Abdominal pregnancy is a unique type of ectopic pregnancy that can be easily missed in routine obstetric practice. Current studies estimate an incidence of 1.3% (1-4). This type of pregnancy can be classified as primary or secondary, based on whether fertilization occurs in the peritoneal cavity followed by peritoneal implantation or whether normal fertilization is followed by rupture of the uterine or tube wall, leading to secondary implantation in the peritoneal cavity (5-7). The affected woman may not have any major complaints other than some discomfort. The abdomen enlarges, just as in normal pregnancy. To an unsuspecting radiologist doing a routine ultrasonography, the growing intra-abdominal fetus may appear quite healthy and have normal systemic development. We present the case of a 24-yearold patient who presented with loss of fetal movement at 26 weeks and subsequently was diagnosed with abdominal pregnancy by magnetic resonance imaging (MRI). We emphasize the importance of MRI in suspected abdominal pregnancies. In our case, the MRI both provided a definitive diagnosis and revealed the significant anatomical relationships of the intra-abdominal organs, thus aiding in the surgical management. Case reportA 24-year-old female (gravida 2, para 1, living 1) presented with a sixmonth history of amenorrhea, vague abdominal pain, and loss of fetal movements for 10 days. She had no history of vaginal bleeding or passage of clear fluid. She had undergone a caesarean section for her first child one year previously. There was no history of contraceptive use. The patient consulted a local hospital after she noticed reduced fetal movement, and an intra-uterine fetal demise was diagnosed following an ultrasound scan. Medical induction for delivery of the non-viable fetus was attempted, but despite adequate doses of an inducing agent, there were no signs of progress into labor. There was history of some form of attempted instrumentation. Following the unsuccessful induction, the patient was referred to our institute.On examination, the patient was pale with a heart rate of 90/min and blood pressure of 110/68 mmHg. An obstetric examination revealed a fundal height corresponding to 28 weeks, with a transverse lie and easily palpable fetal parts. The fetal heart could not be auscultated. The external os was closed on vaginal and speculum examination, and minimal bleeding was noted. Apart from mild anemia (hemoglobin, 11 g/dL), the laboratory results were within normal limits.A preliminary ultrasound scan with a 3-5 MHz curvilinear probe (Siemens Sonoline G50, Siemens Medical Solutions, Issaquah, Washington, USA) at our institute revealed a non-viable fetus with a transverse lie (Fig. 1). A normally echogenic uterine wall was not noted, which raised the suspicion of an abdominal pregnancy. The placental ABSTRACT Secondary abdominal pregnancy is a rare type of ectopic pregnancy. Following fertilization, the blastocyst escapes from the uterine cavity and implants in the peritoneal cavity. The early antenatal diagnosis and i...

Abscess of the tongue is rare owing to the rich vascularity and muscularity of the tongue and anti-infective properties of saliva. An abscess limited only to one half of the tongue is even more rare. We report a case of hemilingual abscess in a 17-year-old girl who presented with high-grade fever and a swollen and immobile tongue. Ultrasound (US) through floor of mouth showed inflammatory changes and collection within the right half of the genioglossus muscle. Magnetic resonance imaging (MRI) confirmed this finding, and isolated right-sided involvement was identified. US-guided aspiration of the collection yielded pus that showed gram-positive cocci on microscopy. The patient was managed conservatively, and repeat US showed resolution of the abscess. The importance of US as a quick, inexpensive, and versatile imaging technique and the precision of MRI regarding the extent of abscess of tongue are stressed.

Classical imaging manifestations of pulmonary Tuberculosis (TB) include consolidation, cavitation, necrotic mediastinal lymphadenopathy and pleural effusions. On the other hand, atypical imaging findings of pulmonary TB are sometimes encountered which create a diagnostic dilemma; three such patients are reported here. The predominant finding in the first patient (24-year-old female) was diffuse cystic lung disease with associated bilateral secondary spontaneous pneumothoraces. The subacute onset of symptoms, associated nodules and ground glass opacities were a pointer towards an infective aetiology of the diffuse cysts in this case. The second patient (41-year-old female) presented with peribronchovascular and perifissural nodules with the galaxy or cluster sign leading to an erroneous diagnosis of sarcoidosis. However, the patient’s serum Angiotensin Converting Enzyme (ACE) levels were within normal limits; whereas her bronchial washings culture was positive for Mycobacterium TB. Therefore, this was actually a case of pulmonary TB with lymphatic involvement mimicking sarcoidosis. In the third patient (20-year-old female), there were pulmonary parenchymal lesions with the reversed halo sign classically described in cryptogenic organising pneumonia. Micronodularity in the wall and central part of the reversed halo lesion clinched the diagnosis of TB in this case. Laboratory investigations revealed acid fast bacilli or caseating granulomas consistent with TB in all these patients. Therefore, awareness regarding the atypical Computed tomography (CT) findings and a high index of suspicion is necessary to avoid delays in diagnosis and enable early institution of appropriate Antitubercular Therapy (ATT) in such cases.

Spinal hydatid is an uncommon entity that may cause paraplegia due to extensive cord compression. Often, the lesion may be misdiagnosed as spinal tuberculosis, especially in endemic countries. We report such a case of a young female with primary vertebral hydatid disease, who had been on antitubercular treatment for a long time due to misdiagnosis. We discuss the distinguishing diagnostic imaging features of this entity, which would beware radiologists of misdiagnosing this rare but serious condition.

The T2-weighted sequences form an integral part of multiparametric Magnetic Resonance Imaging (MRI) protocol performed for evaluation of the prostate. Most commonly encountered prostatic pathologies are adenocarcinoma and benign prostatic hyperplasia, which are mostly T2W hypointense and heterogeneously hypointense, respectively. Apart from prostatic cysts, only a small proportion of prostatic lesions demonstrate predominantly high signal intensity on T2-weighted sequences. Herein, the authors present three such cases with T2W hyperintense prostatic lesions. The first case (60-year-old male) was a prostatic abscess, which apart from T2W hyperintensity, showed central restricted diffusion and peripheral enhancement. The second case (40-year-old male) was a cystic lesion in left side of prostate, which was an ectopic ureterocele opening into the prostatic urethra with associated left renal agenesis. The third case (35-year-old male) was of a metastatic prostatic malignancy, which was a rare prostatic sarcoma. Radiologists should be cognizant of such conditions so as to enable them to make accurate diagnosis and guide appropriate patient management.