Radiology Case Review Series: Breast Imaging

423 Pages·2014·19.48 MB·English

by  Flowers

RADIOLOGY
|
CASE REVIEW SERIES Breast Imaging
Notice
Medicine is an ever-changing science. As new research and clinical experience broaden our knowledge, changes
in treatment and drug therapy are required. The authors and the publisher of this work have checked with sources
believed to be reliable in their eff orts to provide information that is complete and generally in accord with the
standards accepted at the time of publication. However, in view of the possibility of human error or changes in
medical sciences, neither the authors nor the publisher nor any other party who has been involved in the preparation
or publication of this work warrants that the information contained herein is in every respect accurate or complete,
and they disclaim all responsibility for any errors or omissions or for the results obtained from use of the information
contained in this work. Readers are encouraged to confi rm the information contained herein with other sources. For
example and in particular, readers are advised to check the product information sheet included in the package of each
drug they plan to administer to be certain that the information contained in this work is accurate and that changes
have not been made in the recommended dose or in the contraindications for administration. This recommendation
is of particular importance in connection with new or infrequently used drugs.
RADIOLOGY
|
CASE REVIEW SERIES Breast Imaging
Chris I. Flowers, MD, FRCR, FSBI
Director of Breast Imaging and Research
Department of Diagnostic Imaging
H. Lee Moffi tt Cancer Center & Research Institute
Associate Professor of Radiology
Department of Oncological Sciences
College of Medicine
University of South Florida
Tampa, Florida
Markus K. Holzhauer, MD
Windsong Radiology Group
Williamsville, New York
S E R I E S E D I TO R
Roland Talanow, MD, PhD
President
Department of Radiology Education
Radiolopolis, a subdivision of InnoMed, LLC
Stateline, Nevada
New York Chicago San Francisco Athens London
Madrid Mexico City Milan New Delhi Singapore
Sydney Toronto
Copyright © 2014 by McGraw-Hill Education. All rights reserved. Except as permitted under the United States Copyright Act of 1976, no part of this
publication may be reproduced or distributed in any form or by any means, or stored in a database or retrieval system, without the prior written permission of
the publisher.
ISBN: 978-0-07-178763-5
MHID: 0-07-178763-1
The material in this eBook also appears in the print version of this title: ISBN: 978-0-07-178719-2,
MHID: 0-07-178719-4.
eBook conversion by codeMantra
Version 1.0
All trademarks are trademarks of their respective owners. Rather than put a trademark symbol after every occurrence of a trademarked name, we use names in
an editorial fashion only, and to the benefit of the trademark owner, with no intention of infringement of the trademark. Where such designations appear in this
book, they have been printed with initial caps.
McGraw-Hill Education eBooks are available at special quantity discounts to use as premiums and sales promotions or for use in corporate training programs. To
contact a representative, please visit the Contact Us page at www.mhprofessional.com.
TERMS OF USE
This is a copyrighted work and McGraw-Hill Education and its licensors reserve all rights in and to the work. Use of this work is subject to these terms.
Except as permitted under the Copyright Act of 1976 and the right to store and retrieve one copy of the work, you may not decompile, disassemble, reverse
engineer, reproduce, modify, create derivative works based upon, transmit, distribute, disseminate, sell, publish or sublicense the work or any part of it without
McGraw-Hill Education’s prior consent. You may use the work for your own noncommercial and personal use; any other use of the work is strictly prohibited.
Your right to use the work may be terminated if you fail to comply with these terms.
THE WORK IS PROVIDED “AS IS.” McGRAW-HILL EDUCATION AND ITS LICENSORS MAKE NO GUARANTEES OR WARRANTIES AS
TO THE ACCURACY, ADEQUACY OR COMPLETENESS OF OR RESULTS TO BE OBTAINED FROM USING THE WORK, INCLUDING ANY
INFORMATION THAT CAN BE ACCESSED THROUGH THE WORK VIA HYPERLINK OR OTHERWISE, AND EXPRESSLY DISCLAIM ANY
WARRANTY, EXPRESS OR IMPLIED, INCLUDING BUT NOT LIMITED TO IMPLIED WARRANTIES OF MERCHANTABILITY OR FITNESS FOR
A PARTICULAR PURPOSE. McGraw-Hill Education and its licensors do not warrant or guarantee that the functions contained in the work will meet your
requirements or that its operation will be uninterrupted or error free. Neither McGraw-Hill Education nor its licensors shall be liable to you or anyone else for
any inaccuracy, error or omission, regardless of cause, in the work or for any damages resulting therefrom. McGraw-Hill Education has no responsibility for
the content of any information accessed through the work. Under no circumstances shall McGraw-Hill Education and/or its licensors be liable for any indirect,
incidental, special, punitive, consequential or similar damages that result from the use of or inability to use the work, even if any of them has been advised of
the possibility of such damages. This limitation of liability shall apply to any claim or cause whatsoever whether such claim or cause arises in contract, tort or
otherwise.
To our wives and families who have had to put up
with endless hours of poring over cases and our computers,
when we could have been taking the family to the Mall or
