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Ocular adnexal lymphoma accounts for approximately 1%-2% of non-Hodgkin lymphomas and 8% of extranodal lymphomas. Lacrimal gland lymphoma, especially bilateral lacrimal gland lymphoma, is rare, and imaging is often utilized to differentiate lacrimal lymphoma from other types of masses that involve the lacrimal gland and the fossa. We describe a 74-year-old male patient presenting with bilateral eye proptosis, lachrymose without pain, and no changes in eyesight. Brain-orbit magnetic resonance imaging revealed bilateral lacrimal fossa masses with regular contours, moderate enhancement, and restriction on diffusion imaging, consistent with a lymphoma diagnosis, which was confirmed by histopathological results. Positron emission tomography-computed tomography was used to determine lymphoma grading. MRI, especially diffusion imaging, can be useful for guiding clinicians in the diagnosis and differentiation of lacrimal gland lymphoma from other lesions.

Hypovascular pancreatic neuroendocrine tumors are uncommon pancreatic tumors and commonly misdiagnosed as pancreatic ductal adenocarcinoma or chronic mass-forming pancreatitis. The liver is the organ most commonly affected by neuroendocrine tumor metastases but hepatic neuroendocrine tumor metastases are quite difficult to discriminate from other hepatic metastases and primary hepatic tumors. We describe a case of a 47-year-old man with incidentally detected multiple hepatic lesions on ultrasound. On further imaging technique including computed tomography and magnetic resonance imaging, the patient had an abnormal hypoenhancing lesion at the pancreatic tail and multiple hyperenhancing hepatic metastases that were diagnosed as hypovascular pancreatic well-differentiated neuroendocrine tumor Grade 2 with multiple hypervascular hepatic metastases after liver biopsy and surgery. Neuroendocrine tumor is a rare etiology among hypoenhancing pancreatic tumors, and must be considered to discriminate from pancreatic adenocarcinomas in cases there are multiple hyperenhancing hepatic metastases on the arterial phase without typical washout on the portal venous phase.

Nguyen Duy Hung,1,2,* Vuong Kim Ngan,3 Nguyen Minh Duc4,5,* 1Department of Radiology, Hanoi Medical University, Hanoi, Vietnam; 2Department of Radiology, Viet Duc Hospital, Hanoi, Vietnam; 3Department of Radiology, Vinmec Times City International Hospital, Hanoi, Vietnam; 4Department of Radiology, Pham Ngoc Thach University of Medicine, Ho Chi Minh City, Vietnam; 5Department of Radiology, Children’s Hospital 2, Ho Chi Minh City, Vietnam*These authors contributed equally to this workCorrespondence: Nguyen Minh DucDepartment of Radiology, Pham Ngoc Thach University of Medicine, Ho Chi Minh City, VietnamEmail bsnguyenminhduc@pnt.edu.vnBackground: Craniopharyngiomas are common lesions that occur in the suprasellar region; however, strictly intrinsic third ventricular craniopharyngiomas are rare.Case Series: We aimed to describe the magnetic resonance imaging features observed in five cases of strictly intrinsic third ventricular papillary craniopharyngiomas, including two cases of mixed cystic and solid tumors and three cases of pure solid masses.Conclusion: Among the adult population, intrinsic third ventricular papillary craniopharyngiomas should be considered when either solid or mixed cystic and solid masses are observed, in which the solid component shows heterogeneous intensity, heterogeneous and strong enhancement, and is strictly located in the third ventricle.Keywords: strictly intrinsic third ventricle, craniopharyngioma, magnetic resonance imaging

McCune-Albright syndrome (MAS), a rare genetic disorder, affects multiple organs and classically presents with the triad of polyostotic fibrous dysplasia (FD), skin hyperpigmentation (café-au-lait spots) and precocious puberty. Diagnosis occurs when patients manifest at least two of these three symptoms. We describe a 4-year-old girl who was admitted to our hospital due to recurrent vaginal bleeding, initially diagnosed as precocious puberty. On brain MRI, abnormalities in the maxillary and occipital bones were compatible with FD. Clinical examination after craniofacial bone lesions and clinical signs indicated MAS revealed abnormally pigmented macules on the neck and back, which were initially overlooked. No abnormal hormone tests were observed. Precocious puberty is the most common MAS-associated symptom that results in the admission to the hospital, whereas the clinical manifestation of FD in the first years of life is usually equivocal and probably has not been discovered by parents. Thus, comprehensive medical examinations are necessary to obtain a prompt and proper diagnosis.

Background: Bowel and mesenteric injuries have high morbidity and mortality rates in the trauma group due to non-specific symptoms and are often obscured in the context of multiple traumas, contributing to an increased risk of peritonitis and sepsis. The purpose of this research was to assess the diagnostic accuracy of 16-slice multidetector computed tomography (MDCT) findings in the diagnosis of bowel and mesenteric injuries accompanied by the association of these findings with the treatment strategy. Methods: A retrospective study was performed on 86 blunt-abdominal-trauma patients, hospitalized at the emergency department of our institution from June 2018 to July 2019 (75 men and 11 women aged 4–76 years old with a median age of 40.88), who had 16-slice MDCT diagnosis of blunt bowel and mesenteric injuries and were treated by nonsurgical and surgical treatment. Ethical clearance was taken from the institute ethics committee with waiver of consent. Results: The specificity of bowel-wall rupture, active extravasation, and reduced bowel-wall enhancement were 100%, 98.15%, and 100%, respectively. Pneumoperitoneum had the highest sensitivity of 83.33%. Bowel-wall rupture, Janus signs, pneumoperitoneum, and mesenteric stranding were significantly correlated with surgical results. The existence of these results improved the likelihood of 7-, 6-, 29- and 3-fold surgical treatment, respectively. Inter-observer consensus was very strong for bowel-wall rupture, active extravasation, bowel hematoma, and pneumoperitoneum. Conclusion: Bowel-wall rupture was the definite sign of bowel injury and its connection with surgical treatment was important. Pneumoperitoneum was not a specific indication of blunt bowel injury; but when this is detected, emergency intervention should be suggested.