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Pleuropulmonary blastoma is a rare and highly aggressive pulmonary malignancy in children. Clinically, the malignancy is often mistaken for symptoms of respiratory tract infection or pneumothorax. The neoplasm is histologically characterized by primitive blastema and a malignant mesenchymal stroma that demonstrates multidirectional differentiation. The patients with PPB are managed by multimodal therapy. We present a report of 3 cases of histopathologically diagnosed pleuropulmonary blastoma. The patients presented with chief complaints of difficulty in breathing, cough, fever and chest pain. Radiographs of the patients showed partial to complete opacification of hemithorax. Contrast enhanced computed tomography scans revealed large well defined heterogenously enhancing solid mass lesions in the hemithorax. Knowledge of types, imaging findings, staging and association with other tumors is crucial for correct diagnosis of pleuropulmonary blastoma and subsequent adequate management.

Renal leiomyoma is a rare benign mesenchymal tumor. It arises from the smooth muscle cells of the kidney and renal capsule is its most common location. Small tumor may be asymptomatic and usually appears as a well circumscribed peripherally located solid mass. Large tumor may manifest with pain, palpable flank mass or hematuria. Intersecting fascicles of spindle cells showing immunoreactivity to actin or desmin are characteristic histologic features. We present a case of giant renal leiomyoma in a 20-year-old female with chief complaints of abdominal discomfort and lump in her left side of abdomen. AP radiograph showed a large abdominopelvic soft tissue opacity. Contrast-enhanced computed tomography scan revealed a massive well circumscribed exophytic complex solid cystic mass of size 17 cm × 15 cm × 13 cm arising from upper pole of left kidney. The role of percutaneous biopsy is limited in such lesions and surgery is the only therapeutic option. Keywords: Mesenchymal tumor, Renal leiomyoma, Computed tomography (CT)

A criss-cross heart is an uncommon congenital rotational anomaly. It accounts for less than 0.1% of all congenital heart defects. The anomaly is characterized by crossing of the atrioventricular connections caused by rotation of the heart about its long axis. It is commonly associated with diverse cardiac defects. Cardiac CT imaging of criss-cross heart is sparse. We present a case of 1-year-old child with chief complaints of bluish discoloration of the body and fast breathing. Cardiac CT revealed atrial situs solitus, criss-cross-atrioventricular connections, atrioventricular discordance, double outlet right ventricle and dextro-malposed great arteries (Van Praagh S,D,D).

Herlyn–Werner–Wunderlich syndrome is a rare complex congenital anomaly of the urogenital tract involving Mullerian ducts and mesonephric ducts. It is also called OHVIRA syndrome (Obstructed Hemivagina and Ipsilateral Renal agenesis). It is characterized by a triad of uterus didelphys, obstructed hemivagina and ipsilateral renal agenesis. Patients usually present after menarche with pelvic pain, dysmenorrhea, mass, and rarely with primary infertility in later years. We report a case of a multiparous female who presented to the hospital with pain in lower abdomen for the past 2 months and acute retention of urine for 1 day. This is an atypical presentation in a multiparous female that has been described in a single case report so far. 1 Intravenous pyelogram and MRI of the patient revealed uterine didelphys, obstructed right hemivagina causing hematohemicolpos and right renal agenesis. Thorough knowledge of imaging features can enable a radiologist to make a correct diagnosis even in an atypical presentation.

Mediastinal tumours are not uncommon in paediatric population and often pose a diagnostic challenge. They include a variety of entities including developmental, inflammatory, infectious and neoplastic; most are malignant. These lesions can be classified based on imaging according to the specific compartment (anterior, middle and posterior), generating a focused differential diagnosis. This combined with a rational, clinically oriented approach based on patient's history, focused physical examination, age, gender, symptoms, signs, anatomic localization, imaging characteristics and laboratory investigations including tumor markers paves way to a presumptive diagnosis guiding additional and prudent investigations. For example, a suspicion of lymphoma should be kept in a child presenting with a neck mass and superior vena cava syndrome. Neuroblastoma should be suspected among children younger than 5 years old with a posterior mediastinal mass. Such a structured approach along with histopathology will lead to an exact diagnosis. Surgery remains the mainstay of treatment of most benign and malignant non-lymphoid tumours. For optimal management, a combined modality of treatment incorporating chemotherapy and radiotherapy is often required in malignant tumours and is associated with high survival rates in these patients. In the present article, we review the approach to evaluation of mediastinal masses in childhood from a clinical perspective.

Background: Diffuse lung diseases describe a heterogeneous group of disorders of the lower respiratory tract characterized by inflammation and derangement of the interstitium and loss of functional alveolar units. The disease is not restricted to the interstitium only, as it involves epithelial, endothelial and mesenchymal cells with the disease process extending into the alveoli, acini and bronchioles. Thus, the entire pulmonary parenchyma is involved. The objective of the study was to evaluate diffuse lung diseases by high resolution computed tomography of chest.Methods: A cross-sectional observational study was done in 30 patients. Adult patients of either sex of age group 18 and above showing reticular opacities on chest X-ray and those patients who were incidentally diagnosed as cases of diffuse lung diseases on HRCT chest were included in present study.Results: Reticular opacities were the most common roentgenographic finding followed by reticulonodular opacities. On HRCT, intra and interlobular septal thickening was the most common finding in Idiopathic interstitial pneumonia (usual interstitial pneumonia).Conclusions: High resolution computed tomography (HRCT) is superior to the plain chest X-ray for early detection and confirmation of suspected diffuse lung diseases. In addition, HRCT allows better assessment of the extent and distribution of disease, and it is especially useful in the investigation of patients with a normal chest radiograph. Coexisting disease is often best recognized on HRCT scanning.