Langerhans cell histiocytosis (LCH) is systemic disease resulting from the proliferation and dissemination of abnormal histiocytic cells of the Langerhans cell system. Common sites of involvement include the skin, bone, bone marrow, lung, lymph nodes and central nervous system, and the condition manifests in a variety of ways. We present the CT and MR findings of a case of LCH involving the spleen, an organ involved relatively rarely. Post-contrast CT revealed multiple hypodense nodules. T1-weighted MR images of the spleen depicted no definitive lesion, but T2-weighted images showed abnormal low signals scattered throughout this organ. In addition, post-contrast, fat-saturated T1-weighted MR images lesions showed multiple, low-signal-intensity lesions.
Bone Marrow ; Central Nervous System ; Histiocytosis ; Histiocytosis, Langerhans-Cell ; Lung ; Lymph Nodes ; Skin ; Spleen*

OBJECTIVE: Unexpected Solitaire stent detachment can occur during mechanical Solitaire thrombectomy. The purpose of this study was to retrospectively evaluate the influencing factors causing unexpected Solitaire stent detachment and the clinical outcomes. METHODS: Between October 2011 to December 2013, 232 cases of mechanical Solitaire thrombectomy for acute ischemic stroke were performed in 3 stroke centers. During this period, we encountered unexpected Solitaire stent detachments during mechanical Solitaire thrombectomies in 9 cases. RESULTS: Solitaire stents unexpectedly detached in 9 cases (3.9%) during the retrieval of Solitaire stents. The median patient age was 76 years. The occlusion sites of the unexpected stent detachment were the proximal middle cerebral artery (MCA) in 7 cases and the internal carotid artery in 2 cases. The sizes of the stents that unexpectedly detached were 6x30 mm in 7 cases, 5x30 mm in 1 case, and 4x20 mm in 1 case. Four patients had unexpected detachment at the first retrieval, 1 patient at the second, 3 patients at the third, and 1 patient at the fifth. In all of the cases of unexpected detachment at the first retrieval, the stent deployment site was the proximal MCA. After detachment, a proximal marker of the Solitaire stent was observed in 3 patients. However, no marker was visible in the remaining 6 patients. CONCLUSION: Unexpected Solitaire stent detachment should be considered in the first instance of stent retrieval for a relatively large-diameter stent, especially in elderly patients with MCA occlusions.
Aged ; Carotid Artery, Internal ; Humans ; Middle Cerebral Artery ; Retrospective Studies ; Stents* ; Stroke ; Thrombectomy*

BACKGROUND AND PURPOSE: Elevated plasma total homocysteine (tHcy) levels are reported to be associated with an increased risk of Alzheimer's disease (AD). However, the mechanism by which homocysteine contributes to the pathogenesis of AD is as yet unknown. The aim of this study was to elucidate the relationship between white matter changes (WMC) and medial temporal lobe atrophy (MTA) on brain magnetic resonance imaging (MRI), and plasma levels of tHcy in AD patients. METHODS: Seventy-two patients with a clinical diagnosis of probable AD were recruited to the study. Plasma tHcy levels, vascular risk factors, and WMC and MTA on brain MRI were evaluated in all patients. The AD patients were classified into two groups: those with no or minimal WMC (69.2+/-8.8 years, mean+/-SD, n=36) and those with moderate-to-severe WMC (74.6+/-4.6 years, n=36) on brain MRI. RESULTS: In a univariate logistic regression analysis, the risk of moderate-to-severe WMC in AD was significantly associated with increasing age, female gender, lower education level, hypertension, high plasma tHcy levels, and lower Mini-Mental State Examination (MMSE) score. Multivariate logistic regression analysis revealed only high plasma tHcy as the independent and significant risk factor for moderate-to-severe WMC [odds ratio (OR; adjusted for age, gender, education level, MMSE score, and hypertension comparing the top tertile - tHcy levels > or =12.9 micromol/L - with the bottom tertile - tHcy levels < or =9.4 micromol/L)=7.35; 95% confidence interval, confidence interval=1.36-39.84; p=0.02], and age as a borderline significant risk factor (OR=1.08, 95% CI=0.99-1.19, p=0.09) in AD patients. Plasma tHcy levels were not correlated significantly with either right or left MTA. CONCLUSIONS: Our results suggest that the vascular pathway mediates the association between elevated plasma tHcy levels and AD.
Alzheimer Disease ; Atrophy ; Brain ; Female ; Glutamates ; Guanine ; Homocysteine ; Humans ; Hypertension ; Leukoaraiosis ; Logistic Models ; Magnetic Resonance Imaging ; Plasma ; Risk Factors ; Temporal Lobe ; Pemetrexed

