Medical Challenge | CT Interpretation

Posted on July 25, 2011

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This time, a more detailed history is provided, and you are the inexperienced medical intern, not the seasoned radiologist.  If you missed last week’s challenge, you can still give it a shot.

You are asked to examine an 84 year old Hispanic female who was admitted to the hospital with shortness of breath.

  • Her past medical history includes congestive heart failure, diabetes, osteoarthritis, diverticulosis and hypertension.
  • Her surgical history includes a left total knee replacement and a hysterectomy for endometrial cancer 6 years prior to admission.
  • She is well-groomed & overweight, and her vital signs & physical exam are unremarkable.  She smoked 2 packs of cigarettes daily for 40 years before quitting 6 years ago, and reports using alcohol socially.
  • On review of systems, she complains of headaches, morning stiffness, periodic shortness of breath as well as a poorly characterized epigastric pain that comes and goes.  She also notes that she has been feeling full earlier in her meals and complains of belching.

She receives a CT scan as part of her work-up; your medical student decides to view the images before the official radiology report is back and asks you to comment on the sagittal  slice below:

Click to enlarge

What do you say?

A) There is no pathology present on this cut

B) There is a hernia

C) There is a mass in the stomach

D) There is a mass in the lung

E) There is a mass in the liver

School your med student below & check back in 24-48 hours for the answer.

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Posted in: Medicine