0:01

Okay, so for our next case, we've got another finding

0:03

that's in the right colon in the cecum in this case,

0:07

we've got a polypoid finding here right in the cecum

0:09

that's measuring, uh, sizably,

0:13

but not everything that's measured

0:15

and luminal is going

0:17

to be accurately measured in this particular case.

0:20

The location of this polypoid lesion is important.

0:24

Uh, it's definitely meets criteria to be at least AC three.

0:29

You can see here it's relationship

0:30

with the adjacent ileocecal valve stick.

0:34

Look, there is our ileocecal valve.

0:35

Again, this is kind of our,

0:37

our internal control for every case.

0:39

You can see this one has a little bit more

0:40

of a bulbous appearance here, lower down,

0:43

but it's all fat attenuation.

0:45

On the two D images, you can see the fat attenuation within

0:48

the ileal SQL valve.

0:49

But the mass here is located right at the SQL tip.

0:53

This is it right here. And

0:55

what we're really looking at is kind of the tip

0:57

of the iceberg of this lesion.

0:59

If you follow this mass deeper,

1:03

it looks like it's the base of the appendix.

1:05

I'll show this to you on the coronal images as well.

1:08

So you can see here the SQL valve, the cecum SQL cap,

1:13

here's the sequel tip, and this,

1:15

this polypoid lesions right at the appendiceal base.

1:18

And then it continues down

1:19

and the remainder of the appendix looks

1:21

dilated just at the base.

1:23

And then just to prove that it's the appendix,

1:24

you can see the, the blind ending tip right there.

1:27

So this is actually an appendic mass

1:29

of which we're only measuring the portion that's protruding

1:32

through the appendiceal orifice under the cecum.

1:36

But this appearance as well as a little bit

1:38

of mixed attenuation with within there,

1:40

when we're talking about an appendiceal mass,

1:43

I would not mistake any calcifications

1:46

or microcalcifications within appendiceal mass to be, um,

1:50

contrast material because anybody

1:52

that's seen enough appendiceal mucosal

1:55

and mucinous neoplasms knows that, uh,

1:57

calcifications can occur sometimes with kind

2:00

of an onion skin appearance, um,

2:02

and an appendiceal mucinous neoplasm.

2:05

And that's what this mass ended up being.