Congenital glioblastoma multiforme is relatively rare accounting for 2-9% of all congenital brain tumors. We deseribe a case of congenital glioblastoma multiforme which occurred in the lateral ventricle. T1-weighted images revealed high signal intensity, with areas of internal low signal intensity, while T2-weighted images showed low signal intensity with focal internal high-signal portions. Post-contrast T1-weighted images depicted a lateral ventricular mass which extended to adjacent brain parenchyme and had a serpentine signal void representing internal vessel.
Brain ; Brain Neoplasms ; Glioblastoma* ; Lateral Ventricles

Castleman's disease is a rare lymphoproliferative disorder of uncertain etiology which most commonly occurs in the mediastinum. We describe a case of a benign Castleman 's disease of the hyaline vascular type affecting the upper extremity, an extremely rare site of the disease.
Giant Lymph Node Hyperplasia* ; Hamartoma ; Hyalin ; Lymphoproliferative Disorders ; Mediastinum ; Upper Extremity*

Rhabdomyosarcoma is the most common soft tissue sarcoma occurring in children, though retroperitoneal rhabdomyosarcoma is rare. We experienced a case of embryonal rhabdomyosarcoma of the retroperitoneum in a 43-month-old child, and describe the CT , MRI and pathologic findings.
Child* ; Child, Preschool ; Humans ; Magnetic Resonance Imaging ; Myosarcoma ; Rhabdomyosarcoma ; Rhabdomyosarcoma, Embryonal* ; Sarcoma

Inflammatory pseudotumor is a rare benign lesion consisting of inflammatory cells and fibroblastic stroma, and is reported to have occurred. in various organs. Splenic involvement, however, is extremely rare. We report the spiral CT findings of pathologically proven inflammatory pseudotumor of the spleen. The CT scan shows delayed enhancement with central, stellate, low attenuation.
Fibroblasts ; Granuloma, Plasma Cell* ; Spleen* ; Tomography, Spiral Computed ; Tomography, X-Ray Computed

Right intrathoracic stomach associated with organoaxial torsion is a rare form of congenital hiatal hernia. We report the radiologic findings in two cases of complete or partial right intrathoracic stomach secondary to congenital hiatal hernia. The barium meal test demonstrated the presence of complete or partial right intrathoracic stomach and non-obstructive organoaxial torsion with the greater curvature lying against the right chest wall. The esophagogastric junction was located above the diaphragm. CT revealed a cystic mass in the right posterior mediastinum. This cystic lesion should be differentiated from other congenital mediastinal cysts.
Barium ; Deception ; Diaphragm ; Esophagogastric Junction ; Hernia, Hiatal* ; Meals ; Mediastinal Cyst ; Mediastinum ; Stomach* ; Thoracic Wall

We present a case of 44-year-old male with spontaneous right vertebral arteriovenous fistula associated with neurofibromatosis type 1. The symptom of this patient was myeloradiculopathy of which was due to compressed cervical spinal cord by enlarged epidural vein. Complete occlusion of the fistula using coils resulted in relief of the patient symptom and complete disappearance of enlarged epidural vein on follow-up MR image one month later.
Adult ; Arteriovenous Fistula* ; Embolization, Therapeutic* ; Fistula ; Follow-Up Studies ; Humans ; Male ; Neurofibromatoses* ; Neurofibromatosis 1* ; Spinal Cord ; Veins

Purpose: A CT angiography spot sign (CTA-spot) is a significant predictor of the early expansion of an intracerebral hemorrhage (ICH-Ex). Dynamic-susceptibility-contrast magnetic resonance imaging (DSC-MRI) can track the real-time leaking of contrast agents. It may be able to indicate active bleeding, like a CTA-spot. Materials and Methods: From September 2014 to February 2017, we did noncontrast CT, CTA, and DSC-MRI examinations of seven patients with acute ICH. We investigated the time from symptom onset to the first contrast-enhanced imaging.We evaluated the time course of the contrast leak within the ICH at the source image of the DSC-MRI and the volume change of ICH between non-contrast CT and DSCMRI. We compared the number of slices showing CTA-spots and DSC-MRI leaks. Results: The CTA-spot and DSC-MRI leak-sign were present in four patients, and two patients among those showed ICH-Ex. The time from the symptom onset to CTA or DSC-MRI was shorter for those with a DSC-MRI leak or CTA-spot than for three patients without either (70-130 minutes vs. 135-270 minutes). The leak-sign began earlier, lasted longer, and spread to more slices in the patients with ICH-Ex than in those without ICH-Ex. The number of slices of the DSC-MRI leak and the number of the CTA-spot were well correlated. Conclusion DSC-MRI can demonstrate the leakage of GBCA within hyperacute ICH, showing the good contrast between hematoma and contrast. The DSC-MRI leakage sign could be related to the hematoma expansion in patients with ICH.