Dirofilariasis is a parasitic infection transmitted by mosquitoes from domestic and wild animals. Humans accidentally get infected and can present with a lung nodule, subcutaneous mass or an ocular lesion which will be either subconjunctival or periorbital. Proper microbiological and histopathological examinations aid in proper diagnosis. Herein, we present a case report of a 64-year-old female patient from Kerala with an infraorbital mass diagnosed as dirofilariasis.

INTRODUCTIONCharacterizing adrenal lesions in patients with a known primary malignancy has a vital role in treatment and prognostication. Approximately 40-57% of adrenal incidentalomas are benign in these patients. 1 The prevalence of adrenal metastases in patients with known primary malignancy ranges between 32% and 73% in different series.2 CT, MRI and FDG PET are widely used to characterize adrenal lesions.In a retrospective study by Gufler et al, the combined morphologic criteria with the density measurements on NECT, found a high accuracy in differentiating adrenal adenomas from metastases in patients with a known malignancy.3 They proposed a scoring system based on density, contour, homogeneity and size.This study evaluates the sensitivity and specificity of this NECT scoring system and comparing it with that of 18F FDG PET. ABSTRACTBackground: Characterizing adrenal lesions in patients with a known primary malignancy has a vital role in treatment and prognostication. A study by Gufler et al proposed a scoring system based on density, contour, homogeneity and size and found a high accuracy in differentiating adrenal adenomas from metastasis in patients with a known malignancy. This study evaluates the sensitivity and specificity of this NECT scoring system and comparing it with that of 18F FDG PET. Methods: The study was conducted on patients with diagnosed malignancies with adrenal mass, referred for 18F-FDG PET-CT scanning as a part of work up or follows up between October 2014 and March 2016. Whole-body CT and PET images were obtained using standard protocol. NECT scoring and quantitative analysis of FDG uptake in the adrenal lesions (SUVavg analysis) is done separately. Results: Of the 50 patients studied, 33 patients had benign adrenal lesions and the rest had metastatic lesions. Most common site of primary was lung. NECT score yielded a sensitivity of 88.2%, specificity of 100% and positive predictive value of 100%. SUVavg analysis yielded a 100% sensitivity, specificity and positive predictive value. Comparison of the predictive power of the two tests showed a z score of 2.5 and p value of 0.0124. Conclusions: 18-FDG PET can be considered as a gold standard for differentiating between metastasis and benign lesions of adrenal glands in patients with known primary. NECT has a comparable specificity as that of FDG PET, however with lower sensitivity.

Background: Endometrial carcinoma is the fourth most common cancer in females and the most common malignancy of the female reproductive tract. The prognosis of endometrial carcinoma depends on a number of factors, including stage, depth of myometrial invasion, lympho-vascular invasion, nodal status and histologic grade. Preoperative assessment with MRI is essential for planning surgery and lymph node sampling. The objectives of this study were to determine the myometrial invasion of endometrial carcinoma by MRI and to obtain histopathology in surgically resected specimen, to compare the MRI findings of myometrial invasion in endometrial carcinoma with histopathology in respectable cases.Methods: Authors analyzed 41 cases in whom, histopathological diagnosis of carcinoma endometrium was established by means of pre-treatment biopsy. Consenting patients were taken up for preoperative MRI FIGO staging. MR images were reviewed for parameters like depth of myometrial invasion. Further surgical management followed by histopathological FIGO staging was done.Results: The study showed MRI was highly sensitive and specific tool for identifying depth of myometrial invasion, cervical invasion, serosal invasion, vaginal and parametrial invasion.Conclusions: There was statistically significant difference between histopathological and MRI assessment of local invasion of endometrial carcinoma.

Background: Due to the global burden of obesity and type 2 diabetes, prevalence of NAFLD is now increasing, becoming one of the most common cause of chronic liver disease and liver transplantation both for end-stage liver disease and hepatocellular carcinoma. Although traditionally liver biopsy is gold standard for diagnosis of NAFLD, majority of patients can be non-invasively diagnosed with various tools like scoring systems (NAFLD fibrosis score, BARD score), ultrasound and MR elastographic techniques. The primary objective of this study was to assess the liver stiffness measurement by shear wave elastography and assess correlation between LSM by SWE and NAFLD fibrosis score in NAFLD patients.Methods: This is a descriptive study comprising 75 patients with clinical suspicion of NAFLD, referred from Gastroenterology department from January 2020 to June 2021. All patients had undergone SWE, NAFLD fibrosis score calculated and results analyzed.Results: Among the 75 patients studied, applying low cut off value of NAFLD fibrosis score (below -1.455), the presence of advanced fibrosis was excluded and by applying the high cut off point (>0.676) majority of subjects had advanced fibrosis. The NAFLD fibrosis score was correlated with E median values of liver stiffness measurement using Pearson correlation test and showed a moderate positive correlation (p=0.0001, =0.685) between both the variables.Conclusions: Our study showed positive moderate correlation between NAFLD fibrosis score and LSM by 2D SWE. Multistep strategies using liver 2D SWE and NAFLD fibrosis score in combination can be used in the future to accurately diagnose or exclude the presence of advanced fibrosis in NAFLD patients.