PMC3703684_01
An arterio venous malformation present on the left palm and thumb diagnosed as arterio-venous malformation on ultrasonography
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F1
Her left palm and left thumb showed presence of lobulated nodules [Figure 1].
Multiple papules (trichilemmomas) on the bridge of the nose
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F2
Extra-oral examination revealed presence of multiple skin colored flat papules (trichilemmomas) on her face involving the bridge of the nose, forehead region and on the upper lip measuring around 1-5 mm in diameter [Figure 2].
Cluster of papules on the lower lip
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F3
Lower lip also showed multiple non-tender papular growths around 1-3mm in diameter, clustered at certain places [Figure 3].
Papillomatous lesions on the dorsal surface of tongue
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F4
Intra oral examination revealed smooth whitish papillomatous lesions involving the dorsal surface of the tongue and the buccal mucosa measuring 1-5 mm in diameter [Figures 4 and 5].
Papules seen on the buccal mucosa
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F5
Intra oral examination revealed smooth whitish papillomatous lesions involving the dorsal surface of the tongue and the buccal mucosa measuring 1-5 mm in diameter [Figures 4 and 5].
Ultrasonography with color Doppler showing multiple nodules in the lobes of the thyroid
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F6
Few cysts were also seen within the thyroid with internal finger like solid projections showing increased vascularity (intracystic papillary mass) which gave the impression of multinodular goiter [Figure 6].
Ultrasonography showing oval hypoechoic areas in the breast with smaller adjacent similar areas suggestive of multiple fibroadenomas
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F7
Ultrasonography examination of breast showed multiple nodular cystic areas bilaterally suggestive of fibroadenomas which were confirmed by FNAC and miscroscopy while a cystic area with nodular solid component eccentrically originating from the walls occupying more than 50% of the cystic lumen was seen at a single area in the left breast which was suggestive of intracystic complex mass [Figure 7a and b]. Ultrasonography of the left palm showed 12 mm x 9 mm sized mildly hypoechoic lobulated nodule with internal arterial and venous vascular channels suggestive of arterio-venous malformation.
Ultrasonography showing cystic area with nodular solid component in the left breast suggestive of an intracystic mass
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F8
These were randomly distributed throughout the stomach and duodenum, mostly measuring less than 1 cm in diameter [Figure 8].
Multiple polypoid lesions having smooth overlying mucosa seen randomly distributed throughout the stomach and duodenum on upper GI endoscopy
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F9