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Objectives Marginal zone lymphoma accounts 5%-17% of all non-Hodgkin lymphomas and has an indolent clinical course. The parameters that predict prognosis and the need for treatment are still unclear. The aim of the current study was to examine the impact of parameters on the course of disease and the need for treatment in marginal zone lymphoma. Methods A retrospective study was conducted with marginal zone lymphoma patients in the two centres between 2010 and 2018. The demographic and disease characteristics, and also hematological and biochemical parameters at the time of diagnosis were examined. The effect of the parameters on overall survival and need for treatment were analyzed. Results During the follow-up, 25 patients required treatment and 15 patiens were followed up without treatment. Overall survival was significantly higher in patients with nodal marginal zone lymphoma than in extranodal and splenic marginal zone lymphoma patients. overall survival of patients who required treatment was 92.9 months while untreated patients was 58.4 months and there was no significant difference among the groups. The platelet count of untreated patients at the time of diagnosis were significantly higher than patients who received treatment. No significant relationship was found between any parameter and overall survival. Conclusions We demonstrated platelet count at the time of diagnosis as a predictive factor for future treatment need. It is an objective and simple blood test that may be helpful to predict the course of the disease although further studies are warranted.

Background Hemangiondothelioma is a rare vascular tumor that can occur in the bone. Temporal bone involvement has been reported extremely rare in the literature. Case Radiological examination of a one-year-old girl who was admitted due to facial paralysis revealed vascular tumor of the temporal bone and Galen vein aneurysm. Pathological examination showed retiform hemangioendothelioma. She was treated with propranolol, prednisolone, vincristine, and endovascular embolization followed by oral sirolimus. With sirolimus treatment, a partial response was obtained first, then the tumor remained stable and sirolimus treatment was discontinued. No progression was observed in the disease after discontinuation of treatment. Conclusion In this article, a case of hemangioendothelioma originating from the temporal bone is discussed in the light of other case reports in the literature.

Summary Background Ophthalmoplegia secondary to a traumatic dissecting aneurysm in the cavernous segment of internal carotid artery (ICA) is a relatively rare entity. Anticoagulant or antiplatelet therapy is the preferred treatment option for carotid dissections. However, endovascular interventions are noninvasive and alternative methods to surgery, especially in cases of aneurysms that do not respond to medical therapy. Case Report We report of a 19-year-old man presenting with left-sided, total ophthalmoplegia after a traffic accident. Magnetic resonance imaging (MRI) and digital subtraction angiography (DSA) revealed a dissection beginning at the cervical segment of internal carotid artery (ICA) together with a dissecting aneurysm in the cavernous segment. A stent was placed in the narrowed and dissected segment of ICA, and the dissecting aneurysm of the cavernous segment was successfully managed with a stent-assisted coil embolization. After the endovascular treatment of the aneurysm, a full recovery of cranial nerve function was achieved. Conclusions Immediate diagnosis and appropriate therapy of dissecting aneurysms is necessary for good clinical outcomes in cases of ophthalmoplegia.

Extraskeletal Ewing's sarcoma is usually described as a tumor localizing the soft tissues lower extremities and the paravertebral region. Paranasal primary Ewing's sarcomas are extremely rare entity. We present a case of primary Ewing's sarcoma of the paranasal sinus extending left orbit and middle cranial fossa in a 14-year-old male. CT and MRI findings of the rare case are discussed.

Objectives To evaluate the diagnostic value of the renal parenchymal density difference, detected using unenhanced helical computed tomography, as a secondary sign of acute obstruction due to a ureteral stone. Methods Fifty-five patients with acute flank pain, in whom a ureteral stone was detected on the symptomatic side using unenhanced helical computed tomography, and 22 control subjects with no urinary stone disease were included in this prospective study. Computed tomography was performed, starting from the upper poles of the kidneys down to the base of the urinary bladder. The renal parenchymal density was measured in the upper, middle, and lower portions of each kidney, and a mean value was calculated. The difference between the mean values of the two kidneys was used to predict the presence of an acutely obstructing ureteral stone. Results In 49 patients with a ureteral stone (89.1%), the difference between the parenchymal densities of the obstructed and nonobstructed kidneys was 5 Hounsfield units (HU) or greater and was lower on the obstructed side. In the remaining 6 patients (10.9%), the density difference was less than 5 HU but was still lower on the obstructed side. All subjects in the control group had a density difference of less than 5 HU. A renal parenchymal density difference of 5.0 HU or greater had 89.1% sensitivity, 100% specificity, 100% positive predictive value, 85.7% negative predictive value, and 93.4% accuracy in predicting the presence of an acute obstructing ureteral stone. Conclusions These data suggest that the renal parenchymal density difference may be a valuable secondary sign of acute obstructing ureteral stone disease.

