rare cases with radio and clinical correlation

crin

1. CLINICO RADIOLOGY MEET 26/6/2024 Presented By:- Dr. Abhinav Juneja Associate consultant, Radiology & Imaging

2. Case 1 An 18 yo female presented in OPD with c/o Pain abdomen, colicky in nature and fever x 10 days Constipation x 2 days Nausea x 2 days Decreased oral intake and generalized weakness Patient was admitted on 21/4/24 CECT abdomen was done on 22/4/24

3. USG

4. CECT DONE ON 22/4/24

5. Lab parameters on 21/4/24 TLC – 11.09k Hb – 10.7 g/dL DLC N-70%, L-16.4%, M-10%, E-3.2% ANC- 7.77k

6. CE MRI 27/4/24

7. Patient was being managed conservatively with I.V. antibiotics and symptomatic treatment.

8. Patient was discharged on 30/4/24 with conservative management However, she was admitted again on 4/5/24 with c/o lower right abdomen pain, uneasiness and gen. weakness USG was done on 4/5/24 and a non contrast MRI was done on 5/5/24

9. MRI ON 5/5/24

10. Patient was managed conservatively and discharged in stable condition on 7/5/24 Patient reviewed in OPD on 18/5/24 with mild persistent tenderness in RIF, low grade fever. Collection had decreased in size. Patient reviewed in OPD again on 21/5/24 – patient was afebrile, asymptomatic – was managed conservatively with antibiotics and symptomatic treatment.

11. Case 2 A 22 y.o . female came with c/o weight loss, cough, chest pain -- Past medical history - Operated for brain AVM in 2016 An X-ray chest was done on 22/3/24 followed by CECT chest

12. X ray chest

13. CECT of the chest was done on 22 march itself

14. The CECT revealed a large Ant. Mediastinal mass, following which a CT guided biopsy was done on 23/4/24

15. Trucut biopsy done on 23/3 Impr – Infective lymphadenitis – Hodgkin’s disease – Kikuchi’s ds. IHC – possibility of acute lymphadenitis of infective etiology

16. Patient was managed conservatively with antibiotics and symptomatic treatment and was discharged on 24/3/24

17. Another follow up CECT was done on 7/5/24

18. Biopsy was reviewed elsewhere (outside) on 15/5 which reported – Classical Hodgkin’s lymphoma (nodular sclerosis type). Patient is planned to be further evaluated with PET CT and, BMA and Bx

19. CASE 3 A 69 y.o . male came with complaints of - Lower abdominal pain and burning micturition Increased frequency of urination Low grade fever o/e – small umbilical hernia

20. Case 4 A 53 y.o . male came with complaints of Difficulty in breathing CLD Fever UGIE – grade I varices

21. THANK YOU