Faculty of Medicine

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Author: search.filters.author.Jovanovska, ZlaticaSubject: search.filters.subject.CT

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    CT Findings in Progressive Xanthogranulomatous Pyelonephritis
    (Department of Anaesthesia and Reanimation, Faculty of Medicine, Ss. Cyril and Methodius University in Skopje, R.N. Macedonia, 2023)
    Jovanovska, Zlatica
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    Petkovikj, Magdalena
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    Donevska Efremovska, Kristina
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    Kamcheva, Marta
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    Resulting from recurrent subacute or chronic urinary infections, a chronic pyelonephritis develops, which can be represented as several entities. Xanthogranulomatous (XGP) pyelonephritis is one of those entities which has characteristic radiographic features. The inflammatory process following the recurrent infections causes destructions to the parenchymal wall of the kidneys and over time it is replaced with a mass of reactive granulomatous tissue, containing lipid-laden macrophages, which surrounds the typical form of calculi – staghorn calculi. These are the pathognomonic radiological signs. CT is the modality of choice in diagnostic imaging for xanthogranulomatous pyelonephritis for two reasons – in the most of cases it demonstrates a highly specific tirade of findings that allow a confident diagnosis and offers accurate follow-up of the disease which is of great importance for the further surgical treatment. We present the CT findings of a clinical case throughout 6 years long follow up of chronic pyelonephritis which advanced to development of XGP and a complication with purulent collection in the left kidney, which resulted in left sided nephrectomy. This article describes the role of diagnostic imaging and correlates the radiologic findings to the underlying disease process. Additionally, we emphasize the diagnostic importance of CT in treatment, follow-up and preoperative planning.
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    Large Ovarian Cyst Presenting as Weight Gain in an Adolescent Girl: A Case Report
    (SHMSHM - AAMD, 2022)
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    ;
    Jovanovska, Zlatica
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    Kamcheva, Marta
    ;
    Dukovska, Marija
    Ovarian cysts are a common finding in female adolescents presenting with macrocysts that occupy the entire pelvis or abdomen. Ovarian cysts can be asymptomatic and found accidentally or be manifested as a painful syndrome in which one of the first clinical signs is the feeling of abdominal fullness or progressive enlargement of the abdomen. The frequency of which ovarian cyst are present in adolescent young females has raised and is in the range from 3,8% to 30,9%. Peak ovarian cyst frequency was at age of 15 years with a rate of 31.3%.1 We report an unusual case of a large ovarian cyst in a 12-year-old girl without previous medical information of illness. The cyst was asymptomatic until it became large enough and manifested as weight gain and progressive abdominal distension over the course of a few months and was an accidental finding on an abdominal CT. Because of the progressive pain and discomfort of the patient, CT and MR imaging were performed. The radiographic features of the cyst together with the further management and treatment are discussed below.