Appendicitis and diverticulitis of the colon: Misleading forms

AbstractAppendicitis and diverticulitis of the colon are the two main causes of febrile acute abdomen in adults. Diagnosis from imaging (ultrasound and CT) is usually easy. However, an imaging procedure which is not suitable for the clinical situation and an examination performed with the wrong protocol are sources of error and must be avoided. Anatomical variants, inflammatory cancers, complicated forms (perforation, secondary occlusion of the small intestine, peripheral abscesses, fistulae, pylephlebitis, liver abscesses) and associated signs related to a peritoneal inflammatory reaction (reflex ileus, reactive ileitis or salpingitis) can also lead to a wrong diagnosis

Imaging of mesothelioma of tunica vaginalis testis

Objectives: To describe the imaging findings in a series of patients with mesothelioma of the tunica vaginalis testis. Methods: We reviewed clinical data, imaging findings and follow-up information in a series of 10 pathology-proven cases of mesothelioma (all had US; 2 had MR) of the tunica vaginalis. Results: A variety of patterns could be observed, the most common (5/10) being a hydrocele with parietal, solid and hypervascular vegetations; one patient had a septated hydrocele with hypervascular walls; one had multiple, solid nodules surrounded by a small, physiological quantity of fluid; one a cystic lesion with thick walls and vegetations compressing the testis; two had a solid paratesticular mass. MR showed multiple small nodules on the surface of the tunica vaginalis in one case and diffuse thickening and vegetations in the other one; lesions had low signal intensity on T2-w images and were hypervascular after contrast injection. Conclusions: A preoperative diagnosis of mesotheliomas presenting as solid paratesticular masses seems very difficult with imaging. On the contrary, the diagnosis must be considered in patients in whom a hydrocele with parietal vegetations is detected, especially if these show high vascularity. Key Points: \ue2\u80\ua2 Mesotheliomas of the tunica vaginalis are rare, often challenging to diagnose preoperatively. \ue2\u80\ua2 Most common finding is a complex hydrocele with hypervascular parietal vegetations. \ue2\u80\ua2 Septated hydrocele, nodules without hydrocele, a thick-walled paratesticular cyst are less common. \ue2\u80\ua2 Preoperative diagnosis may allow aggressive surgical approach and, possibly, a better prognosis

Imaging of mesothelioma of tunica vaginalis testis

To describe the imaging findings in a series of patients with mesothelioma of the tunica vaginalis testis