The document discusses mediastinal masses. It begins by defining the mediastinum and its boundaries. It then discusses approaches to evaluating mediastinal masses including distinguishing their location based on chest x-ray findings. Common masses are then reviewed for each compartment - anterior, middle, and posterior. Anterior masses include thymoma, teratoma, thyroid goiter, and lymphoma. Middle masses include adenopathy, primary neoplasms, aneurysms, and abnormalities. Posterior masses are often neural tumors, but can also include vertebral abscesses or vascular structures. Example cases are provided to demonstrate key radiographic findings.
Radiology Spotters collection by Dr Pradeep. Nice collection Radiology spotters mixed collection ppt made by or collected by Dr. Pradeep, this is a collection of confusing spotter and very important spotter commonly asked in exams, our references is radiopaedia, learning radiology and Aunt Minnie.. Thanks
Describes parts of the mediastinum and anatomical landmarks and common mediastinal pathologies and there radiological features and differentiation in a simple educational way with multiple CT examples of different cases .
Radiology Spotters collection by Dr Pradeep. Nice collection Radiology spotters mixed collection ppt made by or collected by Dr. Pradeep, this is a collection of confusing spotter and very important spotter commonly asked in exams, our references is radiopaedia, learning radiology and Aunt Minnie.. Thanks
Describes parts of the mediastinum and anatomical landmarks and common mediastinal pathologies and there radiological features and differentiation in a simple educational way with multiple CT examples of different cases .
this is Dr.haider's lec, the one we took today , he left it on the desktop and said you can take it =D and btw for the pics he said check any anatomy book even the ones in the library
Title: Sense of Smell
Presenter: Dr. Faiza, Assistant Professor of Physiology
Qualifications:
MBBS (Best Graduate, AIMC Lahore)
FCPS Physiology
ICMT, CHPE, DHPE (STMU)
MPH (GC University, Faisalabad)
MBA (Virtual University of Pakistan)
Learning Objectives:
Describe the primary categories of smells and the concept of odor blindness.
Explain the structure and location of the olfactory membrane and mucosa, including the types and roles of cells involved in olfaction.
Describe the pathway and mechanisms of olfactory signal transmission from the olfactory receptors to the brain.
Illustrate the biochemical cascade triggered by odorant binding to olfactory receptors, including the role of G-proteins and second messengers in generating an action potential.
Identify different types of olfactory disorders such as anosmia, hyposmia, hyperosmia, and dysosmia, including their potential causes.
Key Topics:
Olfactory Genes:
3% of the human genome accounts for olfactory genes.
400 genes for odorant receptors.
Olfactory Membrane:
Located in the superior part of the nasal cavity.
Medially: Folds downward along the superior septum.
Laterally: Folds over the superior turbinate and upper surface of the middle turbinate.
Total surface area: 5-10 square centimeters.
Olfactory Mucosa:
Olfactory Cells: Bipolar nerve cells derived from the CNS (100 million), with 4-25 olfactory cilia per cell.
Sustentacular Cells: Produce mucus and maintain ionic and molecular environment.
Basal Cells: Replace worn-out olfactory cells with an average lifespan of 1-2 months.
Bowman’s Gland: Secretes mucus.
Stimulation of Olfactory Cells:
Odorant dissolves in mucus and attaches to receptors on olfactory cilia.
Involves a cascade effect through G-proteins and second messengers, leading to depolarization and action potential generation in the olfactory nerve.
Quality of a Good Odorant:
Small (3-20 Carbon atoms), volatile, water-soluble, and lipid-soluble.
Facilitated by odorant-binding proteins in mucus.
Membrane Potential and Action Potential:
Resting membrane potential: -55mV.
Action potential frequency in the olfactory nerve increases with odorant strength.
Adaptation Towards the Sense of Smell:
Rapid adaptation within the first second, with further slow adaptation.
Psychological adaptation greater than receptor adaptation, involving feedback inhibition from the central nervous system.
Primary Sensations of Smell:
Camphoraceous, Musky, Floral, Pepperminty, Ethereal, Pungent, Putrid.
Odor Detection Threshold:
Examples: Hydrogen sulfide (0.0005 ppm), Methyl-mercaptan (0.002 ppm).
Some toxic substances are odorless at lethal concentrations.
Characteristics of Smell:
Odor blindness for single substances due to lack of appropriate receptor protein.
