CASE 504: PERIHEPATIC ABSCESS DUE TO FISHBONE, Dr PHAN THANH HẢI, Dr LÊ THỊ THANH THẢO, MEDIC MEDICAL CENTER, HCMC, VIETNAM

Woman 43 yo with  epigastric pain  has been treated as gastritis.

Ultrasound detected near  falciform ligamentun of liver  one abscess  with  foreign body long 3 cm  look like  fishbone  ( US1, US 2, US 3  SWE shows  it is very hard, US video).

CT scan no CE shows this fishbone is in a perihepatic abscess (CT1). 

One month later  the second CT examination with CE:  CT 2  shows  this abscess is  pulling abdominal wall out like a  hourglass [CT 2,  CT 3  sagital view].

Emergency operation of this abscess retrieved pus with a fishbone.

CASE 503: SUBUNGUAL GLOMUS TUMOR, Dr LÝ HỮU ĐỨC, Dr PHAN THANH HẢI, MEDIC MEDICAL CENTER, HCMC, VIETNAM.

WOMAN  46 YO  WITH  HISTORY  OF  5 YEARS AGO  PAIN AT  FIRST FINGER OF LEFT HAND, SWELLING AND BLEEDDING.

ULTRASOUND  OF THIS FINGER   WITH CDI    US 1   LONGITUDINAL SCANNING   DETECTED  ONE  MASS HYPOECHOIC BUT HYPERVASCULAR.

US 2: CROSSED-SECTION OF THIS MASS UNDER UNGUAL  

 HYPERVASCULAR  OF DISTAL FINGER.

MRI 2  =THIS MASS IS UNDER  UNGUAL   NO  INVASION OF THE BONE.

MRI 3 = CROSSED- SECTION OF THIS TUMOR IS  SUB UNGUAL WITHOUT EROSION OF THE BONE.

OPERATION  REMOVED THIS TUMOR.

 MICROSCOPIC RESULT IS  GLOMUS TUMOR.

CASE 502: DIFFUSE SKIN XANTHOMA, Dr DƯƠNG NGỌC THÀNH, Dr LÝ HỮU ĐỨC, Dr PHAN THANH HẢI, MEDIC MEDICAL CENTER, HCMC, VIETNAM.

MAN 32 YO 2 YEARS AGO   BEGINNING AT THE HAND   AND FOOT  RISING SMALL NODULES AND HARD, SIZE 1-2 CM, COULORED  REED TO YELLOW   AND FULL BODY  APPEARED BUT NOT IN THE FACE. SEE PHOTOS ( PHOTO 1  THE BACK ,  PHOTO 2  THE FOOT,  PHOTO 3   THE HAND,  PHOTO 4  IN FOCUS NODULES,  PHPOTO 5  THE SKIN OVER ACHILLUS TENDON.

ULTRASOUND:   US 1=  THE NODULE 1,5 CM  UNDER SKIN   AND FATTY LAYER,   US 2 =  CDI  NO BLOOD TO THIS NODULE,  US 3  ACHILLE TENDON IS  NORMAL .

BLOOD TESTS MADE DIAGNOSING ARE DIABETES AND HYPERCHOLESTEROLEMIA AND RISING TRIGLYCERIDS.

BIOPSY  ( SEE MACRO).  

WHILE WAITING FOR  PATHOLOGY REPORT,

ONE DERMATOLOGIST SAYS IT IS ERUPTIVE  XANTHOMATOSIS.

MICROSCOPIC RESULT IS XANTHOMA.

For one month treatment, xanthomatous nodules reduce # 70%.