BACKGROUND AND PURPOSE: Paracoccidioidomycosis is a fungal infection mainly caused by the thermodimorphic fungus Paracoccidioides. The purpose of our study was to demonstrate the neuroimaging findings from 24 patients with CNS paracoccidioidomycosis. MATERIALS AND METHODS:We performed a retrospective analysis focusing on the radiologic characteristics of CNS paracoccidioidomycosis. The 24 selected patients underwent MR imaging and/or CT, and the diagnosis was made by the presence of typical neuroimaging features, combined with fungus isolation, a serologic test, or the presence of disseminated disease. RESULTS:Headache was the most common neurologic symptom, while the pseudotumoral form was the most common pattern. The number of lesions ranged from 1 to 11, with most localized on the frontal lobe with .2-cm lesions. CT showed mainly hypoattenuating lesions, whereas MR imaging demonstrated mainly hyposignal lesions on T1WI and T2WI. Furthermore, ring enhancement was present in most patients. The "dual rim sign" on SWI occurred in 100% of our patients with lesions of .2 cm. CONCLUSIONS:The diagnosis of CNS paracoccidioidomycosis is difficult. Nevertheless, imaging examinations can play an important role in the diagnosis and evaluation of the disease.ABBREVIATIONS: PCM ¼ paracoccidioidomycosis; CT ¼ computed tomography; MRI ¼ magnetic resonance imaging; CNS ¼ central nervous system; DSC ¼ dynamic susceptibility contrast; DCE ¼ dynamic contrast enhanced; rCBV ¼ relative cerebral blood volume; Gd ¼ gadolinium P aracoccidioidomycosis (PCM) is a fungal infection, which is endemic in Latin America and is mainly caused by the thermodimorphic fungus Paracoccidioides spp, which primarily attacks the lungs and has a potential to disseminate to other organs. 1 Recently described are 4 other species of the genus Paracoccidioides apart from P brasiliensis: P lutzii, P restrepiensis, P venezuelensis, and P Americana. 2,3 Paracoccidioides spp inhabits primarily the soil and causes autochthonous infection from southern Mexico to northern Argentina. 4-6 Most reported cases (approximately 80%) are from Brazil, and the rest are mainly from Venezuela, Colombia, and Argentina. [6][7][8][9][10][11][12][13][14] The criterion standard for the diagnosis of PCM consists of demonstrating the presence of the fungus as multiple budding cells in clinical or tissue specimens. Nevertheless, serologic tests and imaging examinations such as CT, MR imaging, and x-rays also play an important role in the diagnosis and evaluation of the disease. 1,[5][6][7][8][9][10][11][12][13][14][15][16][17] CNS involvement is more common than it was once believed, and the disease can affect the CNS, ranging from 1% to 27.27% of cases. [18][19][20][21][22][23][24][25] Although the brain form of PCM is usually an outcome of hematogenous or lymphatic dissemination of a primary focus, it is not necessarily followed by disseminated PCM; in a few cases, it is the only location of the fungus in the body. 26 Our purpose was to describe the clinical and radiologic data (CT ...

No abstract

Background The active extravasation of contrast on CT angiography (CTA) in primary intracerebral hemorrhages (ICH) is recognized as a predictive factor for ICH expansion, unfavorable outcomes and mortality. However, few studies have been conducted on the setting of traumatic brain injury (TBI). Purpose To perform a literature systematic review and meta-analysis of the association of contrast extravasation on cerebral hemorrhagic contusion expansion, neurological outcomes and mortality. Data sources The PubMed, Cochrane Library, Medline, Scielo, VHL and IBECS databases up to September 21, 2019, were searched for eligible studies. Study selection A total of 505 individual titles and abstracts were identified and screened. A total of 36 were selected for full text analysis, out of which 4 fulfilled all inclusion and exclusion criteria.

A hiperplasia nodular histiocítica (HNH) consiste em uma condição rara, sem predileção por sexo ou idade, marcada por um processo proliferativo benigno, por vezes confundido com neoplasia maligna, constituído majoritariamente por histiócitos (1, 2). Inflamação crônica local e irritação mecânica estão entre as principais causas postuladas para essa entidade. Patologias malignas, por outro lado, representam os principais diagnósticos diferenciais, o que evidencia a importância clínica de seu diagnóstico assertivo sendo a imunohistoquímica uma importante ferramenta diagnóstica (3). Nesse artigo, os autores descrevem um relato de caso de hiperplasia nodular histiocítica pleuro-pulmonar em um paciente do sexo masculino, não tabagista, com história de exposição ao asbesto o qual provavelmente incitou um processo inflamatório crônico com proliferação de histiócitos. O paciente apresentava dispnéia, dor pleurítica e hemoptise além de derrame pleural hemorrágico recorrente evoluindo a óbito por exacerbação dos sintomas. Apesar da entidade ser descrita na literatura como uma proliferação celular benigna histiocitária, há raros casos relatados sobre a evolução e tratamento da doença. Palavras chaves: Hiperplasia nodular histiocítica, asbesto, pleura, pulmão.

No abstract