X-ray Case (1)

[Diagnostic]

We need different ways of group studying in this site, so that everyone can participate and get benefits, X-ray cases are interesting to every practioner and it's helpful mthod during diagnosis. I have a good collection of different X-rays and I would like to post it as cases, if you have any comments or suggestions feel free to contact me. ThanksCase: A 48-year old female from Iceland presented with hemoptysis preceeded by chronic cough for 3 months & pleuretic chest pain. On Examination: the patient was jaundiced, with mild fever, decreased breath sounds in RT side of the lung, the liver is enlarged 3 cm below the costal margin & tender. Basic routine investigations shows leukocytosis with marked increase in eosinophils. CXR shows mass lesion with good margin in the right lower zone. Questions: 1- What is your diagnosis? (look at the X-ray) 2- If that mass go into changes, what do you call that change & the sign that will appear?! 3- Mention other sites this mass can appear? 4- What is the worst complication can happen to this patient? 5- What is the treatment? Diagnostic

[Kassim]

1- What is your diagnosis? (look at the X-ray)

 i think it is Echinococcus granulosus, also known as hydatid disease

2- If that mass go into changes, what do you call that change & the sign that will appear?!

hydatid cysts. The sign will depend on the particular organ that are affected, e.g. in the brain hydatid cyst will present as a space-occupying lesion.  If the diaphragm is involved the patient presents with clinical picture simulating pleurisy.

3-Mention other sites this mass can appear?

Kidney, CNS,  Spleen, heart, abdominal cavity,  the diaphragm, and can affect any organ in the body

4-What is the worst complication can happen to this patient?[/b]

The cyst my rupture and lead Systemic anaphylaxis.
Other complication includes: Vena cava obstruction, Small bowel obstruction, Gastric perforation, Pulmonary embolism, Focal cerebral disorders (eg, seizures, hemiparesis, aphasia), cardiac tamponade

5- What is the treatment?
Albendazole 400mg BD before and continue for 28 days after the drainage.
surgical intervention if needed.
 
hope this is right answer


Hope this is right answer   

[Diagnostic]

Well done
your answer is correct although in question "2":
The mass may repture forming what is called "Water lilly sign" that may appear in the X-ray.
Diagnostic

[Admin]

Congratulations
the 15 points of this case goes to Kassim
Dr.Mahdi