Intracystic papilloma of breast

The risk of cancer in intracystic pailloma of breast is 1.7 to 7.5%.

Thoracic manifestations of breast carcinoma

It is an interesting exercise to consider what you should look for in the thorax in a patient with breast carcinoma. There would of coarse be the primary tumour with the breast mass, skin thickening and puckering. There would be manifestations of thoracic metastases like endobronchial metastases, lymphangitis carcinomatosa, pleural effusion and nodules, skeletal metastases and lymph nodes. One should also look for treatment complications like mastectomy, radiation pneumonitis and radiation osteonecrosis.

To read more: Clinical Radiology August 1999

Giant fibroadenoma

The differential for a well defined huge lesion in the breast would be giant fibroadenoma and cystosarcoma phylloides. Biopsy is perfunctionary since such a big lesion would definitely have to be removed.

Breast augmentation

'Woman thy name is vanity'Yes breast augmentation has come of age.Breast augmentation is cosmetic surgery where a breast implant is used to enhance the size of a women’s breast. Starting from the earliest by Czemy who used a women’s own adipose tissue from a lipoma on her back to the present silicone implants it has come a long way. Two main types are used presently - saline implants (silicone elastomer shell filled with sterile saline)and silicone implants (silicone rubber envelope filled with thick viscous silicone gel).The complications are systemic (rheumatological problems and fibromyalgia) and local (rupture and capsular contracture). Rupture can be intracapsular (teardrop and capsular fold -linguine sign)or extracapsular (granulomas).

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CHARGE with ACC and Jouberts syndrome

Rare case of CHARGE (coloboma of eyes, heart defect, atresia of choana, retarded growth, genital hypoplasia, ear anomalies) associated with Jouberts syndrome and agenesis of corpus callosum

MRI of injuries in the child athlete

In a child physeal and apophyseal injuries and avulsion injuries are common.In the acute setting one must keep in mind atypical muscle injuries (contusions and pyomyositis), intervertebral disc injuries, acute tendon injuries, apophyseal injuries and internal joint derangements. In chronic cases chondral and osteochondral injuries (stress fractures and osteochondritis), joint instability and impingement phenomena (os acromiale and os trigonum)must be kept in mind.

To read more: Clinical Radiology Dec 1999

Peripheral Nerve Tumours

Usg, CT and MRI are the main standbys in imaging the peripheral nerve tumours. The differential for peripheral nerve tumours must be kept in mind when imaging.Neurilemmomas are solitary, encapsulated with the nerve at the periphery.Neurofibromas have no capsule and the nerve is central. Plexiform neurofibroma has a bag of worms appearance. Malignant schwanoma is seen in 10% of cases with previous radiation and 50% of cases of Von Reklinghausens disease. Truamatic neuroma is the stump or amputation neuroma.Mortons neuroma is fibrosis and degeneration of plantar digiral nerves.Intraneural ganglion invades the nerve and may be associated with atrophy of muscles in the peroneal compartment.

To read more: Clinical Radiology Jan 1997

Definitely malignant

A high density spiculated lesion with microcalcification would put your lesion in the ACR BIRADS 5 category. Definitely malignant.

Potts spine, myelitis and thoracic TB

Its a field day for a radiologist when we can demonstrate so many manifestations of a disease in a single study

Choroid Plexus Disease

Choroid plexus are vascular membranes made up of epithelial and endothelial cell types in the ventricles. What are the diseases that have a predeliction for the choroid plexus. Tumours like papillomas, carcinomas, metastases, meningioma and leukemia chloromas. Infections like nocardia, TB, cryptococcus and CMV. Cysts larger than 1 cm are seen in Trisomy 18. Haemorrhage may occur with truama, vascular malformations and Down's syndrome. Enlarged CP is seen in Sturge Weber syndrome and Klippel Trenaunay syndrome.

To read more: Clinical Radiology July 2000

Non-hyperfunctioning adrenal mass

The differenciation of benign from malignant lesions is based on lipid content of cells. Adenomas contain lipid, metastases do not. How you pick up the lipid content is the basis of all imaging. With CT three criteria are used: size of >5cm is malignant, threshold of 0 HU has a specificity of 100% in differentiating and delayed CECT with a cut off > 24 HU is malignant. MRI too has three criteria: signal intensity ratio of metastases/liver > adenoma/liver on T2 images, metastases have marked enhancement and slow washout and signal drop off in adenomas on chemical shift imaging. Finally iodomethylnorcholesterol scintigraphy helps with the adenomas taking up the cholesterol esters.

To read more: Clinical Radiology Nov 1998

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