A 90 year-old male patient with a painless node at right angle of his mouth. His past history was a left kidney cancer that had been cured for 5 years.
Skin utrasound by VINNO M86 system with linear probe 16MHz and 23MHz.
Focal cystic lesion # 9x4mm, represented mixed structure in subcutaneous layer, with fluid, non vascular, well limitted capsule. Elastography was green code that means a medium hardness. A benign mucous cyst was noted.
A 11 year-old female patient with a small cyst on left side of her neck for 5 months. A TB regimen started for a while.
Ultrasound detected a cyst of subcutaneous layer on left side of the neck, well-limited, round, with a dark line adhered the skin. Echostructure is mixed: cystic and some trabecular thicker semisolid structures inside which are like septation. It exists some septa with colored signal arterial type.
Discussion:
Common cystic lesion in subcutaneous layer adhering the skin usually named sebaceous cyst, epidermoid cyst. But in this case, a very small dark incontinuous in upper border of the cyst helps thinking to a skin hair. That is the key of a pilomatrixoma which is still a rare entity of habit in clinic.
The cyst was entirely removed.
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References:
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A male doctor 69 year-old patient with sputum cough for one week. He got a submandibular mass in suspecting lymphoma or parotid tumor. But on the neck, ultrasound revealed parotid tumor that was concluded a Warthin 's tumor with pathological result of core biopsy.
Morever the doctor patient suffers from a benign tumor of sigmoid colon, gastritis with ulcer and hepatosplenomegaly, and fortunatly gets over the lymphoma haunting.
References
1. Warthin Tumor: Papillary Cystadenoma Lymphomatosum "occurs in the tail of the parotid in aged men". [DeGowin's Diagnostic Examination, 2004].
A 56 year-old female patient suffered from epigastric pain for one month with out fever. WBC 18,880/L , hCRP 129.5mg/L.
Ultrasound of abdomen revealed an abscess of liver that came from a cholecystitis due to stone. Gall bladder wall thickening was perforated that connected to the abscess. And there were stones in CBD and cystic duct.
MRI was done before a surgical treatment.
Endoscopic surgery at first but it did to change to open surgery to take away the hepatic abscess, that was in GB bed. Inflammed GB adhered to liver, mesentery and duodenum that has been dissected difficultly.
Surgeons performed partial cholecystectomy, and Kehr drainage after removing stones in CBD and in cystic duct.
Hepatic abscess due to perforated cholecystitis with biliary stone is still a rare entity. Ultrasound could detect successfully cholecystitis due to biliary stone [84-97 % sensitive, and 95-97% specific] that seems to be higher than CT or MRI does.
