From the Departments of Radiology (V.B.), Radiodiagnosis (S. Sharma, S. Sood, B.V.), and Pathology (K.M.), Indira Gandhi Medical College, Shimla, India.
Radiology. 2016 Jul;280(1):317-21. doi: 10.1148/radiol.2016140459.
History A 24-year-old woman from a rural village presented with vague left hypochondrium pain and a cough for the past 2 years. She had a history of occasionally expectorating hairlike strands with her cough. Because the patient was from a rural area, she first consulted with the village priest, as she presumed her illness to be some supernatural phenomenon. The priest advised her to collect the strands for religious rituals ( Fig 1 ). She collected these strands for some time; however, because her cough worsened, she visited the hospital. General physical examination findings were within normal limits. On palpation, there was evidence of a vague lump in the left hypochondrial region. At ultrasonography (US) (images not shown), a large mass with heterogeneous echotexture was seen in the left suprarenal region; cystic areas and calcification were present. Chest radiography (images not shown) revealed bronchiectatic changes, with consolidation in the left lower zone. Results of a blood examination, including assessment of renal function, liver function, and complete blood count, were within normal limits. Unenhanced and contrast material-enhanced computed tomography (CT) images of the chest and abdomen were obtained.
病史 一名 24 岁的年轻女性，来自农村，主诉过去 2 年来出现左上腹隐痛和咳嗽，偶尔咳嗽时会咳出毛发样的条索状物。由于患者来自农村，她首先向乡村牧师咨询，因为她认为自己的病是某种超自然现象。牧师建议她收集这些条索状物进行宗教仪式（图 1）。她收集了一段时间，但由于咳嗽加重，她去了医院。一般体格检查未见明显异常。触诊时，左上腹区域可触及模糊的肿块。超声检查（未提供图像）显示左肾上腺区有一个回声不均的巨大肿块，有囊性区域和钙化。胸部 X 线摄影（未提供图像）显示支气管扩张改变，左下区实变。血液检查结果，包括肾功能、肝功能和全血细胞计数均在正常范围内。进行了胸部和腹部的平扫及增强 CT 检查。
