Thanatophoric dysplasia type 1 is a lethal congenital anomaly with skeletal dysplasia. It is characterized by short limb dwarfism, enlarged head with frontal bossing, short neck, protuberant abdomen. It is detected in early gestational period by ultrasonography. The other associated anatomical abnormalities and characteristic laboratory findings aid in the early diagnosis and further work-up.

Objectives:To assess the utility of dynamic imaging namely, wash-in and wash-out characteristics through multidetector contrast-enhanced computed tomography in differentiating benign and malignant pulmonary masses.Materials and Methods:Seventy-three patients who were suspected to have malignant pulmonary mass on the basis of clinical symptoms and chest radiograph were included in the study. All the patients underwent multidetector computed tomography scanning, and three series of images were obtained for each patient-noncontrast, early enhanced, and 15 min delayed enhanced scans. Computed tomography (CT) findings were assessed in terms of washin, absolute, and relative percentage washout of contrast. Biopsy of the mass was done and sent for histopathological evaluation. Sensitivity, specificity, and area under curve for diagnosing malignancy in the lung masses were calculated by considering both the wash-in and wash-out characteristics at dynamic CT and plotting the receiver operating curve after the final diagnosis which was obtained by histopathological evaluation.Results:Threshold net enhancement (washin) value of >22.5 HU had sensitivity, specificity, and diagnostic accuracy of 88.5%, 57.1%, and 82%, respectively, in predicting malignancy. Threshold relative percentage washout of <16.235% had 98.1%, 85.7%, and 94% sensitivity, specificity, and diagnostic accuracy, respectively, and threshold absolute percentage washout of <42.72% had 98.1%, 95.2%, and 95% sensitivity, specificity, and diagnostic accuracy, respectively, in predicting malignancy.Conclusion:Threshold net enhancement (washin), absolute and relative washout percentages can be used to predict malignancy with very high diagnostic yield, and possibly obviate the need of invasive procedures for diagnosis of bronchogenic carcinoma.

Idiopathic giant bullous emphysema or vanishing lung syndrome is a very rare condition associated with severe forms of emphysema in which the lungs appear to be disappearing on radiograph. It is a progressive condition which usually affects young male smokers and characterised by the presence of giant emphysematous bullae in lungs asymmetrically. The authors hereby describe a rare case of an 18 year old female non smoker, presented with a history of chest pain of two weeks duration. Her chest radiograph showed large bullae in both lungs, more on the left. HRCT thorax confirmed giant bullae in both upper, middle, lingula and apical segments of lower lobes compressing the surrounding lung parenchyma. Diagnosis of idiopathic giant bullous emphysema or vanishing lung syndrome was made based on imaging, for which the patient underwent surgical resection.

Teratomas are congenital tumours arising from all three germ cell layers. Retroperitoneal teratoma is very uncommon in the infant age group. Patient commonly presents with progressive abdominal distension and intra-abdominal lump. Teratomas comprises of third most common type of retroperitoneal neoplasm seen in infants and children after Wilms' tumour and neuroblastoma. We hereby report a case of a giant retroperitoneal teratoma in an infant. A 3-month-old female child was admitted with complaint of abdominal distension. Abdominal USG and CT scan revealed a tumour suggestive of retroperitoneal teratoma. Intraoperative finding revealed a large retroperitoneal tumour occupying mainly the whole of the abdomen. Resection of tumour was done successfully.