Intrapancreatic accessory spleen: An imaging enigma

The pancreatic tail is an uncommon location for the accessory spleen. Although it is a benign entity, it can mimic and get misdiagnosed as a pancreatic tumor which can lead to unnecessary biopsy and surgery. Here, we present a case who was detected to have a tail of pancreas mass. On CT and MRI, it showed similar density, signal intensity, and matching enhancement pattern with the orthotopic spleen. The ADC value of the mass was found to be similar to that of the spleen and significantly less than that of normal pancreas. A diagnosis of intrapancreatic accessory spleen was hence made and the patient was followed up after 6 months on MRI. No change in lesion morphology and size was noted. Thus, intrapancreatic accessory spleen should be kept in mind as a differential diagnosis while reviewing a case with pancreatic mass

CT chest analysis of 2019 novel coronavirus pneumonia: An Indian perspective

Context: Since its outbreak, the COVID-19 pneumonia pandemic is rapidly spreading across India; although computed tomography of chest (CT chest) is not recommended as a screening tool, there is a rapid surge in the CT chest performed in suspected cases. We should be aware of the imaging features among the Indian population. Aim: To analyze the CT chest features in Indian COVID-19 patients. Settings and Design: Retrospective study. Subjects and Methods: CT chest of 31 polymerase chain reaction (PCR) verified patients of COVID-19 was assessed for ground-glass opacities (GGO), consolidations, bronchiectasis, pleural effusions, vascular enlargement, crazy paving, and reverse halo sign. Statistical Analysis Used: The data was analyzed in Microsoft Excel 2019. Results: Only one patient showed a normal scan. Multilobar involvements with parenchymal abnormalities were seen in all the patients with bilateral involvement in 74.1%. 42.5% of the lung parenchymal abnormalities were pure GGOs, while 41.6% had GGOs mixed with consolidation. Peripheral and posterior lung field involvement was seen in 70.5% and 65.5%, respectively; 56.8% had well-defined margins. Pure GGOs were seen in all six patients, who underwent CT in the first 2 days of onset of symptoms. Seventeen patients scanned between 3 and 6 days of the illness showed GGOs mixed with consolidation and pure consolidations 76%. Vascular enlargement, crazy paving, and reverse halo sign were seen in 70%, 53%, and 35% of the patients, respectively. Patients scanned after 1 week of symptoms showed traction bronchiectasis along with GGOs and or consolidations. Conclusions: COVID-19 pneumonia showed multifocal predominantly subpleural basal posteriorly located GGOs and/or consolidations which were predominantly well defined. “Crazy paving” was prevailing in the intermediate stage while early traction bronchiectasis among the patients presented later in the course of illness