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Undifferentiated embryonal sarcoma (UES) is a highly malignant hepatic neoplasm, which occurs mostly in pediatric population. There is a link between embryonal sarcoma and mesenchymal hamartoma as evidenced by clinicopathological overlap and similar genetic abnormality. Here, we report a case of UES in a young female in a background of mesenchymal hamartoma of liver.

Background: Acute disseminated encephalomyelitis (ADEM) is an inflammatory demyelinating disease of the CNS, characterized by fulminant multifocal neurologic injury and distinct neuropathologic findings. Case Report: We report a case of a forty-nine-year-old female who presented with progressive weakness of right side of the body of one-week duration. Clinical, laboratory and radiological features favored demyelination. There was temporal association with taking SARS COV 2 vaccination (ChAdOx1 n cov -19 (AZD1222)). She was treated with a course of steroids and made a good recovery. Conclusion: To our knowledge this is a rare case of ADEM noticed after ChAdOx1 nCoV-19 vaccine (AZD1222).

Pericardial tumors are very rare. It can be primary or secondary, of which secondary tumors are more common. Pericardial hemangiomas are extremely rare primary neoplasms and there are only very few cases published in the literature. These patients can be asymptomatic. When symptomatic, they present with dyspnea, palpitation, or atypical chest pain. Severity of symptoms depends on the size and location of the tumor. Pericardial effusion with features of cardiac tamponade can lead to a life-threatening situation. Here, we report a case of pericardial hemangioma in a patient who presented with breathlessness and tamponade which was diagnosed preoperatively with computed tomography.

Toxoplasmosis is caused by Toxoplasma gondii an obligate protozoan intracellular parasite. The disease has variable prevalence globally and is usually asymptomatic. Pregnant and immunocompromised people are at risk of getting infected. Enlarged lymph nodes are the most frequently observed clinical form of Toxoplasma in humans, mostly affecting posterior cervical nodes. Other organs usually affected are the brain and eyes. We present a case of toxoplasmosis with generalized lymphadenopathy mimicking metastasis in a lady with a previous history of operated pancreatic neoplasm.

Background Gastrointestinal stromal tumors (GISTs) are the most common gastrointestinal mesenchymal neoplasms which can arise from any part of the gastrointestinal tract (GIT) or an extraintestinal location. Size and the organ of origin are the major imaging inputs expected from the radiologist. However, it is worthwhile to find out which imaging characteristics on MDCT correlate with risk stratification. This knowledge would help the clinician in treatment planning and prognostication. The aim of this retrospective study is to evaluate the various MDCT imaging characteristics of GISTs and find out which parameters have significant association with risk and subsequent development of metastasis on follow-up whenever it was possible. Materials and Methods This is a retrospective study conducted on 45 histopathologically proven cases of GIST from two institutions by searching from the digital archives. The following imaging parameters were analyzed: maximum size in any plane, organ of origin, shape (round, ovoid or irregular), margin (well-defined or ill-defined), surface (smooth or lobulated), percentage of necrosis, growth pattern, enhancement characteristics–both intensity (mild, moderate or significant) and pattern (homogenous vs. heterogenous), calcification, infiltration into adjacent organs, and presence of metastasis at presentation or on follow-up. Results CT morphological parameters of significance in risk stratification as per our study include tumor necrosis, predominant cystic change, irregular and lobulated shape/surface characteristics, and adjacent organ infiltration.The parameters which were associated with development of metastasis were size > 5 cm, necrosis > 30%, and the presence of adjacent organ infiltration. Conclusion The radiologist has an important role in ascertaining the size of tumor as well as the organ of origin accurately to guide the clinician in risk calculation and subsequent prognostication. In addition, certain CT characteristics mentioned above, namely, tumor size, significant necrosis/cystic changes, irregular/lobulated contour, and invasion of adjacent organs, help in risk stratification and in predicting metastasis/poor prognosis.

Collision tumour is the coexistence of two adjacent, but histologically distinct tumours without histologic admixture. Collision tumours are rare in the ovary. It is mostly a histopathological diagnosis often missed in preoperative imaging. The radiologist, gynaecologists and pathologists should be aware of such a combination of tumours to avoid misdiagnosis. We describe the finding of a rare collision tumour, mature cystic teratoma and ovarian fibroma complicated by torsion.

