tổng hợp hình ảnh ct bụng

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Nam 28 tuổi với đau HC(P)
Đại tràng lên
Khối cạnh ĐT kèm thậm nhiểm
Thậm nhiễm quanh ĐT
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Vieõm ruoọt thửứa laùc choồ.
Brief review of Epiploic Appendagitis Rare inflammatory and
ischemic condition Results from torsion or spontaneous venous
thrombosis of one of the appendices epiploicae ischemia or
infarction of the appendix epiploica & localized inflammation
Sudden, severe, focal abdominal pain, mimic other conditions
such as appendicitis.
Can be managed conservatively CT: 1- 4-cm, oval, fatty
pericolic lesion with surrounding mesenteric inflammation
Adjacent cecal wall thickening and compression Rarely, a
central high-attenuation "dot" within the inflamed appendage;
corresponds to the thrombosed vein (17).
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Diffuse largeB-cell lymphoma
Brief review of round solid
mesenteric masses Malignant
solid tumors have a tendency to
be located near root of mesentery
benign solid tumors in periphery
near bowel! 1. Metastases
especially from colon, ovary (most
frequent neoplasm of mesentery)
2. Lymphoma 3.
Leiomyosarcoma (more frequent

than leiomyoma) 4. Neural tumor
(neurofibroma, ganglioneuroma)
5. Lipoma (uncommon),
lipomatosis, liposarcoma 6.
Fibrous histiocytoma 7.
Hemangioma 8. Desmoid tumor
(most common primary)
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60/M
Chief complaint: jaundice, fever and
chill
*not hach
*day thanh
Figure(s)
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Gallbladder carcinoma
Brief review of gallbladder carcinoma Most common biliary
cancer Associated with: (1) Gallstones in 64 - 98%
Gallbladder carcinoma occurs in only 1% of all patients with
gallstones! (2) Porcelain gallbladder (in 4 - 60%) (3)
Inflammatory bowel disease (predominantly ulcerative colitis)
(4) Familial polyposis coli (5) Chronic cholecystitis Growth
types: replacement of gallbladder by mass (37 - 70%)
focal / diffuse asymmetric irregular thickening of GB wall (15 -
47%) polypoid / fungating intraluminal mass with wide base
(14 - 25%) Differential diagnosis see note below
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45/M

Chief complaint: general weakness
Figure(s)
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Addison disease caused by adrenal tuberculosis
Brief review of addison disease
= Primary adrenal insufficiency 90% of adrenal cortex must be destroyed!
Cause:
1. Idiopathic adrenal atrophy (60 - 70%): likely autoimmune disorder

2. Granulomatous disease: tuberculosis, sarcoidosis
3. Fungal infection: histoplasmosis, blastomycosis, coccidioidomycosis 4.
Adrenal hemorrhage: anticoagulation therapy, bleeding, coagulation
disorders, sepsis, shock
5. Bilateral metastatic disease (rare) Diminutive glands (in idiopathic
atrophy + chronic inflammation) Enlarged glands (acute inflammation,
acute hemorrhage, metastasis
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These are images from contrast-
enhanced abdomen CT. There is
a large, round mass between the
right hepatic lobe and the
duodenum. The mass is well
encapsulated. Majority of the
mass shows fat attenuation and
geographic or tread-like areas
with soft tissue attenuation are
scattered between them. The
duodenum and the pancreas are
displaced by the mass but look

clearly separated from the mass.
What are the differential
diagnoses?
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AnswerMyxoid liposarcoma
Brief review of myxoid liposarcoma most common type
of liposarcoma varying degrees of mucinous
+ fibrous tissue
+ relatively little lipid intermediate differentiation CT
solid pattern: inhomogeneous poorly marginated
infiltrating mass mixed pattern: focal fatty areas
+ areas of higher density pseudocystic pattern: water-
density mass calcifications in up to 12% DDx: malignant
fibrous histiocytoma, leiomyosarcoma, desmoid tumor
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M/40
chief complaint:
jaundice
PTC
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Percutaneous transhepatic cholangiography shows
multiple ovoid filling defects in dilated intrahepatic
bile ducts. Focal stricture is noted in right main
IHD. What are the differential diagnoses?
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Clonorchiasis of the liver
Brief review of clonorchiasis of the liver Endemic Country: Japan,
Korea, China, Taiwan, Indochina Organism: Chinese liver fluke =
Clonorchis sinensis Pathology (a) desquamation of epithelial bile

duct lining with adenomatous proliferation of ducts + thickening of
duct walls (inflammation, necrosis, fibrosis) (b) bacterial
superinfection with formation of liver abscess Remittent incomplete
obstruction + bacterial superinfection Multiple crescent- / stiletto-
shaped filling defects within bile ducts Complication (1) Bile duct
obstruction (conglomerate of worms / adenomatous proliferation (2)
Calculus formation (stasis / dead worms / epithelial debris) (3)
Jaundice in 8% (stone / stricture / tumor) (4) Generalized dilatation
of bile ducts (2%)