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33 Cards in this Set
- Front
- Back
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A 58 year old female with a diagnosis of breast cancer 5 years ago comes in for a checkup after complaining of headaches, visual changes and vertigo. Bilateral breast ultrasound is done on the patient’s mastectomy sites. Some abnormal lymph nodes are seen. A CT scan shows multiple lesions within the brain and the patient is told there is nothing else they can do for her.
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Metastases of the Breast
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30 year old female with implants comes in for an US after complaining of asymmetrical appearance of her breasts. She has had the implants for over 10 years. US reveals a focal, prominent, irregular bulge in the implant and an ill defined implant margin. Also, the “stepladder” sign can be appreciated.
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Intracapsular Implant Rupture
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60 year old breast cancer patient with bilateral mastectomy and bilateral silicone implants comes in for mammo and US after her grandson accidentally elbowed her in the left breast. Mammo is abnormal and an US reveals a hyperechoic noise, or “snowstorm” sign and multiple pockets of free silicone are seen throughout the breast parenchyma.
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Extracapsular Implant Rupture
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67 year old male complains of muscle weakness and fatigue. His Dr orders an US after labs show an increased Blood calcium and Blood PTH level. US reveals a hypoechoic, vascular tumor that does not appear to be located within the thyroid. A sestamibi scan is done in Nuclear Medicine and confirms the mass is located in the parathyroid gland.
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Parathyroid Carcinoma
*rare* |
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47 year old female comes in for a Dr visit after labs show an increase in blood cholesterol levels. She states she has had some weight gain over the past few months and admits she has been dealing with some depression. US reveals a diffusely, heterogeneous thyroid gland that appears enlarged. It also appears to have increased vascularity.
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Hashimoto’s Thyroiditis
MCC of hypothyroidism |
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CLINICAL: A 42 year old female was referred for a mammogram and a breast ultrasound after informing her OB/GYN that she had identified a palpable, painful breast mass through regular self exams, and she had also experienced nipple discharge.
U/S: Ultrasound imaging revealed cystic lesions with projections of tissue into the lumen that had vascular stalks. Mammography imaging revealed lesions with a Raspberry appearance. NOTE: benign tumor of the milk ducts |
Intraductal Papilloma
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CLINICAL: A 57 year old female was referred for a breast ultrasound after having a suspicious lesion identified through her yearly mammogram.
U/S: The ultrasound exam revealed an irregularly shaped mass with spiculated margins, shadowing and distortion of the adjacent breast tissue. NOTE: Most Common type of breast cancer |
Invasive Ductal Carcinoma
AKA Infiltrating Ductal Carcinoma |
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CLINICAL: A 30 year old female was scheduled for a thyroid ultrasound after presenting with a small palpable mass in the area of the right lobe of her thyroid.
U/S: Ultrasound identified the palpable mass as a benign nodule. An incidental finding was an anechoic, well-defined, unilocular cyst with posterior enhancement located midline. The technician had the patient swallow, and determined that the cyst was superior to the thyroid and not in the thyroid tissue. |
Thyroglossal Duct Cyst
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CLINICAL: A 24 year old female was referred for an ultrasound after a visit to her family doctor where she presented with an enlarged thyroid, diarrhea, memory problems and depression.
U/S: Ultrasound revealed bilateral medullary thyroid cancer along with tumors of the parathyroid glands. NOTE: inherited as an autosomal dominant disorder; prognosis depends on stage of disease when identified. |
MEN Syndrome
(Multiple Endocrine Neoplasia) |
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54 year old female has her annual mammogram which reveals abnormal areas. A breast ultrasound was ordered and a hypoechoic ill defined area of distortion with infiltration into the adjacent fobroglandular parenchyma was found at 3:00 on right breast and a second hypoechoic angular mass found on the left breast at 10:00. A biopsy was ordered and the patient was told she needed to have either a lumpectomy or a masectomy.