Fulminant hepatic failure as initial presentation due to diffuse parenchymal infiltration by cholangiocarcinoma is a rare entity. We present the case of a 49-year-old female patient who had a fatal outcome with acute liver failure due to diffuse intrahepatic cholangiocarcinoma. No definite mass lesion was identified on cross-sectional imaging. The final diagnosis was made on transjugular liver biopsy. This discussion highlights the possibility of infiltrative cholangiocarcinoma as a rare cause of fulminant hepatic failure.

Hepatocellular carcinoma (HCC) usually metastasizes to the regional abdominal lymph node, lungs, and bones. Nonregional lymph node involvement by HCC in the absence of regional lymph nodes is rare. We describe the 18F-fluorodeoxyglucose positron-emission tomography-computed tomography findings of an HCC patient with histopathologically proven inguinal lymph nodal metastasis in the absence of regional lymph nodal metastases.

Peritoneal lymphomatosis is relatively uncommon cause of diffuse malignant peritoneal disease, and differentiating it from other causes of diffuse peritoneal disease such as peritoneal carcinomatosis is often difficult on imaging. Common findings observed in peritoneal lymphomatosis in contrast to other etiologies include frequent nodal involvement and splenomegaly. We present a case of diffuse peritoneal disease along with ovarian lesions in the absence of abdominal lymphadenopathy or splenomegaly on fluorodeoxyglucose positron emission tomography–computed tomography in the setting of elevated cancer antigen-125 levels, mimicking primary ovarian malignancy causing peritoneal carcinomatosis, which was finally proven to be lymphoma.

Listeria monocytogenes infections are rare. Neonates and geriatric population, pregnant women, and diabetic and immunocompromised patients are at higher risk for invasive listeriosis. Early recognition of Listeria brain abscess remains a major challenge. Here, we describe a case of intratumoral abscess with L. monocytogenes in a patient with intracerebellar metastasis from poorly differentiated adenocarcinoma lung. Right cerebellar tumor with a thick-walled purulent cavity was resected. Histopathologic examination revealed acute inflammation consistent with abscess and showed metastatic poorly differentiated adenocarcinoma. Cultures of the abscess fluid grew L. monocytogenes. She responded well to ampicillin-gentamycin therapy and the surveillance imaging done on the seventh postoperative day showed clearance of the abscess. The patient is further being planned for radiotherapy in regard to metastasis. Listeria abscess within a metastatic tumor is very rare and only one case is reported as of our knowledge. Listeria abscess being reported within an intracerebellar metastatic space-occupying lesion is for the first time.

Malignant transformation Paget's disease of bone to sarcoma is relatively rare, occurring in approximately 1% of these patients. Although few clinical and imaging findings may help in prediction of malignant transformation, most of them are nonspecific. We describe a case of carcinoma vocal cord and Paget's disease of bone with sarcomatous transformation, where 18F-fluorodeoxyglucose (FDG) positron emission tomography-computed tomography was helpful in accurate diagnosis by demonstrating differential intense FDG uptake in transformed areas of pagetic bone and also FDG-avid osteoblastic pulmonary metastasis.

Lymphomatoid papulosis is a benign self-healing condition, presenting as papulonodular skin eruptions and mimicking malignant cutaneous lymphomas histopathologically. F-FDG PET/CT findings in this benign condition have not been described in detail in the literature. We present a case of lymphomatoid papulosis mimicking primary cutaneous anaplastic large cell lymphoma histopathologically and demonstrating intensely FDG-avid cutaneous lesions on F-FDG PET/CT, which disappear spontaneously in the follow-up scan.

Neuroendocrine tumors (NET) are rare neoplasms and commonly metastasize to liver, lymph nodes and less frequently to bones and lungs. Metastases to other organs are extremely rare and we report a case of NET clinically presenting with bilateral proptosis secondary to metastases in orbits. Ga-DOTANOC PET/CT demonstrated somatostatin receptor overexpressing lesions in bilateral orbits, small intestine, lymph nodes, lungs, heart and testes in the absence of liver metastases.

