A 33 year-old male patient with dysuria
His history noted 6 times of long bone fracture, and renal stone and double JJ sonde on the right kidney.
Ultrasound detects some renal stones on 2 sides. And with herself experience sonologist reveales a left parathyroid tumor next to left lobe of thyroid.
Surgery removes the parathyroid tumor and the PTH goes down after that.
A 56 male patient with right shoulder pain for a half of month.
Chest X-Ray and ultrasound show a #3.1x2.5 cm right posterior legion of 7th rib with hypoechoic pattern, neovascular signals and moderate of hard code on elastography ultrasound.
A 29 year-old female patient in a general chek-up for a preparation of a study abroad.
Ultrasound detects lymph nodes in her mesentery in the abdomen and on her neck # 5-25 mm in suspecting TB infiltrating type. Also a slight thickening of wall of colon is noted.
A colonoendoscopy performs shows findings of ulcerative colitis from the cecum to the transverse colon due to TB infected.
A 61 year-old female patient suffers from 2 tumors of her right breast which are abandoned for 2 years by her husband's deadly illness.
Ultrasound and elastography technique notes 2 BI-RADS 4B tumors of her right breast.
Mammography notes a non symetric sign in superiolateral region of the right breast.
MRI confirms the 2 BI-RADS 5 right malignant breast tumors: # 34x28 mm and # 21x 27 mm, spiculated border, high signals on T2W2 and medium signals on T1W1, captured contrast media type 3-2.
But the report of histoimmunology is a breast sarcoma while axillary lymph nodes are not in malignancy.
Surgery is done in large field, no mastectomy nor lymph node curetage due to the sarcoma tumor characters.
As no clue of gene mutation, the patient is planned for 3 months of 54Gy dosages in 27 times of radiation therapy.
A 58 year-old male patient in general check-up is revealed incidentaĺly by ultrasound an aneurysm of left iliac vein # 48x66 mm without thrombosis. In addition, the left external iliac artery dilates #15-21mm appears in tortuosity like a corkscrew.
MSCT 64 confirmes the findings of the aneurysm of left iliac vein # 48x66 mm without thrombosis.
And in 3 D reconstruction the corkscrew of left external iliac artery appears clearly in mild dilatation without damage of its wall beside the aneurysm of the left iliac vein.
The corkscrew of external iliac artery is an anatomic variant incidentally revealed by CTA but a skilled sonologist could detects it with experience oneself. However, the key of this case is the aneurysm of iliac vein which leads to find out an uncomplicated aneurysm and the arterial tortuosity of the external iliac artery close by. But the cause of the left iliac vein aneurysm is unknown.
Aneurysm of iliac vein is a rare entity which appears in men and on the left side. And in contrast, female gender is a predisposing factor of the arterial tortuosity.
The patient is planned to the conservative management.
REFERENCES
MSCT later confirms the 35x32 mm arterial aneurysm of gastroduodenal artery.
The patient goes through an endovascular aneurysm repair (EVAR) by biological glue.
The patient remains well post-op.
But ultrasound could note the vestige of aneurysm # 34x31 mm without any Doppler signal and flow after 8 months.
Ultrasound notes a left submadibular gland tumor.
MSCT confirms the left submandibular that invaded the mouth floor and node.
But result of FNAC has only an amount epithelium cells and RBC. And in the second time maybe a pleomorphic tumor.
Goes through a surgery, the specimen is a malignant submandibular gland tumor, mucoepidermoid carcinoma low-grade.
But MSCT in Hoan my hospital Cantho province proves a slight stenosis 30% of coronary arteries.
In COVID 19 pandemic, he goes around the private clinics with his HTA status and his heart but nothing change.
In May to July 2022 he goes to Medic Can tho and then Medic Hoa Hao Center in HCMC.
An coronary CTA of this second time shows slight stenosis under 30% and slight pericardial effusion but notes a hypertrophic cardiomyopathy of his heart.
At last Cardiac MRI confirms an asymmetrical hypertrophy of the heart.
He gets well with the management of hypertrophic cardiomyopathy.
REFERENCE
A 56 year-old female patient with 6 month constipation and bleeding from her anus for 2 weeks.
Rectal endoscopic result is a hemorrhagic rectal tumor which is far from anal orifice 20 millimeters.
MRI confirms a 53x41 mm tumor of the rectal canal.
A transperineal biopsy with ultrasound-based guiding is done for a 42x48x44mm vascularised solid mixed tumor.
Result of histoimmunology is a GIST tumor of rectum wall.
The female patient is planned for a surgery and chemotherapy.
A 56 year-old female patient with umbilical pain for one week, comes to Binh an hospital after 4 days in constipation.
Ultrasound detects an abscess in RLQ but could not rule out a PID. Although sonologist notes an appendicular abscess but could not reveal the inflammed appendix into the pelvic abscess.
MSCT confirms a 60x80 mm right pelvic abscess contrast captured and edema of the wall of terminal jejunum. The report is pelvic abscess maybe an appendicular abscess.
Endoscopic surgery drained the pelvic abscess and the patient remains well.
A 48 year-old female patient without arterial hypertension signs is incidentally detected a tumor of adrenal gland #20×22 mm by ultrasound.
MSCT confirmes a 16x22 mm left adrenal benign tumor which HU before CE is 69 and HU post CE =26. CE discharge is over 50% that may proove the benignity of the tumor.
4 months after the left adrenal tumor is removed by endoscopic surgery.
A 71 year-old female patient with her history of a liver tumor which was quite difficult diagnosed 5 years before.