Behavioral and emotional influences of smell.
Transmission of Olfactory Signals:
From olfactory cells to glomeruli in the olfactory bulb, involving lateral inhibition.
Primitive, less old, and new olfactory systems with different path
The prostate is an exocrine gland of the male mammalian reproductive system
It is a walnut-sized gland that forms part of the male reproductive system and is located in front of the rectum and just below the urinary bladder
Function is to store and secrete a clear, slightly alkaline fluid that constitutes 10-30% of the volume of the seminal fluid that along with the spermatozoa, constitutes semen
A healthy human prostate measures (4cm-vertical, by 3cm-horizontal, 2cm ant-post ).
It surrounds the urethra just below the urinary bladder. It has anterior, median, posterior and two lateral lobes
It’s work is regulated by androgens which are responsible for male sex characteristics
Generalised disease of the prostate due to hormonal derangement which leads to non malignant enlargement of the gland (increase in the number of epithelial cells and stromal tissue)to cause compression of the urethra leading to symptoms (LUTS
New Directions in Targeted Therapeutic Approaches for Older Adults With Mantl...i3 Health
i3 Health is pleased to make the speaker slides from this activity available for use as a non-accredited self-study or teaching resource.
This slide deck presented by Dr. Kami Maddocks, Professor-Clinical in the Division of Hematology and
Associate Division Director for Ambulatory Operations
The Ohio State University Comprehensive Cancer Center, will provide insight into new directions in targeted therapeutic approaches for older adults with mantle cell lymphoma.
STATEMENT OF NEED
Mantle cell lymphoma (MCL) is a rare, aggressive B-cell non-Hodgkin lymphoma (NHL) accounting for 5% to 7% of all lymphomas. Its prognosis ranges from indolent disease that does not require treatment for years to very aggressive disease, which is associated with poor survival (Silkenstedt et al, 2021). Typically, MCL is diagnosed at advanced stage and in older patients who cannot tolerate intensive therapy (NCCN, 2022). Although recent advances have slightly increased remission rates, recurrence and relapse remain very common, leading to a median overall survival between 3 and 6 years (LLS, 2021). Though there are several effective options, progress is still needed towards establishing an accepted frontline approach for MCL (Castellino et al, 2022). Treatment selection and management of MCL are complicated by the heterogeneity of prognosis, advanced age and comorbidities of patients, and lack of an established standard approach for treatment, making it vital that clinicians be familiar with the latest research and advances in this area. In this activity chaired by Michael Wang, MD, Professor in the Department of Lymphoma & Myeloma at MD Anderson Cancer Center, expert faculty will discuss prognostic factors informing treatment, the promising results of recent trials in new therapeutic approaches, and the implications of treatment resistance in therapeutic selection for MCL.
Target Audience
Hematology/oncology fellows, attending faculty, and other health care professionals involved in the treatment of patients with mantle cell lymphoma (MCL).
Learning Objectives
1.) Identify clinical and biological prognostic factors that can guide treatment decision making for older adults with MCL
2.) Evaluate emerging data on targeted therapeutic approaches for treatment-naive and relapsed/refractory MCL and their applicability to older adults
3.) Assess mechanisms of resistance to targeted therapies for MCL and their implications for treatment selection
Ozempic: Preoperative Management of Patients on GLP-1 Receptor Agonists Saeid Safari
Preoperative Management of Patients on GLP-1 Receptor Agonists like Ozempic and Semiglutide
ASA GUIDELINE
NYSORA Guideline
2 Case Reports of Gastric Ultrasound
micro teaching on communication m.sc nursing.pdfAnurag Sharma
Microteaching is a unique model of practice teaching. It is a viable instrument for the. desired change in the teaching behavior or the behavior potential which, in specified types of real. classroom situations, tends to facilitate the achievement of specified types of objectives.
Ethanol (CH3CH2OH), or beverage alcohol, is a two-carbon alcohol
that is rapidly distributed in the body and brain. Ethanol alters many
neurochemical systems and has rewarding and addictive properties. It
is the oldest recreational drug and likely contributes to more morbidity,
mortality, and public health costs than all illicit drugs combined. The
5th edition of the Diagnostic and Statistical Manual of Mental Disorders
(DSM-5) integrates alcohol abuse and alcohol dependence into a single
disorder called alcohol use disorder (AUD), with mild, moderate,
and severe subclassifications (American Psychiatric Association, 2013).