Thyroid hemiagenesis is a rare congenital anomaly, which is usually discovered incidentally during thyroid work up or during surgery especially in recent years. The imaging modalities are helpful not only in the diagnosis of this condition, but also in the demonstration of associated anomalies. In this study, two cases of thyroid hemiagenesis are reported with ultrasonography (US), computed tomography and scintigraphy findings.

Introduction: The differentiation of unilateral versus bilateral varicoceles and testicular volume measurements are important in determining the need for adolescent varicocele surgery and also in following patients after varicocelectomy. The aim of this study was to prospectively compare the findings of physical examination and color Doppler ultrasonography in the diagnosis of pediatric varicoceles and to compare the findings using the Prader orchidometer and scrotal ultrasonography in the measurement of testicular volumes. Patients and Methods: This study included 68 boys with varicoceles, ranging in age from 8 to 19 years. Varicoceles were diagnosed using both physical examination and scrotal color Doppler ultrasonography. The testicular volumes of 136 testicles were measured using the Prader orchidometer and scrotal ultrasonography. A difference of more than 10% or 2 ml in each testicular volume was considered significant. Results: The mean age of the boys was 13.5 ± 2.3 years. On physical examination, a left unilateral varicocele was diagnosed in 46 boys (67.6%). The other 22 boys (32.4%) had bilateral varicoceles. Color Doppler ultrasonography detected bilateral varicoceles in 4 of the 46 boys (8.7%) who were diagnosed by physical examination as having only left unilateral varicoceles (grade 3 in 3 patients and grade 2 in 1 patient). A different of more than 10% or 2 ml in testicular volume using the Prader orchidometer versus scrotal ultrasonography was detected in 3 out of 136 testicles (2.2%). The correlation between ultrasonography and Prader orchidometer results in the measurement of testicular volumes was statistically highly significantly consistent using the intraclass correlation test (r = 0.997 and p < 0.001 for the left testis; r = 0.998 and p < 0.001 for the right testis). Conclusions: Although the management of subclinical varicoceles remains controversial, these data show that color Doppler ultrasonography may be necessary in the diagnosis of bilateral varicoceles, especially in boys with high-grade left varicoceles. In contrast, scrotal ultrasonography, if considered the gold standard, did not show superiority over the Prader orchidometer in measuring testicular volumes.

An extremely rare bifurcation pattern at the caudal abdominal aorta was encountered on the pelvic angiography and MR angiography of a male patient. Instead of dividing into two common iliac arteries, the caudal abdominal aorta first gave the right external iliac artery at the level of the last lumbar arteries, then bifurcated into a right internal iliac artery and a left common iliac artery. The median sacral artery originated at this anomalous bifurcation. This high origin of the right external iliac artery and separate branching of these right iliac vessels from the abdominal aorta are important during the interventions in the region. We present the angiography findings and discuss the embryological origin of this unusual and unreported congenital anomaly.

Hydatid disease is a parasitic infection, which generally occurs in the liver and lung. Localization of hydatid cyst in the thoracic aorta and false aneurysm formation are extremely rare in the endemic countries. We report a rare case of hydatid cyst invading the wall of thoracic aorta resulting in a false aneurysm, which was clearly demonstrated by contrast enhanced computed tomography (CT).

Background There are many systemic complications of conventional selective renal arteriography (SRA), such as contrast-mediated nephropathy. Contrast-enhanced magnetic resonance angiography (CE-MRA) and renal artery Doppler ultrasonography (DUSG) have been used increasingly for renal artery stenosis (RAS). The aim of this study was to evaluate the accuracy of CE-MRA and DUSG as used for diagnosis of RAS. Material/Methods We divided 130 consecutive patients investigated for resistant hypertension into 2 groups based on age: group 1 was patients 60 year. DUSG, CE-MRA, and SRA were performed in group 1 and group 2 patients. Results Seventy-two patients (24 males [M], 48 females [F]) in group 1, and 58 patients (26 M, 32 F) in group 2 were included in the study. In the evaluation of clinically significant renal artery stenosis with DUSG, in group 1 the overall sensitivity was 83.33% and overall specificity was 81.82%, and in group 2 they were 69.23% and 0%, respectively, when compared with SRA. In the evaluation of clinically significant renal artery stenosis with CE-MRA, the overall sensitivity and specificity were 92.31% and 36.36%, respectively, in group 1 and 100.00% and 73.33%, respectively in group 2, when compared with SRA. Conclusions CE-MRA is an accurate, non-invasive method for the diagnosis of RAS in patients above 60 years of age and DUSG may be the choice of diagnostic method for RAS in patients under 60 years of age.

