November 2022 Cases Of The Week

Case of the Week From 11/27/2022

History: History of liposarcoma. First series of films from 5 years ago. Second series of films from today.
What are the findings? Enlarging left axillary lipomatous mass with a clip.
What do you do next? Recommend MRI for pre surgical planning/further evaluation of extent of lesion.
What is the most likely diagnosis? Recurrent liposarcoma.

5 years ago

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Today

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Case of the Week From 11/20/2022

History: History of lymphoma. Hip pain.
What are the findings? Hypermetabolic left iliac wing lesion with anatomic abnormality on CT scan. Increased marrow edema/infiltration on MRI.
What do you do next? Consider bone scan. Multifocal lesions can highly suggest recurrent disease.
What is the most likely diagnosis? Recurrent lymphoma. Other less likely etiologies can include infection/inflammation/trauma/stress reaction.

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Case of the Week From 11/13/2022

History: Wrist pain.
What are the findings and the name of the structure affected? Increased signal at the abductor pollicis longs with mild thickening and adjacent edema. Chronic erosion just adjacent to the radial styloid process on plain film.
What are the symptoms with this etiology and the name of the disease entity? De Quervain tenosynovitis. Focal swelling and tenderness over the radial styloid. Pain on passive ulnar deviation of the wrist.

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Case of the Week From 11/6/2022

History: 80 year old with rheumatoid arthritis. First chest film is from today. Second chest film is from 10 years ago.
What are the findings? Right medial basilar new opacity with with adjacent tenting of the right hemidiaphragm and volume loss
What is the most likely diagnosis and how should it be managed? Right middle lobe collapse. Most likely diagnosis is mucous plugging. Other etiology that is less likely but within the differential diagnosis is a mass with right middle lobe collapse. Short term followup chest film can be performed if there is low clinical suspicion for malignancy. CT scan through the chest can be performed if there is a high clinical suspicion for malignancy.