CASE 563: ILEOCECAL TUBERCULOSIS, Dr PHAN THANH HAI, MEDIC MEDICAL CENTER, HCMC, VIETNAM

MAN 41 YO  with CLINICAL COMPLAINT about HYPERPERISTALTIS AT RLAQ due  to SUB-OCCLUSION OF BOWEL. 

ULTRASOUND  AT  RLAQ   

US1  SHOWS THICKENING of THE WALL OF ILEUM   

US2 COECUM WALL

US3  MANY LYMPH NODES AROUND ILEO-COECAL AREA

MSCT WITH CE    

CT1  CROSS SECTION THE COECUM , THICKENING OF THE WALL AND SOME LYMPH NODES  ENHANCED CE 

CT2  = FRONTAL VIEW OF  ILEO-COECUM

COLONO ENDOSCOPY   REPORTS  STENOSIS AT ILIO-COECAL JUNCTION ( PHOTO ENDOSC).

OPERATION OF  LAPAROSCOPY AT  FIRST   DETECTED COECUM  CHANGES SURFACE  NODULAR  ( IMAGE LAPARO)

SURGERY RESECTION of the USPSTF's COECUM AND 50CM OF ILIUM  ( FOTO MACRO)

MICROSCOPIC REPORT IS  TUBERCULOSIS OF  ILIO-COECUM AND  LYMPH NODES.

CASE 562: CARDIAC CT DETECTED BREAST TUMOR, DR PHAN THANH HAI, MEDIC MEDICAL CENTER, HCMC, VIETNAM.

WOMAN 54 YO in  BEING PERFORMED CT CORONARY ANGIO  SAME TIME  RADIOLOGIST DETECTED ONE MASS AT LEFT BREAST   ( CT)

MAMMOGRAPHY  ALSO  DETECTED ONE MASS 4 CM ROUND BORDER   NO CALCIFICATION INTRA MASS ( MAMMO 1, MAMMO 2 ).

ULTRASOUND: US 1  MASS AT L BREAST IS HYPOECHOIC, THE BORDER IS ROUND 

US 2  CDI  NO MORE BLOOD SUPPLY  

US 3  ELASTOGRAPHY STRAIN TECHNIC,  THIS MASS IS  SOFT  

US 4  ELASTOSCAN   THIS MASS  NOT INVADED AROUND NO LYMPH NODE  AXILLARY

CORE BIOPSY  REPORT IS  FIBROCYSTIC CHANGE . 

SUMMARY: SAME TIME CT CARDIAC  DETECTED INCIDENTILOMA BREAST TUMOR. 

CASE 561: THYROID CANCER, Dr PHAN THANH HAI, MEDIC MEDICAL CENTER, HCMC, VIETNAM.

MAN 38Y0  GENERAL CHECK-UP  ULTRASOUND IN THE NECK  DETECTED ONE MASS AT LEFT THYROID GLAND.0

US 01:  CROSSED SECTION  AT THE LEFT LOBE THYROID HAD ONE MASS, ROUND, BORDER 3 CM , MIXED STRUCTURE WITH CYSTIC AND SOLID PARTS.

US 02: LONGITUDINAL SCAN LEFT LOBE   WITH HALO RIM ARROUND THIS MASS.

US 03: DETECTED  SMALL LYMPH NODE  NEAR LEFT CCA #1CM.

US 04: IN CDI  VASCULAR SUPPLY THIS MASS IS VERY HIGH.

US 05: ELASTOGRAPHY STRAIN  THIS MASS VERY HARD  SCALE .

FNAC   SUSPECTED  CANCER OF THYROID.

WAIT FOR OPERATION OF TOTAL THYROIDECTOMY.
REFERENCE   ACR-TIRADS AND STRAIN ELASTOGRAPHY.

CASE 560: TUMOR IN HORSESHOE KIDNEY, Dr PHAN THANH HAI, Dr PHAN THI HUONG. MEDIC MEDICAL CENTER, HCMC, VIETNAM

WOMAN 30 YO in ROUTINE CHECK-UP.

