Radiology Case Review Series: Breast Imaging PDF
Preview Radiology Case Review Series: Breast Imaging
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. 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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
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