2. Congenital cystic adenomatoid malformation
Findings:
Multilocular low attn lesion in the RLL with thin enhancing septa
ddx:
Pulmonary abscess

4. Adrenal adenoma Findings: Large right adrenal lesion
Isointense to liver on in-phase scan
Hypointense to liver (signal loss) on out-of-phase scan
ddx:
NONE!
This is an Aunt Minnie!

6. Pancreatic pseudocysts
Findings:
Multiple large pancreatic cystic lesions
ddx:
Von-Hippel Lindau
Cystic pancreatic neoplasm

8. Pulmonary hamartoma Findings:
Solitary pulmonary fat-containing nodule in the RML
May exhibit “popcorn” calcification
ddx:
NONE!
This is an Aunt Minnie!

10. Adrenal macronodular hyperplasia
Findings:
Bilateral lobular enlargement of the adrenal glands.
ddx:
Cushing’s syndrome
Metastases
Infection
Tuberculosis
Histoplasmosis

12. Von-Hippel Lindau Findings: Numerous bilateral renal cyst
Solid enhancing right renal mass = RCC
ddx:
NONE!
This is an Aunt Minnie!

14. SVC obstruction Findings:
Contrast-enhanced CT shows intense enhancement of the medial segment of the left lobe = “liver hot spot” sign
Collateral vessels seen anteriorly in the soft tissues
ddx:
NONE!
This is an Aunt Minnie!

16. Adrenal metastasis Findings: Large heterogeneous adrenal mass
Size alone makes it a surgical lesion
ddx:
Adenoma
Adenocarcinoma
Adrenal cortical carcinoma

18. Splenic infarct Findings:
Large spleen containing a low attenuation geographic lesion extending from the hilus to the periphery
ddx:
NONE!
This is an Aunt Minnie!

20. Malignant mesothelioma
Findings:
Encasement and compression of left lung by enhancing soft tissue mass
Invasion of the posterolateral chest wall and mediastinum
ddx:
Metastases
Breast
Thymus

22. ADPKD
Findings:
Enlarged bilateral kidneys containing innumerable cysts
May also see hepatic cysts
Cysts complicated by hemorrhage or infection
NO increase risk of RCC
ddx:
NONE!
This is an Aunt Minnie!

24. Splenic hemangioma Findings: Low attenuation splenic lesion
Most common solid lesion of the spleen
Imaging and enhancement characteristics often unlike hepatic hemangiomas
ddx:
NONE!
This is an Aunt Minnie!

26. Nutmeg liver due to heart failure
Findings:
CT scan shows ascites and paradoxical enhancement of the liver during the arterial phase
ddx:
Hepatitis
Cirrhosis
Budd-Chiari

29. Appendix mucocele Findings:
Smooth round filling defect at the cecal base
CT shows dilated tubular structure filled with low density material
ddx:
Mucinous adenocarcinoma of the appendix
? Tubo-ovarian abscess

31. Calcified splenic cyst
Findings:
Large low density splenic lesion
Thick calcified wall
ddx:
Posttraumatic (false)
Epidermoid (true)
Chronic hydatid disease

33. Pneumacystis pneumonia
Findings:
Bilateral ground glass opacity emanating from the hila
Normal underlying parenchyma
ddx:
Hypersensitivity pneumonitis
Usual interstitial pneumonia
Cryptogenic organizing pneumonia
Hemorrhage

35. Focal nodular hyperplasia
Findings:
Intensely enhancing lesion in the hepatic dome in the arterial phase
Quick washout in the portal-venous phase
ddx:
Hypervascular tumor
Metastasis

37. Non-calcified splenic cyst
Findings:
Large homogeneous low density splenic lesion
No calcified wall
ddx:
Epidermoid cyst (true)
Pancreatic pseudocyst
Hydatid disease
Abscess

39. Right heart dysfunction
Findings:
Opacification of the hepatic veins during the arterial phase
Hepatic parenchyma unremarkable
ddx:
NONE!
This is an Aunt Minnie!

41. Cystic renal mass Findings:
Low density renal mass with numerous thin septations
Partially exophytic, partially extending to the sinus
ddx:
Cystic RCC
Multilocular cystic nephroma
Abscess
Xanthogranulomatous pyelonephritis (focal)

43. Splenic arter aneurysm
Findings:
Dense round lesion medial to the splenic hilum
Same density as the aorta
Causes
Portal hypertension
Pancreatitis
FMD
ddx:
Hypervascular mass of stomach or pancreas

45. Thymic cyst Findings: Large cystic mass in the anterior mediastinum
High attenuation along the periphery = calcification or rim enhancement
ddx:
Cystic teratoma

47. Emphysematous cholecystitis
Findings:
Distended gallbladder with gas within the wall
Increased risk in pts. with DM
Surgical emergency
ddx:
NONE!
This is an Aunt Minnie!

