Tag Archives: diagnostic dilemma
Histopathologic example of segmental arterial mediolysis. (A, B) Microscopic evaluation of an affected mesenteric artery with linear fibrin deposition at the adventitial–medial junction, medial gaps, and dissecting pseudoaneurysms. (C, D) At increased magnification, vacuolar degeneration of medial smooth muscle can be visualized. (A, C: hematoxylin and eosin stain; B, D: elastic van Gieson stain). Bars = 300 µm (A, B) and 100 µm (C, D). Reprinted from Tyler Hall E, Gibson BA, Hennemeyer CT, Devis P, Black S, Larsen BT. Segmental arterial mediolysis and fibromuscular dysplasia: what comes first, the chicken or the egg? Cardiovascular Pathology 2016;25(2):113-115, with permission from Elsevier.

Segmental Arterial Mediolysis: An Important but Often Overlooked Cause of Multi-Vessel Thrombosis

A 52-year-old man with a past medical history significant for hypercholesterolemia and systemic hypertension presented to an outside hospital with acute-onset, diffuse abdominal and bilateral flank pain without fever, constitutional symptoms of infection, or vomiting. On physical examination, abdominal tenderness was present, but abdominal guarding, peritoneal signs, and costovertebral angle tenderness were absent. Computed tomography […]

Read more
Hidden Giant: Medium Vessel Vasculitis as a Cause for Unresolving Fever

Thoracoabdominal Aneurysm in a Professional Body Builder

A 71-year-old man with a history of Parkinson’s disease experienced a sudden decline in function, with multiple falls over 2 weeks. He had previously been able to ambulate independently but had become chair-bound over this period. Forty-eight hours into admission he was noted to be spiking fevers of 38°C-39°C daily, without chills or rigors. There […]

Read more
Still frame of long-axis parasternal view on 2-dimensional color flow transthoracic echocardiogram showing severe aortic regurgitation. as depicted by arrow. The thick arrow at the bottom depicts the point of recording of the diastolic frame. AO = ascending aorta; LA = left atrium; LV = left ventricle.

‘Landolfi’s Sign’—Eyes Don’t See What the Mind Does Not Know!

To the Editor: A 60-year-old woman was admitted with progressively worsening dyspnea on exertion associated with intermittent lightheadedness and palpitations. On physical examination, a 3/6 diastolic decrescendo murmur was audible along the left sternal border. The murmur was most prominently heard in the left third intercostal space at end expiration with the patient in the […]

Read more
Axial computed tomography of the abdomen/pelvis following intravenous contrast showing no evidence of paraspinal muscle pathology but an incidental finding of left greater than right quadratus lumborum muscle asymmetry.

An Uncommon Cause of Low Back Pain

A 21-year-old active duty Air Force male without past medical history presented to our Emergency Department with low back pain. The patient had been performing general resistance strength training, including specific exercises focusing on the low back region, for about 2 months. A few hours after a workout session, he developed acute pain to the […]

Read more
Figure 1

Enhanced abdominal computed tomography at age 48 years showed well-circumscribed adrenal masses measuring 2.0 cm in diameter in the right adrenal gland (A) and 2.5 cm in the left (B) (arrows). The size of left adrenal mass increased to 7.3 cm in diameter at the age of 65 years (C). The mass contained tiny calcifications at the periphery of the mass. The size of left adrenal mass increased to 9.7 cm in diameter at the age of 68 years (D).

Slowly Growing Adrenal Mass: A 20-Year Incubation

A 68-year-old Japanese woman was referred for the evaluation of bilateral adrenal masses. These masses were incidentally discovered 20 years previously on computed tomography (CT) when they measured 2.5 cm and 2.0 cm (Figure 1A, B). At that time she had no signs or symptoms of adrenal cortical hormone excess or deficiency. The plasma corticotropin (ACTH) concentration was […]

Read more
Chest x-ray film revealing marked cardiomegaly.

Case of Tuberculous Pericarditis Mimicking Lupus Carditis

A 48-year-old man presented to the emergency department of our hospital complaining of sharp substernal chest pain, fever, and chills for 3 days. He denied shortness of breath, cough, night sweats, nausea, vomiting, or diarrhea. He also denied dry eyes, dry mouth, oral ulcers, or photosensitivity. He was born in the Dominican Republic but has […]

Read more
UA-42320404-1