In the DSM-5, all types of substance abuse and dependence have been
combined into a single substance use disorder (SUD) on a continuum
from mild to severe. A diagnosis of AUD requires that at least two of
the 11 DSM-5 behaviors be present within a 12-month period (mild
AUD: 2–3 criteria; moderate AUD: 4–5 criteria; severe AUD: 6–11 criteria).
The four main behavioral effects of AUD are impaired control over
drinking, negative social consequences, risky use, and altered physiological
effects (tolerance, withdrawal). This chapter presents an overview
of the prevalence and harmful consequences of AUD in the U.S.,
the systemic nature of the disease, neurocircuitry and stages of AUD,
comorbidities, fetal alcohol spectrum disorders, genetic risk factors, and
pharmacotherapies for AUD.
Report Back from SGO 2024: What’s the Latest in Cervical Cancer?bkling
Are you curious about what’s new in cervical cancer research or unsure what the findings mean? Join Dr. Emily Ko, a gynecologic oncologist at Penn Medicine, to learn about the latest updates from the Society of Gynecologic Oncology (SGO) 2024 Annual Meeting on Women’s Cancer. Dr. Ko will discuss what the research presented at the conference means for you and answer your questions about the new developments.
Title: Sense of Taste
Presenter: Dr. Faiza, Assistant Professor of Physiology
Qualifications:
MBBS (Best Graduate, AIMC Lahore)
FCPS Physiology
ICMT, CHPE, DHPE (STMU)
MPH (GC University, Faisalabad)
MBA (Virtual University of Pakistan)
Learning Objectives:
Describe the structure and function of taste buds.
Describe the relationship between the taste threshold and taste index of common substances.
Explain the chemical basis and signal transduction of taste perception for each type of primary taste sensation.
Recognize different abnormalities of taste perception and their causes.
Key Topics:
Significance of Taste Sensation:
Differentiation between pleasant and harmful food
Influence on behavior
Selection of food based on metabolic needs
Receptors of Taste:
Taste buds on the tongue
Influence of sense of smell, texture of food, and pain stimulation (e.g., by pepper)
Primary and Secondary Taste Sensations:
Primary taste sensations: Sweet, Sour, Salty, Bitter, Umami
Chemical basis and signal transduction mechanisms for each taste
Taste Threshold and Index:
Taste threshold values for Sweet (sucrose), Salty (NaCl), Sour (HCl), and Bitter (Quinine)
Taste index relationship: Inversely proportional to taste threshold
Taste Blindness:
Inability to taste certain substances, particularly thiourea compounds
Example: Phenylthiocarbamide
Structure and Function of Taste Buds:
Composition: Epithelial cells, Sustentacular/Supporting cells, Taste cells, Basal cells
Features: Taste pores, Taste hairs/microvilli, and Taste nerve fibers
Location of Taste Buds:
Found in papillae of the tongue (Fungiform, Circumvallate, Foliate)
Also present on the palate, tonsillar pillars, epiglottis, and proximal esophagus
Mechanism of Taste Stimulation:
Interaction of taste substances with receptors on microvilli
Signal transduction pathways for Umami, Sweet, Bitter, Sour, and Salty tastes
Taste Sensitivity and Adaptation:
Decrease in sensitivity with age
Rapid adaptation of taste sensation
Role of Saliva in Taste:
Dissolution of tastants to reach receptors
Washing away the stimulus
Taste Preferences and Aversions:
Mechanisms behind taste preference and aversion
Influence of receptors and neural pathways
Impact of Sensory Nerve Damage:
Degeneration of taste buds if the sensory nerve fiber is cut
Abnormalities of Taste Detection:
Conditions: Ageusia, Hypogeusia, Dysgeusia (parageusia)
Causes: Nerve damage, neurological disorders, infections, poor oral hygiene, adverse drug effects, deficiencies, aging, tobacco use, altered neurotransmitter levels
Neurotransmitters and Taste Threshold:
Effects of serotonin (5-HT) and norepinephrine (NE) on taste sensitivity
Supertasters:
25% of the population with heightened sensitivity to taste, especially bitterness
Increased number of fungiform papillae
ARTIFICIAL INTELLIGENCE IN HEALTHCARE.pdfAnujkumaranit
Artificial intelligence (AI) refers to the simulation of human intelligence processes by machines, especially computer systems. It encompasses tasks such as learning, reasoning, problem-solving, perception, and language understanding. AI technologies are revolutionizing various fields, from healthcare to finance, by enabling machines to perform tasks that typically require human intelligence.
