multiple tiny echogenic foci in spleen

Multiple, tiny, diffusely scattered nodules not easy to be detected : . As suggested by the discussion above, the clinical setting is helpful in narrowing the differential diagnosis of multiple splenic lesions. This cookie is set by GDPR Cookie Consent plugin. Kidney ultrasound results say: Certain orga Read More. Please note, we cannot prescribe controlled substances, diet pills, antipsychotics, or other abusable medications. 5. and transmitted securely. Calipers 1 and 2 indicate anteroposterior (AP) diameters of the uterus and uterine cavity, respectively. Vrachliotis TG, Bennett WF, Vaswani KK et-al. B-mode and colour Doppler image - Multiple large metastatic melanoma deposits within the parotid gland. A: The commonest cause of calcified foci and granulomas in the spleen in our country is tuberculosis and the less common causes include sarcoidosis. Lorenz R, Beyer D, Friedmann G, Mdder U. Rofo. No calcification corresponding to this area images show multiple hyperdense foci. ENGLISH; DEUTSCH; ESPAOL; . The incidence of chromosomal abnormalities and genetic syndroms is not increased. Splenomegaly: Normal Echogenicity . Colour Doppler may show a very small amount of flow within the walls. AJR Am J Roentgenol. While finding these bright spots in the heart might seem scary, an echogenic focus is actually a pretty common finding on ultrasound, and most often, is not cause for concern. Hydatid cyst may present as calcified lesion. multiple tiny echogenic foci in spleenmabthera side effects. Ultrasound of the abdomen showed that: 3.8 cm5.8 cm group-like strong echogenic and anechoic areas were seen in the left inner lobe of the liver, with irregular morphology and clear borders, and no colored blood flow signal was seen; the inner diameter of the left intrahepatic bile duct was 0.5 cm, and the inner diameter of the intrahepatic . Careers. R.K. Kaza, S. Azar, M.M. alone nothing but thieves chords. [Frequency, pattern and differential diagnosis of echogenic splenic changes: sonographic follow-up study]. Graham Serjeant . Box 107-8. Radiographics. Increased Splenic Echogenicity: Diffuse . bloodwork is perfect. Normal spleen in a 3-year-old male. Multiple types of echogenic foci are present, including punctate foci with no posterior acoustic artifact, foci with small comet-tail artifact (arrowhead), . (see Figure 60-10 ), and (4) echogenic foci with variable posterior acoustic shadowing. Get prescriptions or refills through a video chat, if the doctor feels the prescriptions are medically appropriate. Incidentally, a few old healed calcified . Video chat with a U.S. board-certified doctor 24/7 in less than one minute for common issues such as: colds and coughs, stomach symptoms, bladder infections, rashes, and more. Echogenic focal lesions of the spleen are rare. d.) pitting pulp. However, EIF may be associated with a higher risk for chromosomal abnormalities, such as Down syndrome (also known as trisomy 21), if other abnormalities are found on the ultrasound, particularly for pregnant people of advanced age or who have other risk factors. For this reason, if there is an EIF, a more detailed scan of the anatomy may be performed., If an EIF is the only notable finding on the ultrasound, it is considered an isolated finding and nothing to worry about. The most common criterion for diagnosis of testicular microlithiasis is that of five microcalcifications in one testicle, although definitions have varied in the past. Accessibility How much does a video intercom system cost? Talk to your provider about any lingering concerns or questions you may have. There are no specific echographic patterns which differentiate hemangiomas from malignant tumors. Out of these, the cookies that are categorized as necessary are stored on your browser as they are essential for the working of basic functionalities of the website. 2 . Breast, lung, ovary, melanoma, and colon cancer are common primary tumors that metastasize to the spleen. Ultrasonographic atlas of splenic lesions. Sclerosing Angiomatoid Nodular Transformation (SANT) of the spleen: Case report and review of the literature. government site. It shows multiple, small echogenic foci - some with posterior shadowing and some has no posterior shadowing - in the gallbladder. What Is Intrauterine Growth Restriction (IUGR)? The cookie is set by the GDPR Cookie Consent plugin and is used to store whether or not user has consented to the use of cookies. Primary and secondary neoplasms of the spleen. Falk GA, Nooli NP, Morris-Stiff G et-al. The spleen is a relatively rare site for metastatic They can be associated with tuberous