CASE OF THE FORTNIGHT #12.
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.(i) Dr. Aditi Damle (MD, Fellowship in GI & Liver Path) Email id: aditidamle86@gmail.com Affiliation: Associate consultant; Pathology MMM Hospital Chennai (ii) Dr. K. Chandramouleeswari Email id: chandramouleeswarik@gmail.com Affiliations: MD, FICP, SR. Oncopathologist, Fellow Nephropathology Senior Consultant Pathology, MM M Hospital
CASE OF THE FORTNIGHT #11
1.Name of the member submitting: Sakthisankari S (L0156/2018/TN&PCIAPM), Associate Professor, PSG Institute of Medical Sciences and Research, Coimbatore Email id: sakthissankari@gmail.com
2.Clinical history A 45-year-old female presented with complaints of dyspnea on exertion. History of treated pulmonary tuberculosis. No other relevant clinical history. Investigations Echocardiogram- constrictive pericarditis. CT chest – minimal diffuse pericardial and pleural thickening with linear calcifications. She underwent pericardiectomy and the specimen received in histopathology department.
Case of the fortnight# 10
Dr.N.Priyathersini, Associate Professor, Department of Pathology,Sri Ramachandra Medical College, SRIHER, Chennai.
Case History: 38-year-old female presented to emergency room with spontaneous bleeding per rectum. Patient is a known case of rheumatoid arthritis and is on methotrexate since 2 years. Physical examination revealed that the patient is pale and is moderately built , vague abdominal tenderness in lower quadrant. Patient was managed conservatively initially in emergency department. Owing to the massive bleeding surgical intervention was sought for and patient underwent left hemicolectomy surgery and the specimen was sent for histopathological
CASE OF THE FORTNIGHT #9
CLINICAL HISTORY
3-year-old girl born of non consanguineous marriage was brought to paediatric oncology OPD with History of left ovarian mass diagnosed elsewhere at the age of 1.5 years
CT FINDINGS
Well-defined solid mass with small cystic component arising from the left adnexa s/o left ovarian mass (arrow). Other findings: Multiple polyps in the rectum. Well- defined cystic lesion in right lower abdomenperitoneal inclusion cyst or lymphangioma. Hemangioma of liver.
Answer DetailCASE OF THE FORTNIGHT#8
34- year - old female presented with postprandial bloating and abdominal distension, loss of weight and appetite.
.Large splenic hemangioma occupying the upper 2/3rd of the spleen.
MRI: Enlarged spleen with well-defined, large, T2 hyperintense, lobulated, heterogenous mass, 10.5 x 10 x 8.5 cm.
GROSS: A well circumscribed lobulated tumour, 10.1x9x8cm with pale tan firm to spongy cut surface and central pale white fibrotic areas with focal yellow areas.
Answer DetailCase of the Fortnight #7
CASE OF THE FORTNIGHT
2 years old girl child presented with complaints of abdominal distension for 4 days duration. No other relevant clinical complaints were identified. On CECT abdomen, a large well defined heterogeneous mass of size 10.4x 9.9x 9.5cm with internal vascularity and multiple cystic/ anechoic areas were noted within the mass in the right lobe of the liver predominantly involving the 7th segment extending into 6 and 8th segments. AFP levels- >3000ng/ml. Trucut biopsy performed, diagnosed as hepatoblastoma. Liver resection specimen received.
Dr. Mithraa Devi S, Senior Resident and Dr. Srinivas BH Additional Professor. JIPMER. Puducherry
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Answer DetailCase of the Fortnight #6
CASE OF THE FORTNIGHT
A case of 65 yr old post menopausal women presented with complaint of lower abdomen pain since 4 months. Clinical examination revealed a left adnexal mass ,diagnosed as left ovarian tumor on pelvic ultrasonography. Patient underwent abdominal hysterectomy with bilateral salpingo-oopherectomy for ovarian tumor. Histopathological examination revealed, primary serous papillary adenocarcinom of fallopian tube. Gross examination (fig-1) showed a solid mass measuring 8X7 cm on left side with attached ovary. Cut surface of mass (fig-2), shows grey white solid mass. Both side ovaries, uterus with cervix and right tube were free of any gross lesions.
Case of the Fortnight #5
51-year-old female who is a known hypertensive and dyslipidemia presented with bilateral lower limb swelling for 1 month, rise in creatinine level and sub-nephrotic range proteinuria.
LABPARAMETERS:.
.Serum Creatinine: 2.16mg/dl,
Serum Albumin:3.8mg/dl,
24hr urine protein:1673mg,
Urine examination: RBC:4-5 /hpf, WBC:4-5 /hpf,
Serum Complements: within normal limits.
ANA: Negative,
Hepatitis B, C, HIV screen- Negative
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Answer DetailCase of the Fortnight #4
Sent by Dr. Aditi Damle
Brief clinical history: 58 year male known hypertensive under treatment, came to Gastro OPD with complaints of epigastric pain x 1 month, abdominal bloating, decrease in appetite and weight loss. CT Abdomen showed: irregular circumferential thickening of the gastric antrum and pylorus with multiple peri-gastric lymph nodes. OGD with biopsy done.
Case of the Fortnight #3
Case of the Fortnight:
Clinical history: 58 year old female underwent evaluation for renal colic and was found to have a right sided pleural effusion on imaging. MRI showed a 11.4x11.7x10.6 cm complex solid-cystic lesion in the right paravertebral region with extension into the right thoracic cavity and into the thecal sac with widening of the T9-T10 neural foramina. There was moderate to gross pleural effusion. Gross: Encapsulated globular mass measuring 12.5x9.5x8.5cm. The external surface appeared congested. Sectioning revealed a partly cystic tumor. The solid areas showed haemorrhagic foci and areas of yellowish discolouration. Also present in the container was a strip of greyish membranous tissue, 10x4cm.
Case of the Fortnight #2
Case of the Fortnight:
By Dr Srinivas BH (PDCC in Renal&Transplant Pathology) Additional Professor. JIPMER. Puducherry
24yr old female case of PCOD and infertility. Presented with vomiting, loss of appetite. H/o of herbal medicine for 2months S. Creatinine 11.3 mg/dl. Anemia: (HB 7.6gr/dl) Urine microscopy: Trace Proteinuria; WBC 5-6/HPF RPRF ?AIN Renal Biopsy performed.
Case of the Fortnight #1
Clinical history:
68-year-old male patient with rapidly growing swelling of 4 months duration. On the dorsal aspect of the forearm. O/e fairly well-circumscribed flesh-colored nodule., 2 x 1.8 cm. No history of other tumors in the body.