Objectives. – To measure the anterior center edge (VCE) angle that reflects anterior coverage of the femoral head. Patients and methods. – False profile views of both hips of 102 volunteers, 23 male and 79 female, were taken between October 2000 and October 2001. Radiographs with evidence of degenerative hip disease and those with poor image quality were excluded from the study. This left 181 radiographs. Results. – An orthopedic surgeon and a radiologist used a standard protractor to examine each of the 181 radiographs twice, at an interval of 24 h. The mean VCE angle was 49.27 ± 7.77° (range, 24.75–68.75), a value different from those found in previous studies. No significant intraobserver or interobserver differences were found. Conclusions. – Our findings may contribute to the determination of a new parameter for evaluating anterior femoral head covering. In patients with acetabular dysplasia and deficient anterior coverage, this parameter may prove useful for selecting patients for surgery, planning the procedure, and evaluating postoperative results.

Primary carcinoma of the fallopian tube (FTC) is extremely rare. We report a case of serous adenocarcinoma of the fallopian tube. A 60-year-old, nulliparous and post-menopausal woman had a complaint of serohaemorrhagical vaginal discharge. Laboratory results, including serum CA-125, were normal. Transvaginal ultrasonography (US) revealed a tubular cystic lesion with multiple echogenic mural nodules in the right adnexal region. On computed tomography (CT), a well-delineated, tubular, hypodense lesion with thickened wall, mural nodular densities and septations was detected. Fallopian tube tumour was suspected radiologically and was proved operatively and histopathologically. The clinical and radiological clues that were of help in the diagnosis were discussed.

This study was performed to evaluate the possible involvement of the proximal tibiofibular joint in primary osteoarthritis of the knee. A total of 40 patients with primary osteoarthritis of the knee who had magnetic resonance imaging scans were reexamined for proximal tibiofibular joint involvement. The patient was questioned if pain was present in the proximal tibiofibular joint while at rest, when walking and climbing stairs. Symptoms were evaluated by applying moderate compression over the proximal tibiofibular joint during active ankle and knee motions. Magnetic resonance imaging scans were reexamined by two radiologists. Three of the 40 patients had minimal or moderate pain in the proximal tibiofibular joint during stair-climbing and on clinical examination. Magnetic resonance imaging scans of these three patients revealed osteophyte or subchondral cyst formation, or both. Degenerative changes in the proximal tibiofibular joint may be evident in association with osteoarthritis of the knee and may result in lateral-sided pain at the knee.

Arachnoid granulations show typical imaging features that allow their distinction from dural sinus thrombosis and intrasinus tumor. These features include a mid-lateral transverse sinus location, focality, common adjacent entering superficial veins, origin of attachment, low density on computed tomography (CT), isointensity-hypointensity on T1-weighted magnetic resonance imaging (MRI) and hyperintensity on T2-weighted MRI. We report the CT and MRI findings of incidentally detected bilateral arachnoid granulations in the transverse sinuses of a patient with ocular melanoma.

The abdominal aorta (AA) begins at the aortic hiatus of the diaphragm, in front of the lower border of the body of the last thoracic vertebra and descending in front of the vertebral column and ends on the body of the fourth lumbar vertebra, commonly a little to the left of the middle line by dividing into the two common iliac arteries. The celiac trunk (CeT) and superior mesenteric artery (SMA) are the two widest vessels arising from the ventral aorta. The celiac trunk divides into the left gastric, common hepatic and splenic arteries. SMA and the coeliac trunk can arise from the ventral aorta as a common origin.1 The unusual embryologic development of the ventral splanchnic arteries can lead to considerable variations.2 Many variational patterns of the CeT have been described. A review by Yi et al.3 summarized that only 87.7% of CeTs exhibited classic trifurcation. An incomplete CeT, namely bifurcation, accounted for 5.8–24.1%. Aside from these variations, the CeT itself may be absent and its branches can arise directly from the aorta. Moreover, in rare cases, the CeT and SMA may be fused into a common celiacomesenteric trunk (CMT), of which the incidence was mentioned as 0–11% (average, 1.5%).3 Many different types of catheter or intra‐aortic balloon pumping are commonly used either to diagnose vascular diseases or treat them via the AA. In abnormalities like a tortuous AA, use of catheters is advised with great caution; straight‐tipped catheters are discouraged.4-7

An ectopic kidney was found incidentally in a 20-year-old male patient during the abdominopelvic CT angiography. It was situated on the right side at the abdominopelvic junction, partly in the abdomen at the level of the intervertebral disc between L3 and L4 superiorly and partly in the greater pelvis at the level of the promontorium and close to the inferior border of the sacroiliac joints. It was supplied by two arteries which were nearly in the same caliber, and each of which branched from the common iliac arteries both close to the aortic bifurcation. There were two renal veins. The larger one which was emerging from the lateral part of the ectopic kidney was draining into the inferior vena cava. The smaller one which was the only hilar vessel of the ectopic kidney was draining into the left common iliac vein. The orthotopic left kidney was also supplied by two arteries from the abdominal aorta. Ectopic kidneys pose a problem for any planned surgical intervention given their anomalous blood supply. Ectopic position and varied vasculature can predispose to iatrogenic trauma during interventional radiological and laparoscopic procedures, and emergency operations.

