CASE 603: DVT in ANEMIA PATIENT with ILEUM TUMOR, Dr PHAN THANH HẢI, Dr NGUYỄN NGHIỆP VĂN, Dr TRẦN THỊ THANH NGA, MEDIC MEDICAL CENTER, HCMC,VIETNAM.

Male patient,55yo from Kien giang province, with history of HCV infection, diabetes and  

arterial hypertension suffered from swollen right leg which is due to DVT and stenosis of tibial artery of right lower limb on anemia status. 

He has been managed his anemia and venous thrombosis in a local hospital by folic acid and Rivaroxaban 10mg. 

In general examination, slight anemia. P=90b/min,TA=130/80mmHg. 

Lab results shows anemia status Hb=9.8g/dL, Hct=31.3%, dDimer=511.  

[maybe with a relation of cancer #21%]  

Ultrasound at Medic detected DVT right leg 

and ileum wall thickening #23mm that  MSCT confirmed later. 

 

MSCT=

Surgery removed bowel tumor and histopathologic report 

is medium differentiated invasive carcinoma. 

CONCLUSIONS=

In old patient with anemia and venous thrombosis should be find out GI tract tumor. 

CASE 602: HEPATIC ABSCESS MIMICKING HCC in CHRONIC HBV PATIENT, Dr PHAN THANH HẢI, Dr TRẦN THÙY TRANG, MEDIC MEDICAL CENTER, HCMC, VIETNAM

Male patient 36yo with HBV infection  known by himself since November 2019 without treatment.

Ultrasound at Medic Center showed a 39x22mm mass in right lobe on chronic hepatitis # F 3.

•      US 1: Ultrasound detect an ill-defined, hypoechoic mass #4cm (with a small cyst in center) in hepatic segment VI.

•      US 2: Superb microvascular imaging (SMI) shows small blood vessels in tumor.

•      US 3, 4: Elastography shows that the stiffness of the tumor and its outline are harder than the liver parenchyma.

Lab results: HBsAg +; HBeAg +; HBV DNA =62,953U/mL; AFP=5.97. Wako tests=AFP L3 <0.5, PIVKA II(DCP)=19

MRI with Gado thought about 36x30mm HCC= T2 higher signal than liver; T1 lower signal. Gado caught more in arterial phase, in late phase lower signal than liver.

Operation removed the liver mass 

and histopathologic report said liver tissue inflamed with majority of eosinophil leucocytes.