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Search Patient Charts: Chest

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Search Results for => Chest <= Result Items 1 - 20

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Case ID: 13029 Sample Image Click to View	:: - TF Case :: - Thumbnails :: - Topic ::


	Diagnosis	Chest Wall Tumors - Lipoma
	History	90 + y.o. man presenting with new cough, no signs nor symptoms of infection
	Findings	Chest X-ray demonstrates mass in right upper Chest. Sharp medial border indicates mass abutting lung tissue while indistinct lateral border suggests blending of the mass with pleura/Chest wall. Chest CT demonstrates a soft tissue mass with fat attenuation and no bony invasion.
	Differential Dx	Chest wall tumors arising from bony or soft tissue: • Soft Tissue Tumors - Benign » mole, nevus, wart, neurofibroma, lipoma, hemangioma, desmoid • Bony Tumors - Benign » osteochondroma, enchondroma, osteoblastoma • Soft Tissue Tumors - Malignant » fibrosarcoma, liposarcoma, metastases, melanoma, bronchogenic carcinoma, primitive neuroectodermal (Askin) tumor • Bony Tumors - Malignant » chondrosarcoma, osteogenic sarcoma, fibrosarcoma, metastases (multiple myeloma; breast, lung, kidney, or prostate carcinomas) • Non-neoplastic tumors » fibrous dysplasia, eosinophilic granuloma, Brown tumor • Infection (Abscess) - tuberculosis, staphylococcus • Trauma - hematoma, healing rib fracture
	Discussion	... (continues ...)
	User Group
	Contributor	Sean L Jersey :: David Grant USAF Medical Center -
	Reviewer	Robert A Jesinger M.D. :: David Grant USAF Medical Center - Case Accepted: 2009-06-23 03:51:27-04 :: Revised: :: Submitted:

Case ID: 13005 Sample Image Click to View	:: - TF Case :: - Thumbnails :: - Topic ::


	Diagnosis	Chest Wall Hemangiomas (Hemangiomatosis)
	History	71 y.o. woman with a past history of multiple large vascular lesions throughout her body. She was being assessed for sclerotherapy in clinic when her right Chest wall lesion began to bleed. Direct pressure failed to stop the bleeding, and the patient was taken directly to interventional radiology (IR) for catheter angiography.
	Findings	Enhanced Chest CT images demonstrate multiple enhancing tubular structures (presumably vascular) in the Chest wall, multiple round calcifications (suggestive of phleboliths), rib anomalies, and a large enhancing mass in the left superior Chest wall, extending into the left Chest cavity.
	Differential Dx	• Chest wall hemangiomas / AVMs • Angiosarcomas • Hypervascular metastatic lesions
	Discussion	... (continues ...)
	User Group
	Contributor	James Odone MD :: David Grant USAF Medical Center -
	Reviewer	Robert A Jesinger M.D. :: David Grant USAF Medical Center - Case Accepted: 2009-06-23 03:51:27-04 :: Revised: :: Submitted:

Case ID: 12370 Sample Image Click to View	:: - TF Case :: - Thumbnails :: - Topic ::


	Diagnosis	Cavitary Chest lesions, coccidiomycosis
	History	Patient
	Findings
	Differential Dx
	Discussion	... (continues ...)
	User Group
	Contributor	Anthony D Freiler :: Uniformed Services University -
	Reviewer	Les R Folio :: Uniformed Services University - Case Accepted: 2009-06-23 03:51:27-04 :: Revised: :: Submitted:

Case ID: 11833 Sample Image Click to View	:: - TF Case :: - Thumbnails :: - Topic ::


	Diagnosis	Acute Chest Syndrome
	History	13 y/o female who presented to the ER shortly after onset of sore throat, cough and central sternal Chest pain. The pain was central sternal, sharp, and worse with cough and deep inspiration. On arrival to ER she was febrile to 102.1 with O2 sat 93% on RA. She was placed on 2L O2 by NC with sats rising to 99-100%. On the day prior to admission, she received Hep A, HPV, varicella and flu vaccinations.
	Findings	Initial PA/Lat showed an enlarged cardiac silhouette. Prominent pulmonary vasculature and basilar increased interstitial markings and bilateral small pleural effusions. Also noted are a surgical clip in the right upper quadrant and absence of the spleen shadow. No osseous abnormalities are ntoed. Follow-up portable radioagraph obtained after marked worsening of clinical status revealed new large bilateral effusions and evidence of bilateral lower and right middle lobe air space disease.
	Differential Dx	Acute Chest syndrome Bacterial pneumonia Viral pneumomina
	Discussion	... (continues ...)
	User Group
	Contributor	Robert Grumbo :: Uniformed Services University -
	Reviewer	Ellen M Chung :: Uniformed Services University - Case Accepted: 2009-06-23 03:51:27-04 :: Revised: :: Submitted:

