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C ASE S TUDIES IN N EUROPATHOLOGY

C ASE S TUDIES IN N EUROPATHOLOGY. Kenneth Clark, MD Neuropathology Fellow, UPMC. C LINICAL H ISTORY. 30-year-old man with no significant past medical history. No smoking, no drug abuse, no meds 2-month history of “flu-like” symptoms

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C ASE S TUDIES IN N EUROPATHOLOGY

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  1. CASE STUDIES IN NEUROPATHOLOGY Kenneth Clark, MD Neuropathology Fellow, UPMC

  2. CLINICAL HISTORY • 30-year-old man with no significant past medical history. No smoking, no drug abuse, no meds • 2-month history of “flu-like” symptoms • Awoke in the morning and returned to bed stating “I don’t feel well” • A couple of hours later his wife found him unresponsive in bed  medics

  3. Clinical Course • Arrived at the emergency department, intubated and unresponsive • CT scan of the head revealed the following…

  4. Differential Diagnosis

  5. Clinical Course • Labs drawn… • Physical exam: • Pupils fixed and dilated • No pain response • No spontaneous respirations

  6. Clinical Course • Lab results • WBC > 600,000 • 14% blasts • 6% promyelocytes • 22% myelocytes • 5% metamyelocytes • 22% bands • 22% neutrophils • 5% eosinophils

  7. Differential Diagnosis

  8. LENTICULOSTRIATE VESSELS • http://www.radiologyassistant.nl/en/48f4c4ccd9682

  9. Cause of Death Acute Myelogenous Leukemia

  10. MECHANISMOF DEATH

  11. HERNIATION http://missinglink.ucsf.edu/lm/ids_104_cns_injury/Herniation/Herniation.htm

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