A 62 year-old male HTA patient with an aliasing cystic lesion close by his prostate without urogenic symptom was revealed by Doppler technique. A note of an pseudoaneurysm of the right internal iliac artery due to A-V fistula is written down, but it has been missed out on it in 3 other examinations in the past.
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A 64 year-old male diabetic patient with right painfull swollen neck for 2 weeks, he has also got impermanent tinnitus and hoarse voice due to right vocal cord paralysis.
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Ultrasound of his neck shows a 29x33 mm big right lobe of thyroid, hypoechoic mixed pattern, poor-limited while the left lobe is intact with its slightly small size #15x17mm. It exists many round and ovale, hypoechoic lymph nodes on both 2 sides of his neck maybe due to metastase or infiltrated lymphoma.
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Result of lymph node biopsy is poorly differentiated carcinoma metastase node.
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MSCT of neck and chest detect lymph nodes in mediastinum, and on 2 sides of neck that are thought due to metastasis from unknown origin. The right lobe of thyroid represents undetermined lesion and low captured CE.
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As a poorly differentiated carcinoma of thyroid is a rare entity, a FNAC of right thyroid lobe is performed.
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And the result of FNAC of right lobe of thyroid is poorly differentiated thyroid carcinoma.
As the poor status the patient just only undergoes a chemotherapy.
A 51 year-old male patient with hematuria for 6 months but since last month he suffered from a full hematuria. Ultrasound detected a hypoechoic mass nearby left inferior renal pole. SMI showed hypervascular pattern inside the mass.
MSCT later confirmed a left renal tumor RCC or oncocytoma and a proximal upper left ureter tumor.
Surgery removed the left kidney, left ureter and a part of bladder as high malignant upper tract urothelial cancer (UTUC).
A 53 year-old male patient with a painless big abdomen was accidentally detected having a right giant hydronephrosis via ultrasound examination.
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Later, MSCT confirmed easier than ultrasound the 20 mm right ureteral stone which caused the right giant hydronephrosis.
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The patient went through a right nephrostomy in emergency situation. About 4.5 liters of urine was drained out and then his abdomen getting flatten.
Two weeks later was done an evaluation of the right kidney function via Tc-99m DTPA scan. Ultrasound re-examination noted a distortion of right kidney structure: thickness of renal cortex thinner than 6 millimeter and nonexistent differentiation of renal medulla from cortex of renal parenchyma.
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A 55 year-old female patient suffers from a painful epigastric mass for one week. As gastritis management failed, ultrasound reexamines her abdomen.
A 117x67 milimeter mass is detected between liver and right kidney. Its structure is poor with some cystic lesions and central part more rich echogeneicity that is thought to be an intestinal GIST.
Her uterus gets having some fibroma lesions also which have the same echogeneicity.
MSCT later confirmes the intestinal GIST and uterine fibroma.
Surgery removes the intestinal GIST [left specimen] and an uterine fibroma with stalk (right specimen).
The histopathologic and chemohistoimmuno- staining results are intestinal GIST, and uterine leiomyoma.
3 cases of prostate disorders wit low values of PSA= two cases of TB and one case of carcinoma that concludes prostate cancer may happen with any value of PSA [but not only PSA>4 ng/mL]; although value of PSA being considered a guiding lab data for prostate cancer.
Should base on free PSA, DRE, MRI, elasto ultrasound together for screening prostate cancer, but these lab data and diagnostic imaging not stand for a diagnostic of prostate cancer.
CASE 1
CASE 2
A 38 year-old female patient, TPAL 1-0-0-1, with sideropenia, dysmenorrhea and menorrhagia that has been diagnosed endometriosis in uterus and right ovary by transvaginal ultrasound (TVUS) and pelvic MRI.
On MRI, size of endometriosis in uterus # 5×7 centimeter and, in ovary # 1.5 centimeter.
She is managed for iron deficiency, and her endometriosis with Dienogest 2mg one tablet per day. For 5 months, focal lesions in her uterus and right ovary are getting smaller sizes. Dysmenorrhea appears slightly and she is with the new generation of progestin acceptable menorrhagia.
NOTA:
