FINAL DIAGNOSE CASE 24&25

  Radiology Report case 24&25 FB and INSTA post Analysis

Clinical History:
30-year-old male patient with history of chronic heavy smoking presents with chest and abdominal pain, vomiting, and generalized weakness.

Examination:
CECT Whole Abdomen and HRCT Chest

HRCT Chest Findings:

  • Nodular masses are seen in bilateral lungs, more prominently in the upper lobes (image 1), suspicious for lung metastasis or primary neoplasm (e.g., bronchogenic carcinoma).
  • Confluent mediastinal lymphadenopathy noted (image 2), suggesting metastatic lymph node involvement or granulomatous disease 

CECT Abdomen Findings:

  • Confluent retroperitoneal lymph nodal mass is seen (image 3), consistent with nodal  or lymphoma.
  • Mild ascites is present.
  • Cholelithiasis (image 4) – multiple calculi noted in the gallbladder, no obvious signs of cholecystitis.

Impression:

  1. Bilateral pulmonary nodular masses, likely malignant (primary or metastatic).
  2. Confluent mediastinal and retroperitoneal lymphadenopathy – likely metastatic or lymphoproliferative disorder.
  3. Moderate ascites – possibly malignant or reactive.
  4. Cholelithiasis – incidental finding.

Suggestions:

  • CT-guided biopsy/FNAC from accessible nodular/lymph nodal mass for histopathology.
  • Tumor marker evaluation (e.g., CEA, AFP, LDH).
  • Sputum cytology and GeneXpert to rule out TB.
  • Oncology and gastroenterology consultations.
                                   *********

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