case_images: PMC4584436_01
case_images: 28-year-old male presenting with nonspecific symptoms of abdominal pain weakness and pulsatile abdominal mass on examination later diagnosed with mycotic abdominal aneurysm underwent computerized tomography angiography (CTA) of abdomen. 3D reconstructed image shows two large saccular aneurysms (arrows) arising from the abdominal aorta, one arising anteriorly and the other arising posteriorly.
case_images: JCIS-5-49-g002.jpg
case_images: PMC4584436_01_JCIS-5-49-g002.jpg
case_images: F1
case_images: The CT angiography revealed multiple saccular aneurysms with thin irregular walls, arising from the abdominal aorta [Figures 1 and 2].
case_images: 28-year-old male presenting with nonspecific symptoms of abdominal pain weakness and pulsatile abdominal mass on examination later diagnosed with mycotic abdominal aneurysm underwent computerized tomography angiography of abdomen. Maximum intensity projection reformatted image in sagittal plane of abdomen shows two abdominal aortic saccular aneurysms (arrows).
case_images: JCIS-5-49-g003.jpg
case_images: PMC4584436_01_JCIS-5-49-g003.jpg
case_images: F2
case_images: The CT angiography revealed multiple saccular aneurysms with thin irregular walls, arising from the abdominal aorta [Figures 1 and 2].
case_images: 28-year-old male presenting with nonspecific symptoms of abdominal pain weakness and pulsatile abdominal mass on examination later diagnosed with mycotic abdominal aneurysm underwent computerized tomography angiography of abdomen. CECT abdomen with maximum intensity projection reformatted image in axial plane shows pre-para aortic necrotic lymphadenopathy (white straight arrow) compressing right renal artery at its origin, thus causing chronic renal parenchymal changes on the right side (white arrowhead).
case_images: JCIS-5-49-g004.jpg
case_images: PMC4584436_01_JCIS-5-49-g004.jpg
case_images: F3
case_images: One of the aneurysms was causing near-total compression of right renal artery, resulting in chronic renal parenchymal changes secondary to ischemia [Figure 3].
case_images: 28-year-old male presenting with nonspecific symptoms of abdominal pain weakness and pulsatile abdominal mass on examination later diagnosed with mycotic abdominal aneurysm underwent computerized tomography angiography of abdomen. Contrast-enhanced CT axial section of abdomen shows enlarged para-aortic lymph nodes (arrowhead) in the vicinity of aneurysm (black arrow).
case_images: JCIS-5-49-g005.jpg
case_images: PMC4584436_01_JCIS-5-49-g005.jpg
case_images: F4
case_images: Multiple enlarged (largest 2.8 cm in short-axis dimension) para-aortic lymph nodes were identified in the vicinity of the aneurysms showing evidence of internal necrosis [Figure 4].
case_images: 28-year-old male presenting with nonspecific symptoms of abdominal pain weakness and pulsatile abdominal mass on examination later diagnosed with mycotic abdominal aneurysm underwent computerized tomography angiography of abdomen. Microphotograph of core biopsy specimen from the retroperitoneal lymph node (hematoxylin and eosin, x400 magnification) shows caseous necrosis with surrounding epithelioid cells (modified macrophages, black arrows), suggesting a tubercular etiology.
case_images: JCIS-5-49-g006.jpg
case_images: PMC4584436_01_JCIS-5-49-g006.jpg
case_images: F5
case_images: The lymph node biopsy revealed central caseous necrotic material with epithelioid cells and macrophages consistent with tubercular etiology [Figure 5].