History: 67 yo male with localized pancreatic cancer
Solution: The finding in this case is a "mass" in the region of the right inguinal canal. On the report, this was described as an enlarged, irregular right external iliac lymph node, but when US was performed, only a densely shadowing structure was identified.
After clinical correlation, it was determined that the patient had a right inguinal hernia repair with a mesh plug. This appearance is actually quite typical on CT and has been described (Journal of Computer Assisted Tomography. 32(4):529-532, July/August 2008). The conclusion of their paper is that "Focal inguinal findings from mesh plug inguinal hernioplasty are common, have characteristic appearances at CT, and should not be mistaken as lymphadenopathy." Moral of the story is to correlate clinically if you see something like this to avoid calling adenopathy.
After clinical correlation, it was determined that the patient had a right inguinal hernia repair with a mesh plug. This appearance is actually quite typical on CT and has been described (Journal of Computer Assisted Tomography. 32(4):529-532, July/August 2008). The conclusion of their paper is that "Focal inguinal findings from mesh plug inguinal hernioplasty are common, have characteristic appearances at CT, and should not be mistaken as lymphadenopathy." Moral of the story is to correlate clinically if you see something like this to avoid calling adenopathy.
CT Images
