Terence M. Brady, MD




Plasmacytoma of the Bone

September 14, 2005

A 55-year-old man complaining of backache had localized tenderness at the paraspinal region over the posterior portion of the right 7th rib. A CT scan of the thorax revealed erosion of this portion of the rib, along with a space-occupying lesion that displaced the adjacent pleura and lung. Needle aspiration and biopsy study of this mass showed it to be a plasmacytoma.

Hepatic Hemangioma

September 14, 2005

A 56-year-old man who had hematuria for 2 weeks underwent ultrasonography. This disclosed a well-circumscribed cyst in the lower pole of the left kidney and echogenic foci in the upper pole of the right kidney, without any evidence of posterior shadowing. A hyperechoic, well-circumscribed, circular focus was also seen in the right lobe of the liver. Abdominal CT confirmed the presence of a left renal cyst and revealed a 4.7-cm hypodense lesion in the right lobe of the liver, which suggested hemangioma.

Renal Cell Carcinoma

September 14, 2005

A 42-year-old woman came to the emergency department because of hematuria for 1 day, a low-grade fever, and weight loss over the past 2 months. She denied having any abdominal pain or urinary problems. Pallor was the only noteworthy physical finding.


September 14, 2005

For the past year, a 45-year-old man experienced dull, aching chest pain and breathlessness following routine work. He had no history of fever, cough, dysphagia, or change in voice.

Superior Vena Cava Syndrome

September 14, 2005

A 42-year-old woman complained of facial puffiness, fullness, and redness for 2 weeks, which were gradually becoming more severe. She also noticed a sensation of “heaviness” in her head. The patient had no significant past medical history. She denied having a cough, shortness of breath, hoarseness, allergies of any kind, and neurologic deficits. Her weight and appetite were unchanged. She had smoked a pack of cigarettes every day for the past 20 years.

Achalasia in a 48-Year-Old Man

September 14, 2005

A 48-year-old man complained of difficulty in swallowing both solid food and liquids. The dysphagia began several years earlier and had become increasingly severe and more frequent over the past 2 to 3 years. Vague heartburn without reflux and frequent regurgitation were also troublesome.