49. Islet cell tumor Findings:
Enhancing mass in the pancreatic tail = gastrinoma
Pancreatic cysts
Associations:
Z-E syndrome
VHL
MEN I
ddx:
Hypervascular metastasis

51. Neuroblastoma Findings:
Large retroperitoneal mass encases the aorta and extends to the renal hilum
Peripheral enhancement and several foci of high density (? Ca2+)
ddx:
Lymphoma
Metastatic LAN

53. Focal nodular hyperplasia
Findings:
Isointense T1 and T2 hepatic mass = “stealth” lesion
Intense enhancement in the arterial phase
ddx:
NONE!
This is an Aunt Minnie!

55. Lymphoma
Findings:
Innumerable low density lesions of the liver and one in the spleen
ddx:
Metastatic disease
Fungal abscesses

57. Dissecting pancreatic pseudocyst
Findings:
Lobular low density subcapsular lesion of the posterior spleen
ddx:
Lymphoma
Abscess

59. Hepatosplenic sarcoidosis
Findings:
Hepatosplenomegaly
Diffuse infiltration by innumerable tiny low density lesions
ddx:
Microabscesses
TB, histo, CMV, PCP
Bacterial microabscesses
Metastatic disease
Kaposi’s sarcoma

61. Moire spleen Findings:
Normal swirling enhancement pattern of the spleen during the arterial phase
ddx:
NONE!
This is an Aunt Minnie!

63. Adenomyosis of the gallbladder
Findings:
Diffuse gallbladder wall thickening
“ring down” artifact from the non-dependent wall
Abnl thickening of the smooth muscle layer
May be focal or diffuse
No long term consequence
ddx:
NONE!
This is an Aunt Minnie!

65. Focal nodular hyperplasia of the liver
Findings:
Single mass in the lateral segment of the left lobe
Intense arterial enhancement EXCEPT for a central “scar”
ddx:
NONE!
This is an Aunt Minnie!

67. Osteitis condensans Findings:
Focal increased bone density of the medial head of the left clavicle
No periosteal reaction or soft tissue mass
Rare idiopathic disorder
ddx:
Sclerotic metastasis
Radiation necrosis
Osteomyelitis

69. Atrophy of the teres minor
Findings:
High T1 signal at the attachment of the teres minor = fatty muscular atrophy
Axillary nerve impingement in the quadralateral space
ddx:
NONE!
This is an Aunt Minnie! S I S T

71. Achalasia Findings: Dilated and debris-filled esophagus ddx:
Pseudoachalasia
Obstructing tumor
Benign or malignant stricture
Chaga’s disease
Posterior mediastinal abscess

73. Bladder TCC Findings: Diffuse wall thickening of the bladder ddx:
Underdistension
Muscular hypertrophy from outlet obstruction
Cystitis

75. Cervical carcinoma Findings: Fluid-filled endometrial cavity
Suggestion of soft tissue fullness in LUS
Incidental left rectus sheath hematoma
ddx:
Normal menses
Cervical stenosis
Obstructing metastasis

77. Cholangiocarcinoma Findings:
ERCP shows diffuse irregular narrowing of the CBD and intrahepatic biliary tree
ddx:
Scerlosing cholangitis
Ascending cholangitis
AIDS cholangiopathy

79. Thyroid opthalmopathy
Findings:
Bilateral enlargement of the extraoccular muscles except the lateral rectus = “I ’ M S L ow”
Sparing of the tendon
Usually NO eye pain
ddx:
Pseudotumor
Involves tendons
Pts have eye pain

81. Closed loop SBO Findings:
Dilated fluid-filled small bowel loops localized in the RUQ
Medial displacement of the colon
ddx:
Internal hernia
Small bowel volvulus

83. Endometrial carcinoma
Findings:
Irregular enhancing mass extending from the endomentrial cavity to the myometrium
ddx:
Leiomyosarcoma
Metastasis
Gestational trophoblastic disease (if pt pregnant)

85. Pulmonary alveolar proteinosis
Findings:
Diffuse ground glass opacities of the secondary pulmonary lobules = “crazy paving”
Scatter thickening of the interlobular septa
Increased risk of Nocardia infection
Rx: BAL
ddx:
NONE!
This is an Aunt Minnie!

