Hydatid disease in children classically involves the liver, lung and brain but can involve almost any organ and numerous organs simultaneously. Whether hydatid disease is discovered incidentally or by intentional imaging, extended imaging is recommended to identify multifocal disease which may also display complicated cysts that may assist in the diagnostic process. All patients with one known site should undergo a minimum of an abdominal US and CT scan of the chest and brain. CT may be used instead of US of the abdomen, and MRI may be used to replace CT of the brain. Over 50% of cases in our study showed complicated cysts. Unique findings of this study include multi-organ involvement without liver cysts. Multiplicity and complications of cysts can assist diagnosis. Intraventricular and intrathecal CSF spread of a spontaneously ruptured intracerebral cyst has not, to our knowledge, been previously reported.
The clinical features of ATB are protean. This usually results in a delay in diagnosis and impacts negatively on patient morbidity and mortality. On CT, the constellation of findings is highly suggestive of the diagnosis of ATB and, used in conjunction with clinical and laboratory data, should narrow the differential considerably. Unique findings include histologically proven active TB in calcified lymph nodes and a pancreatic TB granuloma.
Childhood bronchial mucoepidermoid tumours (BMET) are rare. A 12-year-old boy with hepatosplenomegaly underwent liver biopsy which diagnosed amyloidosis. Chest radiograph and CT, performed for recurrent respiratory symptoms, identified a left lower lobe tumour, which was subsequently excised. Histology showed a BMET. A literature review reveals 51 reported cases of BMET in children. Common presenting symptoms include fever, cough and recurrent pneumonia. Diagnosis is often delayed and patients with recurrent respiratory symptoms should undergo CT or bronchoscopy. The association between amyloidosis and BMET in this case is unique and has not been previously described, but may be coincidental.
Large oval lucencies seen on the paediatric skull radiograph (SXR) may be normal or pathological. The radiologist, however, must be clear about which findings are pathological and the appropriate terminology when reporting on a paediatric SXR. By noting the clinical setting, the age of the patient and associated skull abnormalities, the appropriate terms can be used so that normal convolutional markings can be distinguished from accentuated markings of copper (silver)-beaten skull in raised intracranial pressure (ICP) and the lacunae in patients with Lückenschadel accompanying spinal dysraphism.
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