Case of the Week For 9/27/20
History: Palpable supraclavicular lump.
What are the findings? Circumscribed lesion with T2 bright signal and T1 intermediate signal abutting the acromioclavicular joint.
What is the differential/most likely diagnosis? Most likely a synovial cyst. Synovial carcinoma unlikely given benign homogeneous circumscribed features.
What would you recommend next? Correlate with symptoms. Recommend ortho consult/clinical followup. Can impinge upon adjacent structures.
Case of the Week For 9/20/20
History: History of multiple myeloma. On chemotherapy. Diplopia.
What are the findings? Decreased attenuation at the posterior cerebrum on CT scan. High FLAIR Signal on MRI at the posterior gray matter/gray white matter junction.
What is the differential/most likely diagnosis? Most likely diagnosis-PRES (Posterior Reversible Encephalopathy Syndrome). Differential diagnosis also includes less likely encephalitis.
What would you recommend next? Clinical followup. Followup MRI.
Case of the Week For 9/13/20
History:History of prostate cancer.
What are the findings? Focal thickening of the left distal ureter with narrowing of the lumen with contrast distal to the site of narrowing and no complete mechanical obstruction (partial obstruction possible). Left hydronephrosis with delayed nephrogram.
What is the differential diagnosis? Distal left ureteral stricture/scarring/inflammation vs primary ureteral mass.
What would you recommend next? Consider retrograde ureterogram for further evaluation of the ureter.
Case of the Week For 9/6/20
History: Status post partial pancreatectomy for insulinoma. Followup.
What are the findings? Middle portal venous thrombus. Residual collection at the pancreatic tail.
What should you tell the surgeon? Middle portal venous thrombosis. Consider thrombolysis.
