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Thursday, 12 November 2015
Sunday, 8 November 2015
CASE 345: LEFT RENAL VENOUS ANEURYSM, Dr NGUYỄN NGHIỆP VĂN-Dr VÕ NGUYỄN THÀNH NHÂN,MEDIC MEDICAL CENTER, HCMC, VIETNAM
FOR PICTURES PLS CONNECT TO 3G/DOWNLOAD THE LINK
Female
27yo from Baclieu province, suffered from left side lumbago, which was getting
worse in effort
No
history of trauma. Entered 121 hospital,
Cantho hospital but status not changing then went to Medic
Center
Sonologist
said left kidney AVM which caused left renal vein dilatation of 48mm in diameter.
MSCT
with CE was done that IVC appeared early with taken CE of aorta and presented a
huge renal vein on left side.
DISCUSSIONS
•
Left renal vein aneurysm
presented commonly on left side, and true renal vein aneurysm ( absence of media
tunica) which was rare, from now on about 10 cases in literature.
•
Etiology of aneurysm of left
renal vein : hypertrophy of the tunica media with fibrotic thickening) : AVM ( post trauma, RCC ), intrarenal AVM, AVM of aorta and renal vein (in
case of renal vein behind AAA).
For prevention of lung venous embolism, rupture
of aneuysm... patient was repaired in Cho Ray left renal AVM by coiling and getting well .
Left venous aneurysm disappeared totally post op.
Sunday, 1 November 2015
CASE 344 :LEFT GROIN TUMOR, Dr PHAN THANH HẢI, Dr LÊ TỰ PHÚC, MEDIC MEDICAL CENTER, HCMC, VIETNAM
FOR PICTURES PLS CONNECT TO 3G/DOWNLOAD THE LINK
Man 33 yo, detected left groin having a mass slow growth for 1 year, no pain ( see foto).
Ultrasound scanning of this
mass=
US1: more calcification and very strong shadowing, but
femur bone was intact.
US 2: tumor had cystic part and
hypovascular
US 3 elasto scanning= inhomogeneous structure
tumor
MSCT without CE=
CT 1 structure of tumor from ischium bone extension
to muscle.
CT 2 ischium bone was destroyed by tumor.
CT 3..3D view of this tumor.
Core biopsy of this tumor with report is
osteo-enchondroma.
Friday, 23 October 2015
CASE 343: TB AXILLARY NODES, Dr PHAN THANH HẢI, Dr JASMINE THANH XUÂN, MEDIC MEDICAL CENTER, HCMC, VIETNAM.
Woman 49 yo, on mammography screening detected many
left axillary nodes and calcification, no detected tumor in mammary
gland (see mammogram).
Ultrasound of left axillary found many
lymph nodes, sizes of 1-2 cm, round
and calcification inside node ( US picture 1).
CDI cannot
detect hilus of nodes, no vascular signal in
nodes, ( US 2, US 3). Elastoscan US of this node was hard, 17.3 kPa ( US 4)
MRI with FAST SCAN DWI..made sure no
tumor intra left breast and
axillary nodes.
Biopsy removed one big node with structure
inside look liked caseum.
Microscopy result was tuberculosis with typical
big cell LANGHANS.
CONCLUSION: Tuberculosis of axillary lymph nodes..
Tuesday, 20 October 2015
CASE 342 : FRONTAL LUMP, Dr PHAN THANH HẢI, Dr LÊ THỐNG NHẤT, MEDIC MEDICAL CENTER, HCMC, VIETNAM
FOR PICTURES PLS CONNECT TO 3 G / DOWNLOAD THE LINK
MAN 65 YO ONE YEAR AGO DETECTED AT RIGHT
FRONTAL A SMALL MASS UNDER SCALP SLOWLY GROWING WITHOUT PAIN.
ULTRASOUND FINDINGS=
US 1:TUMOR DESTRUCTING
FRONTAL BONE, SIZE OF 2CM.
US 2: HYPERVASCULAR TUMOR.
US 3:ELASTOSCAN OF TUMOR OF 36.3kPA.
US 4. ULTRASOUND FINDINGS OF LIVER TUMOR OF 5 CM.
US 5: ELASTOSCAN OF LIVER TUMORS = HARD, 55.9 kPA
MSCT BRAIN= 3
CT PICTURES SUSPECTED METASTASIS TO FRONTAL BONE.
BLOOD TESTS= HCV
POSITIVE AND WAKO TEST WASE STRONG POSITIVE WITH DCP. IT
MEANS HCC.
FNAC OF THE FRONTAL TUMOR WAS HCC METASTASIS.
CONCLUSION: HCC IN LIVER METASTASIS TO FRONTAL BONE.
REFERENCE
REFERENCE
Sunday, 18 October 2015
CASE 341: THYROID TOXIC ADENOMA, Dr LÊ TỰ PHÚC, MEDIC MEDICAL CENTER, HCMC, VIETNAM
A 41 yo male patient with chronic fatigue syndrome and nervousness, irritability; sometimes he feels muscle weakness and hand tremor for three months and getting severe in ten days. Wants to check up his liver and nervous system.
Abdominal ultrasound revealed nothing abnormal. Because of his symptoms, sonologist also perfomed a thyroid ultrasound.
Thyroid ultrasound showed that right lobe and upper portion of left lobe were normal in size with smooth margin and homogeneous echotexture, normal blood flow in Doppler ultrasound.
But lower portion of the left lobe had a 5 cm, mixed cystic-solid nodule with hypervascular, isoechoic in peripheric part and nonvascular cystic degeneration in center part of tumor.
On Doppler US, inferior thyroid artery showed peak systolic velocity in left lobe is 122.7 cm/s, five times more than one of right lobe 24.3 cm/s. So, sonologist suspected nodule in lower left lobe maybe a toxic thyroid adenoma, which is cause of hyperthyroidism.
Blood tests were done and confirmed the diagnosis with low level of TSH and high level of Free T3, Free T4.
Measuring the peak systolic velocity of inferior thyroid artery in both side to diagnose toxic thyroid adenoma. Do you think we can diagnose toxic thyroid adenoma by ultrasound?
Thursday, 15 October 2015
CASE 340 : UMBILICAL TUMOR, Dr PHAN THANH HẢI, Dr LÊ THÔNG LƯU, Dr NGUYỄN THị KIM UYÊN, MEDIC MEDICAL CENTER, HCMC, VIETNAM
FOR PICTURES PLS CONNECT TO 3G / DOWNLOAD THE LINK
Woman 45 yo, PARA 2002, normal spontaneous vaginal
deliveries,no cesarean operation nor history of hormonal contraception.
2 years
ago she detected her umbilicus swelling some days before her
menses and continuous pain during
the entire of her period in some times bleeding.
In clinical examination the umbilicus deformed by one mass which were bluish-black,
hard and not hot (see 2 photos).
Ultrasound findings of this mass=
US1: this mass was well bordered, localized in cavity
of navel. Structure of mass was solid, size of 2.68 cm.
US 2: in CDI, vascular supplying from peripheral
part of mass.
US 3: in elastography: hard mass in comparison to muscle.
US 4 : uterus and pelvis were not intact.
Preoperative diagnosis is primary endometriosis. Removed this tumor. See macroscopic specimen.
Preoperative diagnosis is primary endometriosis. Removed this tumor. See macroscopic specimen.
Microscopic report: ENDOMETRIOSIS.
CONCLUSION: This is a case of PRIMARY ENDOMETRIOSIS in umbilicus.
REFERENCE:
REFERENCE:
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