Multimodality imaging evaluation of pseudotumors in chronic renal dysfunction: exposing the masquerade!

Focal renal lesions in the background of chronic kidney disease (CKD) present a diagnostic challenge. Contrast administration is usually avoided in such a setting, undermining the usefulness of computed tomography and magnetic resonance imaging. Focal regenerating nodules may occur in the background of CKD and closely mimic renal neoplasms. The aim of the present article was to highlight the salient manifestations of such CKD pseudotumors on different imaging modalities and also to depict the differentiating features from malignancy. Radiologists must be aware of the imaging appearance of this uncommonly talked about entity so as to avoid inadvertent surgery or cause undue anxiety to the patient.

Solitary Temporal Plasmocytoma: A Case Report

Introduction: Solitary plasmacytoma is a malignant plasma cell tumor that is much rarer than multiple myeloma. The location in the vault of plasmacytoma is extremely rare. We report the case of a plasmacytoma of the cranial vault in a 53-year-old adult. Observation: A 53-year-old man consulted for tinnitus, left hypoacusis and trigeminal neuralgia of the left V2 and V3, which had been evolving for one year and was aggravated one month later by the appearance of a left temporal swelling with decreased visual acuity on the left. The MRI confirmed the existence of a lesional process of the temporal vault, in T1 iso signal, T2 hypersignal and flair, intensely and heterogeneously enhanced after injection of gadolinium. Anatomopathological study revealed a solitary temporal plasmacytoma, which was referred to oncology for further management. Discussion: Plasmacytoma is defined as an isolated malignant plasma cell tumor without clinical, biological, or radiological signs of Myeloma. Craniocerebral localization is rare and constitutes only 0.7% of all solitary plasmacytomas. Conclusion: Cranial plasmacytoma is a rare tumor that should be investigated for associated myeloma. Although the imaging appearance is not very specific, plasmacytoma should be considered in the differential diagnosis of any invasive lytic lesion of the cranial vault.

Role of imaging and endovascular radiology in endoscopically missed Dieulafoy’s lesion of stomach – A case report with review

Dieulafoy’s lesion is an uncommon cause of life-threatening gastrointestinal bleed from a dilated and tortuous submucosal artery. With the advent of endoscopy-guided intervention, the mortality of the condition has reduced significantly from 80 to 8%. Imaging plays a vital role in diagnosing them in endoscopically negative cases. Endovascular management can also be offered for unidentified lesions or failed endoscopic treatment. We report a middle-aged male with acute hematemesis where endoscopy was unable to reveal the source of the bleed. Contrast CT detected the lesion, which was embolised by endovascular route. The clinical details, imaging appearance and treatment of this uncommon lesion is presented.