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Monday, 17 June 2019

CASE 555 :R_CCA Obstruction, Dr PHAN THANH HAI, Dr DUONG XUAN TUNG, Dr PHAN THANH HAI PHUONG, Dr LE THI THANH THAO, MEDIC MEDICAL CENTER, HCMC, VIETNAM.


Woman 66yo with past history  of 10 years ago had been treated by radiation of the neck as NPC.
Now her chief complaint is headache.

ULTRASOUND OF THE NECK   DETECTED R CCA OBSTRUCTION  COMPLETELY BUT R/ECA STILL HAD FLOW.
US1, US2, US3 =  R -CERVICAL ARTERY  HAD FLOW UP.




MSCT ANGIO OF THE NECK ARTERY.

CT1   ( DISCONTINUE RCCA )  CT2   CERVICAL SINE ARTERY  
CT3  3 D  VASCULAR OF THE NECK  WITH ANASTOMOSIS.




CONCLUSION= RADIATION OF THE NECK INDUCED STENOSIS of  R-CCA.

REFERENCE  CASE REPORT

Sunday, 2 June 2019

CASE 554: PULMONARY AVM, Dr PHAN THANH HAI, Dr TRAN THUY TRANG, MEDIC MEDICAL CENTER, HCMC, VIETNAM.


A 40 YO WOMAN in ANNUAL HEALTH CHECK UP, SHE HAS RECOGNIZED DULL LEFT CHEST PAIN FOR MANY YEARS.

US1: IN CROSSED SECTION OF SPLEEN AND LEFT LOWER PULMONARY LOBE INCIDENTALLY NOTES THAT A CYSTIC LESION IN LOWER LEFT LUNG TISSUE AND PLEURAL EFFUSION.



US2:  CDUS IN THIS CYSTIC LESION REPRESENTS YIN-YANG SIGN.


US3: SPECTRAL DOPPLER TRACE FROM THIS CYSTIC CONFIRMING ARTERIAL BLOOD FLOW.



US 4, US 5: THERE IS A PULMONARY ARTERIAL AND VENOUS FLOW BESIDE THE CYST.



MSCT CE:
CT1, CT2: FRONTAL VIEW CONFIRMS AN ANEURYSM IN THE LEFT LOWER LOBE WITH AN FEEDING ARTERY AND A DRAINING VEIN.


RADIOLOGICAL DIAGNOSIS IS A PULMONARY ARTERIOVENOUS MALFORMATION CASE.

OPEN SURGERY REMOVED LOWER  LOBE OF LEFT LUNG AND THE PULMONARY AVM.

MICROSCOPIC REPORT IS HAEMORRHAGE OF PULMONARY VASCULAR CONGESTION.



Conclusion:
This is a pulmonary AVM case incidentally found out in a pleural effusion that was discovered by ultrasound and confirmed by MSCT later.

Saturday, 1 June 2019

CASE 553: MANTLE CELL LYMPHOMA, DR PHAN THANH HAI, MEDIC MEDICAL CENTER, HCMC. VIETNAM.


Woman 40 yo, 2 years ago  detected at left frontal  area over eye brow a tumor slow growth, no pain  hard palpation (photo).




CT scan of the head,  this tumor is out of skull bone  below the skin  3 cm.
CT1 CT2 with ce,  this tumor had ce enhancement  



Ultrasound of this tumor.
US 1  with Bmode  this mass is hypoechoic very black look like a cyst,   with mirror effect  ( us 1)  US2  cdi  it had vascular    
US 3  with pdi   detected vasculature intra tumor  US4  with SMI many small vascular







US 5  video of SMI.

Ultrasound suspected lymphoma.
Open surgery removed this tumor and histology with immuno histo chemystry is  MANTLE CELL LYMPHOMA.

NOTA: Mantle cell  is  cell  from the mantle zone of lymph node.