CASE 594: LUNG TUMOR ON PATIENT WITH CORONARY STENTS, Dr PHAN THANH HẢI, Dr DƯƠNG PHI SƠN, MEDIC MEDICAL CENTER,HCMC VIETNAM

Male patient 66yo with 6 year stenting 2 coronary branches  now left chest pain and dypsnea.

Chest CT for check-up. Coronary stents in good condition, but detected left lung tumor while expands FOV

Ultrasound of liver detected hypoechoic solid mass # 46x30mm at subsegment VII, well-bordered, basket shape vascularized that was  thought a metastasis lesion maybe from left lung tumor.

Lung biopsy and  histopathological result= adenocarcinoma poor differentialized invasive in lung [C34].

CONCLUSION=Coronary CTA helps revealing exactly coronary lesions, but detecting other lesions nearby heart if enlarging FOV.  In this case, coronary CT detected left lung tumor that confirmed later by lung biospy with histopathological result.

CASE 593: HYPERTHYROIDISM and DIARRHEA, Dr PHAN THANH HẢI, Dr TRƯƠNG CÔNG THÀNH, MEDIC MEDICAL CENTER, HCMC, VIETNAM

Female patient 36yo with diarrhea and loss of weight # 9 kg for 11 months. After being failed of treatment as diarrhea in 4 other hospitals she came to Medic Center.

In clinical examination, P=101 bpm, BP =126/79mmHg, she got diarrhea, tachycardia, slight goiter,  hand tremor, hyperpigmentation and humid skin­.

Hyperthyroidism proved on color Doppler ultrasound, rapid sinusoid heart rate on EKG, low TSH and raised free T4 on lab results.

With Grave's disease management [methimazole 5mg] for one month, free T4 downs from 3.61 to 1.9, patient remains well and stop diarrhea.

Diarrhea for a long time due to many items of etiology including a thyroid mass.

According to Robbin's Pathology, hyperthyroidism leads to an overactivity of the sympathetic system. It also goes on to mention that this sympathetic hyperstimulation in the gut leads to increased motility leading to diarrhea and malabsorption.