A 67 year-old male patient with multinodular goiter in reexamination.
Ultrasound Medic revealed a cystic lesion with air inside that was in posterior of right thyroid lobe. The lesion may be mimicking a calcified thyroid nodule in right lobe.
CT with CE confirmed the cyst captured contrast media which is in connection to esophagus on the right side. A Zenker's diverticulum was noted.
A 66 year-old male patient (170 cm height, 64 kg weight) with thoracic pain was suffering from arterial hypertension [164/84 mmHg, BP 64b/min] for 3 years, and diabetes mellitus for 2 years.
Ultrasound detected aliasing artifact from right common iliac artery [r CIA] which has been a dissection aneurysm # 34x23x20mm with 2 lumens. The peak systolic velocity (PSV) of the false lumen of right CIA was lower than the true one. It existed atheromatic plaques in the abdominal artery [AA] wall, but it [AA] was not aneurysm. A note of arterial aneurysm dissection of the right common iliac artery [r CIA] was made.
MSCT confirmed the 19x7 mm isolated right common iliac artery dissecting.
DISCUSSION and CONCLUSIONS
Isolated common iliac artery dissection is a very rare disease which is detected by chance. The possible causes included atherosclerosis, fibromuscular dysplasia, connective tissue disease, trauma and pregnancy.
It is certainly wherever to look for an arterial aneurysm in a hypertensive old patient in routine workflow not only for abdominal aorta (AAA) but also for other arteries and its branches or inside any abdominal organes.
DISCUSSIONS
Case 1= Pneumomediastinum
Case 2= Fracture of left clavicule
Case 3 = Sealed - off right pleural effusion
Ultrasound could find out the abnormalities of 3 cases above but it need to confirm the diagnosing for them by other imaging modalities.
A 56 yo male patient undergoes hoarse voice for 6 months after screaming, now out of breath talking loud voice.
Laryngoscopy= Left apical arytenoid cartilage incompletely closed.
Cardiac ultrasound detected descending thoracic aneurysm witth aortic wall lesions.
MSCT confirmed atresia of left vocal cord and descending thoracic aneurysm in saccular form, non dissecting.
The recurrent laryngeal nerve RLN *from vagus nerve * supplies muscles of the larynx with the posterior and lateral cricoarytenoid.
In the case, descending thoracic aneurysm with aortic wall lesions may damaged the left RLN nearby which makes him the hoarse voice.
A 43 yo female patient found herself a mass of left thoracic wall for one month. It is painful when she palpates it and moves her left arm.
Mammography and breast US in Vietnam detected nothing abnormal. PET-CT in Singapore was normal.
Female patient 55yo loss of weight 7 kg for 4 months with bad feelings of contracting her muscle trying to empty her bowels. There was no blood stool, but existing abnormal uterine bleeding. Digital rectal exam revealed a rigid, mobile mass at posterior wall that suggested a rectum cancer which took part of 1/3 of lumen of the rectum.
MSCT whole body detected thickening of rectum wall that adhered uterus, captured contrast and blurred fatty tissue around. Results confirmed a rectum cancer invading around with some pelvic lymph nodes.
