{"title":"Role of cardiac magnetic resonance in MINOCA of unclear etiology: a case report of a suspicious paradoxical coronary embolism.","authors":"Francesca Scabbia, Michela Zerbini, Lucia Pirani, Riccardo Righi, Monica Viola, Ada Collevecchio, Roberto Rizzati, Biagio Sassone","doi":"10.1259/bjrcr.20220114","DOIUrl":"10.1259/bjrcr.20220114","url":null,"abstract":"<p><p>The acronym MINOCA (Myocardial Infarction with Non-Obstructive Coronary Arteries) refers to myocardial infarction with normal or near-normal coronary arteries on invasive angiography. The broad spectrum of pathological mechanisms responsible for myocardial injury in MINOCA makes defining the exact underlying etiology challenging. We report the uncommon case of an acute myocardial infarction with normal coronary arteries suggestive of MINOCA caused by paradoxical coronary embolism due to a wide right-to-left shunting through a patent fossa ovalis. Integrated multimodality imaging diagnostic work-up, including cardiac magnetic resonance, transesophageal contrast echocardiography, and transcranial contrast Doppler, has been crucial for identifying the most likely mechanism underlying MINOCA.</p>","PeriodicalId":45216,"journal":{"name":"BJR Case Reports","volume":null,"pages":null},"PeriodicalIF":0.5,"publicationDate":"2023-02-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9976720/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10847924","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
BJR Case ReportsPub Date : 2023-02-01DOI: 10.1259/bjrcr.20220012
Darren Hudson, Luis Abrantes
{"title":"Heattech clothing technology and potential for thermal injury in MRI.","authors":"Darren Hudson, Luis Abrantes","doi":"10.1259/bjrcr.20220012","DOIUrl":"https://doi.org/10.1259/bjrcr.20220012","url":null,"abstract":"<p><p>A patient attended for an MRI scan wearing Heattech thermal clothing. Following the scan, the patient experienced a heating and sunburn sensation over their back. Further investigation has highlighted one similar event to this internationally due to the clothing technology used. The intention of this report is to raise awareness of the potential for this clothing technology to cause thermal injury when worn within MRI, as well as to further emphasise the importance of assessing patient clothing prior to scanning.</p>","PeriodicalId":45216,"journal":{"name":"BJR Case Reports","volume":null,"pages":null},"PeriodicalIF":0.6,"publicationDate":"2023-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9976719/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9410260","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
BJR Case ReportsPub Date : 2023-02-01DOI: 10.1259/bjrcr.20220142
Giovanni Foti, Chiara Longo, Fabio Lombardo, Enrico Piovan, Francesco Colpani, Alberto Beltramello
{"title":"Langerhans cell histiocytosis: unusual dorsal spine localization in an adult male.","authors":"Giovanni Foti, Chiara Longo, Fabio Lombardo, Enrico Piovan, Francesco Colpani, Alberto Beltramello","doi":"10.1259/bjrcr.20220142","DOIUrl":"https://doi.org/10.1259/bjrcr.20220142","url":null,"abstract":"<p><p>This case report describes the clinical, imaging, and pathological features of a case of Langerhans cell histiocytosis affecting a patient suffering from chronic thoracic spine pain. Spinal localizations of Langerhans cell histiocytosis have been rarely described and they are usually characterized by involvement of vertebral bodies with osteolytic lesions. Our case presented with several unusual features that delayed the diagnosis, including the age of patient and the involvement of left T10 costovertebral junction with relative sparing of vertebral body and costal bone. The clues for diagnosis were represented by increased signal intensity both on <i>T</i> <sub>2</sub>W fat-saturated and <i>T</i> <sub>1</sub>W images after administration of gadolinium. The diagnosis was finally confirmed by means of percutaneous biopsy with subsequent histological/immunohistochemical study.</p>","PeriodicalId":45216,"journal":{"name":"BJR Case Reports","volume":null,"pages":null},"PeriodicalIF":0.6,"publicationDate":"2023-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9976724/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9410262","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
BJR Case ReportsPub Date : 2023-02-01DOI: 10.1259/bjrcr.20220059
Chau Hung Lee
