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A 44-year-old man came to the emergency room for two-week progressive dyspnea. His medical history included morbid obesity, active smoking and childhood severe trauma that required splenectomy. The computed tomography (CT) pulmonary angiography performed to rule out a pulmonary embolism revealed several peritoneal nodules in the upper abdomen (Figure 1A). The additional abdominal contrast-enhanced CT revealed multiple other nodules and homogeneous disseminated peritoneal masses (Figure1B-C). Splenosis nodules were suspected given the history of splenic trauma and the lack of cancer history. A Tc-99m-tagged heat-damaged

We report a case of methotrexate (MTX)-induced stroke-like encephalopathy in an 18-year-old woman, with acute lymphoblastic leukemia, who developed a sudden neurological deficit mimicking a cerebrovascular event. Bain MRI showed hyperintensities on diffusion-weighted-imaging (DWI) with matching apparent diffusion coefficient hypointensities, which also represent the commonest MRI findings in acute cerebral infarction. DWI changes spared the cerebral cortex and did not respect vascular territories, supporting a non-vascular mechanism. MRI plays a crucial role in the diagnostic workup and is essential to avoid unnecessary intervention such as thrombolytic therapy.Teaching Point: Methotrexate-induced stroke like neurotoxicity should be considered in patients treated with methotrexate and presenting with a stroke-like clinical picture and radiological findings consistent with acute cerebral infarction.

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We report the case of a 45-year-old male referred to our hospital with fever, asthenia, visual disturbances and increasing headaches. Diffusion-weighted imaging of the brain showed high signal intensity in the splenium of corpus callosum with low apparent diffusion coefficient values. Diagnosis of cytotoxic lesion of corpus callosum was made with Puumala Hantavirus infection serologically confirmed and should not be mistaken for ischemia. Patient was discharged 8 days after admission and imaging findings had resolved 3 weeks later.