ULTRASOUND of ABDOMEN DETECTED RIGHT  SITE KIDNEY TUMOR   ON THE  HORSESHOE KIDNEY.

US1  RIGHT KIDNEY ONE MASS IN PELVIS OF KIDNEY, SOLID. SIZE 3-4 CM.

US2  CROSSED- SECTION   THIS  HORSESHOE KIDNEY  OVER AORTA

US3  LEFT KIDNEY IS NORMAL.

MSCT CE   

CT1  HORSESHOE KIDNEY

CT2  THE TUMOR INTRA CENTRAL RIGHT KIDNEY  

CT3  HORSESHOE KIDNEY   WITH CE NORMAL PERFUSION. 

CT4  VASCULAR SUPPLY FOR  HSK

OPERATION for  RESECTION of  RIGHT PART OF HSK  ( see SCHEMA of OPERATION)

SPECIMEN OF OPERATION  (macro1, macro2).

Microscopic histology report of this tumor is RCC.

Reference  urotoday

CASE 559: WARTHIN TUMOR, Dr PHAN THANH HAI, MEDIC MEDICAL CENTER, HCMC, VIETNAM.

MAN 62 YO WITH HISTORY OF 2 YEARS AGO  SLOW GROWTH AT RIGHT PAROTID GLAND  NO PAIN NO DISTURBE  OF MASTICATION. 

ULTRASOUND  REPORT

US 1: ONE MASS AT SUPERFICAL LOBE OF RIGHT PAROTID GLAND # 3 CM HYPOECHOIC.

US 2 :  DILATATION OF SALIVARY DUCT.

US 3 : SMI  SHOWS MORE VASCULAR MICROSTRUCTURE NO LYMPH NODE AROUND.

US 4 : ELASTOSCAN THIS TUMOR IS SOFT PATTERN.

MS CT with CE = THIS TUMOR IS ENHANCED VERY HIGH, WELL LIMITED  BORDER, CT 1 CT2 CT3 .

OPERATION for PAROTIDECTOMY.  SEE MACRO  TUMOR IS NECROTIC CENTRAL

MICROSCOPIC REPORT IS WARTHIN TUMOR.

FOTO OF  PATHOLOGIST ALDRED SCOTT WARTHIN

REFERENCE CASE.

CASE 558: OVARIAN TUMOR but RISING CA 19-9, Dr PHAN THANH HAI, Dr LE DINH TIN, MEDIC MEDICAL CENTER, HCMC, VIETNAM.

WOMAN  39YO  SINGLE, WITH  PELVIS PAIN

ULTRASOUND  DETECTED  LEFT OVARY CYST  SIZE 4 CM, CLASSIFIED IOTA 3   SUSPECTED  ENDOMETRIOSIS OF LEFT OVARY.  

US 1=   CYST  MIXED   SOLID.

US2 = ELASTO  SUSPECTED  BENIGN CYST.

ROUTINE BLOOD TEST   HAD  CA19-9  VERY HIGH VALUE  MORE THAN 1000 UI, CA 125 = 32 UI.

MSCT OF ABDOMEN WITH CE 

CT1:  PELVIS   HAD CYST OF LEFT OVARY  LOOKED LIKE SIMPLE CYST. 

CT2 :IN UPPER ABDOMEN,  LIVER,  BILIARY SYSTEM AND PANCREAS ARE NORMAL.

LAPAROOPERATION   REPORTED  LEFT OVARY CHOCOLATE CYST  THAT SUSPECTED  ENDOMETRIOSIS.

MICROSCOPIC REPORT OF THIS CYST IS   ENDOMETRIOSIS CYST.

LAB TEST AGAIN AFTER 2 WEEKS  OF OPERATION  THE CA19-9 DROPPED DOWN TO 123 UI.

CONCLUSION :  ENDOMETRIOSIS CYST RISED VERY HIGH CA-19-9 VALUE  WHICH IS RARE CASE

UNKNOWN REASON. 

REFERENCE CASE .

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