Date : 00.00.00
Name of the Patient : Abc Xyzl T. Shlmn / M / 32 yrs.
Referred by : Dr. Abc Xyz Shah.
Examination : M.R.I. of the Lower Neck & Chest-Wall.
CLINICAL PROFILE :
C/O gradually progressive swelling in the left axilla since 1 month with inability to lift the LUE.
M.R.I. of the lower neck and chest-wall was performed using the following parameters:
7 mm thick T1 Weighted and T2 Weighted axial images.8 mm thick T1 Weighted and STIR coronal images.OBSERVATION :
There is seen a fairly large, intermediate signal intensity mass lesion on the T1 Weighted images along the left lateral chest wall. This lesion appears heterogeneously hyperintense on the T2 Weighted images. Extension of this lesion into the lower neck on the left, axilla and into the proximal left arm is noted. The pectoralis muscle along the anterior chest-wall is displaced by the lesion. The trapezius, latissimus dorsi and the serratus anterior muscles are displaced posteriorly and laterally respectively. The scapula is displaced postero-laterally and the left arm and shoulder girdle are displaced laterally. In the proximal left arm, the lesion is noted between the biceps and the triceps muscles, along the posterior margin of the humerus. In the axilla, the lesion is probably exposed to the exterior with loss of overlying subcutaneous fat. The fat planes between the mass lesion and the visualized muscles is well demarcated. No obvious involvement of the muscles per se is noted.
At the root of the neck on the left side, the lesion is seen to encase the left subclavian artery. The left subclavian artery is encased along its course upto the proximal left arm. The left carotid sheath is displaced slightly antero-medially at the root of the neck. The left sternocleidomastoid muscles is also displaced slight anteriorly. Enlarged lymph nodes are noted, in the neck deep to the sternocleidomastoid muscles.
There is no obvious bone erosion or destruction seen. No obvious extension of the lesion through the chest wall into the left hemithorax is noted. There are no abnormally enlarged mediastinal lymph nodes identified.
It is difficult to assess metastasis into the lung parenchyma on this study.
Subcutaneous edema is noted on the skin surface overlying this lesion.
IMPRESSION :A fairly large, mass lesion along the left lateral chest-wall, extending into the lower neck on the left, left axilla and proximal left arm, medially, as described, is not specific for a single etiology. A soft tissue sarcoma is a likely possibility.