Portal hypertension is a common clinical syndrome, defined by a pathologic increase in the portal venous pressure. Increased resistance to portal blood flow, the primary factor in the pathophysiology of portal hypertension, is in part due to morphological changes occurring in chronic liver diseases. This results in rerouting of blood flow away from the liver through collateral pathways to low-pressure systemic veins. Through a variety of computed tomographic, sonographic, magnetic resonance imaging and angiographic examples, this article discusses the appearances and prevalence of both common and less common portosystemic collateral channels in the thorax and abdomen. A brief overview of established interventional radiologic techniques for treatment of portal hypertension will also be provided. Awareness of the various imaging manifestations of portal hypertension can be helpful for assessing overall prognosis and planning proper management.

Multiple myeloma is a malignant tumour characterized by proliferation of a single clone of plasma cells, this cell line will produce large amount of ineffective immunoglobulins that are ineffective at fighting infection resulting in immunosuppression. These are medullary tumours most of the time; however, in rare cases they may arise extra medullary. The incidence of extramedullary plasmocytoma is about 5% and they arise in the chest most of the time; but they can also arise in other body systems like gastrointestinal system, which is involved in 10% of the time. We present a very rare case of primary plasmocytoma involving the pancreas. According to our research, there are only 25 cases of primary pancreatic plasmocytoma reported in english literature.

A young Somali immigrant presents with a two-year history of a large, firm, painful right anterolateral chest wall sternal mass. The patient denied any history of trauma or infection at the site and did not have a fever, erythematous lesion at the site, clubbing, or lymphadenopathy. A lateral chest radiograph demonstrated a low density mass isolated to the subcutaneous soft tissue overlying the sternum, ribs and clavicle. Computed tomography(CT) with contrast demonstrated a cystic lesion in the right anterolateral chest wall deep to the pectoralis muscle. Enhanced CT of the chest demonstrated sclerosis and destruction of the rib and costochondral joint and manubrio-sternal joint narrowing. Ultrasound-guided biopsy and aspiration returned 500 cc of purulent, cloudy yellow, foul-smelling fluid. Acidfact bacilli stain and the nucleic acid amplification test identified and confirmed Mycobacterium tuberculosis. A diagnosis of tuberculous osteomyelitis/septic arthritis was made and antibiotic coverage for tuberculosis was initiated.

To the best of our knowledge, we report the first known case of a large intraprostatic hematoma with active bleeding following transrectal ultrasound-guided prostate biopsy.

We present a rare case of aberrant supra-diaphragmatic renal artery originates at the level of T12 piercing the right hemi diaphragm and entering the hilum of the right kidney. Variations in renal arteries are quite common, and it is very important for renal interventionists to have a good knowledge about the possibility of anatomical variations in renal arteries. The most common reported variations are early division and accessory vessels, however, other rare variations like higher origin of renal arteries, as reported in this case report, should also be taken in consideration. The importance of these variations arise from the increase number of renal interventional procedures performed by interventional radiologists, urologists and general surgeons; in interventional radiology it is very important to know the possibility of higher origin renal artery in order to cover this vessel when performing conventional angiography. It is also important for urologists when performing renal transplant. The embryology of renal arteries dictates the possibility of these variations; theoretically, renal arteries can arise from the aorta along the whole length of rete arteriosum urogenitale which extends from cervical 6th to lumbar 3rd vertebra.

A young Somali immigrant presents with a two-year history of a large, firm, painful right anterolateral chest wall sternal mass. The patient denied any history of trauma or infection at the site and did not have a fever, erythematous lesion at the site, clubbing, or lymphadenopathy. A lateral chest radiograph demonstrated a low density mass isolated to the subcutaneous soft tissue overlying the sternum, ribs and clavicle. Computed tomography (CT) with contrast demonstrated a cystic lesion in the right anterolateral chest wall deep to the pectoralis muscle. Enhanced CT of the chest demonstrated sclerosis and destruction of the rib and costochondral joint and manubrio-sternal joint narrowing. Ultrasound-guided biopsy and aspiration returned 500 cc of purulent, cloudy yellow, foul-smelling fluid. Acid-fact bacilli stain and the nucleic acid amplification test identified and confirmed Mycobacterium tuberculosis. A diagnosis of tuberculous osteomyelitis/septic arthritis was made and antibiotic coverage for tuberculosis was initiated.

A 58-year-old physician with an elevated prostate specific antigen developed severe septic shock following a repeat transrectal prostate biopsy despite standard preoperative prophylactic protocol. This case highlights the significance of harbouring antibiotic-resistant bacteria and the risk of previous quinolone exposure. We believe this case may herald a rare but potentially serious consequence of increasingly common antibiotic resistance and that high-risk patients should be studied to determine their likelihood of carrying antibiotic-resistant flora in their genitourinary/gastrointestinal tract.

Primary malignant tumours of vascular origin are rare. The most common is the leiomyosarcoma, a malignant neoplasm derived from smooth-muscle tissue and accounting for less than 1% of all malignant tumours.1 Leiomyosarcomas are seen principally in adults, with the majority of patients presenting in the fifth and sixth decades. We describe a case of a leiomyosarcoma involving the inferior vena cava (IVC) with metastases to the liver.