Findings
1. CT scanogram shows opacity in the right paracardiac location causing obscuration of the right cardiac margin. Chest Radiograph(not shown) also showed a similar finding for which CT Chest was suggested. Looking at CT chest findings, CT abdomen was also performed that revealed heterogeneously hypodense lesion involving the distal body and tail of pancreas(2) with exophytic component that abuts the adjacent stomach likely pancreatic neoplastic lesion. Also noted was an associated enlarged peripancreatic lymph node. Image 3 shows peritoneal nodular deposits suggestive of peritoneal metastasis. Coronal(4) and sagittal(5) images show right sided Morgagni hernia with hernia of peritoneal deposits and peritoneal fluid through it. Lung window(6) showed few lung nodules and mild right pleural effusion suggestive of metastasis.
Diagnosis
Pancreatic carcinoma with peritoneal and lung metastasis with right Morgagni hernia containing peritoneal metastatic deposits
Summary
At times, the diagnosis we make at initial imaging are totally different from the actual diagnosis. It is always imperative to evaluate clinical symptoms and do complete evaluation of patients to reach to an accurate diagnosis that governs optimal treatment.
Further reads
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