Answer for BIR CoW 01 Jan 2023
Pancreatic metastases
Findings
Ill defined lobulated T1 isointensity with central hypointensity and T2 isointensity with central hyperintensity lesion showing peripheral diffusion restriction noted in tail of pancreas abutting the greater curvature of stomach superiorly and anterior surface of left kidney posteriorly. A similar lesion in head and uncinate process of pancreas causing dilatation of main pancreatic duct (4mm), common bile duct (1.7cm), gall bladder and bilateral intra hepatic biliary radicles . On contrast administration, the lesions show heterogenous enhancement with central areas of necrosis. Patchy areas of diffusion restriction in segment 8, 7 and 3 of liver reflecting cholangitic abscess.
Discussion
Lung cancer is a leading type of cancer, equal in prevalence to breast cancer 13. It is the leading cause of cancer mortality worldwide; accounting for ~20% of all cancer deaths . The major risk factor is cigarette smoking which is implicated in 90% of cases and increase the risk of lung cancer, which can be divided by histological subtype 10: squamous cell lung cancer( most common cavitating carcinoma) small cell lung cancer large cell lung cancer lung adenocarcinoma Clinical features: Patients with lung cancer may be asymptomatic in up to 50% of cases. Cough and dyspnea are rather non-specific symptoms that are common amongst those with lung cancer. Central tumors may result in hemoptysis and peripheral lesions with pleuritic chest pain. Pneumonia, pleural effusion, wheeze, lymphadenopathy are not uncommon. Other symptoms may be secondary to metastases (bone, contralateral lung, brain, adrenal glands or paraneoplastic syndromes. Pancreatic metastases of lung cancers are rare and incidental. It is usually seen at an advanced stage of the disease with other associated metastases
Findings
Ill defined lobulated T1 isointensity with central hypointensity and T2 isointensity with central hyperintensity lesion showing peripheral diffusion restriction noted in tail of pancreas abutting the greater curvature of stomach superiorly and anterior surface of left kidney posteriorly. A similar lesion in head and uncinate process of pancreas causing dilatation of main pancreatic duct (4mm), common bile duct (1.7cm), gall bladder and bilateral intra hepatic biliary radicles . On contrast administration, the lesions show heterogenous enhancement with central areas of necrosis. Patchy areas of diffusion restriction in segment 8, 7 and 3 of liver reflecting cholangitic abscess.
Discussion
Lung cancer is a leading type of cancer, equal in prevalence to breast cancer 13. It is the leading cause of cancer mortality worldwide; accounting for ~20% of all cancer deaths . The major risk factor is cigarette smoking which is implicated in 90% of cases and increase the risk of lung cancer, which can be divided by histological subtype 10: squamous cell lung cancer( most common cavitating carcinoma) small cell lung cancer large cell lung cancer lung adenocarcinoma Clinical features: Patients with lung cancer may be asymptomatic in up to 50% of cases. Cough and dyspnea are rather non-specific symptoms that are common amongst those with lung cancer. Central tumors may result in hemoptysis and peripheral lesions with pleuritic chest pain. Pneumonia, pleural effusion, wheeze, lymphadenopathy are not uncommon. Other symptoms may be secondary to metastases (bone, contralateral lung, brain, adrenal glands or paraneoplastic syndromes. Pancreatic metastases of lung cancers are rare and incidental. It is usually seen at an advanced stage of the disease with other associated metastases
Note:
We do not discourage differential diagnosis. But all the differentials must satisfy the findings noted in the case.
If you feel you have answered rightly but cannot find your name in the above list, please call 09551942599.
Did you Know?
The order in which the names appear in this winner's list is based on the time of submission. The first person to send the correct answer gets his/her name on top of the list!
We do not discourage differential diagnosis. But all the differentials must satisfy the findings noted in the case.
If you feel you have answered rightly but cannot find your name in the above list, please call 09551942599.
Did you Know?
The order in which the names appear in this winner's list is based on the time of submission. The first person to send the correct answer gets his/her name on top of the list!