Case 2

• A 23-year-old abaca farmer from Albay Bicol presented to a primary care facility with fever and acute abdominal pain radiating to the right groin.

• Bilateral inguinal adenopathy was found, and a whole-body CT scan was done

• He had no scrotal abnormalities. His symptoms improved on empiric antibiotic therapy, and fine-needle aspiration of an enlarged right inguinal lymph node was performed.

• He was then referred to our institution.

• Enhanced CT scans of the chest, abdomen, and pelvis were obtained at our institution.

• A,B Enhanced Contrast CT can of the chest

• MRI• Single-shot fast spin-

echo images (TR/TE, 12,630/99).

• E and F, Coronal (E) and rotated oblique coronal (F) single-shot fast spin-echo images (11,430/98)

• Enhanced CT Scan• G and H, Enhanced CT

scans of abdomen (G) and pelvis (H)

• Central attenuation value of this diffusely distributed material ranged from 8 to 27 H in retroperitoneum and from 22 to 30 H along common iliac and external iliac vessels.

• MRI• I and J, Single-shot

fast spin-echo images (12,500/99)

• MRI• K, Single-shot fast

spin-echo image (12,500/99)

• Differential diagnosis?

• Diagnosis?

• Discussion