She had been go through ultrasound, MSCT and liver biopsy 2 times in 2 other hospitals, but the results were benign hepatic tumor and no clue of infected HCV and HBV.
In Medic Center, ultrasound noted a 50 milimeter right liver hemangioma and MRI with gado was an AML but not ruling out HCC.
But HCC risk tests with WAKO test were positive and positive antiHBe in that time.
After 2 months of the five year before to examine the liver tumor, the HCC diagnosis was made and the tumor was removed surgically when the patient aged 66.
And 5 years went by the female patient remains well. The right lobe of liver exists a fibrosis scar.
The prognosis of HCC patient will be well if an effective management performs successfully in time for the female patient [Acceptable 5-year survival].
A 66 year-old male patient with necrotic periaortic lymph nodes and microscopic blood urine on abdominal ultrasound comes to Medic for a prostate biopsy. PSA value is 1.38mg/mL.
By via TRUS it exists a #55x43x62 mm big prostate, loss its capsule and distorsion of prostatic structure. The hole prostate is noted many hard sites on shear wave elastoultrasound.
12 specimen prostate biopsy performed and 16 items histoimmunopathologic report is a non specialized malignant mesenchymal cell of prostate tumor (PCa) on a chronic TB old inflammed based structure.
This is a rare PCa malignant mesenchymal cell of prostate tumor may happen on 1/1000 cases.
A male patient 56 year-old with one day of pain at left side of abdomen, obesity, and five-year chronic leukemia. His history is noted splenohepatomegaly and cirrhosis and controlled type 2 diabetes.
At Medic Center ultrasound detects free fluid in abdomen and big spleen with hematoma inside which makes thought about a spontaneous spleen laceration without any injured causes in spite of spleen infarction.
Chronic leukemia and obesity and DM maybe the causes of a spontaneous spleen laceration.
Two cases of infected Fasciola hepatica whose larva migrants having in the same time some hepatic lesions and thickening of duodenum (2023) and right colon wall (2017) that are noted at Medic Center.
CASE ONE: A male patient 45 year-old with history of thyroid cancer in 2013 goes to a hospital as nausea, abdominal pain without fever after a ceremony buffet. Ultrasound detects hepatic lesions and MRI later reveals lesions in caudate lobe of liver and duodenum D3 wall thickening that is thought a case of infiltration of lymphoma on GI tract and liver.
REFERENCE:
Ultrasound and Fascioliasis at MEDIC CENTER, Vietnam (slideshare.net) Oct, 21, 2013
A male patient 53 year-old with tumor in right lobe of liver and negative WAKO tests.
Ultrasound notes a 55x42 mm liver tumor in segment 7, nearly homogeneous, well-limited, poor vascularised and elastographic ultrasound SWE harder 5-fold than hepatic parenchyma: 29 kPa in comparison to 6.3 kPa.
MRI with Primovist confirms a 50 milimeter clear cell HCC (CCHCC). T2 CE captured signals are higher than liver parenchyma and lower than on T1.
Biopsy results of tumor is an HCC well differentiazed.
A 47 year-old female patient with a gastric tumor at lesser curvature which is spontaneously revealed by ultrasound.
But gastroendoscopy result is only a gastritis.
Later MSCT confirms a 50x58 mm gastric wall tumor maybe a stomach GIST. The tumor captures CE inhomogeneously and goes out in compression organs around in abdominal cavity.
Surgery removes the gastric tumor and the histopathological result is gastric GIST.
REFERENCE:
A 53 yearale patient with a gastric tumor which is spontaneously evealed
Lab data is normal.
At last, DSA detects 2 renal arteries each side that belongs to a renal artery malformation.
REFERENCE
Renal arteries are a pair of lateral branches from abdominal aorta. Normally each kidney receives one renal artery. However, accessory renal arteries can also exist. The normal renal arteries enter the kidney through its hilum where as the accessory renal arteries might enter the renal artery through the hilum or through the surfaces of the kidney. Knowledge of the variations in the renal arteries is important for urologists, radiologists and surgeons in general.
A male patient 41 year-old with multiple cervical nodes and sore throat as tonsillitis.
Chest X-RAY notes left lung lesion.
Ultrasound detects many lymph nodes # 17-15-13 mm without nodal hilus, solid, hypoechoic on his neck and in the abdomen : at liver hilus :27mm, mesenteric, pelvic: 17-21 mm and a splenomegaly :141mm. Results of ultrasound notes a multiple lymph nodes in cervical, supraclavicular and abdominal region that leads to a diffuse lymphoma.
Biopsies of tonsils and pharyngeal cavum results are lymphoma infiltration without immunohistochemical staining.
ENT examinations results are many lesions of tonsils and oral cavity and Waldayer's ring.
Biopsy of right tonsil ulcer for ruling out cancer and immuohistochemical staining result is diffuse lymphoma type large B cell.
Patient goes through a chemotherapy planning for lymphoma. Cervical nodes reduce their sizes with effective management.
A 45 year-old female patient with right thoracic painful swollen area for 5 months.
Ultrasound detects right pleural effusion, thoracic wall mass which contains rib cartilage destruction, close by pleural wall thickening at 4 th intercostal space, and local lymph nodes.
Chest X-RAY shows right pleural effusion and nothing about thoracic wall.
FNAC and core biopsy of right thoracic wall results think about TB inflammed lesion with ADA raises slightly in right pleural fluid.
So it exists a painful right thoracic wall for 5 months and evidents belongs to a TB infection without primary lung lesion.
It will be planned for a TB regimen in TB and Lung hospital.
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