A Mass In The Abdomen Identified on Routine Ultrasound

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Mass in the abdomen
Image Source: Ask Hematologist

Routine ultrasound in a patient with hemangioma revealed a mass in the abdomen, doctors suspected it to be of pancreatic origin

A 32-year-old man underwent an abdominal ultrasound during routine investigations. The ultrasound identified a mass in the abdomen. The patient had a history of hepatic hemangioma for the past 10 years.

Cardiac and respiratory examinations were unremarkable. Moreover, the physical examination did not reveal any enlarged lymph nodes.

Serological investigations revealed normal tumour markers.

The doctors decided to perform computed tomography (CT) scan of the abdomen. The CT scan identified a well-circumscribed and encapsulated mass. Additionally, the mass showed calcifications of variable shapes. Since the mass was adherent to the pancreatic neck, it seemed to arise from the pancreas. The mass enhanced intensely in the arterial phase with moderate washout in the venous phase. Besides the mass, the CT scan did not reveal any other abnormalities or enlarged lymph nodes.

During the exploratory laparotomy, the surgeons identified an encapsulated mass adjacent to the pancreatic neck. The mass measured 6 × 7 cm. The surgeons successfully and completely excised the tumour.

Histopathological evaluation of the mass revealed Castleman lymphadenopathy of hyaline-vascular type, which is also known as giant lymph node hyperplasia. The hyaline-vascular type is its histopathological classification. The cause still remains unknown, however, genetic factors, immune dysregulation, and infections play their part in the pathogenesis.

Since the patient was improving and had no post-operative complication, the doctors discharged the patient 7 days later.

At 2-year follow-up after surgery, the patient was doing well.

Reference:

Liu L, Wang Z, Cao D (2016) Parapancreatic Castleman Disease. Clin Med Img Lib 2:029. doi.org/10.23937/2474-3682/1510029

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Dr. Arsia Parekh
Dr. Arsia Hanif has been a meritorious Healthcare professional with a proven track record throughout her academic life securing first position in her MCAT examination and then, in 2017, she successfully completed her Bachelors of Medicine and Surgery from Dow University of Health Sciences. She has had the opportunity to apply her theoretical knowledge to the real-life scenarios, as a House Officer (HO) serving at Civil Hospital. Whilst working at the Civil Hospital, she discovered that nothing satisfies her more than helping other humans in need and since then has made a commitment to implement her expertise in the field of medicine to cure the sick and regain the state of health and well-being. Being a Doctor is exactly what you’d think it’s like. She is the colleague at work that everyone wants to know but nobody wants to be. If you want to get something done, you approach her – everyone knows that! She is currently studying with Medical Council of Canada and aspires to be a leading Neurologist someday. Alongside, she has taken up medical writing to exercise her skills of delivering comprehensible version of the otherwise difficult medical literature. Her breaks comprise either of swimming, volunteering services at a Medical Camp or spending time with family.

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