87. Ovarian cystadenocarcinoma
Findings:
Large multilocular cystic lesion with fine septa in the right hemipelvis
ddx:
Ovarian cystadenoma
Tubo-ovarian abscess
Mucocele of the appendix

89. Normal head US Findings:
Sagittal images through the anterior fontanel show normal appearance of the caudo-thalamic groove
Normal choroid plexus in the lateral ventricle

91. Diffuse bronchiectasis
Findings:
Thick-walled tubular structures extending from the hila to the periphery
Accompanying pulmonary artery = “signet ring” sign
ddx:
Immotile ciliary syndrome
Chronic infections (immune deficiency)

93. Early necrotizing enterocolitis
Findings:
Mildly distended bowel loops with “soap bubble” appearance in the RLQ
No evidence of pneumatosis or perforation
Rx: bowel rest; surgery if free gas
ddx:
NONE!
This is an Aunt Minnie!

95. Intussusception Findings:
Low density intraluminal mass within a small bowel loop
Contrast surrounding this mass produced the “coil spring” appearance
Associated with a lead point in adults:
Lipoma
Carcinoma
lymphoma
Meckel’s diverticulum

97. Gaucher spleen Findings:
Enlarged spleen containing numerous low density lesions with mild peripheral enhancement
ddx:
Lymphoma
Metastases
Abscesses

99. Klippel Trauneny Webber syndrome
Findings:
Unilateral muscular and soft tissues enlargement
Numerous vessels within the soft tissues
ddx:
NONE!
This is an Aunt Minnie!

101. Metastatic ovarian carcinoma
Findings:
Numerous low density round lesions within the anterior spleen and within the gastrosplenic ligament
ddx:
Dissecting pancreatic pseudocyst

103. Sickle cell spleen Findings: Small, densely calcified spleen ddx:
NONE!
This is an Aunt Minnie!

105. Splenic tuberculosis & retrocrural LAN
Findings:
Several punctate low density lesions within an otherwise unremarkable spleen
Large enhancing lymph nodes surrouding the aorta in the retrocrural space
ddx:
Lymphoma
MAI

107. Splenic microabscesses
Findings:
Enlarged spleen contains innumerable low density lesions
ddx:
Fungal
Bacterial
Metastases
Lymphoma
Kaposi’s sarcoma
Gamma-Gandy bodies (portal hypertension)
Sarcoidosis

109. Allergic bronchopulmonary aspergillosis
Findings:
Tubular branching opacities of the left upper lobe emanating from the hilum = “finger-in-glove” appearance
ddx:
Pulmonary AVM
Rule out malignancy!

111. Thrombocytopenia-absent radius syndrome
Findings:
Absent bilateral radii and left thumb
Prone to bleeding due to thrombocytopenia
ddx:
Many other causes of radial dysplasia
Holt Oram
VATER
Fanconi syndrome

113. Swyer-James syndrome Findings: Hyperlucent left lung
Diminished pulmonary parenchymal and vascular markings
Expiration view shows air trapping
ddx:
Endobronhial foreign body
Pneumothorax
Congenital lobar emphysema
Pulomary artery hypoplasia

115. RUL collapse Findings: Wedge-shaped opacity of the right apex
Upper displacement of the minor fissure
Right sided mediastinal shift
Elevation of the right hemidiaphragm
ddx:
NONE!
This is an Aunt Minnie!

117. Cystic hygroma Findings:
2nd trimester fetal US shows a large cystic structure along the posterior neck
Recommend amnio
Causes:
Isoloated (nl karyotype)
Generalized hydrops = lymphagiectasia (fatal)
Turner’s / Noonan’s
Trisomy 21, 18, 13

119. Langerhan’s cell histiocytosis
Findings:
Single geographic lytic lesion of the skull involving inner and outer table
No sclerotic margin but surrounding sclerotic reaction
ddx:
Metastasis
Osteomyelitis
Multiple myeloma (multiple)
Epidermoid (sclerotic rim)

121. Laryngotracheobronchitis
Findings:
Narrowing of the subglottic airway = “steeple sign”
a.k.a. Croup
viral infxn (parainfluenza) but may be bacterial (S. aureus)
Check lateral film for acute epiglottitis (25% have subglottic narrowing)
ddx:
epiglotitis
membranous croup

123. Pulmonary sling Findings:
Soft tissue opacity between the trachea and esophagus
Normal appearance on the frontal radiograph
Pt. may present with wheezing
ddx:
Lymphadenopathy
Esophageal mass