Presentation
Lower abdominal pulsatile swelling.
Patient Data
Aneurysmal dilatation of both common iliac arteries (from origins up to their bifurcation) with right saccular component, mural thrombosis (more marked on the right side with the irregular contour of the remaining patent lumen) and calcifications. The aneurysms measures about 5.5 cm and 3.3 cm on the right and left sides respectively. Mass effects are seen on adjacent organs, however, no contrast extravasation. The rest of the major vessels appear unremarkable.
Innumerable calcified lymph nodes are also noted in the abdominopelvic cavity which is most likely remnants of the previous chronic granulomatous disorder.
A well-defined, oval-shaped, hyperdense lesion of 3.7 x 2.7 cm is noted in the vicinity of the right iliac lymphatic chain (closely abutting the right lateral wall of the urinary bladder) with about mean density of 450 HU which is most likely an enlarged lymph node or large phlebolith.
Slices through the lung bases are showing evidence of chronic granulomatous disease process.
Case Discussion
Findings are of aneurysms of the common iliac arteries bilaterally, sequelae of the chronic granulomatous disease process in the abdominopelvic cavity.
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