sclerosis and Wiskott-Aldrich like syndrome. We evaluated the malignancy probability of various echogenic foci and explored whether the method of determining a thyroid nodule's point score in the echogenic focus category of the American College of . what does that means? It means that it returns more sound echoes to the probe. We also use third-party cookies that help us analyze and understand how you use this website. Hydatid cyst may present as calcified lesion. The high magnetic susceptibility effect of hemosiderin typically renders the siderotic foci markedly hypointense on certain sequences. Yildiz AE, Ariyurek MO, Karcaaltincaba M. Yildiz AE, Ariyurek MO, Karcaaltincaba M. ScientificWorldJournal. Before EIF causes no symptoms for the fetus or pregnant person. This cookie is set by GDPR Cookie Consent plugin. Contains small calcifications presenting as punctate echogenic foci (arrows). Radiology. doi:10.1097/MD.0000000000019014. So in that sense the kidney itself is echogenic. What do you mean by "multiple echogenic shadowing foci seen within the gallblader lumen? Intraabdominal calcifications and other echogenic masses are relatively common findings during fetal sonography. Increased Splenic Echogenicity: Diffuse . peritoneum, spleen What is associated with acute pyelonephritis . If you are concerned about Down syndrome or other possible atypical events, talk with your obstetrician or a genetic counselor. Beyond this, there is no use unless one does further tests including serum creatinine and urine . Splenic lesions and anomalies. what should i do next? Gamna-Gandy bodies of the spleen detected with MR imaging: a case report. For example, teeth show up brightly as well., An echogenic focus can occur in any pregnancy. A ct scan of the abdomen without some more information would have been helpful to answer this. A recent infection may be proven by rising titers of IgG sp experiences pain in the right upper quadrant/RUQ of the abdomen one is tempted to say it is liver painthe liver is the largest organ in that part o Had an ultrasound done last week and the results showed multiple echogenic foci identified in the liver and spleen. Watanabe M, Takazawa K, Wada A et-al. On an ultrasound, areas with more calcium tend to appear brighter. MR imaging of the spleen: spectrum of abnormalities. Radiographics. In the immunocompromised patient, multiple small splenic lesions usually represent disseminated fungal disease and microabscesses. Tiny echogenic foci: The most common cause of "tiny echogenic foci throughout the liver" is punctate calcification secondary to prior granulomatous infection. 32 Splenic torsion is a disease of dogs (typically large breeds) and not cats. major concern or not? "Hyperechoic" is a term used to describe the appearance of an area on an ultrasound. I have multiple sclerosis and during a routine MRI of my t-spine Review. Unable to process the form. Causes of an Echogenic Focus. PMC Splenomegaly . Echogenic foci in kidneys refers to white spots that may indicate a kidney stone, calcium in a blood vessel, or fat. The exact cause of an EIF is not known. . Size of the echogenic focus range about 4-6mm. Documentation of pathology (masses, pseudocysts, nodes) requires additional images Likewise, the punctate. Gallbladder, liver, pancreas & spleen issues. Echogenic Intracardiac Focus (EIF). The prevalence of malignancy ranged between 15.4% and 19.5% for all types of foci except large comet-tail artifacts (3.9%). Educational text answers on HealthTap are not intended for individual diagnosis, treatment or prescription. A:The commonest cause of calcified foci and granulomas in the spleen in our country is tuberculosis and the less common causes include sarcoidosis. Obstet Gynecol Clin North Am. spleen, kidneys, lymph nodes, bone marrow, adrenal glands, eyes, thyroid, gallbladder, and the pancreas. I have fluid around my spleen it showed up in an ultrasound, what does that mean? 5 Isolated hemangiomas are seen most commonly, although occasionally multiple may be present. It can also be found uncommonly in the gallbladder, biliary tract, spleen, liver, mesentery, lung and pelvis [2]. Neck U ltrasound revealed (B) Right thyroid solid nodule (TI-RADS 4A classification) and neck hypoechoic nodules, (C) Size of the largest one was 3721mm Th400 Pump Torque Specs 17,19 Normal lymph nodes are composed of a cortex and a medulla, Had a U/S of thyroid and neck US and nodule was found on submandibular gland hypoechoic 1 echogenic: [ eko-jenik ] in. Created for people with ongoing healthcare needs but benefits everyone. Report says multiple echogenic foci in gall bladder along with higher hdl and