We report a case of broncho-esophageal fistula associated with tuberculosis. A 29-year-old female diagnosed with smear-positive pulmonary tuberculosis on anti-tuberculosis treatment for 2 months presented with complaints of cough on food intake with food particles present in the expectorant. Radiological examination revealed mediastinal lymphadenopathy and upper gastrointestinal endoscopy revealed multiple fistulous tracts in the esophagus. Small fistulae were treated by clipping and large fistulae were treated with self-expandable metallic stents which resulted in the alleviation of symptoms.

Hepatocellular carcinoma usually metastasizes to regional abdominal lymph nodes. Distant lymph nodal metastases are relatively rare with most common extra abdominal sites being mediastinum and juxtaphrenic regions. Metastasis to internal mammary lymph nodes is extremely rare, and we present a case of hepatocellular carcinoma with histopathologically proven internal mammary lymph nodal metastasis in the absence of regional abdominal lymph nodal metastases.

T-cell large granular lymphocytic leukemia is a rare form of leukemia, caused by clonal proliferation of cytotoxic T-cells, characterized by modest lymphocytosis and cytopenias of other lineage with hepatosplenomegaly and relatively rare lymph nodal involvement. Involvement of other organs is extremely rare. It is predominantly an indolent disease and most of patients remain asymptomatic for a long period. We present a rare case of aggressive form (CD56 positive) of large granular lymphocytic leukemia with atypical presentations mimicking pleural malignancy on F-FDG PET/CT.

Majority of ovarian cancer (OC) patients are usually diagnosed at advanced stage and present with peritoneal spread/ascites. Some patients develop pleural deposits/effusion secondary to transdiaphragmatic spread of peritoneal disease/ascites. However, pleural deposits/effusion from OC in the absence of peritoneal disease/ascites are very rare. We present a case of serous carcinoma of the left ovary with fluorodeoxyglucose (FDG) avid right pleural deposits and effusion in the absence of peritoneal disease/ascites on FDG positron emission tomography (PET)/computed tomography (CT), showing excellent response to chemotherapy in subsequent PET/CT. We also discuss the pathophysiology of pleural abnormalities in patients with ovarian diseases, a characteristic disease spread pattern and recognition of which would help in the imaging interpretation.

Granulomatosis with polyangiitis (GPA) is a small-to-medium vessel vasculitis, which affects multiple organs. We describe a patient with GPA who initially presented with multiple ischemic toes. The diagnosis was supported by a positive c-ANCA (anti-neutrophil cytoplasmic antibody). The involvement of digital arteries in this condition is very unusual, and only a few cases have been reported so far.

We present a case with space-occupying lesion in cirrhotic liver, diagnosed as hepatocellular carcinoma on immunohistochemistry, who underwent F-18 fluorodeoxyglucose positron emission tomography/computed tomography (FDG PET/CT) and showed FDG-avid lesions in liver as well as in the prostate. These findings guided in establishing the diagnosis of prostate cancer, metastasizing to liver by performing additional immunohistochemical markers. PET/CT was also useful in identifying coexisting non-Hodgkin's lymphoma.

May–Thurner syndrome (MTS) is an anatomically variable clinical condition in which the left common iliac vein is compressed between the right common iliac artery and the underlying spine. This anatomic variant results in an increased incidence of left iliac or iliofemoral vein thrombosis. We would like to substantiate that MTS is often underdiagnosed, and it should always be suspected in left iliofemoral vein thrombosis in young individuals.

Normal cerebrospinal fluid (CSF) does not contain eosinophils. The presence of >10 eosinophils/μL in CSF or at least 10% eosinophils in total CSF leukocyte count confirms eosinophilic meningitis. We present three patients with eosinophilic meningitis from the same locality with peripheral eosinophilia.

Imaging modalities for evaluation of uterine malignancy include ultrasonography, sonohysterography, computed tomography (CT), magnetic resonance imaging (MRI), and positron emission tomography (PET-CT). The role of color Doppler with spectral tracing is limited. 3D ultrasonography, contrast ultrasonography, and ultrasound elastography are new techniques which may be useful for better evaluation in certain situations.