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Monday, 30 December 2019

CASE 578: CYSTIC TERATOMA OF THE LUNG, Dr PHAN THANH HAI, Dr NGUYEN TUAN VU, MEDIC MEDICAL CENTER, HCMC, VIETNAM.


WOMAN 29YO  WITH RIGHT LUNG  PAIN.    
CARDIAC ULTRASOUND DETECTS NORMAL HEART  AND A BIG MASS  COVERED RIGHT LUNG  ( US1).   





US 2 : THE MASS IS ROUND WITH SIZE 30CM.





US 3 : CDI  NO VASCULAR IN TUMOR .



US 4 : ELASTO  IS SOFT   LIKE A CYST  NO SEPTATION NO HARD TISSUE.




CHEST X-RAYS= THIS MASS COVERED THE RIGHT LUNG  NO PLEURAL  FLUID.


CT OF THE LUNG    
CT1 : SAGITTAL VIEW, THIS MASS IS INSIDE RIGHT LUNG
CT2  : CROSSED SECTION,   THIS CYSTIC  CONTENT IS VISCEOUS FLUID.


Operation  removed this cyst with chocolate fluid.



Reference


  
SUMMARY  =  CYSTIC TERATOMA OF THE LUNG.

Monday, 16 December 2019

CASE 577: TOS (THORACIC OUTLET SYNDROME), Dr PHAN THANH HAI, MEDIC MEDICAL CENTER, HCMC, VIETNAM.

MAN 52 YO WITH  PAIN AND COLD FEELING OF RIGHT HAND.


ULTRASOUND   DETECTED NO PULSE AT RADIAL ARTERY  AND THROMBOSIS OF HUMERAL ARTERY JUST TO SUBCLAVICULAR ARTERY WITH DILATATION  AND ZIN-ZANG FLOW.



MSCT ANGIO  SHOWED STENOSIS AT RIGHT  SUBCLAVICULAR ARTERY DUE TO RIGHT CERVICAL RIB  C7 COMPRESSION.





CONCLUSION=  THORACIC OUTLET  SYNDROME  WITH COMPLICATION OF THROMBOSIS ARTERY.


OPERATION FOR  RESECTION OF THE RIB  AND REMOVING OF THROMBUS.

REFERENCE :


Thursday, 5 December 2019

CASE 576:ECTOPIC LIVER TISSUE or ADRENAL TUMOR, Dr PHAN THANH HAI, MEDIC MEDICAL CENTER, HCMC,VIETNAM.

Man 46yo in general check- up by  CT total body was detected a tumor # 3 cm at right adrenal area.
CT 1  crossed section  the tumor near the liver border  
CT 2  tumor near pancreas head  
CT 3  frontal view  the tumor  3 cm far from upper pole R renal  near IVC.





Ultrasound  detected  this mass well bordered, solid structure, d #  3 cm  (US 1, US 2,  US 3).




CT and ultrasound  diagnostics are adrenal tumor  
Blood test  is normal hormone from adrenal gland
Laparoscopic surgery in retroperitoneum removed this tumor ( pictures ope, and macro 1, macro 2).


.

Microscopic report is liver tissue.


Summary : It is an ectopic liver tissue in adrenal area.

REFERENCE CASE STUDY



Saturday, 30 November 2019

CASE 575: LYMPH NODE TUBERCULOSIS, Dr PHAN THANH HAI, MEDIC MEDICAL CENTER, HCMC, VIETNAM.

MAN 35 YO  PAIN AT   PERIUMBILICAL  AREA OF ABDOMEN.
US SCAN   
US 1:  ONE MASS  NEAR LEFT SITE OF  UMBILICUS  WITH  SANDWICH SIGN.


US 2: MANY LYMPH NODES HYPOECHOIC,  SIZE 2-3 CM  WITH STRUCTURE CHANGE AND NO HILUS.


US 3: SAME  STRUCTURE  OF LYMPH NODE IN MESENTERIUM.


US 4: 2 BIG LYMPH NODES AT THE LEFT SUPRACLAVICULAR AREA.



