Radiology patient cases

Today’s cases: October 25th, 2015

These are a selection of today’s cases:
1. Lumbar canal stenosis, spur pressing on canal, strongest at L3/4 in this pt (may not be shown in random image below, herniation of lumbar disk). The radiologist said this looked similar to the previous study.


2. 37 y.o., fever, back pain, tongue cancer with bone metastasis, paravertebral abscess, sometimes this goes unnoticed, CT drainage of abcess


3. Advanced gastric cancer, stenting easier than a bipass, invasion of colon, , cancer derived peritonitis, edematous descending and transverse colon due to cancer invasion, no liver metastasis, need stent b/c if there is an obstruction – could lead to vomiting and death – or ileus.

CT scan of abdomen showing massive ascites


4. Female 26 y.o., Rt knee, OA degenerative change, ACL injury, medial and lateral meniscus mostly clear, small amount of joint effusion which is normal, synovial membrane looked ok

 


5. Maxillary sinus cancer after radiation therapy, ethmoid sinus, lumph nodes were ok

A Unilateral Maxillary Sinus Tumor


6. 81 y.o. female from clinic, low O2 sats, left bronchus obstruction by lesion, cancer left main bronchus obstructed, left sided mass, upper lobe of bronchus, narrowing but open, lower bronchus completely obstructed, enlarged peripheral bronchus, Primary lung cancer or metastatic? Probably primary – derived from pharyngeal area/trachea, often squamous, always think of the ORIGIN, most common lung cancers are adenocarcinomas, then squamous, then small/large -rare. So, primary lung cancer. LUNG and BREAST love bone…so need to check these out too.

Adenocarcinoma

Adenocarcinoma


7. 53 y.o. male, pharyngeal cancer, post-radiological and chemotherapy recurrence, difficult to treat (can’t – only get ONE chance), near the brain, spreads, cannot guage deepness, skull base, The pharyngeal (or superficial) mucosal space is a tough area to treat, clivus.


8. Parotid gland cancer, after metastasis to axilla, parotid gland cancer (primary), same – no change after one month…but loks like it is gradually shrinking, PET CT shows more clearly what is going on – malignant area is brighter – thin on CT, lungs look ok.


9. Post tib-fib fracture operation, check fusion, fracture line disappeared (good), cortex attached, and good remodeling

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