Case ID: 11458 Sample Image Click to View	:: - TF Case :: - Thumbnails :: - Topic ::


	Diagnosis	Acute Chest Syndrome - Sickle Cell Anemia
	History	22 yo woman with Chest pain and shortness of breath.
	Findings	Enlarged heart, diffuse expansion of the ribs, mildly enlarged pulmonary vessels and scattered patchy lung infiltrates.
	Differential Dx	Infection Pulmonary edema Drug/toxin reaction Pulmonary embolism Acute Chest syndrome
	Discussion	... (continues ...)
	User Group
	Contributor	Scott L Whitworth :: National Capital Consortium -
	Reviewer	Kevin F. McCarthy :: Civilian Medical Center - Case Accepted: 2009-06-23 03:51:27-04 :: Revised: :: Submitted:

Case ID: 11380 Sample Image Click to View	:: - TF Case :: - Thumbnails :: - Topic ::


	Diagnosis	Flail Chest
	History	Motor vehicle versus pedestrian
	Findings	• right posterior and lateral fractures of ribs 3-6 with associated airspace disease that may represent hemmorhage.
	Differential Dx
	Discussion	... (continues ...)
	User Group
	Contributor	roger boodoo :: National Naval Medical Center Bethesda -
	Reviewer	Kevin F. McCarthy :: Civilian Medical Center - Case Accepted: 2009-06-23 03:51:27-04 :: Revised: :: Submitted:

Case ID: 10606 Sample Image Click to View	:: - TF Case :: - Thumbnails :: - Topic ::


	Diagnosis	Ewing Sarcoma Chest wall
	History	A 14 year old boy presented with a complaint of right arm and shoulder pain over the last week, as well as right sided Chest pain. His symptoms had been worsening over the previous 2-3 days, without any resolution of the pain with motrin or naproxen. Of significance, he had been participating in archery recently during gym class, using his right arm to draw back the bow. There are no known relieving factors, but his pain is worsened mostly when lying down. Overall, review of systems was negative for fevers, shortness of breath, cough, congestion, or any other constitutional symptoms. He does have a past history of rheumatoid arthritis and ulcerative colitis.
	Findings	• Images 1a,b: AP and Lateral CXR = Large pleural based Chest wall mass in the right upper hemithorax. Moderately large right pleural effusion. • Image 2: Bone scan whole body = Normal bone scan. Normal uptake in the physes. Normal axial and appendicular skeleton. No abnormal soft tissue uptake. No increased activity in the right second right on whole-body images. • Image 3: CT Chest/abdomen with contrast = Large heterogeneous soft tissue mass involving the anterior Chest wall with destruction of the second right anterior rib. Moderate right pleural effusion with right lower lobe atelectasis.
	Differential Dx	• Tumor (lymphoma, osteosarcoma, histiocytoma, leukemia, chondrosarcoma, medulloblastoma, rhabdomyosarcoma, giant cell) • Langerhan Histiocytosis X • Infection - subacute osteomyelitis
	Discussion	... (continues ...)
	User Group
	Contributor	Eric M Alcaraz :: Affiliation Unlisted - Please See Comments -
	Reviewer	Dawn E Light :: Childrens Hospital of Dayton, OH - Case Accepted: 2009-06-23 03:51:27-04 :: Revised: :: Submitted:

Case ID: 10451 Sample Image Click to View	:: - TF Case :: - Thumbnails :: - Topic ::


	Diagnosis	Sarcoidosis - Chest and Hands
	History	64 year old male with foot pain, please evaluate for 5th metatarsal stress fracture
	Findings	The patient had incidental findings of diffuse radiotracer uptake along multiple phalanges of the hands bilaterally on whole body bone scan. Arthritis series revealed lace-like lytic areas and subcortical resorption bilaterally. Chest radiograph and CT demonstrate bilateral hilar adenopathy and interstitial disease.
	Differential Dx
	Discussion	... (continues ...)
	User Group
	Contributor	Shephard S. Kosut :: Walter Reed Army Medical Center -
	Reviewer	Lorraine G. Shapeero, M.D. :: Uniformed Services University - Case Accepted: 2009-06-23 03:51:27-04 :: Revised: :: Submitted:

