A 49-year-old male with history of chronic alcohol-induced pancreatitis presented with one month of worsening left pleuritic chest pain and shortness of breath. Chest radiograph demonstrated bilateral pleural effusions. Thoracentesis revealed increased amylase in the pleural fluid. Computed tomography (CT) and magnetic resonance cholangiopancreatography (MRCP) showed a fistula tract between the left pleural cavity and pancreas which was confirmed on endoscopic retrograde cholangiopancreatography (ERCP). Patient was treated with placement of a pancreatic stent with complete resolution of the fistula tract approximately in 9 weeks. A systematic literature search was performed on reported cases with pancreaticopleural fistula (PPF) who underwent early therapeutic endoscopy within the last 10 years. Imaging modalities, particularly CT and MRCP, play essential role in prompt preprocedural diagnosis of PPF. Early therapeutic ERCP is an effective and relatively safe treatment option for PPF, so invasive surgery may be avoided.
Objectives: To compare breast density assessments between C-View™ and Intelligent 2D™, different generations of synthesized mammography (SM) from Hologic. Methods: In this retrospective study, we identified a subset of females between March 2017 and December 2019 who underwent screening digital breast tomosynthesis (DBT) with C-View followed by DBT with Intelligent 2D. Clinical BI-RADS breast density was obtained along with volumetric breast density measures (including density grade, breast volume, percentage volumetric density, dense volume) using VolparaTM. Differences in density measures by type of synthesized image were calculated using the pairwise t-test or McNemar’s test, as appropriate. Results: Sixty-seven patients (avg age 62.7; range 40–84) were included with an average of 13.3 months between the two exams. No difference was found in BI-RADS density between the SM reconstructions (p = 0.74). Similarly, there was no difference in VolparaTM mean density grade (p = 0.71), mean breast volume (p = 0.48), mean dense volume (p = 0.43) or mean percent volumetric density (p = 0.12) between the exams. Conclusions: We found no significant differences in clinical and automated breast density assessments between these two versions of SM. Advances in knowledge: Lack of differences in density estimates between the two SM reconstructions is important as density assignment impacts risk stratification and adjunct screening recommendations.
Objectives
To describe an extremely rare case of sporadic hemangioblastoma (HB) within the cavernous sinus and Meckel's cave with extension to the cerebellopontine angle (CPA) cistern.
Methods
A 73-year-old male presented with hearing loss, unilateral ptosis, and facial numbness.
Results
The imaging showed a complex cystic-solid mass centered at the left cavernous sinus and Meckel's cave with extension to the CPA cistern. Patient underwent retrosigmoid craniectomy for partial resection of the CPA angle component of the mass. Surgical pathology confirmed the diagnosis of HB and patient was scheduled for subsequent radiotherapy of the residual mass.
Conclusions
We present an exceptional case of supratentorial HB without associated von Hippel–Lindau (VHL) disease, which was predominantly located in the cavernous sinus and Meckel's cave and led to multiple cranial nerve symptoms. We describe imaging characteristics and radiologic–pathologic correlation of this atypically located HB, which can be difficult to consider in the differential diagnosis presurgically.
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