise, anorexia, jaundice, and hepatomegaly. Characteristics such as middle age and male sex, seropositivity for hepatitis B and/or hepatitis C, chronic liver disease, unexplained anemia, marked weight loss, and a severely inversed albumin/globulin ratio raise suspicions about the underlying hepatocellular carcinoma. Management strategies included percutaneous drainage (n = 3), surgical drainage (n = 4), and hepatectomy (n = 3) in addition to administration of parenteral antibiotics in all cases. The prognosis was dismal, with a mean survival of 3.5 months (range, 8 days to 6 months).     

Wegener''s granulomatosis manifested as a perirectal abscess

PURPOSE: To evaluate the detection of experimental hepatic metastases at CT with the hepatocyte-specific contrast medium FP 736-03. MATERIAL AND METHODS: A nude-rat model of experimental multiple hepatic metastases from a human colonic cancer was used. Three weeks after intraportal tumour cell injection, the CT examination was performed before and after i.v. injection of FP 736-03 at a dose of 0.5 ml/kg b.w. RESULTS: The overall detection rate was determined in a lesion-by-lesion analysis of 87 metastases. Irrespective of metastatic size, the mean detection rate for two viewers was significantly higher at the FP-736-03-enhanced examination (59%) than at the unenhanced CT examination (16%). CONCLUSION: The detection rate increased with the i.v. administration of FP 736-03 at a dose of 0.5 ml/kg b.w. compared with that at unenhanced examination.     

Rosai-Dorfman disease presenting as a meningioma

This report documents an unusal case of extranodal sinus histiocytosis (Rosai-Dorfman disease) which produced a solitary intracranial mass lesion that was diagnosed clinically and radiologically as a meningioma. Morphological features have been described and literature extensively reviewed.     

Primary ilio-psoas abscess extending to the thigh in a neonate: US, CT and MR findings

Psoas abscess in children, and especially in neonates, is an uncommon condition which is difficult to diagnose clinically. The US, CT and MR findings of a psoas abscess in a neonate, which extended to the thigh, are reported. Imaging was helpful in revealing the abnormality, in demonstrating its extension and in determining its nature. The child was treated conservatively and the abscess resolved, leaving atrophy of the psoas muscle.     

Secondary syphilis presenting as a pruritic dermatosis

Three patients had secondary syphilis with severely pruritic skin lesions. This presentation contradicts several modern medical texts in which the lesions of secondary syphilis are described as nonpruitic.     

Tuberculosis presenting as a solitary splenic tumour

The authors presented a case of ethmoid glioma which had performed as nasal polyp. They also discussed about problems of classification and treatment this type of neoplasm.