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Infiltrating Lobular Carcinoma - 2nd most common type of invasive tumors, accounting for 10-15% of all breast cancers
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63 year old female goes in for a follow up ultrasound on an area found on her mammogram. Ultrasound finds a lesion with smooth margins and posterior enhancement with "salt and pepper" like echotexture.
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Colloid Carcinoma- aka mucinous carcinoma, rare type of ductal carcinoma
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36 year old female is sent for an ultrasound by her primary physician who thought her thyroid felt enlarged upon physical examination, she also is demonstrating exophthalmos, heat intolerence, nervousness, weight and hair loss. The ultrasound finds the thyroid to be hypoechoic with diffuse enlargement but no palpable nodules. Color doppler demonstrates increased vascularity (thyroid inferno).
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Graves' Disease
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43 year old female comes in for a thyroid ultrasound for mild hyperthyroidism. A complex anechoic area in the left lobe of the thyroid is found, the lesion has irregular margins and a hypoechoic halo is surrounding it.
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Thyroid Adenoma
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14 year old male comes in for a breast ultrasound because of unilateral breast enlargement. No tumors were found with ultrasound. The doctor explained that the patient’s condition was likely due to puberty and hormone changes and that it should resolve within six months.
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: Gynecomastia – B9 enlargement of the male breast. Caused by an increase in estrogen.
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A 32 year old patient comes in for a breast ultrasound. She had felt two painless, BB sized lumps in the 3:00 and 4:00 areas of her right breast. The sonographer had to use a standoff pad to identify two, superficial, hypoechoic masses with internal echoes and posterior enhancement.
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Sebaceous Cyst
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An 83 year old male is referred for a thyroid ultrasound by his doctor with symptoms of dysphagia (difficulty swallowing), coughing, neck pain, dyspnea (difficulty breathing) and a palpable neck mass. Ultrasound shows a hypoechoic, vascular mass stretching beyond the thyroid to invade the neck muscles. The 5 year survival rate for this pathology is less than 10%.
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Anaplastic thyroid carcinoma
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A 53 year old female is scheduled for an ultrasound because of pain in thyroid area. The patient had a previous scan 2 months ago because of thyroid pain. The diagnosis then was hyperthyroidism. The patient’s labs today show an increase in TSH and a decrease in both T4 and T3. As in the previous scan, the thyroid is enlarged and diffusely hypoechoic with ill-defined borders. According to here lab values, the patient now has hypothyroidism.
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De Quervain’s Thyroiditis
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A 29 year old women who was currently breastfeeding her 6 month old daughter came to the emergency room with a large palpable lump towards her sub-areolar region. On the recommended ultrasound there was a 5cm by 4cm complex appearing cyst with a fluid-fluid level. Her doctor suggested that it was only a clogged milk duct and probably was benign.
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Galactocele(milky white pouch in Greek)
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A week before her menstruation a 48 year old women called her doctor with complaints of painful lumpy breasts that felt heavy and swollen. She wasn't able to come in for an appointment until a week after her menstruation. When she came in for her appointment she realized her breasts were slightly less painful and the lumps were much smaller. On ultrasound it appeared she had multiple small cysts bilaterally. Her doctor told her not to worry because this condition does not increase the risk for breast cancer. He also recommended reducing caffeine and salt intake.
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Fibrocystic Condition
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A 33 year old woman was referred for an ultrasound because of a painless palpable lump in her right breast. On ultrasound a round, anechoic lesion with well-defined borders and posterior enhancement was imaged. Her doctor reassured her that this was the most common breast pathology and was benign.
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Simple cyst
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A 17 year old male was brought to his doctor because of difficult in breathing and swallowing. He also had a papable lump near the angle of his mandible on his sternocleidomastoid muscle that appeared to be draining fluid. Ultrasound showed a simple appearing cyst with posterior enhancement. His doctor seemed fairly certain this was a congenital anomaly of the failure of the obliteration of an epithelial cyst in embryonic development.
