Abnormal iron deposition associated with the degenerative process could be the source of T2 shortening, which is a useful MR imaging finding in the diagnosis of ALS.
Schistosomiasis is an infection of trematodes, Schistosoma, causing periportal fibrosis and liver cirrhosis due to deposition of eggs in the small portal venules. In schistosomiasis caused by S. mansoni, sonography shows echogenic thickening or fibrotic band along the portal veins. CT shows low-attenuation bands or rings around the large portal vein branches in the central part of the liver with marked enhancement. Hepatoplenomegaly, liver cirrhosis, portal hypertension and gastroesophageal varies are commonly associated. In schistosomiasis caused by S. japonicum, sonography shows echogenic septae in the liver, utlining the polygonal liver lobules, mimicking "fish-scale" network appearance, reflecting fibrosis. CT shows periportal septae in the peripheral part of the liver parenchyma, producing "turtle-back" appearance, representing calcified eggs along the portal tracts. The portal tracts and hepatic capsule are enhanced on contrast-enhanced CT images. The size and shape of the liver are relatively preserved. MR images show fibrous septae as low signal intensity on T1-weighted images, high signal intensity on T2-weighted images, and these fibrous septae are enhanced. CT images of the lungs show multiple scattered nodules with halo of ground-glass opacities. Exudative granulomatous inflammation of the colonic wall may produce inflammatory polyps, fibrous thickening or stenosis of the colonic wall.
Acute tumor lysis syndrome results from a sudden and rapid release of products of cellular breakdown after anticancer therapy. Severe alterations of metabolic profile might occur and result in acute renal failure. We present a patient with a large hepatocellular carcinoma who received transcatheter oily chemoembolization and died subsequently of this syndrome. To our knowledge, there has been only one report of this syndrome induced by chemoembolization for hepatocellular carcinoma. This case illustrates the need to anticipate the development of acute tumor lysis syndrome when chemoembolization is planned for a large hepatocellular carcinoma.
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