CASE 444: FEVER in PREGNANCY, Dr PHAN THANH HẢI, MEDIC MEDICAL CENTER, HCMC, VIETNAM

Woman 23 yo, 28 weeks primigravida with 5 days fever and abdominal pain in  periodic crisis.

WBC=  27 k  with neutro 97% ;  CRP= 342 mg/L,  normal urine test . And clinical suspected  appendicitis.

Ultrasound of  abdomen reported 29w pregnancy and  normal status of fetus. One cystic mass retro-uterus  near left pelvis  iliac artery, was suspected  left kidney  ectopic pelvis with hydro-pyonephrosis while  right kidney is normal ( US 1, US 2, US 3, US 4).

MRI  reported  left kidney hydronephrosis due to ureter obstruction.

Emergency cystoendoscopy was done for putting  stent  to release pus out from left kidney.

Conclusion=Pregnancy with  fever due to left pyohydronephrotic kidney as obstruction of ureter.

Reference :

http://www.bjuinternational.com/case-studies/hydronephrosis-pregnancy-ectopic-pelvic-kidney/

CASE 443: DUODENAL TUMOR, Dr PHAN THANH HẢI, Dr LÊ ĐÌNH TÍN, Dr NGUYỄN PHÚ HỮU, MEDIC MEDICAL CENTER, HCMC, VIETNAM

Man 54yo with epigastric pain  crisis  after eating.

Ultrasound of abdomen  detected  tumor  at duodenum  D3, size of  3 cm,  hypoechoic (US 1),  and CDI  showed  hypervascular tumor  (US 2, US 3, US 4).

Gastrograph  with barium meal detected  filling defect  at  duodenum D 3 ( X rays1, X rays 2).

MSCT with CE:revealed  this tumor  very quick and high contrast enhanced (CT 1, 2, 3, 4).

Normal blood tests, and  nothing abnormal detected on endoscopy.

Operation for  resection of duodenum D 3  with the tumor from the wall  and central necrosis.

Microcsopic  this tumor is GIST.

NHÂN CA 312 ĐƯỢC ĐĂNG TRÊN ULTRASOUND (UK) 2017, Vol 25(2)

CASE 312 : Fetal Body Hyperflexion { PENA-SHOKEIR phenotype} published on ULTRASOUND 2017, Vol 25(2) sagepub.co.uk/journal SAGE DOI: 10.1177/1742271X16688235

case 312 VUD

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CASE 442: BILOBATE GALLBLADDER: Dr PHAN THANH HẢI - Dr LÊ THANH LIÊM, MEDIC MEDICAL CENTER, HCMC, VIETNAM. .

Male 18yo  with recurrent right subcostal pain.  

Ultrasound of abdomen detected abnormal gallbladder, size of 5 cm, bilobe, thickening wall of GB fundus  with more  twinkling artifact pattern on Doppler examination.

MRI of liver and biliary confirmed the morphology of gallbladder, its shape is bilobe and abnormal signal of GB fundus.

Radiologist report is gallbladder adenomyomatosis.

Operation laparoscopy removed the bilobate gallbladder.
Microscopic report is adenomyomatosis  of gallbladder.

Reference : US, CT , MRI diagnosis of   adenomyomatosis gall bladder

CASE 441: LIKE CHERRY SKIN TUMOR, Dr PHAN THANH HẢI, MEDIC MEDICAL CENTER, HCMC, VIETNAM

Lady 17 yo  with tumor  on her left shoulder   which was  detected for  2 weeks,  size of 3 cm, red and soft,  no pain ( see photo 1,2).

On ultrasound examination,  this tumor  came from  skin layer, inhomogenous with solid part in the root and calcification, while upper part is fluid (US 1, US 2). On CDI, tumor  has hyper vascular pattern like an octopus.

OPERATION  REMOVED THIS TUMOR.

MICROSCOPIC RESULT IS MALHERBE'S disease  

[ PILOMATRICOMA ).

CASE 440: MULTIPLE TUMORS of the LEG, Dr PHAN THANH HẢI, MEDIC MEDICAL CENTER, HCMC, VIETNAM

Man 20 yo with  history of 10 years ago having many small subcutaneous  tumors on left  foot ,  size of 2 cm, no pain. And now he detected another nodule near his left knee (see photo1, photo 2).

 It  is soft in palpation, no pain,  compressible and reexpansion after releasing it.

Ultrasound examination of  this tumor showed  tumor belonging to sapheneous vein while  deep vein is normal.

MRI reported that tumor of superficial vein of left foot.

Biopsy of this small  tumor. Microscopic and histoimmuno staining is angioleiomyoma.

REFERENCE: