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CASE 519: LYMPHOMA in RETROPERITONEUM, Dr LY VAN PHAI, Dr PHAN THANH HAI, MEDIC MEDICAL CENTER, HCMC, VIETNAM.

October 22, 2018, 5:05 am
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WOMAN 51 YO WITH  LUMBAGO, PAIN IN RIGHT LEG FOR  3 MONTHS. 
X-RAYS OF LUMBAR SPINE IS NORMAL.


ULTRASOUND  DETECTED  RETROPERITONEAL HYPOECHOIC MASS   COVERING  THE RIGHT PSOAS MUSCLE.
US1 = LONGITUDINAL SCAN OF RIGHT PSOAS MUSCLE  HYPOECHOIC LIKE CYST.



US 2  = PSOAS MUSCLE IS PULL UP ;  US 3  = AVASCULAR HYPOECHOIC AREA ; US 4,  US 5  = BENDING AORTA  AND ILIAC ARTERY .






MSCT CE = CT 1 :CROSSED-SECTION NON CE: THIS MASS  PARAVERTEBRAL; CT 2 : CROSSED- SECTION AT PELVIS  CT3, CT4 : FRONTAL VIEW OF  THIS MASS WITH VERY HIGH CE ENHANCEMENT,  ILIAC ARTERY DEPLACED AND PSOAS MUSCLE  IS  INTACT.







MRI  WITH GADO =  MRI 1:CROSSED- SECTION VIEW, THIS MASS IS SOLID,  PULL UP THE ILIAC ARTERY;   MRI 2 : CROSSED- SECTION AT PELVIS
MRI 3 : FRONTAL VIEW;   MRI 4 : SAGITTAL VIEW,  PSOAS MUSCLE IS ENROUNDED BY TUMOR.






BLOOD TESTS= WBC, CRP ARE NORMAL, MARKER  BETA2 MICROGLOBULINE, LDH, FERRITIN ARE IN NORMAL  LEVELS.
RADIOLOGIST SUGGESTION IS RETROPERITONEAL LYMPHOMA.
BIOPSY WAS DONE .
RESULT OF HISTOLOGY WITH IMMUNO-HISTO -CHEMISTRY  IS  LYMPHOMA B SMALL CELL.


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CASE 520: LIVER TUMOR WITH LOW AFP, Dr PHAN THANH HẢI, MEDIC MEDICAL CENTER, HCMC, VIETNAM.

November 1, 2018, 4:24 am
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MAN 57YO  WITH NO HISTORY OF HEPATITIS.
ULTRASOUND OF ABDOMEN FOR CHECK UP DETECTED ONE MASS AT  RIGHT LIVER , SEGMENT 6, SIZE 3 CM..HY POECHOIC, US1, US 2, US 3 .






MSCT WITH CE, RADIOLOGIST  COULD NOT  SUGGEST WHAT IS THIS
( CT 1).

BLOOD  TESTS= AFP IS  LOW  L3  IS NOT DETECTED  BUT DCP IS HIGH (WAKO TEST).


MRI  WITH PRIMOVIST AND DYNAMIC CONTRAST  GIVE DIAGNOSTIC  OF HCC.




OPERATION FOR LAPARO RESECTION TUMOR.


MICROSCOPIC REPORT IS HCC  UNDIFFERENTED CARCINOMA.


Comparison AFP to DCP in detection of  HCC.


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CASE 521: MULTIPLE CANCERS, Dr PHAN THANH HẢI, MEDIC MEDICAL CENTER, HCMC, VIETNAM.

November 4, 2018, 3:45 am
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MAN DOB 1945,  DIABETES WITH HISTORY  FROM  2008   BLOOD TEST  PAS  5,6ng/mL  9%  TRUS
 DETECTED FOCAL IN PROSTATE AND  BIOPSY MAKE DIAGNOSTIC  PROSTATE CANCER GLEASON 7 
 OPERATION PROSTATECTOMY WAS DONE( SEE TRUS BIOPSY).
 
















IN 2016  WITH RECTORRHAGIA,  CT AND ENDOSCOPY   AND BIOPSY  MAKE DIAGNOSTIC  SIGMA
COLON CANCER.   COLECTOMY  WAS DONE   STAGING  STAGE 1. NO CHEMOTHERAPY POST OP.
( SEE  ENDOSCOPY  )












IN OCT 2018  FOR ROUTINE CHECK -UP,  ULTRASOUND DETECTED  ONE MASS IN HILUS OF LIVER  3 CM 
( US 2) AND  WAKO TEST  MAKE  DIAGNOSTIC  HCC.






















MRI OF LIVER  WITH GADO  AND PET-CT  ALSO  DIAGNOSED   HCC.






















TREATMENT OF TOCE WAS DONE.

SUMMARY = DURING 10 YEARS  3 PRIMARY CANCERS  WERE DETECTED AND MANAGEMENTS..
WHY  ?   


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CASE 522: MOBILE THORACIC UNDERSKIN TUMOR, Dr PHAN THANH HẢI, Dr ĐẶNG BỬU THẤT, MEDIC MEDICAL CENTER, HCMC, VIETNAM.

November 6, 2018, 5:53 am
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WOMAN 54 YO WITH WEAKNESS,  ANOREXIA FOR  ONE MONTH,  NO FEVER  BEING DETECTED ONE MASS AT RIGHT DORSAL AREA, DIFFICULTY IN DORSAL LAYDOWN.
CLINICAL PALPATION THIS MASS IS ROUND, SOFT, MOVING UNDER SKIN (VIDEO).




CHEST X-RAY FILM IS NORMAL.



ULTRASOUND SHOWS CYSTIC MASS , SIZE 20CM,   WELL BORDERED,  WITH CONTENT LIQUID AND SEPTATION ( US 1, US 2, US 3).




CT SCAN :  THIS MASS IS INTRA THORACIC WALL LOOKS LIKE AN ABSCESS ( CT1, CT2, CT3).




PERCUTANEOUS PUNCTURE  REMOVED SERUM AND BLOOD,   ANALYSIS OF ADA NEGATIVE.


OPERATION  REMOVED THIS MASS  WHICH WAS WELL BORDERED AND HAVING BLOOD  CLOTS INSIDE . 
MACROSCOPIC VIEW LIKES HEMANGIOMA.  

  
WAIT FOR MICROSCOPIC REPORT.
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CASE 523: FIBULAR BONE TUMOR, Dr PHAN THANH HẢI,MEDIC MEDICAL CENTER, HCMC, VIETNAM.

November 11, 2018, 4:56 am
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WOMAN 58 YO  WITH PAIN AT LEFT KNEE  AND SWELLING, DIFFICULTY IN WALKING (PHOTO)


ULTRASOUND   DETECTED ONE BIG MASS HYPOECHOIC FROM THE KNEE JOINT 20 CM LONG  WELL BORDERED  (US1).


US 2 : CDI  SHOWS HYPERVASCULAR.


US 3:  THIS MASS IS FROM THE  FIBULAR BONE OUTGROWTH  INTRA MUSCLE.


US 4: THIS MASS  COMPRESSED THE VASCULAR BENDING.


X-RAYS OF THE  KNEE  SHOWS THE UPPER PART OF FIBULAR BONE BEING EROSION.


MRI OF LEFT KNEE   WITH GADO:
 MRI 1= HYPOINTENSE MASS  LIKE CYST.


MR 2 = THIS MASS WITH CENTRAL NECROSIS.


MRI 3 = CROSSED SECTION   VERY HIGH CONTRAST ENHANCEMENT.


MRI 4 =THIS MASS IS FROM PROXIMAL PART OF LEFT FIBULAR BONE.


RADIOLOGIST SUGGESTED  IT SARCOMA OR GIANT CELL TUMOR.
CORE BIOPSY WAS DONE.


Microscopic report is  giant cell tumor of  fibular bone, proximal part.

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CASE 524: DOUBLE AORTIC ANEURYSMS, Dr PHAN THANH HAI, Dr VO HIEU THANH, MEDIC MEDICAL CENTER, HCMC, VIETNAM.

November 14, 2018, 2:47 am
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Man  72 yo with  blood test of PSA high 15ng/mL. MRI  FOR  PROSTATE EVALUATION.
MRI 1 = AT PELVIS, PROSTATE BIG, SUSPECTED  CANCER   PI-RADS 3 

MRI 2 =  GO UP FOR  EVALUATION  LYMPH NODE   DETECTED  ABDOMINAL AORTIC  ANEURYSM THAT HAD BEEN TREATED BY STENT ENDO LUMEN FOR 2 YEARS.


MRI 3 =  MRI RISE TO THORACIC AREA DETECTED ONE MASS  OF ANEURYSM #4 CM  BELONGS AORTIC DESCENDING.

MRI 4 = CROSSED SECTION AT SECOND ANEURYSM.



ULTRASOUND FOR  SECOND LOOK.
 US 1 US 2 : LONGITUDINAL SCANNING AT ABDOMEN AORTA  ANEURYSM.



US 3 AND US 4 : SCANNING AT PARASPINAL THORACIC   WITH  FLOW  EJECTION INTRA ANEURYSM.


SUMMARY = DOUBLE AORTIC ANEURYSMS WERE DETECTED INCIDENTAL BY MRI AND SECOND LOOK BY US.
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CASE 525: LIVER ABSCESS, Dr PHAN THANH HẢI, Dr NGUYỄN THÀNH ĐĂNG, MEDIC MEDICAL CENTER, HCMC, VIETNAM

November 17, 2018, 8:48 pm
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Male  62yo, with history of removing biliary stones in liver for 10 years. 
Ultrasound in 5 times shows biliary stones intraliver, aerobilia and right liver cyst from liver cirrhosis and splenomegaly patient. Blood tests= WBC:19,800g/L, hs CRP=177.2H. AFP=19.8ng/mL.



He came back Medic for reexamination as pain at RUQ and slight fever in Feb 2018.
Ultrasound suspected a liver tumor  with biliary stones and cirrhosis and splenomegaly.



But MRI thought about a new liver abscess with biliary stones of cirrhosis patient.


He entered CR hospital and  the results of ultrasound and CT  were liver tumor and aerobilia. With the diagnosis of CR hospital on liver tumor necrosis and aerobilia he felt no pain and nor fever after using of prescribed medicine drugs in 17 days.


He came back Medic  2 months later. 
Ultrasound detected no liver tumor, only biliary stones and aerobilia. 


MRI revealed no liver tumor, and in reviewing,  MRI noted a sign of head of cauliflower that means a pyogenic abscess  appearing of peripheral lobulated increasing signal intensity on MRI.

SUMMARY: Ultrasound was in mistake as no pay attention of clinical signs. A tumor necrosis could not be in concordance with infectious syndrome. And patients remained quite well because of resolving of liver abscess.

 REFERENCE:


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CASE 526: BIG OVARIAN CYSTIC TUMOR, Dr PHAN THANH HAI, Dr TRAM THI TU HUONG, MEDIC MEDICAL CENTER, HCMC, VIETNAM

November 28, 2018, 3:58 am
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FEMALE 17YO,   SINGLE,  IRREGULAR MENTRUAL CYCLE AND  ABDOMEN DISTENTION.
ULTRASOUND  DETECTED  BIG CYSTIC TUMOR FROM PELVIS TO EPIGATRIC AREA.
US 1 : LONGITUDINAL SCAN OF ABDOMEN AT MIDDLE LINE.



US 2 : AT PELVIS.

 US 3 : CROSSED-SECTION AT ILIAC ARTERY DIVISION.  


US 4 : UTERUS SMALL AND  ASCITIS  ARROUND.




MSCT  WITH CE
CT1 : CROSSED-SECTION OF ABDOMEN AT KIDNEY LEVEL.


CT2 : CROSSED- SECTION OF TUMOR.

  


CT3 : FRONTAL VIEW  


BLOOD TEST : ROMA TEST NEGATIF  
SUMMARY =IT IS BIG OVARY CYSTIC TUMOR, SIZE 50CM,  MULTISEPTATION.  IOTA CLASSIFICATION B4.
OPERATION REMOVED RIGH BIG OVARY TUMOR CASE.


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CASE 527: SPINE METASTASES, Dr PHAN THANH HAI, MEDIC MEDICAL CENTER, HCMC, VIETNAM.

December 3, 2018, 1:23 am
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WOMAN 50 YO  3 YEARS AGO BEING TREATED  AT CANCER CENTER BY NPC  RADIOTHERPY AND RADICAL NECK DISSECTION. BUT NOW PAIN AT DORSAL  AREA.
ULTRASOUND OF PARAVERTEBRAL  AREA DETECTED  ONE MASS HYPOECHOIC AT THE LEFT LATERAL OF THE D10 SPINE.
 US 1, US 2  LONGITUDINAL SCAN,  US 3  CDI  NO MORE COLOR DOPPLER SIGNAL.




MRI  SPINE    DETECTED ABNORMAL D10  ( MRI1)   MRI 2  FOCUS  D10, MRI 3   CROSSED SECTION  D10,  MRI 4  TUMOR  T2   CALCIFICATION INTRATUMOR , MRI5  FRONTAL VIEW  NEAR  KIDNEY  UPPER POLE.





CORE BIOPSY  REPORT  IS  METASTASIS   BY  UNDIFFENTIATED CELL TUMOR .


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CASE 528: LIVER TUMOR, Dr PHAN THANH HAI, MEDIC MEDICAL CENTER, HCMC, VIETNAM.

December 10, 2018, 2:42 am
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Woman 69 yo with history of mastectomy due to breast cancer for 18 years. Now for a screening  she chose full body CT.
CT reported a liver mass   at segment 5 ,  size# 6cm  (CT 1 and  CT 2).


Ultrasound reviewed:

 US 1: Liver  picture scan in April 2018  is  normal

US 2 :   A hypoechoic mass near the gall bladder.


US 3: Vascular supply for this mass is central tumor.


Blood tests= Wako test normal,  CA 15-3  normal .

MRI of iver with primovist  made  diagnostic  by radiologist is metastasis to liver ( MRI 1,  2,  3, 4).





Ultrasound guided  core biopsy  report = fibrosis

Summary of this case: A  mass in liver # 6 cm  suspected metastasis from breast cancer had been treated 18 yrs before and waiting for operation.
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CASE 529: CC HCC, Dr PHAN THANH HAI, Dr DUONG NGOC THANH, MEDIC MEDICAL CENTER, HCMC, VIETNAM.

December 16, 2018, 3:05 am
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WOMAN 66 YO,   ULTRASOUND CHECK -UP DETECTED ONE MASS  5 CM AT R LIVER   HYPERECHOIC WELL- BORDERED  LOOKS LIKE  HEMANGIOMA (US 1, US 2, CENTRAL TUMOR NECROSIS).





BLOOD TESTS=  HBV AND HCV NON REACTIVE   WAKO TEST  STRONG POSITIVE.


MRI OF LIVER WITH GADOVIST , THIS TUMOR IS ENHANCED WITH GADO AND  STRUCTURE IS MORE FATTY TISSUE .  RADIOLOGIST REPORT IS AML LIVER ( MRI 1, MRI 2, MRI 3).




 CORE BIOPSY REPORT IS MORE FATTY TISSUE  WITH THE  SAME NUMBERS OF ABNORMAL CELL.

OPEN SURGERY RESECTION OF TUMOR  ( SEE MACRO  TUMOR WHICH IS  VERY DIFFERENT WITH LIVER TISSUE , WHITE  HARD   CENTRAL NECROSIS  WELL-BORDERD. MACRO 1, MACRO 2).



MICROSCOPIC REPORT IS  CLEAR CELL HCC   MORE 50%  CLEAR CELLS IN TUMOR.


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CASE 530: UMBILICOURACHAL SINUS ABSCESS, Dr PHAN THANH HAI, MEDIC MEDICAL CENTER, HCMC, VIETNAM.

December 26, 2018, 4:31 am
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MAN 36YO, WITH HISTORY OF  SWOLLEN UMBILUS  AND DISCHARGE  AS A  PUS MASS FOR ONE MONTH.




ULTRASOUND SCANNING  SHOWS THE UMBILUS AREA  HAVING ONE MASS # 4 CM   INTRA ABDOMEN WALL AND AIR CONTENT ( US 1).


  
US 2 :CDI  SHOWS   TWINKLING  ARTIFACT  DOPPLER  CONNECTED TO URINARY BLADDER.


CT WITH CE : THIS MASS WITH ROUND BORDER  INTRA ABDOMEN WALL CONNECTED TO UMBILICUS (CT1, CT2  CROSSED-SECTION AND SAGITAL SECTION).



BLOOD TESTS = WBC RISES 12K,  CRP 12ng/mL,
RADIOLOGIST DIAGNOSTIC IS AN ABSCESS OF URACHAL SINUS.
OPERATION REMOVED THE ABSCESS.


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CASE 531: TOOTHPICK PERFORATING SPLEEN, Dr PHAN THANH HAI, Dr LE VAN TAI, MEDIC MEDICAL CENTER, HCMC, VIETNAM.

January 1, 2019, 10:59 pm
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Man 46 yo  with epigastric pain,  gastroscopic result is  gastritis but being treated with  no response. 
Ultrasound of abdomen   detected  foreign body ( fb) intra the spleen that looked like the toothpick
US 1  the  fb is long 5 cm  intra central hilus the pleen to peripheral,  (US 1  crossed-section).


US  2  with CDI vascular of spleen).


US 3  hilus the spleen.


US 4 video.



Blood test is normal,  colonoscopy is normal.
MSCT of abdomen  confirmed the  toothpick in penetration of the spleen, from the gastric wall to hilus of pleen.


Wait for operation for the case.
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CASE 532: URINOMA and A 2-Year Tap Wound, Dr PHAN THANH HAI, Dr NGUYEN THE ANH, MEDIC MEDICAL CENTER, HCMC, VIETNAM.

January 8, 2019, 4:53 am
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MAN 26 YO WITH ABDOMEN PAIN AND DISTENTION.
 US of ABDOMEN DETECTED ASCITES AND LEFT KIDNEY HYDRONEPHROSIS, RIGHT LUNG WITH FLUID COLLECTION ( US 1  R LUNG,  US 2 L KID,  US 3 PELVIS FRONT, US 4 SAGITTAL PELVIS).







X-RAYS OF ABDOMEN DETECTED  METALIC OBJECT AT PELVIC LIKE KNIFE.


MSCT OF THORAX AND ABDOMEN = CT1  CROSSED-SECTION THE  LUNG, CT2  FRONTAL VIEW  LUNG -ABDOMEN,  LEFT KIDNEY HYDRONEPHROSIS, CT  3D VIEW OF  ABDOMEN.





OPERATION   REMOVED A KNIFE HAVING TAP WOUND 2 YEARS BEFORE AT THE LEFT FLANK LOCATED AT CUL- DE- SAC.



 ASCITES ANALYSIS  IS URINE   AND LEFT URETER  HAD BEEN RUPTURED  AND LEAKING URINE TO RETROPERITONEUM AND INTRA ABDOMEN

CONCLUSION:   URINOMA FORMATION BY TAP WOUND AT LEFT FLANK.

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CASE 533: RETROPERITONEAL HEMATOMA, Dr PHAN THANH HAI, MEDIC MEDICAL CENTER, HCMC, VIETNAM.

January 15, 2019, 12:56 pm
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MAN 60YO WITH ACUTE  EPIGATRIC PAIN.

ULTRASOUND EMERGENCY  OF ABDOMEN DETECTED  =
U S 1 :  RIGHT KIDNEY HYDRONEPHROSIS IN FIRST DEGREE).



U S 2 : ONE  9CM MASS   AT BIFURCATION OF ABDOMINAL AORTA TO PELVIS,  HYPOECHOIC STRUCTURE  WITH DEPLACEMENT OF R/L ILIAC ARTERIES).

U S 3: THIS MASS  AT LEFT ILIAC ARTERY.

U S 4 : THIS MASS AT RIGHT ILIAC ARTERY. IT COULD BE A HEMATOMA IN RETROPERITONEUM.
  


