Case of the Week From 7/31/22

History: Lung screening CT scans. 1st case is from October, 2021. 2nd case is from November, 2021. 3rd case is from June, 2022
Based on the ELCAP criteria for lung screening, what would you have recommended after the first two scans?  6 month followup. (non-malignant growth rate)
Based on the ELCAP criteria for lung screening, what would you have recommended after the third scan? PET-CT scan.

1st case                                                                                                                                                                                                2nd case

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

3rd case

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Case of the Week From 7/24/22

History: Status post trauma Hit head and chest after a fall.
What are all the findings? Punched out lesions in the calvarium. Lytic right glenoid lesion. Expansile lytic right 10th rib lesion.
What is the most likely diagnosis? Multiple myeloma. Less likely mets.

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Case of the Week From 7/17/22

History: Abdominal pain.
Describe the relevant findings. Infiltrative mass extending from the right lower pole to the right mid kidney. Slightly heterogeneous spleen.
What is the most likely diagnosis and why? Consider most likely lymphoma given infiltrative appearance and splenic findings. Differential includes less likely transitional cell carcinoma. Not typical appearance for renal cell carcinoma or infection.

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Case of the Week From 7/10/22

History: Shortness of breath. First CT scan is from 3 months ago. Second CT scan from today.
What are the findings on the first study? Multiple cavitary nodules and nodules bilaterally
What has changed between the two studies? Cavitary nodules have resolved and nodules are overall smaller.
What is the differential and most likely diagnosis? Given rapid improvement consider most likely infectious etiology like tuberculosis, fungal, or granulomatous/inflammatory diseases. Metastatic disease is less likely.

 

 

 

 

Case of the Week From 7/3/22

History: 22 year old with a pancreatic lesion
What are the findings on today’s study? Pancreatic body/neck lesion (1 cm) with low T1 signal and mildly high T2 signal and minimal if any enhancement.  Hypodense lesion on CT scan at same location with minimal enhancement
What is the differential diagnosis and most likely diagnosis? Differential for pancreatic lesions includes- solid pseudopapillary neoplasm (SPN), pancreatic neuroendocrine tumor (NET), pancreatic cystic neoplasms. Most likely diagnosis in this age group is SPN.
What is the treatment for the most likely diagnosis? Close interval followup MRI (every 3 months) or endoscopic ultrasound if higher clinical suspicion for other diagnoses.