الموقع الرسمي للدكتور أحمد رفاعي

  • الرئيسية
  • محاضراتي - فيديو
  • محاضراتي - بور بوينت
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Technique:

Axial CT study for the abdomen with intravenous contrast administration,
soft tissue and bone window
Picture
Picture
The CT study revealed:
 -        multiple low attenuation ( dark ) lesions involving both hepatic  lobes
-         Small simple cortical cyst of left kidney
-         Multiple sclerotic bony lesions involving the axial skeleton , proximal
left femur and the skull

According to the above findings:

·        Multiple hemangiomas are excluded because hemangiomas with such small size
have to enhance    homogenously , and the large lesions have to show peripheral nodular
enhancement, which is not the case
·        Calcific lesions are excluded because in CT study it has to be bright, and of the
 same bone density ( like the ribs or the spine )
·        Multiple adenomas are excluded as the lesions do not enhance, and the patient
is not under contraceptive pills
·        Therefore  , we left with the last two possibilities , either metastasis ( specially
 in the presence of the sclerotic bony deposits ) or  multiple lipomas 
·        Echogeneic metastasis is excluded as the patient is clinically well , the CT study
reveals no apparent primary tumors and the attenuation value  of these lesions are of
fat density ( CT number is below 0 ).
 ·        Therefore such findings in the liver represent multiple lipomas

 
Regarding  lipoma of the liver , it is extremely rare , and it is  usually
associated with tuberous sclerosis , therefore I advised to do another
 CT brain study for more  clarification
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