Sthanu Profile picture
Oct 29 4 tweets 2 min read
Butterfly glioma

a high grade astrocytoma, usually a glioblastoma (WHO grade IV), which crosses the midline via the corpus callosum

Other white matter commissures are also occasionally involved

The term butterfly refers to the symmetric wing-like extensions across the midline. Image
Most frequently butterfly gliomas

👉occur in the frontal lobes, crossing via the genu of the corpus callosum

👉 however posterior butterflies are also encountered Image
Ddx

primary CNS lymphoma: especially in AIDS patients

cerebral toxoplasmosis: especially in AIDS patients

tumefactive demyelination
cerebral metastases (rare)

occasionally a leptomeningeal process which fills the quadrigeminal and ambient cisterns can cause confusion Image
Sources:

Radiopedia
Dr Tee Yu Jin

in.pinterest.com/pin/3384033595…

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More from @Sthanu5

Oct 31
DERMATOLOGIC MANIFESTATIONS IN HIV DISEASE

Up to 90% of HIV-infected persons suffer from skin diseases during their course of illness Image
The spectrum of skin disorders depends on:

(a) immunologic stage, as reflected by CD4 count

(b) concurrent use of HAART

(c) pattern of endemic infections
HIV dermatosis
Based om clinical morphology Image
Read 6 tweets
Oct 31
A 31-year-old man

👉 fever, papular skin lesions

👉 weight loss of 10 kg in the past month. Image
👉 temperature was 38°C.

👉 examination, he appeared cachectic

👉 umbilicated papules on his face (Panel A), body, arms, and legs.
👉Labs

👉 Hb 8.3 g

👉 wbc 9200 , with 88% neutrophils and 4% lymphocytes,

👉 platelet count of 80,000
Read 11 tweets
Oct 30
A female infant delivered at term by cesarean section

👉had a “blueberry muffin” rash at birth Image
👉 examination, multiple purple, papulonodular lesions measuring 5 to 10 mm in diameter were seen on her trunk, arms and legs, palms and soles, oral mucosa, and palpebral conjunctiva

👉 no lymphadenopathy or hepatosplenomegaly

👉 the results of funduscopy were normal.
👉 labs, including a cbc, a peripheral-blood smear, a reticulocyte count, a metabolic panel, and a coagulation test, were normal.
Read 11 tweets
Oct 29
Diagnostic approach to patients with suspected vasculitis

👉 presents several diagnostic challenges

👉Firstly, patients could present with protean clinical manifestations with a wide spectrum

👉ranging from isolated cutaneous vasculitis to multisystem involvement.
👉Secondly, there are several medical conditions that could mimic the presentation of vasculitis

👉 range of differential diagnosis is therefore broad.
👉thirdly, vasculitis could occur as a prima or be sec to various medical conditions

👉 becomes important to differentiate them,

👉as trt of some forms such as those that are sec to infection or drugs, is diff from that of primary vasculitis.
Read 5 tweets
Oct 29
An 84-year-old man

👉 fever, malaise, and discoloration and pain in his fingers and toes ongoing for 2 wks

👉 no history of smoking
👉examination was notable for blue-black discolor of the distal second through fifth fingers of the lt hand

👉 dusky discoloration of several fingers of the right hand

👉purpuric lesions on both hands

👉 similar discoloration on the toes of both feet.
👉there was associated edema but no sclerodactyly or telangiectasias

👉 Radial, posterior tibial, and dorsalis pedis pulses were palpable on both sides.
Read 10 tweets
Oct 28
Lemon sign

noted on antenatal imaging, is one of the many notable fruit-inspired signs.

👉 a feature when there appears to be an indentation of the frontal bone (depicting that of a lemon)
It is classically seen as a sign of a Chiari II malformation

👉 also seen in the majority (90-98%) of fetuses with spina bifida.
Lemon sign
conditions associated
👇🏼
Chiari II malformation
spina bifida
encephalocele
Dandy Walker malformation
thanatophoric dysplasia
cystic hygroma
diaphragmatic hernia
corpus callosal agenesis
fetal hydronephrosis
umbilical vein varix
Read 4 tweets

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