CASE 591: RIGHT LUNG MULTIPLE NODULES, Dr PHAN THANH HẢI, Dr LÊ THANH LIÊM, MEDIC MEDICAL CENTER, HCMC, VIETNAM

Female patient 47yo without fever, coughing, no history of diabetis.  In general check-up in Camau hospital nothing abnormal detected but lung MSCT detected multiple nodules 5-28mm at base of right lung.

02 days after at Medic Hòa Hảo Center= BK(AFB)/Sputum (-). Blood tests= AFP, CEA, CA 125, CA 15-3, CA 19-9, Cyfra 21-1 in normal range.

Lung ultrasound detected an oval lesion # 22x29x23mm at posterior peripheral area of  right inferior lobe maybe a cystic pleural effusion; and some small nodules  = 6 - 9mm at anterior base of right lung.

No lymph node at neck, axilla, inguinal regions and inside abdomen.

                                               

Endoscopic surgery removed partial right  lobe in Pham Ngoc Thach lung hospital. A lung tumor#3x4cm belongs S6 segment, solid, smooth surface. Result of biopsy on- site are TB inflammation with caseum necrosis  inside.

DISCUSSION:

A rare clinical case of lung ultrasound for peripheral lesion shows that ultrasound could inform details to discribe findings inside and helps diagnosing and management in contribution with  clinical and other imaging modalities.

Reference:

 Ritesh Agarwal et al, Parenchymal pseudotumoral tuberculosis: Case series and systematic review of literature, Respiratory Medicine, Volume 102, Issue 3, March 2008, Pages 382-389.