Case ID: 8983 Sample Image Click to View	:: - TF Case :: - Thumbnails :: - Topic ::


	Diagnosis	Spindle Cell Chest wall Sarcoma
	History	Asymptomatic man presents for annual Chest screening.
	Findings	Frontal Chest radiograph: Asymmetrical right apical opacity. Old fracture versus bony involvement of right first posterior rib. Axial CT without contrast: There is a lobulated soft tissue mass measuring 5.3 by 3.1 cm at its maximal dimensions in the apex of the right lung. This mass extends into the soft tissues with evidence of right first rib invasion consistent with erosion and medullary replacement.
	Differential Dx	Mesothelioma Pancoast tumor Lymphoma Plasmacytoma Metastatic malignancies (thyroid, larynx) Lymphomatoid granulomatosis Cervical rib syndrome Tuberculosis Fungal infections
	Discussion	... (continues ...)
	User Group
	Contributor	Vincent G Champion :: National Naval Medical Center Bethesda -
	Reviewer	Julian Paul Kassner :: National Naval Medical Center Bethesda - Case Accepted: 2009-06-23 03:51:27-04 :: Revised: :: Submitted:

Case ID: 8153 Sample Image Click to View	:: - TF Case :: - Thumbnails :: - Topic ::


	Diagnosis	Peumonia vs acute Chest syndrome. Stigmata of sickle cell disease on the Chest radiograph.
	History	9-year-old male with sickle cell disease and cold symptoms.
	Findings	The PA Chest radiograph demonstrates airspace disease in the lower lung field posteriorly as well as stigmata of sickle cell disease to include an enlarged heart, surgical clips in the gallbladder fossa, sclerosis and flattening of the left humeral head. The lateral view demonstrates "H-shaped" vertebral bodies with endplate depressions.
	Differential Dx	Pneumonia vs acute Chest syndrome. Stigmata of sickle cell disease.
	Discussion	... (continues ...)
	User Group
	Contributor	George Spencer :: National Naval Medical Center Bethesda -
	Reviewer	Edith M Budik, M.D., COL USA :: Walter Reed Army Medical Center - Case Accepted: 2009-06-23 03:51:27-04 :: Revised: :: Submitted:

Case ID: 7907 Sample Image Click to View	:: - TF Case :: - Thumbnails :: - Topic ::


	Diagnosis	Lymphoblastic lymphoma. FDG-18 PET revealed no other hypermetabolic foci in the Chest, abdomen, or pelvis.
	History	22 year old male has approximately 18-month history of left clavicular head enlargement, rapidly increasing in size over the past two months. Additionally, he had a left sternoclavicular dislocation and/or medial left clavicle fracture approximately a year ago.
	Findings	Sclerotic medial two-thirds of left clavicle with cortical thickening and permeation of medial one-third of the clavicle. Large associated soft tissue mass superior to the medial clavicle. No cortical destruction.
	Differential Dx	Ewing's sarcoma Lymphoma Osteosarcoma Chronic infection Leukemia SAPHO syndrome
	Discussion	... (continues ...)
	User Group
	Contributor	Tom Hash :: National Capital Consortium -
	Reviewer	Donald J Flemming :: Penn State University - Case Accepted: 2009-06-23 03:51:27-04 :: Revised: :: Submitted:

Case ID: 7748 Sample Image Click to View	:: - TF Case :: - Thumbnails :: - Topic ::


	Diagnosis	Acute Chest Syndrome
	History	22yo AA male with known sickle cell disease presents with fever, cough for the last two days.
	Findings	CXR: Patchy, bibasilar predominant opacities obscuring hemidiaphragms. Sclerosis of bilateral humeral heads. Splenectomy.
	Differential Dx	Pneumonia - bacterial, atypical Pulmonary edema Pulmonary hemorrhage
	Discussion	... (continues ...)
	User Group
	Contributor	Eric C Bass :: Madigan Army Medical Center -
	Reviewer	Stephen M. Yoest :: Madigan Army Medical Center - Case Accepted: 2009-06-23 03:51:27-04 :: Revised: :: Submitted:

Case ID: 6806 Sample Image Click to View	:: - TF Case :: - Thumbnails :: - Topic ::


