Plexiform neurofibromas are essentially pathognomonic for neurofibromatosis type 1 (NF1), occurring when there is diffuse involvement along a nerve segment and its branches. Transformation into a malignant peripheral nerve sheath tumour (MPNST) is a major cause of mortality in NF1 patients. These tumours are highly aggressive and particularly difficult to diagnose in NF1 patients due to the clinical overlap between benign and malignant lesions. We present a case of a plexiform neurofibroma and discuss the typical imaging characteristics on ultrasound, CT, and MRI, including the target sign and continuity with the parent nerve. Certain imaging features should raise suspicion for malignancy however, these modalities may not always reliably differentiate between benign and malignant lesions. Recent studies show a very high negative predictive value for FDG-PET making it quite useful in excluding malignancy. In positive scans, PET/CT aids in guiding biopsy to the most metabolically active area of the tumour.

The intracellular localization of [6,7-3H]oestradiol in rat pituitary, liver and uterus has been studied using autoradiography. In the anterior pituitary the oestrogen has been located on the nuclear membrane and nucleolus of the eosinophils. The posterior pituitary did not produce positive autoradiographs and only occasional silver grains were seen in the pars intermedia. In the liver the silver grains were uniformly distributed throughout the cytoplasm; only very occasionally were grains associated with the nucleus. No satisfactory results were obtained with the uterus. Labelled erythrocytes were seen in all the tissues studied. The results are discussed in relation to the mode of action of oestradiol.

This article highlights the range of osseous findings that can be encountered as well as the imaging features of extramedullary haematopoiesis. As iron overload remains a major cause of morbidity and mortality in these disorders, we also discuss the MRI evaluation of hepatic and cardiac hemosiderosis, to aid in the optimization of iron chelation therapy. Future imaging use will be dictated by evolving clinical needs, such as in screening for emerging morbidities, including hepatic fibrosis and hepatocellular carcinoma.

HighlightsThe CT scan finding of sigmoid volvulus is closely resembles to the percussion instrument known as “steel pan”.This Steel pan sign has not yet been described in the literature for sigmoid volvulus.The sign is easier to recognize on CT scan of the abdomen and in some cases on plain abdominal X- rays.This easily recognized symbol enables faster diagnosis and earlier treatment of this disease, thus reducing the morbidity and mortality.