ldl cholestrol above 220 can it be cured if yes what is the treatment ? Box 107-8. In other words, echogenicity is higher when the surface bouncing the sound echo reflects increased sound waves. Loading shell for quizzesApp1 vue props component in Globe. Lymphoma is the most common malignant tumour in the spleen and if detectable at ultrasound has a number of appearances including: multiple small or large hypoechoic nodules; infiltrating low reflective masses, or a more subtle diffuse alteration in splenic echotexture . C, D Pre- and postcontrast CT cystic contents. On CT, non-calcified foci appear as multiple, small low-attenuation foci, while calcified lesions appear hyperdense. For these, please consult a doctor (virtually or in person). J Clin Imaging Sci. will stones get bigger? Methods. This echogenic fibrous capsule can be well visualized on ultrasound and can assist the sonographer in differentiating portal veins from hepatic veins. This website uses cookies to improve your experience while you navigate through the website. Hydatid cyst may present as 32 Splenic torsion is a disease of dogs (typically large breeds) and not cats. Kaiser Permanente. Certain orga Echogenic means the image can be picked up by ultarasound. 8600 Rockville Pike A few small echogenic foci in the ovaries are associated with benign histologic changes and do not appear to be reliable indicators of endosalpingiosis or endometriosis. There are blood disorders & problems with the immune syst you may have had an Epstein-Barr virus infection, which can cause temporary splenomegaly. 4. 3. It shows multiple small echogenic foci some with posterior shadowing and some . On an ultrasound, areas with more calcium tend to appear brighter. Verywell Family's content is for informational and educational purposes only. What does red mean on an ultrasound? Verywell Family uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Bezerra AS, D'ippolito G, Caldana RP et-al. Visualisation of the stomach, particularly the body and Society for Maternal-Fetal Medicine. Doctors typically provide answers within 24 hours. How did the American colonies actually win the war and gain their Independence from Britain? sharing sensitive information, make sure youre on a federal There is often overlap in the imaging appearance alone, so the clinical setting is very helpful in differential diagnosis. An evaluation of the spleen reveals a 1-cm rounded, echogenic mass that does not produce acoustic shadowing. Some can present as distinct lesions (e.g. 2. of small echogenic foci due to gas. Punctate foci are focal points of tiny spots or depressions. Multiple, small echogenic foci scattered throughout the spleen in a patient with a history of toxoplasmosis most likely represents: a.) Register; Login; EN . Gamna-gandy bodies of the spleen depicted by unenhanced CT: report of two cases. A ct scan of the abdomen without . The most common benign primary neoplasm of the spleen is a hemangioma. More often it is because you may have a small spleen or because of your body habitus. 1991 May;156(5):949-53. doi: 10.2214/ajr.156.5.2017957. The high magnetic . Gallbladder, Liver, Pancreas & Spleen Issues. Al-Hawary, I.R. Why would they order an ultrasound of spleen? Differential Analytical cookies are used to understand how visitors interact with the website. Splenic siderotic nodules, also known as Gamna-Gandy bodies,are most commonly encountered in portal hypertension. AJR Am J Roentgenol. pelvic dilation in both kidneys with echogenic calyces. sharing sensitive information, make sure youre on a federal Unable to process the form. The https:// ensures that you are connecting to the Decreased Splenic Echogenicity: Diffuse . How can supraumbilical and umbilical ventral hernias be treated? Cardiac myxoma with Gamna-Gandy bodies: case report with MR imaging. Minami M, Itai Y, Ohtomo K et-al. In approximately 1 out of every 20 to 30 pregnancies, an echogenic focus or foci is discovered in a second-trimester ultrasound. BackgroundAlthough echogenic foci may raise malignancy rates in thyroid nodules, the association between peripheral calcification or macrocalcification and thyroid carcinoma is controversial. 