E5161. When Your Chest Feels Heavy and Your Head Aches: Imaging Diseases with Neurothoracic Manifestations
  1. Kaustav Bera; University Hospitals Cleveland Medical Center
  2. Joshua Hunter; Case Western University Medical School
  3. Sneh Brahmbhatt; GMERS Medical College and Hospital
  4. Mohit Agarwal; University Hospitals Cleveland Medical Center
  5. Michael Coffey; University Hospitals Cleveland Medical Center
  6. Amit Gupta; University Hospitals Cleveland Medical Center
Several conditions, including systemic pathologies, affect both the thoracic and neurological system. Additionally, several neurological disorders affect the thorax and thoracic, primary disorders might exhibit neurological manifestations. The purpose of this exhibit is to discuss these pathologies, focusing on their imaging findings primarily in cross-sectional imaging as well as discussing the presenting signs and symptoms of these pathologies. This would allow the reading radiologist to better understand these pathologies allowing them to order follow-up imaging of the other organs and systems that are commonly involved as part of the disorder.

Educational Goals / Teaching Points
1. To know various pathological entities/disorders with neurological and the cardiothoracic manifestations. 2. To describe a classification system for easy reference. 3. To review the clinical and imaging findings of the above-mentioned entities with case examples.

Key Anatomic/Physiologic Issues and Imaging Findings/Techniques
We will discuss the imaging modality, findings including pathognomic ones as well as discuss the most common presenting signs and symptoms of the common disorders with both neurological and thoracic findings of the common pathological entities as discussed below: a) genetic/multisystem disorders, which includes most commonly neurofibromatosis (NF), tuberous sclerosis complex (TSC), Erdheim-Chester disease, severe liver dysfunction; b) metabolic disorders including mitochondrial disease, metastatic calcification storage disease, amyloidosis, and Niemann-Pick disease; c) inflammatory diseases including sarcoidosis, IgG4-related disease; d) infectious diseases including tuberculosis, aspergillosis, and COVID-19; e) vascular disorders including vasculitis (giant cell arteritis, Takayasu arteritis), embolic shower to brain; f) neoplastic disorders including metastases, paragangliomas, thymoma in myasthenia gravis, lymphoma; g) thoracic complications of neurological compromise including neurogenic edema, aspiration; and h) drugs and toxins including cocaine, methotrexate and oxygen.

The exhibit systematically talks about the most common pathologies and disease entities that manifest in both the thoracic and neurological systems and can be diagnosed using cross-sectional imaging modalities, and lists out the key imaging findings along with common presenting signs and symptoms that would give the radiologist clues in arriving at the diagnosis.