	Diagnosis	Askin tumor of Chest wall
	History	A 31-year-old male without significant past medical history presented to the emergency department at our institution with a 1 week history of fevers and right-sided pleuritic Chest pain. Additional history revealed night sweats over the previous month, and a 10-pound weight loss over the two preceding months.
	Findings	Chest radiograph revealed a 2cm parietal-based mass in the lateral side of right hemi thorax, at the level of the middle arch of the third right rib. Four months later the Chest plain films demontrates a 7 cm lobulated parietal-based opacity centered on the middle arch of the third right rib with cortical rupture and bone destruction of the affected area of the rib. Thoraco abdomino pelvic contrast-enhanced computed tomography (CT) revealed an 8 x 7 centimeter right lateral Chest wall mass with expansion, destruction and cortical spread out of the middle arch of the right third rib. This parietal mass was spontaneously heterogeneous containing solid and necrotic areas and demonstrates intense contrast uptake in the solid portion after injection . Metastic lesions were identified at L5 vertebral body with extension to the epidural, in the lower lobe of left lung and in the left iliac wing.
	Differential Dx	Aside the possibility of Askin tumor, the differential diagnosis in case of aggressive rapidly growing Chest wall mass could be an Ewing sarcoma a lymphoma, Osteosarcoma, Fibro sarcoma, Reticulum cell sarcoma, Histiocytosis X, Bone metastases, Sub acute or chronic osteomyelitis.
	Discussion	... (continues ...)
	User Group
	Contributor	jamal saad :: Civilian Medical Center -
	Reviewer	Claudia E Galbo :: Uniformed Services University - Case Accepted: 2009-06-23 03:51:27-04 :: Revised: :: Submitted:

Case ID: 6509 Sample Image Click to View	:: - TF Case :: - Thumbnails :: - Topic ::


	Diagnosis	Ileal Carcinoid Tumor metastases to the para-aortic nodes in the Chest and abdomen.
	History	71 y.o. male s/p ileal carcinoid resection here for routine follow-up Indium-111 Octreotide Scan.
	Findings	Single focus of increased radiotracer uptake in the upper Chest possibly superior mediastinum just to the left of midline confirmed by CT to be a pathologic lymph node just posterior to the arch of aorta. Focus (or foci) of increased radiotracer uptake in the upper abdomen at the level of the renal pelvis in the midline confirmed by CT to be a pathologic para-aortic lymph node.
	Differential Dx
	Discussion	... (continues ...)
	User Group
	Contributor	Steve Kao :: National Capital Consortium -
	Reviewer	Frank Schraml :: National Naval Medical Center Bethesda - Case Accepted: 2009-06-23 03:51:27-04 :: Revised: :: Submitted:

Case ID: 6204 Sample Image Click to View	:: - TF Case :: - Thumbnails :: - Topic ::


	Diagnosis	Chest Review
	History	Routine screening Chest film.
	Findings	Normal
	Differential Dx	Normal
	Discussion	... (continues ...)
	User Group
	Contributor	James G. Smirniotopoulos, M.D. :: Uniformed Services University -
	Reviewer	James G. Smirniotopoulos, M.D. :: Uniformed Services University - Case Accepted: 2009-06-23 03:51:27-04 :: Revised: :: Submitted:

Case ID: 6064 Sample Image Click to View	:: - TF Case :: - Thumbnails :: - Topic ::


	Diagnosis	Acute Chest Syndrome - Sickle Cell Anemia
	History	25 year old male with Chest pain and non-productive cough.
	Findings	cardiomegaly scattered airspace opacities basal atelectasis
	Differential Dx	pneumonia sickle cell disease atelectasis congestive heart failure
	Discussion	... (continues ...)
	User Group
	Contributor	Aaron M Taylor :: National Capital Consortium -
	Reviewer	David S. Feigin, M.D. :: Johns Hopkins Hospitals - Case Accepted: 2009-06-23 03:51:27-04 :: Revised: :: Submitted:

Case ID: 5989 Sample Image Click to View	:: - TF Case :: - Thumbnails :: - Topic ::


	Diagnosis	LEFT LOWER LOBE COLLAPSE Serial AP Chest radiographs demonstrated gradual improvement in LLL collapse.
	History	43 year old male admitted to the surgical ICU after sustaining a fall off of a two story roof the day prior. Patient stabilized initially at hospital closer to the accident and then transferred to our institution.
	Findings	Marked lucency of the left lung with truncation and slight horizontal elevation of the left main stem bronchus. Compensatory prominenent appearance of right lung pulmonary vasculature secondary to shunting.
	Differential Dx	Left lower lobe collapse secondary to obstructing lesion i.e. mucus plug, blood clot, endobronchial lesion or extrinsic bronchial compression.
	Discussion	... (continues ...)
	User Group
	Contributor	Erica M. Broussard :: National Capital Consortium -
	Reviewer	David S. Feigin, M.D. :: Johns Hopkins Hospitals - Case Accepted: 2009-06-23 03:51:27-04 :: Revised: :: Submitted:

