Adrenal myelolipoma is an unusual, benign and biochemically inactive tumor that is composed of mature adipose and hematopoietic tissue. It is usually diagnosed accidentally and nowadays much more frequently because of widespread use of ultrasonography, computed tomography (CT) and magnetic resonance imaging. Adrenal myelolipoma is usually unilateral and asymptomatic, though known to be associated with obesity, hypertension, endocrinological disorders and some malignancies. We report herein two cases of right-sided giant adrenal myelolipoma diagnosed by multidetector-row CT. One patient was symptomatic because of a large mass in the right upper abdomen, which on imaging with CT was seen to be right adrenal myelolipoma. Another patient had a large left side Bochdalek hernia and right adrenal myelolipoma was incidentally discovered on CT.

We present a case of a 12-year-old boy who developed upper gastrointestinal bleeding in the form of hematemesis and melena 1 month after blunt trauma to liver. Computed tomography (CT) angiography with multidetector-row CT demonstrated pseudoaneurysm of right hepatic artery related to old liver laceration to be the cause of the bleeding. Pseudoaneurysm was resected using the roadmap provided by CT angiography findings.

Bilateral painful knees with loss of extension in a patient with chronic kidney disease (CKD) may be due to spontaneous quadriceps tendon rupture. This rare complication is usually seen in patients on long term dialysis. We present a case of bilateral spontaneous quadriceps tendon rupture demonstrated by magnetic resonance imaging in a 20-year-old woman who on evaluation was found to have CKD.

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ABSTRACT. Although internal mammary artery pseudoaneurysms are a rare vascular abnormality, they are sometimes seen after sternotomy, diagnostic and therapeutic vascular access or penetrating chest trauma. To our knowledge, internal mammary artery pseudoaneurysm caused by pulmonary actinomycosis has not been reported previously. We report a case of pseudoaneurysm of the left internal mammary artery caused by pulmonary actinomycosis. A 50-year-old woman initially presented with clinical and radiological features of pneumonia, for which she was treated empirically with antibiotics. Later, she developed haemoptysis along with pain and swelling in the left upper chest wall. Multidetector CT (MDCT) with CT angiography showed a cavitating mass in the left upper lobe of the lung that infiltrated into the chest wall and a pseudoaneurysm of the left internal mammary artery. Imaging suggested that the lung mass resulted from pulmonary actinomycosis, which was confirmed by the histopathology of a fine-needle aspiration specimen. Internal mammary artery (IMA) pseudoaneurysm is a rare vascular abnormality that commonly results from sternotomy, insertion of a catheter or central venous line into the subclavian vessels, or penetrating chest trauma such as stab injury [1]. Very rarely, the formation of a IMA pseudoaneurysm has been described in the context of chest wall infection by staphylococcus, tuberculosis or fungi [2,3]. Radiological manifestations of thoracic actinomycosis are varied and diverse. They include airspace consolidation, lung mass, mediastinal lymphadenopathy, empyema, osteomyelitis, chest wall mass with fistula formation, and very rarely, the formation of a pulmonary artery pseudoaneurysm [4]. To our knowledge, however, IMA pseudoaneurysm associated with thoracic actinomycosis has not been reported previously.We report a case of thoracic actinomycosis that started as a non-specific pneumonic consolidation in a 50-yearold female. The disease progressed within a few weeks, invading the chest wall and resulting in left IMA pseudoaneurysm. Case historyA 50-year-old woman presented to the emergency department of our hospital with a two-week history of fever, productive cough and chest pain. Her medical history was marked with type 2 diabetes mellitus, hypertensive heart disease and glaucoma of the left eye. On admission, she was febrile with a temperature of 38˚C. Physical examination of the chest showed dullness on percussion and inspiratory crackles on auscultation in the left infraclavicular area. Routine laboratory investigations revealed an elevated total leukocyte count of 17 000/cumm with 85% neutrophils; blood gas analysis revealed PaO 2 565 mmHg, PaCO 2 530 mmHg and pH5 7.36; and random blood sugar was 160 mg dL 21 . The chest radiograph on admission showed opacity over the left upper lung zone; no definite evidence of cavitation was seen even on the retrospect viewing. The patient was treated for left upper lobe pneumonia with an empirical antibiotic combination of iv third generation cephalosporin and ...