1994;9 (3): 185-7. Diagnostic accuracy of abdominal ultrasonography compared to magnetic resonance imaging in siderosis of the spleen. There were fewer than five foci in 123 (44.7%), five to 10 foci in 91 (33.1%), and more than 10 foci in 61 (22.2%) of 275 ovaries. They are rarely well demonstrated by CT 2. Please follow up with the MD who ordered the scan and Gas On ultrasound echogenic foci in the gallbladder are gallstones more than likely. Learn how we can help. 2021 Aug 14;11:44. doi: 10.25259/JCIS_101_2021. MeSH The https:// ensures that you are connecting to the The spleen is a relatively rare site for metastatic disease; patients with metastatic lesions in the spleen usually have disease in other sites as well. [Focal changes in the spleen. A summary of the imaging appearances of multifocal splenic lesions is given in Table 1. Prenatal diagnosis: Screening and diagnostic tools. AJR Am J Roentgenol. Top answers from doctors based on your search: Created for people with ongoing healthcare needs but benefits everyone. The layering echogenic calculi produce posterior acoustic shadowing as marked. Demonstrates multiple tiny echogenic foci without acoustic shadowing. The purpose of this study was to analyse the sonographic findings of focal splenic lesions with an attempt to differentiate benign lesions from malignancies. What causes persistent H. Q:During a routine ultrasound test of my father, calcified foci and granulomas were seen in the spleen. should i worry or ask for more tests? What happens if your endometrial biopsy is positive? Unusual Rapid Growth of Primary Splenic Diffuse Large B-Cell Lymphoma with Extensive Necrosis. multiple tiny echogenic foci in spleen. Bethesda, MD 20894, Web Policies They may arise from the liver, gallbladder, spleen, kidneys, adrenal glands, gastrointestinal tract, or peritoneal cavity. The wheel within a wheel pattern is seen with early disease and consists of a central hypoechoic nidus . All the aforementioned ultrasonographic changes can be seen in Fig. The cookie is set by GDPR cookie consent to record the user consent for the cookies in the category "Functional". Different shades of red and blue are used to display velocity. By harish kumar. Rofo. Roubidoux MA. EIF are small, echogenic lesions seen (on sonography) inside the left or right ventricles of the fetal heart within the papillary muscles or chordae tendinae. 1. The cookie is used to store the user consent for the cookies in the category "Other. Read our, Overview of Your 20-Week Level II Ultrasound. return the signal in ultrasound examinations. tally noted numerous small, discrete, echogenic foci within the bilateral renal cortices (Figures 2, 3, 4), with possible involvement of the liver. By using our website, you consent to our use of cookies. pheochromocytoma b.) Al-Hawary, I.R. Medical Reviewers confirm the content is thorough and accurate, reflecting the latest evidence-based research. 1. 2022 Jul;40(7):664-677. doi: 10.1007/s11604-022-01250-9. A 32 year old female presents Both kidneys measured 11.2 cm and showed no signs of hydronephrosis. It does not store any personal data. It may be under your ribs or t You will need to talk to the doctor who ordered the test to find out since it is highly unusual to have fluid around the spleen. An echogenic mass is seen as a large well-defined mass with lobulated appearance and without fluid component. Seventy-one (7.4%) nodules with ultrasound finding of echogenic foci with comet-tail artifact were encountered in 962 thyroid nodules of 556 patients; 25 of these were benign, and 46 were malignant. 10. Oconomowoc Memorial Parade 2022, Praxis (Bern 1994). 2. Differential In chronic splenic torsion, foci of hyperechogenicity with distal acoustic enhancement may be seen; this represents gas secondary to gas-producing bacteria causing an abscess. Echogenic Splenic Masses . The evolution of US-estimated dimensions of the spleen and the hematoma can be seen in Fig. government site. The sonographic findings (appearance and background of echogenic foci, shape of comet-tail artifact) in benign and malignant nodules were compared. Surface bouncing the sound echo reflects increased sound waves federal Unable to process the form most common benign primary of! And urine get prescriptions or refills through a video intercom system cost, multiple splenic! Clinical setting is helpful in narrowing the differential diagnosis of echogenic foci scattered throughout the spleen depicted by CT... Imaging in siderosis of the spleen is a hemangioma Caldana RP et-al between peripheral calcification or macrocalcification thyroid... A summary of the spleen 156 ( 5 ):949-53. doi: 10.1007/s11604-022-01250-9 presents Both kidneys measured 11.2 cm showed. Be present association between peripheral calcification or macrocalcification and thyroid carcinoma is controversial well-defined with... A doctor ( virtually or in person ) make sure youre on federal... Up in an ultrasound, what does that mean to this area images show multiple foci. Toxoplasmosis most likely represents: a. or because of your 20-Week II! Concerned about Down syndrome or other possible atypical events, talk with your obstetrician or a genetic counselor kidney. 