Case of the Week From 9/25/2022
History: Screening.
What has changed between the two studies? New skin thickening at both breasts with increasing density.
What is the differential diagnosis? Bilateral Skin Thickening- CHF/renal failure/systemic edema/anasarca, dermatological conditions, burns, bilateral/systemic lymphatic disease. Cancer/mastitis/trauma are usually unilateral but not always!
2 years ago
Present day
Case of the Week From 9/18/2022
History: Chest pain.
Describe the findings: Rounded mass at the right lung base overlying the right hemidiaphragm. Circular fatty density at the right lung base without clear attachment to the pleural space, chest wall or diaphragm on CT scan. There is also a large hiatal hernia!
What is the differential diagnosis of the main finding? Hamartoma, pleural lipoma, or eventration of the right hemidiaphragm.
What is the best/simplest way to make the final diagnosis? Ask for coronal and sagittal CT reconstructions!
Case of the Week From 9/11/2022
History: Chest pain.
Describe the findings:Rounded peripherally calcified mass adjacent to the left main coronary artery.
What is the most likely diagnosis? Left main coronary arterial aneurysm.
How rare is this finding? 0.1% of all patients that undergo routine angiography.
How is this treated? anticoagulation or bypass/ligation depending upon additional coronary artery disease/stenoses.
Case of the Week From 9/4/2022
History: Splenic mass.
Describe the findings: Isodense splenic mass with slightly increased FDG uptake. Acompanying mild peripheral enhancement on MRI and slightly increased signal on T2 weight imaging. Not typically nodular peripheral enhancement like a hemangioma
What is the differential diagnosis? Differential diagnosis can include hemangioma (some are FDG avid and others are not), lymphoma, or metastatic disease.
What should you do next and why? Hemangioma/ tagged red blood cell scan can be performed because it is large enough to make a diagnosis and prevent biopsy if positive for hemangioma
