Date : 00.00.00
Name of the Patient : Abc Xyz Jalmn / M / 50 yrs.
Referred by : Dr. Abc Xyzh.
Examination : M.R.I. of the Abdomen.
CLINICAL PROFILE :
C/O pain in the abdomen since 3 months.
H/O fever since 3 months.
M.R.I of the abdomen was performed using the following parameters:
8 mm thick T1 Weighted and T2 Weighted axial images.
7 mm thick T1 Weighted and STIR coronal images.
7 mm thick T1 Weighted and T2 Weighted (with fat saturation) sagittal images.
There is seen a fairly large, ill-marginated, intermediate signal intensity mass lesion on the T1 Weighted images with its epicentre in the left suprarenal region. This lesion appears significantly hypointense on the T2 Weighted and STIR images. The lesion extends from the left suprarenal region along the anterior and lateral margins of the left kidney, along the medial margin of the spleen, including the splenic hilum and is seen to encase the tail of the pancreas at the splenic hilum. The fat plane along the greater curvature of the stomach is not well-defined. The left suprarenal gland is not identified separately from the lesion.
The liver is normal in size, shape and position. There is no focal or diffuse area of altered signal intensity. There is no intrahepatic biliary radicle dilation. The intrahepatic venous architecture is normal.
The gall bladder is normal and reveals no intrinsic abnormality.
The head and body of the pancreas appear normal in bulk and signal characteristics. The tail of the pancreas also shows normal signal characteristics.
The right adrenal gland is normal. There is mild splenomegaly without change in signal intensity.
The right kidney is normal in size and signal characteristics.
There is no evidence of free fluid within the abdomen.
A fairly large, mass lesion in the left suprarenal region with extensions as described is not specific for a single etiology. The differential diagnosis would include :
a. Tuberculosis of the suprarenal gland.
b. Neoplastic lesions like lymphoma, ? adenocarcinoma.