CHEST X-RAYS SUSPECTED TUBERCULOSIS AT RIGHT LUNG.



CT SCAN OF ABDOMEN WITH CE    

CT 1= FRONTAL VIEW OF ABDOMEN, THIS MASS IS  NEAR ABDOMINAL AORTA.


CT 2 = CROSSED SECTION.



CT 3  = FRONTAL VIEW OF THE LUNG 





BIOPSY REPORT OF THE BIG LYMPH NODE AT THE L NECK IS TUBERCULOSIS.




SUMMARY=  MULTIPLE LYMPH NODES APPEAR SAME TIME WITH LUNG TUBERCULOSIS.

Sunday, 24 November 2019

CASE 574: THORACIC WALL HERNIA, Dr PHAN THANH HAI, Dr TRAN MINH DUNG, MEDIC MEDICAL CENTER, HCMC, VIETNAM.

MAN  52 YO  3 MONTHS AGO,  PAIN AT L THORACIC NEAR  L BREAST NIPPLE   AFTER TRAUMA, COUGH MAKING VERY PAIN AND  L BREAST GETTING BIGGER LOOK LIKE TUMOR   (PHOTO 1: NORMAL BREATH, PHOTO 2  AFTER COUGHING and  VIDEO CLIP in COUGHING).








ULTRASOUND  AT  LEFT THORACIC WALL  DETECTED  ONE  MIXED STRUCTURE MASS  BY RUPTURE OF THE THORACIC WALL MUSCLE  WITH FLUID ( US 1).  



US 2: THE  HERNIA  OF THE LEFT LUNG TO THIS AREA IS SEEN  CLEARLY BY COUGHING , BUT IN NORMAL BREATH  THIS HERNIA IS COVERED BY HYPERECHOIC  STRUCTURE MASS ( US 3)




MSCT OF THE LUNG WITH VALSALVA  MANOEUVRE   DETECTED  INTERCOSTAL MUSCLE  RUPTURE AND  HERNIA FROM THE LUNG GOING OUT   ( CT1 CT2 CT3)



SUMMARY = THIS CASE IS THORACIC WALL HERNIA AFTER TRAUMA.  THE PATIENT HAD BEEN OPERATED FOR REPAIRING THE THORACIC WALL HERNIA BY PROTHESIS.

Sunday, 17 November 2019

CASE 573: BILIARY HAMARTOMA, Dr PHAN THANH HAI, MEDIC MEDICAL CENTER, HCMC, VIETNAM.

WOMAN 51 YO FOR 5 YEARS CHOLECYSTECTOMY BY GALL BLADDER  STONE, NOW GETTING PAIN IN LIVER.

US SCANNING : GALL-BLADDER HAD BEEN REMOVED. CBD DILATED   OF 3CM IN DIAMETER   WITH DILATATION R/L BILIARY DUCTS IN LIVER  AND  THERE  ARE SOME  SMALL SPOTS LIKE CYST 0.5 CM.  CBD  IS  STENOSIS AT ODDI AREA  AND NO TUMOR OF PANCREAS.
US1   BW US   US2 CDI 



MRI OF LIVER   
MRI1  CROSSED SECTION OF LIVER   
MRI2   CBD DILATED WITH MANY SPOTS  LIKE CYST IN LIVER   THAT  ARE HAMARTOMA OF BILIARY CANALS.



ERCP  lCANNOT  ENTER THE CBD  (FOTO1, FOTO2)



OPERATION  REPORT   IS  CYST OF CBD AND STENOSIS  OF CBD AT ODDI SPHINTER.
 AND MANY SMALL NODULES AT SURFACE OF LIVER  BIOPSY (lFOTO CBD).


PROCEDURE  IS ROUX EN Y  FOR  ANASTOMOSIS OF CBD AND  DUODENUM.

CONCLUSION =IT IS  HAMARTOMA OF BILIARY SYSTEIM  WITH STONE STENOSIS OF CBD AND MANY SMALL LIKE -CYSTS OF BILIARY SYSTEM.