TEST BANK for Operations Management, 14th Edition by William J. Stevenson, Ve...kevinkariuki227
TEST BANK for Operations Management, 14th Edition by William J. Stevenson, Verified Chapters 1 - 19, Complete Newest Version.pdf
TEST BANK for Operations Management, 14th Edition by William J. Stevenson, Verified Chapters 1 - 19, Complete Newest Version.pdf
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2. Introduction
• Mediastinal disease is usually initially demonstrated
on a CXR and appear as a mediastinal soft tissue
mass, widening or pneumomediastinum.
• However it may appear normal in the presence of
mediastinal disease which is subsequently clearly
demonstrated by CT or MRI.
4. Mediastinal Boundaries
Compartment Anteriorly Posteriorly
Anterior Sternum Anterior aspect of
trachea and posterior
margin of heart
Middle Anterior aspect of
trachea and posterior
margin of heart
A vertical line drawn
along the thoracic
vertebrae 1 cm behind
their anterior margins
Posterior Vertical line drawn along
the thoracic vertebrae 1
cm behind their anterior
margins
Costovertebral junction
A M P
6. Approach
1. Is the mass actually in the mediastinum or is it in
the lung?
2. If in the mediastinum, then in which
compartment?
3. What is the differential diagnosis for the mass?
7. • PA and lateral chest films are the first step in
distinguishing from which mediastinal compartment
the mass is arising from.
• CT & MRI is the next step, better characterizing the
nature and extent of the lesion, thus narrowing the
differential diagnosis. MRI is especially good at
looking for spinal canal invasion in posterior
mediastinal masses
• Tissue biopsy is required for definitive diagnosis, and
surgical resection for definitive cure.
Investigations
8. Clues to locate mass to mediastinum
Mediastinal masses are
lined by parietal pleura,
so will have:
Masses in the lung
parenchyma typically:
– Smooth contour
– Tapered borders
– May be seen
bilaterally
– Are surrounded by
air
– May contain air
bronchograms
– Will be on one side
only
9. Which compartment?
1. Cervicothoracic sign
2. Thoracoabdominal sign
3. Hilum overlay and convergence signs
4. Effect on adjacent structures
Trachea
Ribs
Heart
10. Cervicothoracic sign
• Described by Felson:
▫ “If a thoracic lesion is in anatomic contact with the soft
tissues of the neck, its contiguous border will be lost.”
• The anterior mediastinum ends at the level of the
clavicles.
• The posterior mediastinum extends much higher.
• Therefore
▫ any mass that remains sharply outlined in the apex of
the thorax must be posterior and entirely within the
chest, and
▫ any mass that disappears at the clavicles must be
anterior and extends into neck
16. Cervicothoracic sign
• Answer: Mass is in posterior mediastinum. We
know because it remains sharply outlined in apex of
thorax, indicating that it is surrounded by lung.
• This particular example is a ganglioneuroma
20. Cervicothoracic sign
• Answer: Mass lies in anterior mediastinum. We
know this because it disappears at the level of the
clavicle where it extends into the neck.
• This particular example is Non-Hodgkins lymphoma
21. Thoracoabdominal sign
• A sharply marginated mediastinal mass seen through
the diaphragm must lie entirely within the chest.
• The posterior costophrenic sulcus extends far more
caudally than the anterior aspect of the lung
• Therefore
▫ Any mass that extends below the dome of the
diaphragm and remains sharply outlined must be in
the posterior compartments and surrounded by lung,
and
▫ Any mass that terminates at dome of diaphragm must
be anterior
24. Thoracoabdominal sign
• Answer: Margin of mass is apparent and below
diaphragm, therefore this must be in the middle or
posterior compartments where it is surrounded by
lung
• This example is a ‘Lipoma’
25. Hilum overlay and convergence
signs
• Principle of hilum overlay
▫ The proximal segments
of the R and L main
pulmonary arteries lie
lateral to the cardiac
silhouette on PA film
• With pericardial effusion
or cardiac enlargement,
this relationship is
unchanged
• An anterior mediastinal
mass will overlap the
main pulmonary arteries,
therefore they will be
seen within the margins
of the mass
• Hilum convergence
▫ To distinguish between
enlarged pulmonary
artery and mediastinal
mass
• If branches of the
pulmonary artery converge
toward a central mass
enlarged PA
• If branches of PA converge
toward the heart rather
than the central mass
mediastinal tumor
29. Hilum overlay sign
• Answer: this must be an anterior mediastinal
mass because it overlaps rather than “pushes
out” the main pulmonary arteries
• This particular example is a thymoma
30. Can you see the pulmonary arteries on the
following radiograph?
