PMC3461402_01
CT of the abdomen shows an abnormal, poorly defined collection (6.9 cm x 4.7 cm) of gas and inflammatory changes in the region of the head and uncinate process of the pancreas and dorsal and inferior to the body of the pancreas. A more focal (2.1 cm x 1.9 cm) fluid density along the posterior left aspect is noted.
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F1
There was also a 4 cm x 7 cm x 4 cm well defined soft tissue mass lesion with central calcification in the left lower quadrant of the abdomen (Figure 1).
DW-MRI of the brain shows multiple areas of confluent restricted diffusion affecting the splenium of the corpus callosum, right medial occipital white matter, right brachium pontis, bilateral dorsal pons, and right cerebral peduncle (A). These areas are hyperintense on Fluid Attenuated Inversion Recovery (FLAIR) sequence. There is no evidence of mass effect (B).
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F2
These regions were associated with non-enhancing hyperintense T2 and fluid attenuated inversion recovery (FLAIR) sequence without mass effect (Figure 2).
T1W-MRI with contrast shows lesions located in the splenium, pons, and cerebellum with minimal contrast enhancement.
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F3
T2/FLAIR, of the lesions located in the splenium, posterior white matter, midbrain, pons, and cerebellum. These lesions had faint enhancement following gadolinium administration (Figure 3).
T2W-MRI of the cervical spine shows multiple non-contiguous expansive lesions from the cervico-medullary junction to the level of the sixth cervical vertebra (A). T1W-MRI with contrast demonstrates patchy enhancement (B).
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F4
MRI of the cervical spine showed multiple non-contiguous spinal cord expansive lesions from the cervico-medullary junction to the level of the sixth cervical vertebra (Figure 4).