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Teaching point: Extrapelvic endometriosis involving pudendal and sciatic nerve may be a cause of lower limb pain., Competing Interests: The authors have no competing interests to declare., (Copyright: © 2024 The Author(s).)

Amyloidosis is an uncommon disorder characterized by extracellular accumulation of misfolded proteins in tissues. We report a unique case of localized breast amyloidosis in an asymptomatic 56-year-old woman with systemic lupus erythematosus, presented as suspicious microcalcifications without mass on mammography. Vacuum biopsy confirmed amyloidosis, producing the typical apple-green birefringence under polarized light after staining with Congo-red. Further workup and follow-up to exclude development into systemic amyloidosis or hematologic malignancy is recommended. If negative, the prognosis is very good, thus no further treatment is needed. A brief review of the literature revealed more about the typical findings and recommended management., Competing Interests: The authors have no competing interests to declare., (Copyright: © 2022 The Author(s).)

Teaching Point: Adenoma malignum is a rare, non-HPV associated subtype of mucinous adenocarcinoma of the cervix, of which we present an exceptional case that was discovered during the third trimester of pregnancy., Competing Interests: The authors have no competing interests to declare., (Copyright: © 2021 The Author(s).)

Teaching Point: Uterine involvement of B-cell acute lymphoblastic leukaemia is exceedingly rare. Globular enlargement of the uterus with diffuse homogeneous signal intensity is suggestive for the diagnosis on magnetic resonance imaging (MRI) in clinically suspected cases., Competing Interests: The authors have no competing interests to declare., (Copyright: © 2020 The Author(s).)

Teaching Point: A submucosal bladder wall lesion with high signal on T2-weighted MRI warrants blood and urine analysis to rule out a paraganglioma., Competing Interests: The authors have no competing interests to declare., (Copyright: © 2020 The Author(s).)

Teaching Point: Color Doppler ultrasound (US) is useful for screening for renal arteriovenous (AV) shunts, especially following renal biopsy, because of its convenience and minimally invasive nature., Competing Interests: The authors have no competing interests to declare., (Copyright: © 2020 The Author(s).)

Competing Interests: The authors have no competing interests to declare.

Competing Interests: The authors have no competing interests to declare.

Objective: To compare the performance of PI-RADSv2 with PI-RADSv1 in patients with elevated PSA before biopsy., Methods: 245 patients with elevated PSA underwent mpMRI before biopsy between May 2011 and December 2014 at 3.0 Tesla without endorectal coil. Patients underwent transrectal ultrasound-guided systematic 12-core biopsy followed by radical prostatectomy (N = 68), radiation therapy (N = 91) or clinical follow-up for at least two years (N = 86). All exams were scored on a per-patient basis according to PI-RADSv1 and PI-RADSv2. ClinsigPC was defined as Gleason score ≥7 (including 3+4 with prominent but not predominant Gleason 4 component), and/or tumour volume of ≥0.5cc, and/or tumour stage ≥T3a., Results: In 144 patients (58.8%) a ClinsigPC was found within two years after mpMRI. The PI-RADSv1 and PI-RADSv2 overall assessment scores were significantly higher (P < 0.001) in patients with ClinsigPC as compared to patients without ClinsigPC. ROC analysis showed an area under the curve of 0.82 (CI 0.76-0.87) for PI-RADSv1 and 0.79 (CI 0.73-0.85) for PI-RADSv2 (P: NS). A threshold score of 3 exhibited sensitivities of 88.2% and 79.2% (P = 0.001) and specificities of 64.4% and 67.3% (P: NS) with PI-RADSv1 and PI-RADSv2, respectively., Conclusions: The mpMRI scoring systems PI-RADSv1 and PI-RADSv2 yield similar accuracy to detect ClinsigPC in patients with elevated PSA, although clinicians should be aware that when an overall assessment score of 3 is used as a threshold for a positive mpMRI, PI-RADSv2 has lower sensitivity than PI-RADSv1. Nevertheless, PI-RADSv2 is preferable over PI-RADSv1 because it has the advantage of providing well-defined instructions on how to determine the overall assessment category., Competing Interests: The authors have no competing interests to declare.

Lymphangioleiomyomatosis (LAM) is a rare debilitating disease of unknown etiology, classically described as almost exclusively affecting women of childbearing age. The disease most commonly involves the lungs and is characterized by hamartomatous smooth muscle cell proliferations along blood vessels, airways and lymphatics. Most patients present with pulmonary symptoms, including shortness of breath, recurrent pneumothorax and pleural effusions. Extrapulmonary manifestations of LAM as the initial presentation of the disease are highly unusual. We present the case of a patient in whom LAM was incidentally discovered when the patient presented with retroperitoneal hemorrhage from a ruptured renal angiomyolipoma.