An 18 year old African American male presented for evaluation of a mediastinal mass seen on chest x ray. He was initially seen in the ED with transient, stabbing, chest pain, which lasted for a few seconds and self-resolved. This prompted evaluation with a chest radiograph. He had no shortness of breath, night sweats, chills, loss of appetite, weight loss, hemoptysis or cough. His past medical history was only significant for seasonal allergies. He had no prior surgeries and had no history of smoking, alcohol or illicit drug use. He was on no medications. Complete physical examination including vital signs and cardiopulmonary exam was normal. Laboratory testing showed a normal complete blood count, biochemistry profiles and he was HIV negative.
A chest radiograph showed a rounded, well-defined soft tissue density measuring 4.5 x 4.2 cm located in the inferior aspect of the left hilum at the level of the mid chest. The chest x-ray was otherwise unremarkable. Computed tomography of the chest revealed a left hilar 3.2 x
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It can be classified as unicentric (localized) or multicentric (systemic). Unicentric Castleman disease (UCD) has an excellent prognosis, where as multicentric Castleman disease (MCD) is associated with significant morbidity and mortality. MCD occurs most commonly in HIV infected individuals and is associated with human herpesvirus 8 (HHV-8). Although the pathogenesis of CD is not completely understood, interleukin (IL) 6 plays a central role in UCD and both IL-6 and HHV-8 in MCD. Histologically, CD, is usually classified as either the hyaline-vascular (usually occurring in UCD) or plasma cell variant (mostly present in MCD), with occasional cases with mixed features. The diagnosis of CD is made by excisional biopsy or core needle biopsy of affected lymph node tissue. Our patient was HIV negative and the specimen pathology was negative for
In general he is a not acutely ill appearing male. His neck veins were elevated to the angle of the jaw. He had no thyromegaly or lymphadenopathy. His lungs were clear to auscultation. His heart was regular rate and rhythm with an S3 and an S4. His PMI was laterally displaced by 1 cm. His abdomen was (full), slightly distended and had a positive fluid wave. He had no pitting edema in the abdominal exterior wall. His rectal exam was heme-negative. His extremities showed 4+ pitting edema up to his knees and in his feet
During my first semester at West Georgia there has been a lot going on. My experience here has somewhat made me more confused about the path I want to take to becoming Radiology Technician. Also during this semester there has been a large amount of violence. Due to the violence it makes me feel less safe on campus making me second guess if I want to stay here at West Georgia.
Hi Caroline. I found your paragraph about radiology to be interesting and very informative. I like how you mention what radiologists are responsible for and what they perform besides taking X-Rays. You talk about the different imaging resources such as ultrasounds, CT scans, nuclear medicine, tomography, and MRIs. The various duties radiologists perform in diagnosing and treating patients are needed to keep the patient informed on their progress and any update that may be present. I originally was going to start the radiology program here at Brookdale and I still find it to be an important area of medical study. I find it's a very critical part of the medical field and I did not realize how far you can study radiology and how you can
Most Dallas pediatric dentists use bitewing x-rays as part of a child's dental exam. There are several reasons why x-rays may need to be taken of your child's mouth. Understanding the importance of x-rays as a diagnostic and preventative tool can help ease your fears as your child gets their dental check-up.
A 37-year-old woman is brought to the emergency department 15 minutes after falling down a flight of stairs. On arrival, she has shortness of breath, right-sided chest pain, right upper quadrant abdominal pain, and right shoulder pain. She is otherwise healthy. She drinks 1–2 beers occasionally and takes no medications. She appears pale. Her temperature is 37°C (98.6°F), pulse is 115/min, respirations are 20/min, and blood pressure is 85/45 mm Hg. Examination shows several ecchymoses over the right chest. There is tenderness to palpation over the right chest wall and right upper quadrant of the abdomen. Bowel sounds are normal. Cardiopulmonary examination shows no abnormalities. Neck veins are flat. Which of the following is the most likely
Initial assessment of my patient revealed she had an increased work of breathing using accessory muscles she had a fever of 39 degrees Celsius. Vital signs included, respiratory rate 31, blood pressure 130/85, breath sounds were diminished with crackles in the bronchioles. Chest physical examined revealed increased fremitus and a dull percussion note.
James Phillips, a 16 year old, Caucasian male presented to the emergency department with joint pain, loss of appetite, and fatigue. Accompanied by his mother, she said his fever was on and off for the last 1 months and had episode of high grade fever for 3 days in a week. She further explained he has experienced several nose bleeds in the last 3 weeks. Vital signs were taken and Temperature was 100.4˚F, his pulse rate was107 bpm, and blood pressure was 136/68 mmHg. Patient is 5'10" weighing 150 pounds. Mother said patient has lost 10 pounds in 1 month but his routine has not changed. During assessment, pallor was noted, palpable nodules noted in bilateral axillary region, and multiple bruises noted on left and right lower extremities. Patient
Head and Neck: Head of the patient round and symmetrical, no lesions or mass noted. Tracheal
According to The Yale School of Medicine, in 2012 4 million pediatric CT scans were performed. The American College and Dose Index Registry has made it their goal to “track and categorize the radiation given by CT scanners in U.S hospitals.” The Alliance for Radiation Safety in Pediatric Imaging is stressing, “one size does not fit all” (Goske, 2008). In order to reduce pediatric radiation dose during CT scans without reducing image quality one should “child-size the amount of radiation used, scan only when necessary, scan only the indicated organ and refrain from using multiphase scanning” (Goske, 2008).
I am thrilled to be choosing Radiology as the path to becoming the kind of doctor I’ve always envisioned: intelligent, collaborative, and compassionate.
A CT scan showed haemorrhaging in various cavities of James’ brain. However, after three months, his brain injuries were resolving but a follow up CT scan still showed damages in certain brain regions. James was cooperative throughout testing but he was little anxious about his health and appeared to be talkative and impulsive in nature. In addition, he showed unstable emotional displays in regards to his family, experienced slight difficulties with his memory and attention, and was easily distracted but he seems very optimistic and believed that his memory was improving.
3. Heart Sounds S1 heard best at apex, S2 heard best at base, no extra sounds or murmurs identified.
Thank you for arranging a CT chest scan that reveals extensive emphysematous change with lower zone bronchiectasis but no active infective changes. I gather Rod has also had a stress echocardiogram, the results of which were not available today.
Case Description: A 25 year old healthy male who is a very active running back in the sport of football came to the emergency room. The patient has a history of previous
of the day. Whether the challenges are mental or purely physical, we have found more