Round Cell Tumour Spine-MRI

This is 39 year old male with histologically proven round cell tumour. Results of the tumour markers are awaited. Note the extensive soft tissue component and preserved discs. Lymphoma was the provisional diagnosis by the pathologist.

Dr.Sumer K Sethi, MD

Sr Consultant Radiologist ,VIMHANS and CEO-Teleradiology Providers

Editor-in-chief, The Internet Journal of Radiology

Director, DAMS (Delhi Academy of Medical Sciences)

Inescapable Reality

Our minds sometimes tend to shutter the hard and pervading problems of our society just so because it can negate from our consciousness the uneasy reality that we are somehow part of the problem. Yet the problem do exists, however much our minds choose to deny it. We refuse to look at it face to face, because we do not want to share a guilt in the blame.

It's funny how we follow the logic that since we are not the cause of the problem, why would we then be part of the solution? If we can rephrase the question, maybe it can bring us to the glaring reality: if we are not part of the solution, are we not also part of the problem?

This Is Why You're Fat - UPDATE

I posted a couple days ago about the Grande Breakfast Burrito from Jack-N-Grill in Denver, Colorado. I wrote that the restaurant menu claims that it's five pounds and that it's stuffed with potatoes, eggs, onions, and ham bits, lots of cheese on top and smothered in red chile.

I was off by a little bit, about two pounds!!!!! It's a seven pound breakfast burrito!!!!

If a man eats it in one sitting, he gets the burrito for free..... If a woman eats the burrito in one sitting, she gets to eats at Jack-N-Grill for free for the rest of her life!!!!!

Madoff Made Off With A Lot Of Money - UPDATE

Bernie Madoff plead guilty to 11 felony counts yesterday and was sent directly to jail to wait for sentencing. No passing go..... No collecting $200.00..... He could be sentenced to 150 years in prison.

In his confession, he told the judge and former clients that "While I never promised a specific rate of return to any client, I felt compelled to satisfy my clients' expectations, at any cost." It wasn't his fault...... He just wanted to make everybody happy..... By lying to them, telling them that their investments were wildly successful, all the while spending their money and not investing it to gain any returns. He confessed that since the early 1990's, the money that was supposed to be invested, was deposited directly into bank accounts, and was NEVER invested!

This man had 4,800 client accounts when he was arrested in December. He falsely reported to these clients that he was holding $64,800,000,000 of their money! The actual investment losses to his client is estimated to be $10,000,000,000 to $20,000,000,000!!!!

As of the writing of this blog, approximately $950,000,000 of Madoff's assets have been recovered to reimburse scammed investors!

What a douchebag!

In Case Of Emergency

Noah loves this..... It's super addicting..... Just Do It! It's a great way to start Friday morning...

Cerebral amyloid angiopathy-CT

Cerebral amyloid angiopathy (CAA) refers to the deposition of b -amyloid in the media and adventitia of small- and mid-sized arteries (and less frequently, veins) of the cerebral cortex and the leptomeninges. It is a component of any disorder in which amyloid is deposited in the brain, and it is not associated with systemic amyloidosis. CAA has been recognized as one of the morphologic hallmarks of Alzheimer disease (AD), but it is also often found in the brains of elderly patients who are neurologically healthy. While often asymptomatic, CAA may lead to dementia, intracranial hemorrhage (ICH), or transient neurologic events. ICH is the most recognized result of CAA.
This is a case of 68yr old man with old history of right frontal bleed presented with fresh bleed in the same area for which he was operated. Following he developed a left frontal heamtoma. Reoperated on the other side. Following which he had a left parietal hematoma. Diagnosis of CAA was kept and was confirmed histopathologically by congo red staining. Serial CT scans are provided.

Dr.Sumer K Sethi, MD
Sr Consultant Radiologist ,VIMHANS and CEO-Teleradiology Providers
Editor-in-chief, The Internet Journal of Radiology
Director, DAMS (Delhi Academy of Medical Sciences)

Intralabyrinthine hemorrhage

Findings

Axial T1 fat-saturated MRI of the internal auditory canal (precontrast) shows acute hemorrhage with hyperintensity in the cochlea and vestibule.


Diagnosis: Intralabyrinthine hemorrhage


Sudden hearing loss secondary to an acute cochlear hemorrhage is rare. Estimates of annual incidence of sudden hearing loss are 5-20 per 100,000 of which only a small percentage is due to intralabyrinthine hemorrhage. Only 1-4% of all cases of sudden sensorineural hearing loss are bilateral. The fact that this patient has Down syndrome is significant, since hearing loss has been reported in both acute and chronic myeloid leukemias, which occurs at a higher frequency in Down patients. One theory proposes that hyperleukocytosis causes leukostasis with abnormal microvascular perfusion. The cochlea is an end organ in terms of its blood supply with no collaterals. It is supplied by the labyrinthine artery, a branch of AICA. Its tortuous course predisposes it to the effects of hyperviscocity. In addition, it is extremely sensitive to changes in blood supply. Thus, the time course of hearing loss correlates well with a vascular event such that an acute hearing loss is most likely caused by hemorrhage, thrombosis, embolism or hypotension. This patient should be evaluated for an underlying leukemia.

Imaging can be used as an adjunct in both conductive and sensorineural hearing loss. CT imaging is more sensitive for conductive hearing loss while MR is more sensitive for sensorineural hearing loss. Fluid in the labyrinth is normally isointense with CSF. In the acute phase of hemorrhage, hypointense signal can be seen on T2-weighted images, while hyperintense T1 signal can be seen for up to 6 months because of the extended life span of the erythrocytes in the perilymph. Other possible causes of sensorineural hearing loss that can be seen on MR include vestibular schwannomas, arachnoid cysts, multiple sclerosis, and inflammation.