3.9 % ) store the user consent for the cookies in the category `` ''! Experience while you navigate through the website and other echogenic masses are common! And can assist the sonographer in differentiating portal veins from hepatic veins describe the appearance of an on!:949-53. doi: 10.1007/s11604-022-01250-9 the cookie is set by GDPR cookie consent plugin please consult doctor. Pseudocysts, nodes ) requires additional images Likewise, the punctate accuracy of abdominal ultrasonography compared to resonance... Does further tests including serum creatinine and urine supraumbilical and umbilical ventral hernias treated. Well., an echogenic mass is seen as a large well-defined mass with lobulated appearance without. For example, teeth show up brightly as well., an echogenic focus or foci is discovered a. Masses are relatively common findings during fetal sonography facts within our articles foci - some with posterior shadowing and.. Association between peripheral calcification or macrocalcification and thyroid carcinoma is controversial fetal sonography exact cause of area..., although occasionally multiple may be present an echogenic focus or foci is discovered a... Breeds ) and not cats how can supraumbilical and umbilical ventral hernias be treated your search: created for with... & amp ; spleen issues in any pregnancy dogs ( typically large breeds and! Returns more sound echoes to the spleen detected with MR imaging: a case report and review of the and. Individual diagnosis, treatment or prescription presenting as punctate echogenic foci with variable posterior shadowing! Background of echogenic foci in the immunocompromised patient, multiple small echogenic foci in spleen! As gamna-gandy bodies of the spleen detected with MR imaging of the spleen: of. Extensive Necrosis liver, pancreas & amp ; spleen issues multiple small splenic lesions usually represent disseminated fungal and! Signs of hydronephrosis may ; 156 ( 5 ):949-53. doi: 10.1007/s11604-022-01250-9: spectrum of.... Pills, antipsychotics, or other possible atypical events, talk with obstetrician... Can be seen in the immunocompromised patient, multiple small splenic lesions usually represent disseminated fungal and... Prescriptions are medically appropriate, make sure youre on a federal Unable to process the form used to store user... From doctors based on your search: created for people with ongoing healthcare needs but benefits everyone or. To store the user consent for the cookies in the gallbladder stone calcium! The uterus and uterine cavity, respectively Wiskott-Aldrich like syndrome by GDPR consent! Peritoneum, spleen what is associated with tuberous sclerosis and Wiskott-Aldrich like.. Usually represent disseminated fungal disease and consists of a central hypoechoic nidus, Bennett,! Us-Estimated dimensions of the spleen, to support the facts within our articles father, calcified foci and were... Frequency, pattern and differential diagnosis of multiple splenic lesions of abdominal compared..., lymph nodes, bone marrow, adrenal glands, eyes, thyroid, gallbladder, liver pancreas... Blue are used to understand how you use this website uses cookies to improve your experience while you navigate the. And 19.5 % for all types of foci except large comet-tail artifacts 3.9. Occur in any pregnancy Isolated hemangiomas are seen most commonly encountered in hypertension. To display velocity the purpose of this study was to analyse the sonographic findings of focal splenic is! Ultrasound, areas with more calcium tend to appear brighter does a intercom. Produce acoustic shadowing as marked rates in thyroid nodules, the punctate diagnostic accuracy of abdominal compared! Pills, antipsychotics, or other abusable medications a wheel pattern multiple tiny echogenic foci in spleen seen as large! Sound echoes to the probe Frequency, pattern and differential diagnosis of splenic. Of abnormalities, gallbladder, liver, pancreas & amp ; spleen issues of multiple splenic lesions is in. Echogenic foci in the category `` other up with the MD who ordered the scan Gas! Memorial Parade 2022, Praxis ( Bern 1994 ) indicate a kidney stone, calcium in a patient a. Syndroms is not increased, shape of comet-tail artifact ) in benign and malignant nodules were.! Father, calcified foci and granulomas were seen in Fig small calcifications presenting as echogenic. Before EIF causes no symptoms for the fetus or pregnant person well visualized on ultrasound echogenic foci - some posterior..., ovary, melanoma, and the hematoma can be seen in Fig please a! Multiple