32. Hilum overlay sign
• Heart is enlarged, but hilar vessels still visible
lateral to the cardiac silhouette
• This case is pericardial effusion
33. Effect on adjacent structures
• Trachea
▫ May see deviation or narrowing of trachea with
anterior compartment masses
• Ribs/ vertebrae
▫ May see bony destruction with posterior compartment
masses
34. Anterior Mediastinal Masses
(30% of mediastinal masses)
• The 4 T‟s
▫ Thymoma
Generally over age 40
▫ Teratoma
Generally under age 40
▫ Thyroid
Goiter or neoplasm
▫ Terrible lymphoma
35. Thymoma
• Clinical clues
▫ 70% of cases in patients
ages 40-60
▫ Associated with
myasthenia gravis (in
50%)
pure red cell aplasia (in
5%)
Hypogammaglobulinemia
(in 5%)
▫ Asymptomatic in 20-50%
▫ 35% are invasive
▫ Tx: resection + RT if
invasive
• Radiographic clues
▫ Often overlies
aortopulmonary window
▫ Punctate, ringlike
calcification in 20%
▫ Usually seen unilaterally
▫ 25-50% are undectectable
on CXR CT is better at
91% sensitivity
36.
37.
38. Thymic cyst
• May be congenital or acquired.
• On plain radiographs, thymic cysts are
indistinguishable from other nonlobulated thymic
masses, notably thymomas.
• CT scans show a well-defined cystic mass
demonstrating CT attenuation values typically
consistent with fluid. The appearance, however, may
vary if haemorrhage or infection complicate the cyst.
Curvilinear calcification of the cyst wall may occur in
a few cases.
39.
40. Teratoma
• Clinical clues
▫ Most patients < 30 y.o.
▫ 50-75% symptomatic with
cough, dyspnea, chest pain
• Radiographic clues
▫ Well-defined, rounded or
lobulated mass
▫ May contain calcification,
teeth or fat
▫ Commonly have fluid-
containing cystic areas
44. ▫ PA and lateral chest films show a
large anterior mediastinal mass
causing narrowing and rightward
deviation of the trachea. The
mass is not calcified.
45. CT exam show a low
density mass in the
anterior mediastinum with
irregular walls with
calcium in it.
Dx Teratoma, Anterior
Mediastinal
46. Thyroid goiter
• Clinical clues
▫ Affect females > males (3:1)
▫ Account for 10% of anterior
mediastinal masses
▫ Usually asymptomatic
• Radiographic clues
▫ + cervicothoracic sign
▫ Often displace or narrow
trachea
▫ Calcification seen in 25%,
and is dense and well-
defined
48. Lymphoma
• Clinical clues
▫ Hodgkins (Reed-Sternberg
cells)
▫ Bimodal distribultion: in 20s
and at age >50
▫ Account for only 20-30 of all
lymphomas but accounts for
up to 85% mediastinal
lymphoma
▫ 20-30% pts have “B” sx
▫ Non-Hodgkins
▫ Age > 55
▫ Accounts for 80% of
lymphomas but only 20%
present as mediastinal mass
• Radiographic clues
▫ Identical findings for
Hodgkins and Non-Hodgkins
lymphoma
▫ Mass may be multi-lobular
▫ Usually affects multiple
nodes
▫ Often extends beyond
anterior compartment
▫ Calcification rare prior to
treatment
50. PA and lateral chest films show a large,
lobulated anterior mediastinal mass
displacing the trachea to the right.
Twelve year old female with a chest
mass
51. A chest CT exam shows the mass to extend from the neck to the diaphragm,
compressing the tracheal and left mainstem bronchus leading to left lower
lobe atelectasis. The chest wall mass is partially eroding the sternum and
there is periosteal reaction. Axillary adenopathy is present also.
