A 70-year-old female patient with known Wegener’s granulomatosis presented with worsening stridor and exertional dyspnoea of 3 months duration; high-dose corticosteroid therapy did not relieve her symptoms.
A Computed Tomography (CT) of the neck with IV-contrast medium was performed.Prior to the CT scan,plain chest radiograph was done.
What are the abnormalities you see in the Plain Xray and the CT of the neck?


A 36-year-old woman presented with pain in the epigastric region and right upper abdominal quadrant that lasted for two weeks. The pain did not remit after taking analgesics. She vomited once 7 days before. Clinical examination revealed abdominal pain on palpation. She was cardio-respiratory stable, in good general health condition without loosing weight.

Contrast-enhanced CT performed after the USS abdomen.What are the abnormalities you can see in this CT?What is the most likely diagnosis?



ANSWER

Adenocarcinoma of the gallbladder with wall calcifications and Liver metastases

Contrast-enhanced CT revealed calcifications in the thickened gallbladder wall.In a liver segment around the gallbladder a hypodense area was noted and hepatic parenchyma infiltration of a gallbladder adenocarcinoma was diagnosed. Hypodense oval lesions in liver segments IV, V, and VIII suggested metastases. Enlarged lymph nodes with central necrosis were depicted in the hepatoduodenal ligament, in the para-aortic and interaortocaval region.

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