EMERGENCY CT CE OF ABDOMEN=
C T 1 : CROSSED SECTION AT R/L KID  SHOWS HYPOPERFUSION IN RIGHT KIDNEY.


C T 2 : CROSSED SECTION AT PELVIS MASS  RUPTURE OF ILIAC ANEURYSM.


C T 3:  FRONTAL VIEW.


C T 4: SAGITTAL VIEW OF  THIS MASS.


C T 5: 3D  VASCULAR  RECONSTRUCTION WITH 2 MASSES LEAKING OF CONTRAST AT R/L ILIAC ARTERIES.


EMERGENCY ENDOVASCULAR  STENTING  OF R/L COMMUN ILIAC ARTERIES WAS DONE SUCCESSFULLY.

SUMMARY:  HEMATOMA IN RETROPERITONEUM DUE TO RUPTURES OF R/L COMMUN ILIAC ARTERIES ANEURYSMS  DETECTED BY ULTRASOUND AND CT WITH CE.

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CASE 534: TUMOR INTRA PSOAS MUSCLE, Dr PHAN THANH HAI, MEDIC MEDICAL CENTER, HCMC, VIETNAM.

January 25, 2019, 5:43 am
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WOMAN 60YO WITH LUMBAGO ON LEFT SITE ULTRASOUND DETECTED HYPOECHOIC MASS INTRA LEFT PSOAS MUSCLE, SIZE 4 CM   LOOKED LIKE ABSCESS   BUT BLOOD TEST IS NORMAL  ( US1, US 2 , US3).




MRI  OF ABDOMEN DETECTED  ONE MASS  WELL BORDERED,  SIZE 4-3CM  INTRA PSOAS MUSCLE NEAR  LEFT LATERAL BORDER OF  LUMBAR SPINE L1  ( MRI 1). 
MRI 2 : SAGITAL VIEW ,  MRI 3 :  T2 W.    




RADIOLOGIST  SUSGESTED  A NEURO TUMOR   
CORE BIOPSY UNDER ULTRASOUND GUIDING IS  NEURINOMA.
OPERATION  REMOVED THIS TUMOR.



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CASE 535: LOWER LEG TUMOR, Dr PHAN THANH HAI, Dr LE THONG LUU, MEDIC MEDICAL CENTER, HCMC VIETNAM.

February 1, 2019, 6:59 pm
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MAN 57 YO  DETECTED  ONE MASS AT LOWER LEFT LEG, 10 CM ABOVE THE ANKLE JOINT . 
THE MASS IS MOVING IN WALKING, BUT NO PAIN.
ULTRASOUND  ( US 1)  WITH LINEAR PROBE 5 MHz,   THIS TUMOR  IS INTRA SOLEUS MUSCLE,  ROUND
# 3 CM, CENTRAL NECROSIS.














US 2 WITH CURVE PROBE 5MHz  THIS TUMOR  BORDER IS  ROUND.














US 3 : TUMOR INHOMOGEOUS WITH CENTRAL NECROSIS.













US 4:  TUMOR   CLOSE BY A VASCULAR  STRUCTURE.












MRI  WITH CE=
MRI 1:  CROSSED SECTION VIEW,  THE LOCALISATION OF THIS TUMOR.



















MRI 2:  LONGITUDINAL SCAN VIEW  THE TUMOR WITH  POSTERIOR TIBIAL ARTERY.




















MRI 3: LOW VASCULAR SUPPLY AROUND  TUMOR.




















RADIOLOGIST  REPORT IS SUSPECTED  NEURINOMA TUMOR.


CORE BIOPSY  OF THIS TUMOR REPORT IS SCHWANNOMA.


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CASE 536: BILATERAL PERIRENAL LYMPHANGIOMATOSIS, Dr PHAN THANH HAI, Dr TRUONG DINH KHAI , Dr NGUYEN ANH TUAN, MEDIC MEDICAL CENTER, HCMC, VIETNAM.

