case_images: PMC3025878_01
case_images: STIR and LGE images. A, four chamber view, T2-weighted image showing thickening of lateral wall with edema (white arrows); B, post-surgical follow-up T2-weighted images showing normalization of wall thickness and regression of edema; C, post-contrast images showing diffuse myocardial enhancement (black arrows); D, post-surgical follow-up post-contrast images showing regression of myocardial enhancement.
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case_images: PMC3025878_01_1532-429X-13-4-1.jpg
case_images: F1
case_images: Non invasive myocardial tissue characterization with T2-weigthed imaging demonstrated myocardial edema of the postero-lateral segments, whereas the T1-weighted late gadolinium enhancement (LGE) images showed diffuse and patchy myocardial enhancement, both consistent with acute non-ischemic myocardial damage (Figure 1A, C). In addition, a large incidental mass was identified in the left suprarenal gland, suggesting pheochromocytoma (Figure 1b). Three months later she underwent a follow-up CMR, showing normalization of wall thickness (Additional file 2), regression of both myocardial edema and LGE (Figure 1B, D).
case_images: Pre-surgical MR and macroscopic anatomy images. A, abdomen MRI showing large left surrenal mass (white arrow); B, pheochromocytoma after surgical resection.
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case_images: PMC3025878_01_1532-429X-13-4-2.jpg
case_images: F2
case_images: The diagnosis of pheochromocytoma was therefore confirmed and the patient underwent surgical resection of the adrenal mass (Figure 2B).
case_images: Histology data. A, low magnification showing the watershed between tumor (T) and normal gland (N), and the tumoral "pseudocapsule"(C). Organoid ( alveolar) arrangement of tumor cells with nests or cords of poligonal eosinophilic tumor cells in a highly vascularised stroma.B, tumor cells showing finely granular, pinkish-brown, delicate cytoplasm, ovoid nuclei with small regular nucleoli. Haemosiderin from small intratumor haemorrages is shown at the top. C, hyaline globules are present in 47% of pheochromocytomas: they are PAS positive, diastase resistant eosinophilic rounded masses of degenerated cytoplasmatic organules. D, synaptophysin immunostain showing intense cytoplasmatic positivity of tumor cells (red), a venule is shown on the top for negative comparison.
case_images: 1532-429X-13-4-3.jpg
case_images: PMC3025878_01_1532-429X-13-4-3.jpg
case_images: F3
case_images: The histological examination (Figure 3) confirmed the diagnosis of secreting pheochromocytoma.