cases

SALWA   CT of the abdomen and pelvis 10 October 2023: Clinical data: Not provided.  technique: CT Abdomen and Pelvis with IV contrast. Coronal and sagittal reformate were obtained.  Comparison: not available. Findings:  A lobulated heterogeneously enhancing mass is seen in the right upper quadrant (Passaro's triangle) inseparable from the head of the pancreas and second part of the duodenum is noted with area of central necrosis and no evidence of calcification . The mass is avidly enhancing in the arterial phase with persistent enhancement in the portovenous and delayed phases. The mass is measuring ( 2.8 cm CC X 2.7 cm AP X 2.9 cm TT ). No significant regional lymphadenopathy is noted. No CT evidence of invasion into adjacent structures and vasculature. The constellation of findings is suggestive of a neuroendocrine tumor likely of the non-functioning subtype. A well defined hypoenhancing liver lesion is noted in segment VIII / IVa with no enhancement in arterial, portal venous or delayed phases . The lesion is measuring ( 1.3 cm CC X 2.3 cm TT X 2 cm AP ). Likely representing a simple liver cyst.  Another well-defined round liver lesion is noted in segment IVb . The lesion is hypoenhancing in arterial phase with peripheral centripetal filling in portal venous phase and complete filling in delayed phase. Measuring 8 mm in its maximum diameter. Likely representing a typical hemangioma. Otherwise the liver is normal in size with homogeneous parenchyma and irregular outlines with no intrahepatic bile duct dilatation . Grossly unremarkable CBD and portal veins. The small and large bowels are grossly unremarkable with normal wall thickness and enhancement. No mechanical bowel obstruction. No pneumatosis intestinalis.  The spleen, gallbladder, kidneys and adrenal glands are grossly unremarkable.  The urinary bladder is not adequately distended however appears grossly unremarkable. Retroverted and bulky uterus is noted for ultrasound correlation. No free fluid or free air.  No lymphadenopathy according to CT size criteria.  The major abdominal vascular structures are grossly unremarkable.  The scanned part of the chest appears unremarkable.  No suspicious bone lesions.   Mild degenerative changes are noted in the lumbar spine. Conclusion:    Heterogeneously enhancing mass is noted in Passaro's triangle as described above likely representing a non-functioning neuroendocrine tumor. Clinical correlation and further assessment utilizing Nuclear Medicine ( Octreotide scan) and Laboratory investigation is advised. Benign liver lesions are noted as described above. Bulky uterus is noted for ultrasound correlation. N.B This is a preliminary report for further review and approval by Radiology Consultant (Dr. Anwar Al-Ghamdi)     -----------------------------------------------------------------   Ahmad ali 1-751561 CT abdomen and pelvis 10 October 2023: Clinical data: Benign lipomatous neoplasm, right inguinal hernia , for assessment. Technique: CT Abdomen and Pelvis with IV contrast. Coronal and sagittal reformat were obtained.  Comparison: Not available. Findings:  Right-sided indirect inguinal herniation emerging laterally to the inferior epigastric vessels containing fat . The hernia's neck measures 3.2 cm . The hernia is measuring approximately ( 11 cm in CC diameter X 4.5 cm in TT diameter X 4 cm in AP diameter). The small and large bowels are grossly unremarkable with normal wall thickness and enhancement. No mechanical bowel obstruction. No pneumatosis intestinalis. No detectable suspicious masses. No free fluid or free air.  The liver is normal in size with homogeneous parenchyma and regular outlines. No focal lesions or intrahepatic bile duct dilatation. Normal CBD and portal veins.  Apart from a tiny left renal cortical cyst, the spleen, gallbladder, pancreas, kidneys and adrenal glands are grossly unremarkable.  The urinary bladder is not adequately distended however, grossly unremarkable. Enlarged prostate with a suspicious regional lymph node measuring 1.3 cm, for MRI prostate correlation. Multiple rounded calcifications are seen within the left ductus deferens . Could be related to remote insult.  The major abdominal vascular structures are grossly unremarkable.  The scanned part of the chest appears unremarkable.  No suspicious bone lesions. Mild degenerative changes are noted in the thoracolumbar spine. Conclusion:    Fat containing right-sided indirect inguinal hernia as described above, for surgical consultation and management. Enlarged prostate with a suspicious regional lymph node, for prostate MRI correlation. N.B. This is a preliminary report for further review and approval by Radiology Consultant (Dr. Anwar Al-Ghamdi)   ----------------------------------------------------------------------------