February 11, 2019, 10:26 pm
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FEMALE  PATIENT 16 YO IN  HEALTH  CHECK-UP  BY ULTRASOUND  DETECTED ASCITES.
MSCT WITH CE FOR DIAGNOSIS= 
CT 1 : CROSSED SECTION DETECTED  2 KIDNEYS BEING PULL UP.



CT 2 : CROSSED SECTION  UPPER    2 CYSTS  RETROPERITONEUM.


CT 3  : SAGITTAL  VIEW, KIDNEYS DEFORMATION AND DEPLACEMENT.




CT 4 : 2 CYSTS RETROPERITONEUM
CT 5 : 3D VIEW  URINARY SYSTEM NORMAL  
RADIOLOGIST SUSPECTED  URINOMA.    PUNCTION ASPIRATION, THE FLUID IS NOT URINE BUT LIKE LYMPHATIC COLLECTION.




ARTER  PUNCTURE ASPIRATION  AND SCLEROTHERAPY.  
MRI 1=THE FLUID IS STILL UPPER  POLE OF  RIGHT KIDNEY AND AROUND LEFT KIDNEY. 
MRI 2 = VASCULAR SUPPLY FOR 2 KIDNEYS IS NORMAL.


ULTRASOUND REVIEW AFTER ONE YEAR.

US 1, US 2:   RIGHT KIDNEY.




US 3, US 4 : LEFT KIDNEY  SHOWED VASCULAR SUPPLY OF 2 KIDNEYS IS NORMAL AND  RENAL FUNCTION IS NORMAL.





CONCLUSION=  IT IS BILATERAL PERIRENAL LYMPHANGIOMATOSIS.

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CASE 537: GASTRIC LYMPHOMA, DR PHAN THANH HAI, DR LE THI THANH THAO, MEDIC MEDICAL CENTER, HCMC, VIETNAM.

February 16, 2019, 5:53 am
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Man 63 yo with gastric ulcer being treated for a  long time but not getting better. 
Gastroendoscopy  found a crater ulcer of antrium  but  in 2 times of biopsy only chronic inflamation.


Ultrasound scanning in epigastris  detected antrium thickening of the wall  and hypoechoic (US 1).   

US 2 : many lymph nodes around antrium.  



US 3: CDI, vascular supply for antrum.



US 4: longitudinal scanning of antrum  is  thickening of  the gastric wall.



MSCT scanning of abdomen.
CT 1= crossed section of   antrum with the mass.


CT 2 = scanning with position rotation of antrum showed stenosis.


Radiologist and sonologist diagnostics were gastric cancer.
Operation of gastrectomy.
Specimen 1= antrum tumors.  

Specimen 2 =
Opening of gastric lumen there wered 2 lesions at antrum and body of stomach.



Microscopic report with immuno-histo chemistry  staining is B cell lymphoma  of antrum and infiltrated lymph nodes.


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CASE 538: SUBMERGED MEDIASTINUM GOITER TUMOR, Dr PHAN THANH HAI, MEDIC MEDICAL CENTER, HCMC, VIETNAM.

February 25, 2019, 6:47 am
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Woman 59 yo, for 10 years, underwent an operation of removing tumor at left lobe of thyroid.
Now she suffers from cough and  change of the speaking voice.
Chest X-Rays shows one mass at upper part of retrosternum.


Ultrasound  of the neck: 

US 1: crossed section of the right big thyroid lobe with tumor.


U S 2 : this tumor is prolonged from retrosternum. to mediastinum.


US 3: CDI with  hypovascular tumor.


US 4: longitudinal tumor scan.



Blood tests: normal thyroid function.

MSCT with CE:


CT 1, CT 2, CT 3                                                                                                                                                            Section  at level of neck  upper sternum  and middle  sternum   this tumor  from right lobe thyroid  calcification.





CT 4 : sagittal,  C T 5 : frontal section.





Isotopic Tech 99m  scan  made  diagnostic is thyroid tumor with cold nodule come from r ight lobe of thyroid gland.


Operation by the way sternotomy  removed this tumor well bordered,  central solid and cystic parts very highly calcified.




Conclusion:  Goiter tumor  submerged in mediastinum.

MICROSCOPIC REPORT IS  NODULAR GOITER.


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