Browsing by Author "Ramachandran, Rajoo"

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    Characterization of Cystic Lesions of Pancreas by Computed Tomography Scan- A Retrospective Study
    (Akshantala Enterprises Private Limited, 2020-03) Ramachandran, Rajoo; Athiyappan, Kumaresh; Radhakrishnan, Prabhu Radhan; Balasubramanian, Ananda Kumar
    Cystic lesions of the pancreas consist of both neoplastic and non-neoplastic lesions. Computed tomography (CT) scan is commonly used in imaging cystic lesions of pancreas as it is easily available and less time consuming. In this study, we evaluate the different characteristic features of cystic lesions of pancreas and differentiate them based on imaging.METHODSThis is a retrospective study done over a period of 5 years. 94 patients with cystic lesions of pancreas were selected and analysed. All patients had proven final diagnosis by surgery, by endoscopy guided aspiration or by follow up. Various parameters of the cysts were studied like the age and sex distribution, incidence, size of the lesion, location, thickness of septations, nature of calcification, pancreatic duct dilatation if any, size of the largest cyst within the lesion, approximate number of cysts, presence of any solid component, nature of enhancement, presence of the wall and contour of the lesion. Descriptive statistics like percentage was used and each cyst was differentiated based on the above features.RESULTSOverall, pseudocysts were the commonest cysts, and all were associated with pancreatitis. They were commonly seen in the middle-aged males. Serous cystadenomas were the commonest neoplastic cysts. Benign neoplastic cysts were common in females and malignant neoplastic cysts were common in males. Serous cystadenomas were common in head of the pancreas whereas mucinous cystadenomas were common in tail of the pancreas. All solid pseudo papillary epithelial neoplasm (SPEN) were seen in the tail of the pancreas. No difference in each cyst based on overall size was seen. Mucinous cystadenomas showed fewer but bigger cysts within the lesion compared to serous cystadenomas. Peripheral wall calcification was seen in mucinous cystadenomas whereas central calcifications were seen in serous cystadenomas. Communication with a dilated pancreatic duct and bulging papillae was seen in intraductal papillary mucinous tumour (IPMT). Most of IPMT and serous cystadenomas showed a lobulated invisible wall whereas mucinous cystadenomas showed a smooth visible wall. All malignant cysts were associated with solid component and thick septations.CONCLUSIONSCT scans helps us to diagnose various cystic lesions of pancreas based on different characteristic imaging features
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    A Rare Case of Asymptomatic Mediastinal Thymolipoma-presenting as Opaque Hemithorax.
    (2015) Ramachandran, Rajoo; Vakamudi, Udaya Bhaskarini; Santosham, Roy; Prithiviraj, Periasamy Varadaraju; Ilanchezhian, Subramanian; Periaswamy, Thangavelu
    Aim: To describe the imaging features of a rare case of an asymptomatic thymolipoma presenting as opaque hemithorax. Thymolipoma is a rare benign neoplasm of the thymus which is composed of thymic elements and adipose tissue. Presentation of Case: We present a case of opaque hemithorax in a 37 year old male following trauma to the chest. The patient had pain in the left side of the chest following a trauma and his physical examination showed tenderness in the left upper chest. Discussion: Plain radiography was done which showed an opaque hemithorax. Computed tomography of the chest was done which revealed a large fat containing mass lesion occupying the entire right hemithorax. Conclusion: To our knowledge there are only few cases of such unusual presentation of giant thymolipomas reported in English literature. The main purpose of this report is to discuss the rare presentation of a giant asymptomatic thymolipoma and the role of imaging in aiding the diagnosis.
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    Unusual Presentation of a Caseating Lymphadenitis Causing Abnormal Lymphadeno-Duodenal Communication.
    (2015) Jayasree, Yamuna; Ilanchezhian, Subramanian; Jeffery, Ralph; Ramachandran, Rajoo; Prithiviraj, Periasamy Varadaraju
    Aim: To describe the imaging features of a case of abnormal lymphadeno-duodenal communication caused by caseating lymphadenitis. Presentation of Case: The case discussed is of a thirty-five year old Indian woman who presented with abdominal pain, vomiting, fever, loss of appetite and later diagnosed with abnormal lymphadeno-duodenal communication caused by caseating lymphadenitis. Discussion: Caseating lymphadenitis is a chronic disease process that occurs anywhere in the human body and its prevalence varies from region and country. Here, we report a case of lymph node with caseous necrosis causing abnormal lymphadeno-duodenal communication which was diagnosed by Computed tomography. This poses a great diagnostic challenge for a variety of reasons which include its non-specific symptoms, wide range of causes and the complications in the case of a delayed diagnosis. Abdominal involvement can occur in the peritoneum and the mesentery. Imaging plays a very important role to assess the cause of caseating lymph nodes and identify the complications. Conclusion: As abnormal lymphadeno-duodenal communication is an unusual condition and rarely reported, it is important to consider the possibility of tuberculosis as one of the underlying etiology. A high index of suspicion needs to be maintained for timely diagnosis and accurate treatment.