This document contains descriptions of various interesting CT scan cases seen at a hospital, including: 1) A 37-year-old male presenting with decreased vision who was found to have a pituitary macroadenoma. 2) A 19-year-old patient with a history of Ewing's sarcoma found to have skull base and cervical vertebral metastases. 3) Descriptions of various differentials for cavitary lung lesions in a patient with a history of osteosarcoma, including cancer, granulomas, vascular causes, infection, and developmental abnormalities.

1. Interesting CT cases
DATE : 09/08/2014

2. compare

3. • Acute arterial thrombosis of right axillary
artery

5. • 37 YR
• MALE
• C/O DECREASE VISION

9. • PITUITARY MACRO ADENOMA

10. • Male patient
• C/O DECREASE VISION
• Age - withheld

16. • AGE IS 19 YR

17. • K/C/O EWING’S SARCOMA
• SKULL BASE AND CERVICAL VERTEBRAL
METASTASIS

18. • FEMALE PATIENT
• C/O EPILESY

23. HYPERDENSE LESION WITHOUT
CONTRAST
• Metastasis - * MRCT * Melanoma/Renal cell
Ca/Choriocarcino
• Meningioma
• Lymphoma
• Medulloblastoma
• Glioblastoma
• Ependymoma
• Colloid cyst (inspissated mucus)
• Hemorrhage (acute) / hemorrhagic infarct
• Craniopharyngioma
• Germinoma

24. • K/C/O TUBERCULOMA

25. • 59 YR MALE
• NON SPECIFIC COMPLAIN

31. • PULMONARY ARTERY ANEURYSM

32. • The cause of pulmonary artery aneurysm
– Idiopathic
– congenital shunt disease
– syphilis
– atherosclerosis
– trauma
– pulmonary hypertension
– infective

33. • 52 YR
• FEMALE
• C/O JAUNDICE

36. • ENHANCING LESION IN DISTAL
CBD…………………………CHOLANGIOCARCINOMA

37. • MALE PATIENT
• C/O HEMETEMESIS

41. • ESOPHAGEAL VARICES IN A K/C/O PORTAL
VEIN THROMBOSIS

42. Uphill varices
– Collateral blood flow from portal vein via azygos
vein into SVC (usually lower esophagus drains via
left gastric vein into portal vein)
– Most common cause is portal hypertension
secondary to cirrhosis
– Varices in lower half of esophagus to the level of
the carina (azygous vein)
– More common than downhill varices

43. Downhill varices
– Collateral blood flow from SVC via azygos vein into IVC / portal
venous system (upper esophagus usually drains via azygos vein
into SVC)
– Varices in upper 1/3 of esophagus
• Usually extend down to the level of the carina (azygous vein)
– Less common than uphill varices
• Causes
– Obstruction of superior vena cava distal to entry of azygos vein
due to
• Lung cancer (most common)
• Lymphoma
• Retrosternal goiter
• Thymoma
• Mediastinal fibrosis

44. • YOUNG MALE
• ABDOMINAL PAIN

48. • GERM CELL TUMOR OF LEFT TESTICLE WITH
RPLN

49. • 22 YR FEMALE PATIENT
• K/C/O RA
• C/O CHEST PAIN AND COUGH

53. • NAME THE SIGN AND D/D

54. • The reversed halo sign (RHS), also known as
the atoll sign, is defined as central ground-
glass opacity (GGO) surrounded by denser
consolidation of crescentic (forming more
than three fourths of a circle) or ring (forming
a complete circle) shape of at least 2 mm in
thickness.

55. • highly specific for cryptogenic organizing
pneumonia (COP),

56. • opportunistic invasive fungal infections (IFI)
– pulmonary mucormycosis (PM),
– invasive pulmonary aspergillosis (IPA)
– paracoccidioidomycosis
• polyangiits with granulomatosis (Wegener's granulomatosis)
• sarcoidosis
• pneumocystis pneumonia
• tuberculosis
• community-acquired pneumonia
• lymphomatoid granulomatosis
• lipoid pneumonitis
• pulmonary neoplasms
• pulmonary infarction
• following radiation therapy and radiofrequency/microwave ablation
of pulmonary malignancies

57. • 35 YR
• MALE

59. • Acute arterial thrombosis of right internal iliac
artery

60. • 25 yr FEMALE
• C/O DIFFICULTY IN DEFECATION

62. • MUCINOUS ADENOCARCINOMA RECTUM

63. differentials
• Rectal neoplasm
• SRUS- solitary rectal ulcer syndrome

64. • MALE PATIENT
• H/O WITHHELD

66. • CAVITORY NODULES
• Differentials?
• K/C/O OSTEOSARCOMA

67. Differentials for cavitory lung lesion
• CAVITY
• Mnemonic
• C - cancer
– bronchogenic carcinoma - most frequently SCC
– cavitatory pulmonary metastasis(es) - again most frequently SCC
• A - autoimmune; granulomas from
– Wegener's granulomatosis
– rheumatoid arthritis (rheumatoid nodules) etc..
• V - vascular (both bland and septic pulmonary embolus)
• I - infection (bacterial/fungal)
– pulmonary abscess
• T - trauma - pneumatocoeles
• Y - youth
– CPAM
– pulmonary sequestration
– bronchogenic cyst

68. • SPOTTER

71. • FRACTURE LT CONDYLE OF MANDIBLE

72. • THANK YOU