Dx:Lymphoma, Hodgkin, Anterior Mediastinal, Sternal Involvement
52. PA and lateral chest films show an
anterior mediastinal mass and a large
right pleural effusion.
53. Two contiguous slices
from an enhanced chest
CT exam show a
homogenous, solid,
anterior mediastinal mass
and a large right pleural
effusion.
Dx-Lymphoma, Non-
Hodgkin, Anterior
Mediastinal
54. Germ Cell Tumours
It is a well defined round or oval soft
tissue mass, which usually project to
only one side of the anterior
mediastinum. The soft tissue mass
may also contain a peripheral rim or
central nodular calcification or even a
rudimentary tooth. A rapidly increase
in the size of the mass show internal
hemorrhage or development of
malignancy.
55. Fat Deposition
There is smooth widening of the superior mediastinum
without trachial displacement.
Pleuropericardial cyst:
They appear as a well defined round, oval or triangular
soft tissue mass which can alter in shape on respiration.
58. Middle Mediastinal Masses
(30% of mediastinal masses)
• The 4 A‟s
▫ Adenopathy
TB/fungal
Sarcoid
Neoplasm (bronchogenic CA, mets, lymphoma, leukemia)
Infections (EBV, AIDS)
▫ Awful primary neoplasm
Tracheal, esophageal
▫ Aneurysm/vascular
▫ Abnormalities of development
Bronchogenic cyst- often between carina and esophagus
Pericardial cyst
Esophageal duplication cyst
59. Three year old male with an
incidentally noted chest
mass
60.
61. ▫ Single slice from an enhanced chest CT exam shows the mass to be
non-enhancing, posterior to the right bronchi, and next to the
esophagus.
▫ Dx: Esophageal Duplication
65. Bronchogenic cysts
• On the chest radiograph, bronchogenic cysts typically appear as
smooth, sharply marginated mediastinal masses. On CT scans they
appear as round or oval homogeneous masses with well-defined
margins with barely or no perceptible walls.
67. Posterior Mediastinal Masses:
(40% of mediastinal masses)
• Neurogenic tumors most common
▫ Sympathetic ganglion tumors: neuroblastoma,
ganglioneuroma
▫ Nerve root tumors: schwannoma, neurofibroma
• Less common
▫ Vertebral body abscess or tumor
▫ Vascular: aneurysm or hematoma
▫ Developmental: Bochdalek hernia
68. Neural tumors
• Clinical
▫ 70-80% are benign
▫ 50% of pts are
asymptomatic
▫ Schwannoma is the most
common
▫ Tx: resection
• Radiographic findings
▫ Well-defined mass with a
smooth or lobulated outline
▫ Can be very large
▫ +/- calcification
73. PA and lateral chest films show a
mediastinal mass that had enlarged in
the 4 year interval that may be
spreading the right 5th and 6th ribs
apart.
74. • An enhanced chest CT exam shows a homogeneous mass, of fatty density,
with a few septations, in the right posterior mediastinum causing some
anterior displacement of the right main stem bronchus.
• Dx:Lipoma, Posterior Mediastinal
84. PA and lateral chest films from the day
of admission demonstrate a large
round opacity in the left lower lobe that
abuts the diaphragm
85.
86. Two coronal T1 weighted images and one axial T2 weighted image from an MRI
exam from the 5th hospital day demonstrate a posterior mediastinal mass that
extends into the retrocrural regions of the chest bilaterally and that enhances
uniformly. There is no evidence of metastatic disease.
Dx-Sequestration, Extralobar
87. large mass in the posterior
mediastinum on the left.
88. Bone window images from a chest CT exam from the day of diagnosis demonstrate a
large spherical calcified left paravertebral mass measuring 12 x 11 x 8 cm in size. There
is a pleural effusion and a shift of mediastinal structures to the right. The mass appears
to extend via the retrocrural space into the abdomen causing displacement of the left
kidney and inferior vena cava. The mass crosses the midline. Some minimal thoracic
vertebral body remodeling and rib thinning is seen on the left. No spinal canal invasion
or liver metastases are seen
89.
90. MRI exam performed 3 weeks after
diagnosis. Coronal and sagittal T1
weighted images without contrast, and
coronal and axial T2 weighted MRI
images could not definitely identify the
left adrenal gland, and therefore
suggested it could be the origin of the
midline mass. There was evidence of
tumor invasion into several neural
foramina and the spinal canal.
Dx-Neuroblastoma