Parto Teb Azma

Patient ID: 89033663

History (HX):
Left renal-colic, hematuria

Findings:
1- Left sided mild hydroureteronephrosis due to distal third ureter stone clearly on axial and reconstructed coronal CT KUB images
2- High dense foci within left renal cortex suggestive of nephrocalcinosisDiagnose (DX):
Left ureter stone, left cortical nephrocalcinosis

Discussion:
A CT KUB is done to evaluate the kidneys, ureters and bladder. Although this type of CT scan can be use to evaluate such things as kidney cysts in the abdomen or tumors in the pelvis, the primary reason is to determine if the patient has kidney stones. Since kidney stones can be very painful the CT KUB can help determine the size and location of these stones and help with the treatment. There is no preparation for a CT KUB and the exam takes only a few minutes to complete (It is unlikely a stone of any size would be missed with ours scans)

Patient ID: 89033147

History (HX):
Left sided palpable mass

Findings:
Large cystic mass in left posterior triangle and lateral to carotid sheath.
Rim and internal septation enhancement

Diagnose (DX):
Second branchial cleft cyst

Discussion:
The second branchial cleft accounts for 95% of branchial anomalies frequently , second branchial cleft cysts are identified along  the anterior border of the upper third of the Sternoclenoidomastoid muscle and adjacent to the muscle . However, these cysts may present any where along the course of a second brachial fistula, which proceeds from the skin of the lateral neck, between the internal and external carotid arteries, and into the palatine tonsil. Therefore, a second branchial cleft cyst is part of the differential diagnosis of a parapharyngeal mass.

Patient ID: 89033271

History (HX):
Known case of ovarian cancer

Findings:
Multiple liver masses, peritoneal masses, lymphadenopathies, thick ascites

Diagnose (DX):
Liver metastasis, peritoneal seeding and omental cake

Discussion:

Nearly all malignant ovarian tumors have combined solid and cystic components.histologically,85-90% are epithelial tumors and include serous, mucinous,endometroid , and clear cell adenocarcinomas.the remaining are malignant germ cell tumors (dysgerminoma, teratoma), sex cord stromal tumors (granulose cell tumor) , and sarcomas.a subset of borderline malignant tumors have a more favorable prognosis.metastatic spread occurs early as peritoneal implants,hematogenously via the ovarian vein to the liver, and lymphogenously to the pelvic and para-aortic lymph nods.

History (HX): Incidental finding on ultrasound exam
Findings:
Low attenuated subcapsular liver mass with peripheral nodular enhancement and filling in on delayed study.
Diagnose (DX): Liver hemangioma
Discussion:
Hemangioma is the most common benign tumor of the liver.
The classic diagnostic findings for hemangioma are as follows:
On unenhanced CT: Hypoattenuation similar to that of vessels
On dynamic contrast CT or MR imaging: Peripheral globular enhancement and a centripetal fill-in pattern with attenuation of enhancing areas identical to that aorta and blood pool.

History (HX): Dyspnea
Findings:
Complete collapse of right lung with heterogeneous attenuation value and obliteration of right bronchus related to tumoral involvement right sided pleural effusion
Diagnose (DX): Bronchogenic carcinoma (S.C.C)
Discussion:
In most cases of S.C.C tumor areas centrally within lobar or segmental bronchus. The central location of the tumor account for the presenting symptoms of cough and hemoptysis and common radiographic finding of a hilar mass with or without obstructive pneumonitis or atelectasis.

History (HX): Hirsutism
Findings:
Small 12×10 mm lesion in left adrenal gland
Normal right sided
Diagnose (DX): Adrenal adenoma
Discussion:
Unenhanced CT attenuation value can characterize an adrenal mass as a benign adenoma (adenoma attenuation value is lower than nonadenomas lesion 25H compared with 32H). Adenoma mean diameter is usually lower than nonadenomas. (<1 cm compared with 2/4 cm)

  HX:A 57 man year old with abdominal pain and nausea.

Findings: A large necrotic mass in jejunum with proximal

loope dilatation , omental fat involvement along with  lymph

nodes .

Diagnosis: malignant spindle cell tumor . 

Discussion: Malignant tumors of small bowel are rare

and accounts for the <2% of total GI malignancy.

Because of the heterogeneous and  aggressive nature many

of them present with recurrence and visceral metastasis.

 

HX: A 52y man complaining of hematuria and flank pain .

Findings: Large solid mass in right kidney .

The mass is causing distortion of the renal parenchyma ,

 collecting system and sinus fat.

Diagnosis: Renal cell carcinoma

Discussion : The most common primary malignant tumors

in adults, 80% of all malignant renal tumors , usually

between 40-60 years of age . Man to woman ratio are 2:1 ,

20-50% of hypernephroma  are associated with von hipple –

 lindau disease.

These tumors mostly spread by direct extension into the

renal pelvis and the blood stream , thus early spread to the

lungs is expected. Involvement of renal sinus soft tissue is

occurred. Secondary deposits to the bones , liver and

opposite kidney are commonly seen.

 HX: A 30y woman with left submandibular gland

 enlargement  and pain.

Findings: Large dense stone in left submandibular region ,

enlarged submandibular gland with dilated duct.

Diagnosis : Stone in Wharton’s duct, sialadenitis.  

Discussion:Sialolithiasis is most common disease of salivary

 gland , twice as

common in males as females , 80-95% occur in

submandibular gland or duct , stones are most common

cause of acute and chronic infection of salivary gland .

HX:A 70 year old man with anemia and right trunk palpable

mass, lower extremity DVT .

Findings: Thick fluid in posterior pararenal space,

heterogeneous enlargement of right psoas muscle.

Diagnosis: Anticoagulant related hematoma.

Discussion: Spontaneous bleeding is a serious complication

that should be promptly recognized and treated.

CT, a simple and safe imaging modality, plays an important

role in the accurate determination of the presence or

absence of an anticoagulant- related bleed , its extent, and

its precise location.