106. A patient from oncology (Hypernephroma).
Thirty years ago, this particular patient suffered from tuberculosis.
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- What are the various findings? What may be confirmed?
(Click here for the answer) - Two significantly large coin lesions( in the right to mid region as well as in the left lower part)
- a "spindle-shaped” shadowing on the right : this signifies an interlobar effusion.
- Wide pleural shadowing in the left apex area.
But what we are unable to detect here is as follows : as an exception to our objective less under-exposed radiographs and one which contains sufficiently high KV, shows the calcification of both pleurae. In effect, therefore, a remnant empyema after an old tuberculosis.
Furthermore, there was evidence of calcification in the area of the pleura diaphragmatica.
In addition, signs of lung adhesions, which condense and lift the left hilus towards the top.
In summary, a combination of a metasatic Hypernephroma progression together with an old tuberculosis.
107. 55 years old lady. Hardly any feeling of sickness; only mild stridor. No signs at all of any infection. Euthyreosis.
Thoracic space-occupying lesion during a course of 8 years. This contains calcifications.
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- Against what and for what is this time-frame?
(Click here for the answer) The very minor change during the 8-year course of events speaks against a malignant tumour as well as against lymphoma.
It might suggest a Struma or a Teratoma.
Would nuclear medicine be of use ?
108. The same case:
Remarkable and obvious storage of Nuclid within the tumour. (szintigraphy is interrupted, thereby the linear limitation below ).
This Thyroidea-szintigraphy with TCO4 and thorax-X-ray are duly projected one on top of the other.
Was sonst kann noch einen Retrosternalen Tumor verursachen?
Der alte Merkspruch sagt: 4 x T
Thyreoidea
Tymoma
Terratoma (siehe nächsten Fall)
Thomas Hodgkin (Lymphoma)
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- Diagnosis?
(Click here for the answer) We are dealing with a large heterotopic thyroid part.
It is not skilfull and arty to perform such a retrosternal struma with TCO4, because there are better tracers for this geometric and biological situation.
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109. A patient with partially solid, partially fatty, partially calcified tumour in the the mediastinum (left). This leads to a distinct lung-compression and to storage of the hilus structure.
- So, a diagnosis?
(Click here for the answer) A Teratoma (malformation tumor): this contains, typically, various tissues.
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110. Another patient with a blotchy, speckled calcified tumor in proiection of the apex of the lung.
- Likely diagnosis?
(Click here for the answer) Rib number 1cannot be distinguished. It appears as if it has caused a tumor. Enchondroma of rib number 1 is the highly likely diagnosis.