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Tuesday, 31 March 2015

CASE 303: INGUINAL SCARPA TUMOR, Dr PHAN THANH HẢI, MEDIC MEDICAL CENTER, HCMC, VIETNAM

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Woman  61 yo  detected  at right inguinal  scarpa a  small tumor  slowly  growth, no  painful,  size of  about  one egg. Clinical palpation was  subcutaneous, hard nodule,  fixed  to  deep  layer.
Ultrasound scanned it was  a round mass , size of 5 cm in diameter,  well-bordered, inside  structure  was  solid and inhomogeneous  ( US picture 1).






 Doppler  scanning  detected  hypervascular  with  hilus,  vascular supplying  of a lymph node (US picture 2), and   Doppler spectrum  of  hilus artery  was  pulsatile , V1= 52 cm/s and  RI=0.6.
  




Elastography ultrasound  was a soft mass, inhomogeneous structure.





Sonologist  cannot  find another abnormal  lymph node at  another  side, and report  suspected  inflammation  lymph node.


Blood tests  WBC, CRP, beta2 microglubuline  were  normal.


Core biopsy with immunohisto staining report was lymphoma.



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1 comment :

Dr. Hai Phuong said...

The enlarged lymphoid nodule have well-defined margin and still remains hilum on Doppler imaging although it's not visible on 2D mode. This suggests a benign sistuation than malignancy. With adjacent soft tissue oedema,hypervascular heterogeneous echotexture soft mass indicates necrotic lymph node.
My initial diagnosis is TB necrotic lymphnode due to patient's painless history.