{"title":"Portal vein thrombosis on unenhanced MRI: a case series.","authors":"Chau Hung Lee","doi":"10.1259/bjrcr.20220059","DOIUrl":"https://doi.org/10.1259/bjrcr.20220059","url":null,"abstract":"<p><p>Portal vein thrombosis (PVT) is usually diagnosed on contrast-enhanced CT, MRI or Doppler ultrasound. However, for patients with contraindications to intravenous contrast, its diagnosis is challenging. In these patients, PVT can be detected on unenhanced MRI using T2, T1 and diffusion-weighted imaging. These sequences may also help differentiate between bland PVT, portal pyemia and tumour thrombus. This case series aims to highlight the various appearances of PVT on unenhanced MRI.</p>","PeriodicalId":45216,"journal":{"name":"BJR Case Reports","volume":null,"pages":null},"PeriodicalIF":0.6,"publicationDate":"2023-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9976726/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9410267","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Repeated recurrence of bilateral gigantomastia after subcutaneous mastectomy caused by tumoral pseudoangiomatous stromal hyperplasia: a case report and review of literature.","authors":"Manisa Sornlertlumvanich, Patteera Rohitopakarn, Srila Samphao, Varanatjaa Pradaranon, Warunee Kaewpiboon, Noppadol Kietsiriroje, Siriorn Danglaoun","doi":"10.1259/bjrcr.20220074","DOIUrl":"https://doi.org/10.1259/bjrcr.20220074","url":null,"abstract":"<p><p>Pseudoangiomatous stromal hyperplasia (PASH) is an uncommon benign proliferative mesenchymal lesion of the breast with a hormonal-sensitive nature. Various manifestations of PASH, ranging from an incidental microscopic finding in a tissue biopsy to a large palpable mass or bilateral gigantomastia, have been described. For tumoral PASH, surgical excision is indicated for a growing and symptomatic mass with a small chance of recurrence. A recurrence of bilateral gigantomastia after surgical excision or reduction mammoplasty is not common but has been occasionally reported, leading to further mastectomy. Repeated recurrence of bilateral gigantomastia is extremely rare. Herein, we report a case of a 13-year-old girl who presented with the third recurrence of bilateral gigantomastia caused by tumoral PASH, after undergoing bilateral reduction mammoplasty, and later subcutaneous mastectomy. Precocious puberty occurred early in this child at the age of 9 years, which may have been a factor unmasking PASH at this young age. The incomplete removal of the PASH could also have been a recurrence risk in our case as extended masses underneath the pectoralis muscle were later identified on the MRI study. This highlights the advantage of preoperative imaging in cases with a very large tumoral PASH in order to maximize the chance of complete tumor removal.</p>","PeriodicalId":45216,"journal":{"name":"BJR Case Reports","volume":null,"pages":null},"PeriodicalIF":0.6,"publicationDate":"2023-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9976717/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10847922","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
BJR Case ReportsPub Date : 2023-02-01DOI: 10.1259/bjrcr.20220046
Joel Hng, Sankar Manchella, Ernest Lekgabe
{"title":"Gout of the temporomandibular joint and review of the literature.","authors":"Joel Hng, Sankar Manchella, Ernest Lekgabe","doi":"10.1259/bjrcr.20220046","DOIUrl":"https://doi.org/10.1259/bjrcr.20220046","url":null,"abstract":"<p><p>Gout is a disease characterised by abnormal deposition of monosodium urate crystals, typically affecting the extremities. This report describes a rare case of gout affecting the left temporomandibular joint with erosion of the skull base. A diagnosis of gout was suspected based on CT and MRI and confirmed with CT-guided biopsy. The temporomandibular joint is an uncommon location for a first presentation of gout, with very few cases documented and only three cases of skull base involvement reported in the English literature previously. Given its radiological appearance, it can easily be misdiagnosed as other erosive arthropathies or malignancy. Our paper highlights an unusual location for the first and only manifestation of gout and offers some diagnostic and treatment ideas that may help clinicians to identify and manage this disease.</p>","PeriodicalId":45216,"journal":{"name":"BJR Case Reports","volume":null,"pages":null},"PeriodicalIF":0.6,"publicationDate":"2023-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9976722/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9410265","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
BJR Case ReportsPub Date : 2023-02-01DOI: 10.1259/bjrcr.20220138
Duc Le, Kelly Trinh, Nirav Das, Anderson H Kuo
{"title":"T2-fluid attenuated inversion recovery mismatch in tumefactive multiple sclerosis.","authors":"Duc Le, Kelly Trinh, Nirav Das, Anderson H Kuo","doi":"10.1259/bjrcr.20220138","DOIUrl":"https://doi.org/10.1259/bjrcr.20220138","url":null,"abstract":"<p><p>The T2-fluid attenuated inversion recovery (FLAIR) mismatch sign has been suggested as an imaging marker of isocitrate dehydrogenase-mutant 1p/19q non-codeleted gliomas with 100% specificity. Tumefactive demyelination is a common mimic of neoplasm that has led to unnecessary biopsies and even resections. We report a case of tumefactive multiple sclerosis in a 46-year-old male without prior symptomatic demyelinating episodes that demonstrates the T2-FLAIR mismatch sign. Our findings suggest the T2-FLAIR mismatch sign should not be used as a differential feature between glioma and tumefactive demyelination. Because typical isocitrate dehydrogenase-mutant 1p/19q non-codeleted gliomas typically do not demonstrate significant enhancement, such diagnosis should be reserved when post-contrast images are unavailable.</p>","PeriodicalId":45216,"journal":{"name":"BJR Case Reports","volume":null,"pages":null},"PeriodicalIF":0.6,"publicationDate":"2023-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9976723/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9410264","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
