Duplication of gall bladder is a rare congenital anomaly of the hepatobiliary system. It is a very important entity in clinical practice as preoperative diagnosis plays a significant role in the management and to avoid unnecessary bile duct injury during surgery. We report a case of duplicated gall bladder presenting as acute cholecystitis.

The differential diagnosis of the cystic lung disease is extensive, ranging from an isolated incidental lung cyst to multiple diffuse lung cysts with other varied associated lung abnormalities. High resolution computed tomography (HRCT) thorax is the imaging modality of choice in the evaluation of these diseases, by improving the characterisation of the lung cysts (number, size, shape, distribution, wall thickness and regularity), and associated pulmonary and extrapulmonary abnormalities (like ground glass densities, nodules, interstitial fibrosis, mediastinal lymphadenopathy). After differentiating from the common cyst mimickers (cavity, centrilobular emphysema and cystic bronchiectasis), they should be grouped by location into subpleural cysts (paraseptal emphysema, bulla and honeycombing) and intraparenchymal cysts. Intraparenchymal cysts are in turn categorised into solitary / localised cysts (incidental cyst, congenital pulmonary airway malformations, intrapulmonary bronchogenic cyst and hydatid cyst) and multiple diffuse cysts. The next step will be the categorisation of these multiple diffuse cysts into those without other lung abnormalities (lymphangioleiomyomatosis and Birt-Hogg-Dube syndrome) and those with other lung abnormalities such as predominant ground glass densities (Pneumocystis jirovecii pneumonia, desquamative interstitial pneumonia, lymphoid interstitial pneumonia, subacute hypersensitivity pneumonitis and pneumatoceles) or predominant nodules (pulmonary Langerhans cell histiocytosis, amyloidosis, light chain deposition disease, follicular bronchiolitis, recurrent respiratory papillomatosis, cystic tuberculosis, cystic lung metastasis, sarcoidosis, and pulmonary mesenchymal cystic hamartomas). We conclude that this orderly radiologic approach in a given HRCT chest study of a cystic lung disease (in addition to correlation with clinical and laboratory findings), can lead us to a specific diagnosis in majority of instances, thereby optimising their treatment management, without the need of an invasive biopsy. KEY WORDS HRCT Thorax, Lung Cysts, Ground Glass Densities, Lung Nodules

A B S T R A C T BACKGROUNDCystic lesions of the pancreas consist of both neoplastic and non-neoplastic lesions. Computed tomography (CT) scan is commonly used in imaging cystic lesions of pancreas as it is easily available and less time consuming. In this study, we evaluate the different characteristic features of cystic lesions of pancreas and differentiate them based on imaging. METHODSThis is a retrospective study done over a period of 5 years. 94 patients with cystic lesions of pancreas were selected and analysed. All patients had proven final diagnosis by surgery, by endoscopy guided aspiration or by follow up. Various parameters of the cysts were studied like the age and sex distribution, incidence, size of the lesion, location, thickness of septations, nature of calcification, pancreatic duct dilatation if any, size of the largest cyst within the lesion, approximate number of cysts, presence of any solid component, nature of enhancement, presence of the wall and contour of the lesion. Descriptive statistics like percentage was used and each cyst was differentiated based on the above features. RESULTSOverall, pseudocysts were the commonest cysts, and all were associated with pancreatitis. They were commonly seen in the middle-aged males. Serous cystadenomas were the commonest neoplastic cysts. Benign neoplastic cysts were common in females and malignant neoplastic cysts were common in males. Serous cystadenomas were common in head of the pancreas whereas mucinous cystadenomas were common in tail of the pancreas. All solid pseudo papillary epithelial neoplasm (SPEN) were seen in the tail of the pancreas. No difference in each cyst based on overall size was seen. Mucinous cystadenomas showed fewer but bigger cysts within the lesion compared to serous cystadenomas. Peripheral wall calcification was seen in mucinous cystadenomas whereas central calcifications were seen in serous cystadenomas. Communication with a dilated pancreatic duct and bulging papillae was seen in intraductal papillary mucinous tumour (IPMT). Most of IPMT and serous cystadenomas showed a lobulated invisible wall whereas mucinous cystadenomas showed a smooth visible wall. All malignant cysts were associated with solid component and thick septations. CONCLUSIONSCT scans helps us to diagnose various cystic lesions of pancreas based on different characteristic imaging features.

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