Tuberculosis (TB) remains a major global public health problem, with 1.5 million deaths annually worldwide. One in five cases of TB present as extrapulmonary TB (EPTB), posing major diagnostic and management challenges. Mycobacterium tuberculosis adapts to a quiescent physiological state and is notable for its complex interaction with the host, producing poorly understood disease states ranging from latent infection to active clinical disease. New tools in the diagnostic armamentarium are urgently required for the rapid diagnosis of TB and monitoring of TB treatments, and to gain new insights into pathogenesis. The typical and atypical imaging features of EPTB are reviewed herein, and the roles of several imaging modalities for the diagnosis and management of EPTB are discussed.

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A 26-year-old woman presented with a headache, left-sided weakness of the body, and pulsatile swelling above the sternal notch. She was treated for abdominal tuberculosis in the past, two years later she developed miliary tuberculosis and was put on modified regimen of antitubercular drugs in view of drug induced hepatitis. Ultrasound neck revealed saccular aneurysm measuring 4 x 3 cm, located in between common carotid arteries with an eccentric thrombus. MRI brain revealed multiple tuberculoma with thick basal meningeal enhancement. Cerebrospinal fluid was positive for Mycobacterium tuberculosis. F-FDG PET/CT was done to delineate the extent of the disease.

Thoraco-abdominal duplication cyst, a congenital malformation of the posterior primitive foregut rarely presents with anaemia. Ectopic gastric mucosa is seen in around 20%-30% of the enteric duplication cysts. We report the scintigraphic findings of one such case which helped in final diagnosis and management of the patient.

Krukenberg tumors described by Friedrich Ernst Krukenberg are still fascinating for their mysterious origin. It is known to be a rare entity and commonly originates from adenocarcinoma of stomach. We present three interestingly rare cases of this entity, revealed by 18F-fluorodeoxyglucose-positron emission tomography/computed tomography (F-18 FDG-PET/CT) scan and discuss how F-18 FDG-PET/CT can prognosticate, alter the course of treatment in such patients. Ovarian metastatic deposits were detected in patients with renal cell, duodenal, and gall bladder carcinoma. Three visits were possible in patient with duodenal cancer (favorable response to therapy), two visits in renal cell cancer (progressive disease pattern) and only single visit for gall bladder cancer. Potentials of F-18 FDG-PET/CT scan for Krukenberg disease is still in exploratory phase, but it's applications in diagnosis, disease monitoring, therapeutic response monitoring, and prognosticating are unparalleled with other imaging modalities.