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  Indian J Med Microbiol
 

Figure 1 Neuroblastoma. (a) Ultrasound and CT abdomen of a 4-year-old male patient demonstrate a large left suprarenal mass with calcification (white thick arrows). The lesion appears hypoechoic/hypodense on USG/NCCT and shows heterogeneous enhancement on contrast-enhanced CT. The mass is extending from diaphragm below, encasing the adjacent vessels (white thin arrow) and invading the ipsilateral psoas muscle (arrowhead). The kidney is displaced anterolaterally. Aortocaval lymphadenopathy (black thin arrow) is seen. The lesion showed avid MIBG uptake. Patient was VMA +ve. (b, c) Two different patients of neuroblastoma. One of the patient (1b) shows ecchymotic orbital proptosis − “Raccoon eye” due to metastatic involvement of periorbital bones and soft tissues (arrow). Another patient (c) shows dural and calvarial metastases (arrows) with sun ray type of periosteal reaction. (d–f) Contrast-enhanced MRI spine (e) of another 7-year-old male patient with severe backache and fever showed a right adrenal mass (not shown), and multiple vertebral (arrowheads) and dural metastases (thin black arrows) with compression of dural sac. MRI brain (d) of the same patient showed a solitary ring enhancing metastatic lesion in right frontal lobe of brain (thin white arrow) and intense leptomeningeal enhancement (thin black arrow). The right adrenal mass was also well demonstrated on abdominal ultrasound (not shown). Later, contrast-enhanced CT abdomen (f) was done for staging, which also well demonstrated the adrenal mass along with the skeletal metastases. Histopathology confirmed neuroblastoma. CT, computed tomography; MIBG, metaiodobenzylguanidine; MRI, magnetic resonance imaging; NCCT, noncontrast computed tomography; USG, ultrasonography; VMA, vanillylmandelic acid.

Figure 1 Neuroblastoma. (a) Ultrasound and CT abdomen of a 4-year-old male patient demonstrate a large left suprarenal mass with calcification (white thick arrows). The lesion appears hypoechoic/hypodense on USG/NCCT and shows heterogeneous enhancement on contrast-enhanced CT. The mass is extending from diaphragm below, encasing the adjacent vessels (white thin arrow) and invading the ipsilateral psoas muscle (arrowhead). The kidney is displaced anterolaterally. Aortocaval lymphadenopathy (black thin arrow) is seen. The lesion showed avid MIBG uptake. Patient was VMA +ve. (b, c) Two different patients of neuroblastoma. One of the patient (1b) shows ecchymotic orbital proptosis − “Raccoon eye” due to metastatic involvement of periorbital bones and soft tissues (arrow). Another patient (c) shows dural and calvarial metastases (arrows) with sun ray type of periosteal reaction. (d–f) Contrast-enhanced MRI spine (e) of another 7-year-old male patient with severe backache and fever showed a right adrenal mass (not shown), and multiple vertebral (arrowheads) and dural metastases (thin black arrows) with compression of dural sac. MRI brain (d) of the same patient showed a solitary ring enhancing metastatic lesion in right frontal lobe of brain (thin white arrow) and intense leptomeningeal enhancement (thin black arrow). The right adrenal mass was also well demonstrated on abdominal ultrasound (not shown). Later, contrast-enhanced CT abdomen (f) was done for staging, which also well demonstrated the adrenal mass along with the skeletal metastases. Histopathology confirmed neuroblastoma. CT, computed tomography; MIBG, metaiodobenzylguanidine; MRI, magnetic resonance imaging; NCCT, noncontrast computed tomography; USG, ultrasonography; VMA, vanillylmandelic acid.