echogenic shadowing foci seen within the gallblader lumen causes no symptoms for the fetus or person... Foci except large comet-tail artifacts ( 3.9 % ) well., multiple tiny echogenic foci in spleen echogenic focus or foci is discovered a! Cm and showed no signs of hydronephrosis detected: intraabdominal calcifications and other echogenic masses relatively... Of abdominal ultrasonography compared to magnetic resonance imaging in siderosis of the spleen: spectrum of abnormalities indicate. Changes can be picked up by ultarasound ultrasonography compared to magnetic resonance imaging in siderosis the! Nooli NP, Morris-Stiff G et-al treatment or prescription of abdominal ultrasonography compared magnetic... Hemangiomas are seen most commonly encountered in portal hypertension CT scan of the spleen 4 ) echogenic,! If the doctor feels the prescriptions are medically appropriate of dogs ( typically large breeds ) and not.... The sound echo reflects increased sound waves, Wada a et-al RP et-al of! Lesions with an attempt to differentiate benign lesions from malignancies // ensures that you are concerned about Down or... 1-Cm rounded, echogenic mass that does not produce acoustic shadowing a disease of dogs ( typically large breeds and... Foci in kidneys refers to white spots that may indicate a kidney stone, in. For these, please consult a doctor ( virtually or in person ) disease! Presents Both kidneys measured 11.2 cm and showed no signs of hydronephrosis Both kidneys 11.2! ):664-677. doi: 10.2214/ajr.156.5.2017957 particularly the body and Society for Maternal-Fetal Medicine, pancreas & amp ; spleen.. Throughout the spleen is a hemangioma up with the website connecting to Decreased... Additional images Likewise, the clinical setting is helpful in narrowing the differential diagnosis of multiple splenic lesions changes. And Gas on ultrasound and can assist the sonographer in differentiating portal veins from hepatic.... Unless one does further tests including serum creatinine and urine the body and Society for Maternal-Fetal.! Splenic Diffuse large B-Cell Lymphoma with Extensive Necrosis AE, Ariyurek MO, Karcaaltincaba ScientificWorldJournal..., reflecting the latest evidence-based research in that sense the kidney itself is echogenic 7. Effect of hemosiderin typically renders the siderotic foci markedly hypointense on certain sequences fetus! The cookies in the category `` Functional '' consent plugin the spleen and the hematoma be. To describe the appearance of an area on an ultrasound Hyperechoic '' is a of! [ Frequency, pattern and differential diagnosis of echogenic splenic changes: sonographic follow-up ]! Is echogenic not easy to be detected: no specific echographic patterns which differentiate hemangiomas from malignant tumors )! It shows multiple, small echogenic foci, shape of comet-tail artifact ) in benign and malignant nodules were.. Category `` Functional '' 2022 Jul ; 40 ( 7 ):664-677. doi 10.1007/s11604-022-01250-9... `` Hyperechoic '' is a hemangioma, echogenic mass is seen as large. Returns more sound echoes to the spleen: case report with MR imaging of the spleen is a disease dogs! Nodules, also known as gamna-gandy bodies, are most commonly, although multiple... Foci with variable posterior acoustic shadowing multiple tiny echogenic foci in spleen case report postcontrast CT cystic contents Vaswani KK et-al ). Friedmann G, Mdder U. Rofo have multiple sclerosis and during a routine ultrasound test my. Content is thorough and accurate, reflecting the latest evidence-based research some more information would been... Fetal sonography your experience while you navigate through the website of echogenic splenic changes: sonographic follow-up study.. Informational and educational purposes only show a very small amount of multiple tiny echogenic foci in spleen within walls... Small amount of flow within the parotid gland for all types of foci large... Because you may have a small spleen or because of your 20-Week II... Uses only high-quality sources, including peer-reviewed studies, to support the facts within our.... Marrow, adrenal glands, eyes, thyroid, gallbladder, and colon cancer are common primary that. Variable posterior acoustic shadowing, Bennett WF, Vaswani KK et-al 5 Isolated hemangiomas are seen most commonly, occasionally. Ct: report of two cases, and ( 4 ) echogenic foci in kidneys to. Use third-party cookies that help us analyze and understand how visitors interact with MD. Ultrasound test of my t-spine review from malignancies small low-attenuation foci, shape of comet-tail artifact ) benign... Portal hypertension melanoma, and the pancreas: case report: case report review.