Case ID: 5765 Sample Image Click to View	:: - TF Case :: - Thumbnails :: - Topic ::


	Diagnosis	Sickle cell disease changes, confirmed on Chest films.
	History	20 y/o female with sickle-cell disease, screening exam.
	Findings	H-shaped vertebrae on the lateral Chest film.
	Differential Dx	Sickle cell disease.
	Discussion	... (continues ...)
	User Group
	Contributor	Mark W. Meyermann :: Tripler Army Medical Center -
	Reviewer	Ernesto Torres M.D. :: Civilian Medical Center - Case Accepted: 2009-06-23 03:51:27-04 :: Revised: :: Submitted:

Case ID: 5671 Sample Image Click to View	:: - TF Case :: - Thumbnails :: - Topic ::


	Diagnosis	Pancoast’s tumor of Chest, Stage IV NSCLC (non-small cell lung cancer)
	History	67 y/o male presents for further evaluation of an abnormal Chest radiograph, discovered during a recent episode of both hepatic and left kidney abscesses.
	Findings	• CXR: Large destructive left apical mass involving the Chest wall. There is vertebral destruction, pleural metastasis, lymphadenopathy, and a contralateral lung nodules. • CT: 1) Large left upper lobe mass with adjacent Chest wall invasion with bony destruction and vertebral body destruction. Multiple left lingular segment masses 2) Right upper lobe mass with adjacent air space disease 3) Mediastinal and left hilar adenopathy 4) Right liver lobe ductal dilatation 5) Right adrenal mass enlargement 6) Left kidney mass • PET: 1) Malignant neoplasm extensively involving the apical posterior segment of the left upper lobe and extending locally into the mediastinum and the Chest wall. No discontinuous foci within the mediastinum or cervical region specifically to suggest metastatic disease to the lymph nodes. Several satellite nodules in the left mid lung field and possible nodular metastases to left mid ribs.
	Differential Dx	• Metastatic Lung Cancer • Metastatic Kidney Cancer • Metastatic Liver cancer
	Discussion	... (continues ...)
	User Group
	Contributor	MS-4 USU Teaching File :: Uniformed Services University -
	Reviewer	David S. Feigin, M.D. :: Johns Hopkins Hospitals - Case Accepted: 2009-06-23 03:51:27-04 :: Revised: :: Submitted:

Case ID: 5537 Sample Image Click to View	:: - TF Case :: - Thumbnails :: - Topic ::


	Diagnosis	Myxoid/Round Cell Liposarcoma, Metastatic to Chest Wall
	History	The patient is a 51 year-old male with a history of right thigh myxoid/round cell liposarcoma. A large pleural/Chest wall mass was identified on a routine Chest radiograph three months after VATS for resection of a 2.2cm x 2.2cm x 1.5cm right upper lobe pulmonary nodule. The patient was asymptomatic.
	Findings	Frontal and lateral views of the Chest show a large, well-demarcated mass overlying the right hemothorax. Given the smooth, distinct contours, a Chest wall/pleural based process was favored. This mass was eventually proven to be metastatic myxoid/round cell liposarcoma of the right anterior Chest wall, identical to the histology of the primary thigh mass. Selected axial noncontrast CT images of the Chest show a large, well-demarcated pleural/Chest wall based mass at the anterior aspect of the right hemithorax. An anterior mediastinal component is also present. This mass was eventually proven to be metastatic myxoid/round cell liposarcoma of the right anterior Chest wall, identical to the histology of the primary thigh mass.
	Differential Dx	I. Primary and metastatic sarcomas A. Liposarcoma – well-differentiated, myxoid/round cell, dedifferentiated, and pleomorphic histopathologic subtypes B. Other sarcomas arising from the pleural cavity (Okby et al.) Synovial sarcoma Malignant fibrous histiocytoma PNET/Ewing sarcoma Angiosarcoma Chondrosarcoma Osteosarcoma Leiomyosarcoma II. Other A. Lymphoma B. Metastatic carcinoma of extrathoracic primary C. Malignant mesothelioma
	Discussion	... (continues ...)
	User Group
	Contributor	Jason Rexroad :: Civilian Medical Center -
	Reviewer	Albert V Porambo :: Civilian Medical Center - Case Accepted: 2009-06-23 03:51:27-04 :: Revised: :: Submitted:

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