case_images: PMC10849877_01
case_images: Axial NCECT at the level of the right upper lobe bronchus (left) and at the right lower lobe bronchus (right), showing bilateral peri-hilar thick-walled cylindrical bronchiectasis (arrows) and bronchiectatic changes with cylindrical and varicoid components, some with mucus plugs, as well as cavitating and non-cavitating fibrotic changes within the apical segment of the right lower lobe (open arrow).
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case_images: There were also a few varicoid forms of bronchiectasis and cavitating and non-cavitating fibrotic changes predominantly in the right lower lobe, while other non-cavitary fibrotic lesions were seen scattered in the other lobes (Figure 1).
case_images: Axial CECT at the level of the main pulmonary artery (MPA) showing enlarged MPA (open arrow) compared to the ascending aorta (triangular open arrow head), measuring 22 mm and 20.1 mm, respectively.
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case_images: On CECT, the main pulmonary artery was enlarged compared to the ascending aorta, evidencing pulmonary arterial hypertension (Figure 2).
case_images: Axial CECT at the level of the gallbladder (between open arrow heads) showing micro-gallbladder (here, measuring 3.79 cm long and 1.3 cm wide), hepatomegaly and hepatic steatosis (elliptical areas showing hepatic and splenic attenuation of -4.65 HU and 154.49 HU, respectively). The vascular markings also stand out against the background hepatic parenchyma, demonstrating more evidence of hepatic steatosis . Measurement of hepatic and splenic attenuation at NCECT and CECT at multiple sections showed a range of -14 to -33 HU on NCECT and -2.5 to 22.5 HU on CECT for liver; which was in comparison to the mean splenic attenuations of 45.5-53.5 and 141.61-154.49 HU at NCECT and CECT, respectively. Please also note beaver's tail, a normal anatomic variant unrelated to CF, where the liver parenchyma of the left hepatic lobe wraps around the spleen. Riedel's lobe, a normal variant of liver parenchymal extension beyond the lower margin of the kidney, was also seen but is not demonstrated here.
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case_images: An enlarged liver with severe steatosis (Figure 3) and a small-sized gallbladder suggestive of micro-gallbladder (Figure 3) were also evidenced.
case_images: CECT at the level of the pancreatic body and tail showing a completely atrophied pancreas, with pancreatic duct ectasia (curved solid line) surrounded by complete fatty replacement (solid arrow). The former two might signify evidence of chronic pancreatitis.
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case_images: A diffuse atrophy and complete fatty replacement of the pancreas with pancreatic duct ectasia, and lipomatous pseudohypertrophy of the tail region (Figure 4), and symmetric concentric smooth thickening and redundancy of the proximal colon (Figure 5) were the features seen on the CT.
case_images: Axial CECT showing symmetric concentric thickening and redundancy of the proximal portion of the colon (open arrow): particularly, the ascending colon, hepatic flexure and proximal half of transverse colon, compared to the distal portion of the transverse colon with normal wall thickness (shaded arrow).
case_images: AHMT-15-19-g0005.jpg
case_images: PMC10849877_01_AHMT-15-19-g0005.jpg
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case_images: A diffuse atrophy and complete fatty replacement of the pancreas with pancreatic duct ectasia, and lipomatous pseudohypertrophy of the tail region (Figure 4), and symmetric concentric smooth thickening and redundancy of the proximal colon (Figure 5) were the features seen on the CT.