off on road trips. Thank you for your patience,
and here is the reward.
This page intentionally left blank
Contents
Series Preface ix
Preface xi
Easy Cases 1
Moderately Diffi cult Cases 173
Most Diffi cult Cases 353
Subject Index 407
Diffi culty Level Index 409
Author Index 410
vii
This page intentionally left blank
Series Preface
M
aybe I have an obsession for cases, but when I was with images and questions and page 2 with the answers and
a radiology resident I loved to learn especially from explanations. This approach avoids unintentional peeking at
cases, not only because they are short, exciting, and the answers before deciding on the correct answers yourself.
fun—similar to a detective story in which the aim is to get to We keep it strict: one case per page! This way it remains up
“the bottom” of the case—but also because, in the end, that’s to your own knowledge to fi gure out the right answer.
what radiologists are faced with during their daily work. Another example that residents (including me) did miss
Since medical school, I have been fascinated with learning, in traditional case review books is that these books did not
not only for my own benefi t but also for the sake of teaching highlight the pertinent fi ndings on the images: sometimes,
others, and I have enjoyed combining my IT skills with my even looking at the images as a group of residents, we could
growing knowledge to develop programs that help others in not fi nd the abnormality. This is not only frustrating but also
their learning process. Later, during my radiology residency, time consuming. When you prepare for the boards, you want
my passion for case-based learning grew to a level where the to use your time as efficiently as possible. Why not show
idea was born to create a case-based journal: integrating new annotated images? We tackled that challenge by provid-
concepts and technologies that aid in the traditional learn- ing, on the second page of each case, the same images with
ing process. Only a few years later, the Journal of Radiology annotations or additional images that highlight the fi ndings.
Case Reports became an internationally popular and PubMed When you are preparing for the boards and managing
indexed radiology journal—popular not only because of your clinical duties, time is a luxury that becomes even more
the interactive features but also because of the case-based precious. Does the resident preparing for the boards truly
approach. This led me to the next step: why not tackle some- need lengthy discussions as in a typical textbook? Or does the
thing that I especially admired during my residency but that resident rather want a “rapid fire” mode in which he or she
could be improved—creating a new interactive case-based can “fly” through as many cases as possible in the shortest
review series. I imagined a book series that would take into possible time? This is the reality when you start your work
account new developments in teaching and technology and after the boards! Part of our concept with the new series is
changes in the examination process. providing short “pearls” instead of lengthy discussions. The
As did most other radiology residents, I loved the tradi- reader can easily read and memorize these “pearls.”
tional case review books, especially for preparation for the Another challenge in traditional books is that questions
boards. These books are quick and fun to read and focus in a are asked on the fi rst page and no direct answer is provided,
condensed way on material that will be examined in the fi nal only a lengthy block of discussion. Again, this might become
boards. However, nothing is perfect and these traditional case time consuming to find the right spot where the answer
review books had their own intrinsic fl aws. The authors and is located if you have doubts about one of several answer
I have tried to learn from our experience by putting the good choices. Remember: time is money—and life! Therefore,
things into this new book series but omitting the bad parts we decided to provide explanations to each individual ques-
and exchanging them with innovative features. tion, so that the reader knows exactly where to fi nd the right
What are the features that distinguish this series from answer to the right question. Questions are phrased in an
traditional series of review books? intuitive way so that they fit not only the print version but
To save space, traditional review books provide two also the multiple-choice questions for that particular case in
cases on one page. This requires the reader to turn the page our online version. This system enables you to move back
to read the answer for the first case but could lead to unin- and forth between the print version and the online version.
tentional “cheating” by seeing also the answer of the second In addition, we have provided up to 3 references for
case. Doesn’t this defeat the purpose of a review book? From each case. This case review is not intended to replace tra-
my own authoring experience on the USMLE Help book ditional textbooks. Instead, it is intended to reiterate and
series, it was well appreciated that we avoided such acciden- strengthen your already existing knowledge (from your train-
tal cheating by separating one case from the other. Taking the ing) and to fi ll potential gaps in your knowledge.
positive experience from that book series, we decided that However, in a collaborative effort with the Journal of
each case in this series should consist of two pages: page 1 Radiology Case Reports and the international radiology
ix