Interesting CT cases

DATE : 09/08/2014

compare

• Acute arterial thrombosis of right axillaryartery

• 37 YR

• MALE

• C/O DECREASE VISION

• PITUITARY MACRO ADENOMA

• Male patient

• C/O DECREASE VISION

• Age - withheld

• AGE IS 19 YR

• K/C/O EWING’S SARCOMA

• SKULL BASE AND CERVICAL VERTEBRAL METASTASIS

• FEMALE PATIENT

• C/O EPILESY

HYPERDENSE LESION WITHOUT CONTRAST

• Metastasis - * MRCT * Melanoma/Renal cell Ca/Choriocarcino

• Meningioma• Lymphoma • Medulloblastoma• Glioblastoma• Ependymoma• Colloid cyst (inspissated mucus)• Hemorrhage (acute) / hemorrhagic infarct• Craniopharyngioma• Germinoma

• K/C/O TUBERCULOMA

• 59 YR MALE

• NON SPECIFIC COMPLAIN

• PULMONARY ARTERY ANEURYSM

• The cause of pulmonary artery aneurysm

– Idiopathic

– congenital shunt disease

– syphilis

– atherosclerosis

– trauma

– pulmonary hypertension

– infective

• 52 YR

• FEMALE

• C/O JAUNDICE

• ENHANCING LESION IN DISTAL CBD…………………………CHOLANGIOCARCINOMA

• MALE PATIENT

• C/O HEMETEMESIS

• ESOPHAGEAL VARICES IN A K/C/O PORTAL VEIN THROMBOSIS

Uphill varices

– Collateral blood flow from portal vein via azygosvein into SVC (usually lower esophagus drains via left gastric vein into portal vein)

– Most common cause is portal hypertension secondary to cirrhosis

– Varices in lower half of esophagus to the level of the carina (azygous vein)

– More common than downhill varices

Downhill varices

– Collateral blood flow from SVC via azygos vein into IVC / portal venous system (upper esophagus usually drains via azygos vein into SVC)

– Varices in upper 1/3 of esophagus• Usually extend down to the level of the carina (azygous vein)

– Less common than uphill varices

• Causes– Obstruction of superior vena cava distal to entry of azygos vein

due to• Lung cancer (most common)• Lymphoma• Retrosternal goiter• Thymoma• Mediastinal fibrosis

• YOUNG MALE

• ABDOMINAL PAIN

• GERM CELL TUMOR OF LEFT TESTICLE WITH RPLN

• 22 YR FEMALE PATIENT

• K/C/O RA

• C/O CHEST PAIN AND COUGH

• NAME THE SIGN AND D/D

• The reversed halo sign (RHS), also known as the atoll sign, is defined as central ground-glass opacity (GGO) surrounded by denser consolidation of crescentic (forming more than three fourths of a circle) or ring (forming a complete circle) shape of at least 2 mm in thickness.

• highly specific for cryptogenic organizing pneumonia (COP),

• opportunistic invasive fungal infections (IFI)– pulmonary mucormycosis (PM), – invasive pulmonary aspergillosis (IPA)– paracoccidioidomycosis

• polyangiits with granulomatosis (Wegener's granulomatosis)• sarcoidosis• pneumocystis pneumonia• tuberculosis• community-acquired pneumonia• lymphomatoid granulomatosis• lipoid pneumonitis• pulmonary neoplasms• pulmonary infarction• following radiation therapy and radiofrequency/microwave ablation

of pulmonary malignancies

• 35 YR

• MALE

• Acute arterial thrombosis of right internal iliac artery

• 25 yr FEMALE

• C/O DIFFICULTY IN DEFECATION

• MUCINOUS ADENOCARCINOMA RECTUM

differentials

• Rectal neoplasm

• SRUS- solitary rectal ulcer syndrome

• MALE PATIENT

• H/O WITHHELD

• CAVITORY NODULES

• Differentials?

• K/C/O OSTEOSARCOMA

Differentials for cavitory lung lesion

• CAVITY• Mnemonic• C - cancer

– bronchogenic carcinoma - most frequently SCC– cavitatory pulmonary metastasis(es) - again most frequently SCC

• A - autoimmune; granulomas from– Wegener's granulomatosis– rheumatoid arthritis (rheumatoid nodules) etc..

• V - vascular (both bland and septic pulmonary embolus)• I - infection (bacterial/fungal)

– pulmonary abscess

• T - trauma - pneumatocoeles• Y - youth

– CPAM– pulmonary sequestration– bronchogenic cyst

• SPOTTER

• FRACTURE LT CONDYLE OF MANDIBLE

• THANK YOU