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: 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): 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 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.

HX:A 56 year old woman , known case of ovarian cancer.

Findings: Soft tissue masses along omentum.

Diagnosis : peritoneal carcinomatosis( omental cake )

Diagnosis: Peritoneal seeding is the most common pathway

for the spread of ovarian cancer.

Because 90% of ovarian cancers are surface epithelial

carcinomas , that tumor cells are able to slough off the

ovary and the peritoneal circulation , thereby seeding

multiple sites.

HX:A 32 year old woman , long period of belly abdominal

pain .

Findings: Thick- wall bowel loops , interlope fluid .

abscess formation in left side of pelvis .

Diagnosis: Chron’s disease in rectosigmoid, involvement of

both fallopian tube, rectovesical fistula.

Discussion: Chron’s disease is a lifelong inflammatory bowel disease that usually is found in illeocecal
region. But it can develop anywhere in the digestive tract from the mouth to the anus. (Above case had rectosigmaid colon and adjacent anatomy involvement with normal illeocecal region on barium study).

HX:A 25 year old woman , painless lump in right lower

abdominal wall .

Findings: Moderate size soft tissue tumor in right transverse / oblique abdominal wall muscles.

Diagnosis : Neurofibroma.

DX: Abdominal wall neurofibroma most common

presenting as inguinal hernia.