14 yr old female with swelling breast Fnac is suggestive of metastatic acute lymphoblastic leukemia ( rare tumor)

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C.T.SCANImaging Features :


There is thick walled cavitatory lesion with spiculated borders in the apical segment of right upper lobe, measuring 50 x 48 x 51 mm. The lesion is causing stranding posterosuperiorly with infiltration & erosion of transverse process of D2, costovertebral joint and adjacent posterior 2nd rib & also erosion of the adjacent 3rd rib. Findings are suggestive of apical lung tumor (Pancost tumor). (Adv : HPE correlation)

There are large fibrocavitatory parenchymal thickening with dystrophic calcification, bronchiectasis, subpleural consolidation with adjacent architectural distortion seen in the left upper lobe. Multiple centrilobular nodules few showing tree in bud pattern & calcification, bronchiectasis, peribronchial thickening, and interlobular interstitial thickening in both lungs. Finding are suggestive of post primary tuberculosis.

There is well defined oval shaped soft tissue density lesion of size 9 x 9 mm seen in the dependent part of the left upper lobe cavity, suggestive of aspergilloma .

Trachea mildly shifted towards right side

Centriacenar emphysematous changes are seen in both lungs.

There are few enlarged lymph nodes noted involving prevascular, pretracheal, bilateral paratracheal, AP window, precarinal & subcarinal regions, largest measures 15 x 10 mm in the subcarinal region, ? Granulomatous ? Metastatic

The arch of the aorta and the vessels arising from it are normal.There is no evidence of pleural effusion seen.

Note is made of sliding hiatus hernia.

Visualized abdomen shows bilateral simple renal cortical cysts.

Visualized bones show old united fracture in the left 11th & 12th ribs posteriorly.

Impression:  Above described CT imaging features reveal

  • Right apical lung tumor (Pancost tumor) as described above. (Adv : HPE correlation)
  • Post primary tuberculosis with aspergilloma in left upper lobe cavity.
  • Diffuse centriacenar emphysematous changes.
  • Mediastinal lymphadenopathy ? Granulomatous ? Metastatic
  • Sliding hiatus hernia.
  • Bilateral simple renal cortical cysts.
  • Old united fracture in the left 11th & 12th ribs posteriorly.

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60 year male presented with slow growing swelling over left ear ( pinna).Histopathology was suggestive of Chondroid Syringoma.It is a benign tumor of sweat glands Ear is an unusual site for this tumor.

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The study shows innumerable well circumscribed subcentimeteric cystic lesions diffusely studded in brain parenchyma involving all the lobes, capsuloganglionic region, right thalamus, corpus callosum, pons and cerebellum with significant perifocal and white matter edema. The lesions appear hyperintense on T2W with central T1W hyperintense signal corresponding gradient susceptibility on FFE, suggestive of calcification. On post contrast study there is thick enhancement of the wall with tiny central enhancing dot

No abnormal leptomeningeal enhancement is seen.  

Rest of the brain parenchyma appears normal.

Ventricular drainage tube is noted on right side with its tip seen at the foramen of monro and traversing through the right lateral ventricle and frontal lobe into the frontal scalp region. There is mild dilatation of left lateral ventricle with midline shift of 8.0 mm towards right side. Right lateral ventricle is partially effaced. Also there is mild prominent of 3rd & 4th ventricle.


Above MR imaging findings suggestive of infective granuloma likely neurocysticercosis at colloid vesicular & granular nodular stage.


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Leptomeningeal myelomatosis: A rare case

A Middle aged male presented with altered sensorium without any signs of renal function deterioration
Csf examination showed monotonous population of malignant plasma cells.





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