SPOTTERS
08.10.2020
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ANSWERS
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Michel aplasia
• Michel aplasia, also known as complete
labyrinthine aplasia (CLA), is a congenital
abnormality of the inner ear and is
characterized by bilateral absence of
differentiated inner ear structures with
resultant anacusis.
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Obturator hernias
• Obturator hernias are characterized by bowel
herniating between the obturator and the
pectineus muscles. They are a rare type of
abdominal hernia and can be very difficult to diagnose
clinically. The diagnosis is readily made on CT/MRI with
either fluid or bowel able to be traced along the
aforementioned course to lie in the medial upper thigh.
• Signs of complication, including:
• bowel obstruction
• strangulation resulting in perforation
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Incisive canal cysts
• , also known as nasopalatine duct cysts (NPDC), are
developmental, non-neoplastic cysts arising from degeneration
of nasopalatine ducts. These ducts usually regress in fetal life.
The persistence of ductal epithelium leads to formation of cyst.
• It is considered the most common non-odontogenic cyst and
develops only in the midline anterior maxilla.
• They are seen as a solitary well-defined, oval or round
unilocular radiolucency, between central incisors, >0.6 cm in
diameter. They may appear “heart-shaped” if the anterior nasal
spine superimposed. Root resorption and tooth displacement
may be present.
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gossypiboma,
• A also called textiloma or cottonoid, refers to a foreign object,
such as a mass of cotton matrix or a sponge, that is left behind in a
body cavity during an operation. It is an uncommon surgical
complication.
• The manifestations and complications of gossypibomas are so
variable that diagnosis may be difficult and patient morbidity is
significant.
• Frequent sites of gossypiboma formation include:
• thoracic cavity
– pleural cavity
– pericardial cavity
• abdominal cavity
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Extramedullary hematopoiesis
Bilateral para-vertebral soft tissue masses.
• Extramedullary hematopoiesis is a response to the failure of erythropoiesis
in the bone marrow.
• When involving an organ, extramedullary hematopoiesis causes
visceromegaly occurring most often in the spleen (splenomegaly) and liver (
hepatomegaly) and occasionally in the lymph nodes. Visceromegaly is best
evaluated with ultrasound, CT or MRI. Lesions are typically hypermetabolic
and are FDG-18 avid on PET-CT 4.
• Extramedullary hematopoiesis less commonly affects the pleura, lungs,
gastrointestinal tract, breast, skin, brain, kidneys, and adrenal glands.
• However, in the less common situation where extramedullary hematopoiesis
involves other tissues within the thorax, they can be seen as a
posterior mediastinal mass. These paraspinal masses may be either
unilateral or bilateral and have smooth, sharply-delineated, often lobulated
margins.
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Chondrosarcoma - Exostosis
• These bone lesions are benign outgrowths from long bones such
as the tibia and humerus. Rarely, they can involve the pelvis and
scapula.
• They can be sessile or pedunculated.
• They are bony outgrowths that classically grow away from the
metaphysis of the bone. They have a cartilage cap which may
calcify with age. They grow as a result of radiation or trauma.
• There exists a syndrome of multiple exostoses which can be
inherited. This syndrome is called diaphyseal aclasia or multiple
osteochondromas.
• There is a small (1%) chance of malignant degeneration to
chondrosarcoma of the cartilage cap in a solitary
osteochondroma.
• This percentage rises to 10% in the multiple osteochondroma
syndrome.
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EXTENSIVE “TROLLEY TRACK CALCIFICATION ” OF LEFT URETER AND BLADDER -
SCHISTOSOMIASIS
• Schistosomiasis is a common parasitic infection in Africa, Arabia, and
southwest Asia.
• Infection usually comes about during swimming or bathing in infested
waters.
• The characteristic changes of schistosomiasis are seen in the ureters and
the bladder.
• In spite of the diffuse bladder involvement, bladder capacity is surprisingly
well maintained whereas in TB, bladder become contracted.
• The intramural ureters become constricted, leading to ureteral dilatation
early in the disease, prior to any discernible ureteral narrowing more
proximally.
• As the disease progress, transmural involvement of the ureter results in
irregular stricturing and dilatation with a beaded appearance to the distal
ureter.
• Calcification first occur in the ureteral mucosa in the walls of small,
hemorrhagic cyst which are represented radiologically as fine, scattered
stipples (ureteritis calcinosa) that eventually coalesce.
• In time entire length of the ureter may calcify.
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Cephalohematoma
• A large high attenuation mass is noted over
the upper right convexity, which does not
cross the plane of the coronal, lambdoid or
sagittal sutures.
• This confirms the subperiosteal location and
therefore typical of cephalohematoma.
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Caput succedaneum
• A smaller extracranial density is noted, which
crosses the level of the superior sagittal suture
near the posterior fontanalle, therefore
confirming this as a caput succedaneum.
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Extensive cysticercosis of the soft tissues,
muscles, diaphragm, and lungs
• The calcified cysticercus produces single (rarely) or multiple (often several
hundred) calcifications in the soft tissues, which are linear or oval in shape
and usually measure 4-10 mm or more in length and 2-5 mm in width.
Cysts as large as 23 mm have been reported. The calcified cysts will have
their long axes in the plane of the surrounding muscle bundle
• Cysticerci may be seen in the lungs, where they are about 3-6 mm in
diameter. The outer shell is calcified, with a somewhat lighter and softer
center. In the lungs, the cysts remain more nearly round compared with
the oval or elongate calcified cysts in muscle.
• In the liver, the cysticercus is larger and has been described as the size of a
cherry (1 cm in diameter). If a cyst is seen in the liver and there are other
calcified cysts in the muscles or lungs, the diagnosis is reasonably reliable.
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