BJR Case ReportsPub Date : 2023-02-01DOI: 10.1259/bjrcr.20220132
Hiba Alessa, Luiz Cesar Peres, Emma Ferriman, Andrew Fry, Elspeth Whitby
{"title":"MRI features of perifibrinous deposits in the placenta due to COVID-19.","authors":"Hiba Alessa, Luiz Cesar Peres, Emma Ferriman, Andrew Fry, Elspeth Whitby","doi":"10.1259/bjrcr.20220132","DOIUrl":"https://doi.org/10.1259/bjrcr.20220132","url":null,"abstract":"<p><p>COVID-19 has been linked to pregnancy complications and loss (1). Infection during pregnancy is usually mild (2). The risk is highest in the third trimester with increased hospital admission rates and maternal and fetal compromise (3). Post-COVID placentitis is uncommon but the effect on the placenta and the fetus is extensive (4). We present a case correlating clinical, imaging, and pathological findings. <b>Case Report:</b> A 29-year-old para 2 gravida 1, with a normal fetal anomaly scan at 22 weeks gestational age (GA) contracted COVID at 24 weeks gestation. Fully recovered but reported reduced fetal movements at 27 weeks and 1 day. <b>Imaging:</b> US scan showed bright echoes within the brain, small lungs, and oligohydramnios. MRI showed abnormal brain signals, small lungs, and oligohydramnios but also a very abnormal placenta. Reduced and heterogeneous T2 signal and a marked reduction in the DWI signal intensity. The placental size was markedly reduced (volume 785.6 cm3 expected for GA is 5604.8-5952.4 cm<sup>3</sup>. The surface area of attachment was 3220 mm<sup>2</sup>, expected 22180.4-29293.2 mm<sup>2</sup>). <b>Pathology:</b> The placenta was small (fifth centile) with massive perivillous fibrin deposition and multifocal chronic deciduitis. Histology revealed placental chorionic villi showing diffuse sclerotic changes surrounded by perivillous fibrin deposition in the intervillous space. The basal plate revealed multifocal chronic deciduitis. When imaging the fetus, it is important to examine the placenta and correlate any abnormalities. The placenta is a forgotten organ and should be routinely included and assessed to allow the detection of important abnormalities.</p>","PeriodicalId":45216,"journal":{"name":"BJR Case Reports","volume":null,"pages":null},"PeriodicalIF":0.6,"publicationDate":"2023-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9976725/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9410263","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Primary vaginal signet ring cell carcinoma.","authors":"Xiao-Shan Huang, Shu-Feng Fan, Jian-Xia Xu, Yong-Jie Xu, Xia Song, Jun-Yi Xiang, Li-Ming Xue","doi":"10.1259/bjrcr.20220050","DOIUrl":"https://doi.org/10.1259/bjrcr.20220050","url":null,"abstract":"<p><p>Primary vaginal cancer is rare, accounting for only 2% of all gynecological malignant tumors. Primary vaginal cell carcinoma is mainly squamous cell carcinoma, accounting for about 90%, and adenocarcinoma only accounts for 8-10%. Primary signet ring cell carcinoma of vagina is rare and has not been reported in the literature. This paper reports a case of signet ring cell carcinoma in vagina.</p>","PeriodicalId":45216,"journal":{"name":"BJR Case Reports","volume":null,"pages":null},"PeriodicalIF":0.6,"publicationDate":"2023-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9976718/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9393802","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
BJR Case ReportsPub Date : 2023-02-01DOI: 10.1259/bjrcr.20220094
Arjunan Kumaran, Si Xuan Koo, Joe Yeong, Angela Maria Takano, Mohamad Farid, Siu Hoong Loke, Wen Long Nei
{"title":"Imaging and treatment with <sup>68</sup>Gallium and <sup>177</sup>Lutetium-DOTATATE in a rare SSTR2 and ESWR1-CREM fusion positive undifferentiated round cell tumour of the lung.","authors":"Arjunan Kumaran, Si Xuan Koo, Joe Yeong, Angela Maria Takano, Mohamad Farid, Siu Hoong Loke, Wen Long Nei","doi":"10.1259/bjrcr.20220094","DOIUrl":"https://doi.org/10.1259/bjrcr.20220094","url":null,"abstract":"<p><p>The authors present a 45-year-old lady with a rare undifferentiated round cell tumour of the lung with a ESWR1-CREM fusion gene that progressed despite multiple lines of therapy. The tumour was Somatostatin Receptors Type 2 (SSTR2) positive and avid on <sup>68</sup>Gallium-DOTATATE imaging. This allowed for novel treatment with Peptide Receptor Radionuclide Therapy (PRRT) using <sup>177</sup>Lutetium-DOTATATE after all other standard of care options were exhausted.</p>","PeriodicalId":45216,"journal":{"name":"BJR Case Reports","volume":null,"pages":null},"PeriodicalIF":0.6,"publicationDate":"2023-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9976727/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9410261","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}