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Thursday, 27 March 2025

CASE 820-821: PRIMARY THYROID LYMPHOMA (PTL): Dr PHAN THANH HẢI, Dr NGUYỄN TUẤN CƯỜNG , MEDIC MEDICAL CENTER, HCMC, VIETNAM.

 CASE 1 : 

A 40 year-old woman with fatigue, dysphagia and rapidly growing goiter but non weight  last month. She got goiter during 10 years.

Ultrasound detected a # 90mm hypoechoic nodule at the isthmus of the thyroid and some cervical lymph nodes.








Biopsy results were a chronic thyroiditis and inflammed lymph nodes.


But the specimen of thyroid post-op was a round cell lymphoma.


CASE 2:

A 44 year-old woman with #5-26mm multinodular goiter with ultrasound exams from 2020 to 2024. But during 5 years, the vascularized left nodule was grown up rapidly to 37 mm. TSH was still in normal value.




But core biopsy result was suspected a thyroid lymphoma.


Immunohistochemistry result was lymphoma.


She was planed to chemotherapy for thyroid lymphoma.


DISCUSSION:




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Friday, 14 March 2025

CASE 819: LEFT CHEST PAIN and LUNG POCUS, Dr PHAN THANH HẢI, Dr LÊ THỊ THANH THẢO, MEDIC MEDICAL CENTER, HCMC, VIETNAM.

A 67 year-old man with left chest pain progressing for 3 days, coughing and no fever.

Lab data nothing abnormal detected. 



EKG  sinus arrhythmia bradycardia.



CT coronary stenosis 40-30%.



Lung POCUS : Left pleural effusion and thickening left pleura zone L5 with seven B-lines: interstitial pneumonia.




Chest MSCT  later confirmed thickening of posterior basal of left lung.



Lung POCUS helps differentiaziting, in a left chest pain , a pneumonia from an angina pectoris.



Thursday, 13 March 2025

CASE 818: BREAST TB LUMP, Dr PHAN THANH HẢI, Dr LÂM CẨM THÙY, MEDIC MEDICAL CENTER, HCMC, VIETNAM

 A 28 year-old woman with fever and pain her left breast for one week.

Ultrasound detected  a  #12x6.6 mm well-border mass  at 3h o'clock with mixed echo, hypovascular and no fistula nor skin red.


FNAC result was chronic inflammed mass maybe a TB mastitis.


Microscopic specimen was a tuberculous mastitis with Langhan cells.



TB 6- month regimen had been done and TB breast mass became a #9x7 mm inflammed breast mass.



CASE 817: BOWEL VOLVULUS due to MESENTERIC LYMPHATIC TUMOR, Dr PHAN THANH HẢI, Dr TRẦN NGÂN CHÂU, MEDIC MEDICAL CENTER, HCMC, VIETNAM.

 A 15 year-old asthenic thin boy with crisii of nausea and colicky pain during ( 3 ? ) years. Failed in management of gastritis HP infected.


Ultrasound detected a malrotated mass with mesenteric vessels inside going to the clockwise.


Beside there was a hyperechoic mass in the pelvis with vessels in the mass.


MSCT confirmed the bowel malrotation and a lipoma in the pelvis.





Surgery was done to remove the #12,5x11mm pelvic mass which was a microcystic lymphatic malformation of the mesentery. It adhered the bowel and caused the bowel volvulus.

The boy gained 10 kilogram and had no pain nor nausea post-op.



CASE 816 : PROSTATE CANCER RISK and Low F/T PSA Ratio, Dr PHAN THANH HẢI, Dr NGUYỄN MINH THIỀN, MEDIC MEDICAL CENTER, HCMC, VIETNAM


A 62 year-old man with  low free/total PSA ratio < 10% which is in risk of prostate cancer.


But ultrasound and MRI detected only calcification of prostate.


 The patient belongs the high risk group of prostate cancer in our report in 2011 although the normal results of diagnostic imaging.





Tuesday, 11 March 2025

CASE 815: ACUTE CHOLECYSTITIS and CHOLECYSTILOSIS, Dr PHAN THANH HẢI, Dr LÊ THANH TÙNG, Dr VÕ THỊ PHƯƠNG TRINH, MEDIC MEDICAL CENTER, HCMC, VIETNAM.

A 78 year-old diabetic man with a colicky pain at RUQ  and nausea last night. Coughing during one month he has been managed antibiotics in time.




Ultrasound detected  a #94x39 mm dilated gallbladder with an impacted biliary stone at the neck of GB and some 8-13 mm other stones in the inflammed GB (# 6mm thickening of the GB wall, anterior wall partial hypoechoic). It existed an amount of fluid around the inflammed gallbladder.










MSCT confirmed an impacted #14 mm GB stone at the neck of the GB.


Emergency endoscopic surgery was done after 8 hours entering the surgical ICU to remove the inflammed GB and peritoneal pseudomembranes.






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