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Branchial Cleft Anomalies
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A 42 year old female comes in for a schedule ultrasound
after an abnormal mammogram. She also has skin discoloration in the right upper inner quadrant. The ultrasound reveal a well-circumscribed 3cm mass with a cystic / necrotic center at 2 o'clock on the right breast. |
Medullary carcinoma, a densely cellular tumor containing
large, round, or oval tumor cells. Relatively rare, comprising less than 5% of breast cancers. Doesn't grow quickly and usually doesn't spread to the lymph nodes. |
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A 65 year old woman comes in for bloody nipple discharge.
The mammo shows a mass in the left lower outer quad. An ultrasound was order and showed a small 1.5 cm mass extending from a duct and has hypervascularity. |
Papillary carcinoma, a tumor that initially arises as an
intraductal mass. Both intraductal and intracystic forms exist, and these represent 1% to 2% of all breast carciniomas. |
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A thyroid ultrasound was order for a 39 year old female who
feels a palpable mass in her thyroid. Her labs revealed elevated serum thhyroglulin, calicium, and calcitonin. Ultrasound shows a 4 cm hypoechoic mass with ill-defined borders in the left lobe of the thyroid, that contains microcalcifications and has hypervascularity. |
Papillary thyroid cancer
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A thyroid ultrasound is schedule for a 43 year old female.
She has recently had a sudden on set of hyperparpthyroidism and hypercalcemia, bone pain, fatigue, weakness, confusion, and depression. The ultrsound reveals a mass posterior to the right lobe of the thyroid. It measures 3cm and appears to have irregular borders. On further examination there also appears to be cervical lymph node adenopathy. |
Parathyroid carcinoma
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A 26-year-old breastfeeding mom had been expressing her milk by hand using relatively firm pressure. She began to notice a painful area on the right outer breast. The area became red and hot to the touch, and she developed a fever of 103. Ultrasound showed inflammation in the area of concern. An antibiotic was prescribed.
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MASTITIS
MCC is lactation |
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31-year-old diabetic mom decided to breastfeed her new baby. She developed pain in the left breast, and a fever rose to 104 degrees. U/S revealed a complex “mass” with irregular margins in the retroareolar region of her left breast. The mass was oval with low-level echoes.
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BREAST ABSCESS
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Female, 42, was referred to U/S for pain and swelling in her left neck. The thyroid u/s showed a normal right lobe. A mass displaying irregular tumor margins, a thick & irregular halo, and a tortuous or chaotic arrangement of blood vessels was discovered in the left lobe. Color Doppler showed a large spoke wheel pattern of vascularity. No microcalcs were seen.
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FOLLICULAR CARCINOMA
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A 47-year-old female with a family history of thyroid cancer was sent for ultrasound when her physician found a hard, bulky palpable mass in the right neck. Labs returned a high level of calcitonin. The sonogram showed a single, solid, hypoechoic nodule displaying psammoma bodies and hypervascularity. A biopsy was ordered and results came back with a prognosis worse than that of follicular carcinoma.
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MEDULLARY CARCINOMA
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A 35 year old woman is seen in the radiology department for a painful, full sensation in her right breast that’s relieved by the expel of bloody discharge from her nipple. The mammogram shows a “raspberry like” configuration. Ultrasound shows a well circumscribed solid lesion within a duct.
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Papilloma- benign- most common cause of bloody discharge from the nipple
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A 32 year old woman is scheduled for an ultrasound because of a palpable mass in her left breast. The exam shows a sharply marinated oval hypoechoic mass with posterior enhancement.
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Fibroadenoma- most common solid breast lesion
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A 40 year old woman with a history of fibroadenomas is seen for a new palpable breast mass that has been growing rapidly. Ultrasound and mammogram show a large well circumscribed lobular mass. Unsure of exactly what the mass is a biopsy is ordered.
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Phyllodes tumor
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A 60 year old female is seen by her physician for swelling and pain under her tongue. Ultrasound shows an echogenic mass with shadowing within the submandibular gland. Her doctor tells her she has a stone in her submandibular gland that is causing the pain and swelling, and that its usually caused by stasis in the duct.
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Sialothiasis
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