The purpose of our study was to describe the pulmonary parenchymal changes of Behçet's disease using high-resolution computed tomography and to correlate them with pulmonary function tests.Thirty-four patients with Behçet's disease (18 men, 16 women), 3 of whom were symptomatic, were included as the study group. Four of 34 patients were smokers. Twenty asymptomatic volunteers (12 men, 8 women), 4 of whom were smokers, constituted the control group. The pulmonary function tests and high-resolution computed tomography were performed for both groups.Inspiratory high-resolution computed tomography findings were abnormal in nine patients (26.5%) of the study group. In eight patients, there were multiple abnormalities, whereas one patient had only one abnormality. Pleural thickening and irregularities, major fissure thickening, emphysematous changes, bronchiectasis, parenchymal bands, and irregular densities, and parenchymal nodules were the encountered abnormalities. Inspiratory high-resolution computed tomography scans were normal in the control group. On expiratory scans, there was statistically significant difference between study group and control group when air trapping, especially grades 3 and 4, was compared (P0.01). Pulmonary function tests of both the study and the control groups were in normal ranges, and there was no statistically significant difference between the two groups according to pulmonary function tests (P0.05).High-resolution computed tomography is sensitive in the demonstration of pulmonary changes in patients with Behçet's disease. End-expiratory high-resolution computed tomography examination is very useful and necessary to show the presence of air trapping, thus the presence of small airway disease, even if the patient is asymptomatic or has normal pulmonary function tests.

The aim of this study was to present a case of disruption of the blood-brain barrier during the coronary and lower extremity angiographies with radiological and clinical findings. This condition was secondary to intraarterial use of a nonionic, monomeric contrast medium. A total of 450 cc contrast media was used. Computed tomography examination showed contrast enhancement of the right occipital and frontoparietal cortical regions, which returned to normal one day after. The patient also fully recovered from the neurological symptoms within 24 h. We discussed the possible mechanism for blood-brain barrier disruption in this case.

Intravascular foreign bodies may be introduced into the circulation as a complication of minimally invasive or interventional techniques, or during cardiac valve surgery. Prosthetic heart valve leaflets have been rarely described as intravascular foreign bodies. Herein we report a case of prosthetic heart valve leaflet embolization to the aortic bifurcation with computed tomography and ultrasonography findings, and the importance of radiographic imaging in the localization of missing leaflet fragment is pointed out.

Aims: To evaluate the diagnostic value of sonohysterography in the evaluation of submucosal fibroids and endometrial polyps. Methods: Thirty-two women whose preliminary transvaginal ultrasound suggested endometrial abnormality underwent sonohysterography. The findings were then compared with histopathological results. Results: The sonohysterographic diagnosis was fibroid in seven patients, endometrial polyp in 23 patients and simple hyperplasia in two patients. Histopathological findings confirmed our diagnosis in all except three patients with endometrial polyps, who had normal secretory endometrium. Sonohysterography was found to have a sensitivity of 100%, a positive predictive value of 90% and diagnostic accuracy of 90.6%. Conclusion: Sonohysterography is a useful, minimally invasive and accurate technique to evaluate the pathologies involving endometrium and uterine cavity.

In this retrospective study, the computed tomography (CT) archives of paranasal sinus examinations were reviewed and three cases of antroliths are presented. The archivesof paranasal sinus CT studies of 1957 patients (1023 females, 934 males, mean age 36.5 years) were surveyed. CT studies were performed using 3 mm collimation and interval in the coronal, axial or both coronal and axial planes.Three out of 1957 patients demonstrated antroliths, all in the left maxillary sinus. Associated sinusitis was detected in all three patients. Only one patient was operated. The chemical analysis of the antrolith revealed it to be a calcium oxalate stone. All the relevant literatureis reviewed and only 25 other cases of true antrolithiasis were encountered. The clinical and radiological features of antroliths,as well as differential diagnosis were discussed.Antrolithiasis should be considered in any case of sinusitis, that does not respond to appropriate medical therapy.

Respiratory amyloidosis is a rare disease that occurs in three forms: tracheobronchial, nodular parenchymal and diffuse parenchymal involment. Tracheobronchial amyloidosis is characterized by focal or diffuse deposition of amyloid in the submucosa of the trachea and proximal bronchi. Herein, we report a case of diffuse tracheobronchial amyloidosis with plain radiography and thorax computed tomography findings.