Case Index - February 2003 - Case of the Month.

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15 year old, FS, DSH with weight loss, anorexia, painful abdomen, elevated ALP
.What do you think?

Ultrasound findings:

Hypoechoic mass lesion adjacent to small intestinal bowel loop. This mass appears to invade into the wall of the intestines causing loss of normal loop layering.

Additional Images:

1. US of sternal LN
2. US of liver
3. Radiographs of thorax

Now what do you think?

















Findings:
1. hypoechic enlarged sternal lymph node and hepatic nodules

Diagnostic Interpretation:
1. pancreatic neoplasia (carcinoma)
2. hepatic and lymph node metastases