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Metastatic Extraskeletal Osteosarcoma

History: 55 year old male with left flank mass on physical exam.  The diagnosis in this case was metastatic extraskeletal osteosarcoma, which is a malignant mesenchymal soft tissue tumor that contains components of cartilage, bone, and osteoid. Unfortunately, these tumors have a poor prognosis, with an approximately 25% 5 year survival rate. Notice the pleural … Continue reading

Esophageal Perforation

History: 50 year old male with a recent surgical intervention in the cervical esophagus.  This patient was status post resection of his Zenker diverticulum a few days prior to the esophagram. When esophageal perforation is the clinical question, it is essential that the first portion of the esophagram be completed with water soluble contrast such … Continue reading

Sarcomatoid Mesothelioma

History: 55 year old male with a right lateral chest wall mass seen on a prior chest radiograph.  The differential diagnosis for the right lateral chest wall mass visualized in the three MR images above includes mesothelioma, primary lung carcinoma, soft tissue sarcomas such as fibrosarcoma and malignant fibrohistiocytoma, fibromatoses such as desmoid tumors and … Continue reading

Accessory Azygous Fissure

History: 50 year old male with cough. This is the typical appearance of the accessory azygous fissure, which demarcates a portion of the right upper lobe of the right lung supplied by branches of the apical segment bronchus. It is a normal variant which is seen in about 0.4% of the population.

Subarachnoid Hemorrhage

History: 60 year old male with severe headache. This is a case of subarachnoid hemorrhage. Typically sudden onset non-traumatic subarachnoid hemorrhage is the result of a ruptured cerebral aneurysm, however, in this case the distribution of subarachnoid hemorrhage is not typical for a ruptured aneurysm, and may be related to other causes such as supratherapeutic … Continue reading

Ascites on Ultrasound

History: 50 year old male with abdominal pain and swelling.  This is the typical appearance of ascites on ultrasound. The right upper quadrant of the abdomen, particularly in Morrison’s Pouch, also known as the hepatorenal recess, is a great place to look for free fluid.

Coronary Artery Bypass Graft with Left Internal Mammary Artery

History: 67 year old male with cough. This is the typical location of vascular clips seen in a patient who has undergone coronary artery bypass graft surgery with the left internal mammary artery. A nice paper on this surgery from 1977 is located here.

The azygoesophageal stripe

History: 40 year old male with cough. Normal chest radiograph showing a nice example of the azygoesophageal stripe.

Bronchitis – The B6 Bronchus

History: 65 year old male with productive cough. This is a case of bronchitis. The bronchi seen on end near the hila are the B6 bronchi, which supply the superior segment of the lower lobes bilaterally. The B6 bronchi in the radiograph above are seen well because they are oriented perpindicular to the x-ray beam, … Continue reading

Schmorl Node

History: 50 year old male undergoing thoracic CT for chest pain has an incidental finding in his lumbar spine.  This is the typical appearance of a Schmorl Node. Frequently they may have a sclerotic border. A Schmorl node is an intravertebral disc herniation due to vertical disc extension through a weakened vertebral body endplate. The … Continue reading